Suicide Attempts In People Research Articles

Impact of treatment with GLP-1RAs on suicide attempts in adults persons with type 2 diabetes: A retrospective comparative effectiveness study based on a global TriNetX health research database.

To assess the association between glucagon-like peptide-1 receptor agonists (GLP-1RA) treatment and the risk of suicide attempts in people with type 2 diabetes (T2D), with a focus on subgroups with and without a history of depression or suicide attempts. This retrospective cohort study utilized TriNetX, a federated network of real-world data. Using the Global Collaborative Network data, we collected electronic medical records from 113 health care organizations with 135 million patient records with 8 million with T2D, 83% from the United States. The four cohorts were identified based on age, medication, diagnosis, and presence of depression or suicide attempts. Analytic methods included measures of association and number of Instances, with propensity score matching employed to mitigate potential confounders. The primary outcome was the incidence of suicide attempts among people with T2D with GLP-1RA treatment in comparison with dipeptidyl peptidase-4 inhibitor (DPP-4i) treatment. People with T2D treated with GLP-1RA consistently exhibited a lower risk of suicide attempts compared to those treated with DPP-4i. This was particularly significant in people with a history of depression or suicide attempts. The risk and odds ratios were significantly lower in the GLP-1RA-treated cohorts than in DPP-4i across all analyses. As compared with DPP-4i, our analysis shows a protective effect associated with GLP-1RA treatment on the risk of suicide attempts among people with T2D. However, further research, particularly prospective and randomized studies, is necessary to confirm these observations and understand the underlying mechanisms.

Study reveals suicide attempts in people with no prior MI

Observing that not all people who die by suicide have a psychiatric diagnosis, researchers set out to estimate the percentage of people with lifetime suicide attempts whose first attempt occurred prior to the onset of any psychiatric disorder.

Prevalence and risk factors of suicide attempts among Chinese elderly patients over 50 years with schizophrenia.

Several research efforts have found that older schizophrenia patients are at higher risk for suicide. Related risk factors for suicide attempts in the elderly with schizophrenia are poorly understood. This study sought to assess the prevalence of suicide attempts and related risk variables in schizophrenia patients over the age of 50. We recruited 591 elderly patients over the age of 50. Demographic, clinical and blood parameters of all patients were collected. Patients with schizophrenia were evaluated for psychopathological symptoms using the Positive and Negative Syndrome Scale (PANSS). The rate of suicide attempts among elderly Chinese schizophrenia patients was 15.2%. In these elderly schizophrenia patients, those who with suicide attempts had significantly higher scores for insomnia, depression and smoking addiction, and higher levels of red blood cells, Hc1 glycosylated hemoglobin and free T3, but significantly lower levels of hypersensitive C-reactive protein and -globulin. Binary logistic regression analysis showed that higher depression scores and smoking addiction were risk factors for suicide attempts in these patients. Additionally, multiple regression analyses showed that higher BMI and insomnia scores were associated with suicide risk scores in elderly schizophrenia patients. Our research shows that there is a high incidence of suicide attempts in people over 50 years of age with schizophrenia. A number of clinically relevant factors and metabolic markers are associated with suicide attempts among elderly patients with schizophrenia.

Interictal Dysphoric Disorder in Epilepsy and Its Relationship with Specific Clinical and Demographic Variables.

Patients with epilepsy present a variety of psychiatric comorbidities, with mood disorders and anxiety disorders as well as interictal dysphoric disorder as the most frequent and often associated with comorbid mental conditions. Interictal dysphoric disorderand ictal and peri-ictal changes may contribute to overall clinical symptomatology in epilepsy, as well as subjective and objective adverse effects of anti-epileptic drugs. We performed a post-hoc analysis to verify the relation of interictal dysphoric disorder with specific clinical and demographic variables in people with epilepsy, including the correlation between interictal dysphoric disorder and anti-epileptic drugs. We found no correlation between the incidence of interictal dysphoric disorder and drug-resistant epilepsy, and no correlation between the incidence of interictal dysphoric disorder and sex was observed. The results of our analysis indicate that patients with interictal dysphoric disorder, compared with those with no interictal dysphoric disorder, had epilepsy onset at a later age, had had a history of psychiatric treatment and had distinctly lower, but not statistically significant, percentage of active employment status. Another finding was the frequent suicide attempts in people with epilepsy (11.5%). However, there was no relationship with interictal dysphoric disorder. We also did not find any evidence supporting the impact of epileptic medication on the incidence of interictal dysphoric disorder nor did the data contribute to support the evidence of interictal dysphoric disorder as a standing-alone phenomenon. An essential issue in epilepsy is awareness and understanding of interictal dysphoric disorder and concomitant mental health abnormalities as this is crucial for clinical practice and may significantly determine the progression and management of epilepsy if it remains ignored, and hence lead to a severe decline in life quality.

687-P: Risk Patterns for Suicide Attempts among People with Diabetes Using Association Rules Mining

Prevalence of suicide attempts among people with diabetes was approximately 10%, higher than the general population (<5%). This is the first study using association rules mining to discover the risk patterns for suicide attempts in people with diabetes using large multi-centered EHR data. We retrieved data on 3,265,041 diabetes patients from 2010-2020, and 0.2% had a record of suicide attempts. Figure 1 shows the visualization of the top ten association rules. The first rule, {benzodiazepines, no. antidepressants ≥2} ≤ {suicide=Yes}, Support=0.19, Confidence=0.87, means “19% of patients had a record of benzodiazepines, the number of antidepressants ≥2 and suicide attempts together.” In addition, “87% of patients with benzodiazepines and the number of antidepressants ≥2 also had a record of suicide attempts.” We found new findings related to suicide attempts in people with diabetes, including the use of benzodiazepines, atypical antipsychotic agents, two and more antidepressants, none or one diabetes medication, and white in the race. Further studies are needed to validate the results and investigate the causality of suicide attempts and diabetes. Our results can be explainable and practically used by providers during outpatient clinic visits. Figure 1. Visualization of the top ten association rules represented by circles. Darker color denotes higher confidence, and a larger circle means greater support. Disclosure P.Narindrarangkura: None. P.Alafaireet: None. U.Z.Khan: None. M.Kim: None.

Predicting suicide attempts among people with diabetes using a large multicenter electronic health records dataset.

People with diabetes have a higher risk of suicidal behaviors than the general population. However, few studies have focused on understanding this relationship. We investigated risk factors and predicted suicide attempts in people with diabetes using Least Absolute Shrinkage and Selection Operator (LASSO) regression. Data was retrieved from Cerner Real-World Data and included over 3 million diabetes patients in the study. LASSO regression was applied to identify associated factors. Gender, diabetes-type, and depression-specific LASSO regression models were analyzed. There were 7764 subjects diagnosed with suicide attempts with an average age of 45. Risk factors for suicide attempts in diabetes patients were American Indian or Alaska Native race (β = 0.637), receiving atypical antipsychotic agents (β = 0.704), benzodiazepines (β = 0.784), or antihistamines (β = 0.528). Amyotrophy was negatively associated with suicide attempts in males (β = 2.025); in contrast, amyotrophy significantly increased the risk in females (β = 3.339). Using a MAOI was negatively related to suicide attempts in T1DM patients (β = 7.304). Age less than 20 was positively associated with suicide attempts in depressed (β = 2.093) and non-depressed patients (β = 1.497). The LASSO model achieved a 94.4% AUC and 87.4% F1 score. To our knowledge, this is the first study to use LASSO regression to identify risk factors for suicide attempts in patients with diabetes. The shrinkage technique successfully reduced the number of variables in the model to improve the fit. Further research is needed to determine cause-and-effect relationships. The results may help providers to identify high-risk groups for suicide attempt among diabetic patients.

High rates of psychological distress, mental health diagnoses and suicide attempts in people with chronic kidney disease in Ireland.

People with chronic kidney disease (CKD) experience high levels of psychological distress, which is associated with higher mortality and adverse health outcomes. Little is known about the rates of a range of mental health difficulties or rates of suicide attempts in people with CKD. Individuals with CKD (n=268; age range 18-94years, mean=49.96years) on haemodialysis (n=79), peritoneal dialysis (n=46), transplant recipients (n=84) and who were not on renal replacement therapy (RRT; n=59) were recruited through the Irish Kidney Association social media pages and three Irish hospitals. Participants completed surveys to gather demographics and mental health histories, the Hospital Anxiety and Depression Scale (HADS) and the 12-item Short Form Health Survey (SF-12) to measure health-related quality of life (HRQoL). A total of 23.5% of participants self-reported they had received a mental health diagnosis, with depression (14.5%) and anxiety (14.2%) being the most common, while 26.4% of participants had experienced suicidal ideation and 9.3% had attempted suicide. Using a clinical cut-off ≥8 on the HADS subscales, current levels of clinically significant anxiety and depression were 50.7% and 35.4%, respectively. Depression levels were slightly higher for those on haemodialysis compared with those with a transplant and those not on RRT. Depression, anxiety and having a mental health diagnosis were all associated with lower HRQoL. People with CKD in Ireland experience high levels of psychological distress, mental health difficulties, suicidal ideation and suicide attempts. The identification of and intervention for mental health difficulties in CKD should be prioritised in clinical care.

Risk of non-fatal suicide attempt in individuals with substance use disorder: the roles of aggregate genetic liability and environmental exposures in a Swedish population-based cohort.

Substance use disorder (SUD) is related to widespread adverse consequences, including higher suicidality. Shared genetic liability has been demonstrated between SUD and suicidality. Here, we measured the factors that contribute to increased risk of non-fatal suicide attempt among individuals with SUD by focusing upon aggregate genetic risks and both childhood and past-year environmental factors. Longitudinal study. Family genetic risk scores and environmental factors (childhood, aged from 0 to 15 years, and the year preceding SUD registration) were used to predict the relative risk of non-fatal suicide attempt using Cox proportional hazards models. Additional analyses employed a co-relative design, accounting for genetic factors and shared familial environment, to test for potential causality. Based on longitudinal Swedish registry data, 228 617 individuals with SUD registrations from 1991 to 2015 were included. SUD and suicide attempts were identified using medical records (International Classification of Diseases codes). SUD was also identified using pharmacy and criminal registries. In multivariable analyses that jointly accounted for all the selected potential predictors, individuals with SUD were at higher risk for non-fatal suicide attempt if they had experienced a parental death [hazard ratio (HR) = 1.58; 95% confidence interval (CI) = 1.30, 1.93], were female (HR = 1.53, 95% CI = 1.49, 1.57), had low educational attainment (HR = 1.50, 95% CI = 1.46, 1.55), received social welfare (HR = 1.21, 95% CI = 1.17, 1.25) or had lived in a non-intact family (HR = 1.11, 95% CI = 1.08, 1.14). In co-relative analyses, low education was supported as a possible causal factor for suicide attempt. Aggregate genetic risks interacted with low education and being raised in a non-intact family, with increased prevalence of suicide attempt in people with high genetic risks and unfavorable environmental exposures. Aggregate genetic liability, childhood environmental experiences and specific socio-economic indicators are important risk factors for non-fatal suicide attempt among individuals with substance use disorder.

Prevalence and Determinants of Suicidal Ideation and Suicide Attempt in People With Human Immunodeficiency Virus in Africa: a Systematic Review

People with human immunodeficiency virus (HIV) are at higher risk of suicidal ideation and suicide attempts. We reviewed the literature for the prevalence and determinants of suicidal ideation and suicide attempt in people with HIV in Africa. The PubMed, Scopus, and Google scholar were searched for original studies published in peer-reviewed journals in English language between January 2015 to July 2020, using the key words: 'suicidal behavior', 'suicidal attempt', 'suicidal ideation', 'HIV/AIDS', and/or 'Africa'. The quality of included studies was assessed using the Newcastle-Ottawa scale. 12 cross-sectional studies published in the past 5 years in African countries were included. The quality of studies was high, with score ranging from 6 to 9. The prevalence of suicidal ideation ranged from 8.8% to 39%. The prevalence of suicide attempt ranged from 2.8% to 20.1%. The most common risk factors for suicidal behaviour were mental health-related problems. Other factors included high clinical stage of HIV, being unmarried, poor medication adherence, poorer quality of life, not taking highly active antiretroviral therapy, female sex, no education, substance use, low CD4 level, and opportunistic infection. Patients with HIV/AIDS have an increased risk of suicidal ideation and suicide attempts. Early screening, treatment, and referral of suicidal patients are necessary for HIV clinics.

Impact of interpersonal relationships and acquired capability for suicide on suicide attempts: An observational study

IntroductionThe Interpersonal-Psychological Theory of Suicide (IPTS) specifically predicts that acquired capability, perceived burdensomeness, and low belongingness are collectively necessary and sufficient proximal causes of serious suicidal behavior. Although the interpersonal theory of suicide is clinically reliable, most previous studies have been conducted on clinical groups including suicidal ideators with no suicide attempters or including only a few suicide attemptersObjectivesThis study aims to investigate interpersonal needs and acquired capability for suicide through questionnaire surveys following suicide attempts in people admitted to hospitals for medical treatment.MethodsA total of 344 participants (200 depressed patients with attempted suicide, 144 depressed patients with suicidal ideation) were enrolled for this study. Depression, anxiety, emotional regulation, interpersonal needs, and acquired capability for suicide were evaluated. A model with pathways from emotional regulation difficulties and interpersonal needs to suicide attempts was proposed. Participants were divided into two groups according to the presence of suicide attempts or suicidal ideation.ResultsAcquired capability for suicide mediated the path from depression to suicide attempts. In the path model, difficulties in emotional regulation and interpersonal needs predicted depression significantly. Although depression itself was not significantly related to acquired capability for suicide, depression was significantly related to acquired capability for suicide in suicide attempter group.ConclusionsInterventions with two factors affecting suicide attempts will clarify the suicide risk and contribute to finding risk factors. It will also help reduce suicide rates through interventions in the processes leading to suicide attempts by identifying variables to predict the attempts through the path to suicide attempts.DisclosureNo significant relationships.

The role of pain, hopelessness, belonging, and suicide capacity in predicting suicide attempt in people with psychiatric disorders

Background. The idea and attempt of suicide are highly predictive of deaths due to suicide and can lead to several negative consequences for both the individual and his family and for society. Therefore, this study was conducted with the aim of the role of pain, hopelessness, belonging and suicidal capacity in predicting suicide attempt in people with psychiatric disorders. Methods. The research method of this study was correlational and the statistical population included all individuals referred to psychiatric outpatient clinics of Razi Hospital in Tabriz in 2020-2021. Sample sizes According to Klein criterion and according to the 62-item questionnaire, 298 subjects were selected. Research tools also include the Suicide Attempt Scale, the Suicide Capacity Scale and to examine the three variables of pain, hopelessness and belonging to the Suicide Motivation Questionnaire were used. Structural equation modeling was used to analyze the data using Smart pls software version 2. Results. In this study, 63.3% of the respondents were men and 36.7% of the respondents were women. The mean and standard deviation of the age of the respondents was 37.26±10.88 years. According to the results of the path coefficients between hopelessness with suicide capacity (β= 0.63), sense of belonging with suicide capacity (β= 0.28) and suicide attempt (β= 0.21), suicide capacity with suicide attempt (β= 0.59) were at a significant level (P<0.05). On the other hand, suicidal capacity had a significant mediating role in the relationship between hopelessness and sense of belonging with suicide attempt. Conclusion. The results showed that the three-step model of suicide has the ability to predict suicide attempt in the community of patients with psychiatric disorders. Practical Implications. The results of this study are very important for professionals who work with people with psychiatric disorders to distinguish the idea of suicide from suicide attempt.

Associations between personality traits and suicidal ideation and suicide attempts in patients with personality disorders

IntroductionPeople with personality disorders (PDs) have an elevated suicide risk. However, correlates of suicidal ideation (SI) and suicide attempts (SA) remain largely unknown in this population. A growing body of literature highlights the contribution of the Big Five personality traits in suicide-outcomes. Therefore, the present study investigates the association between the Big Five personality traits and SI and SA in people with PDs while applying the ideation-to-action framework. MethodData were obtained from 105 treatment-seeking individuals diagnosed with PDs participating in the Trauma tO Personality Spectrum Study (TOPSS). Multinomial logistic regression analyses were used to analyze the association between the NEO Five-Factor Inventory and the three category suicide-outcome: non-suicidal, SI, and SA. ResultsAfter controlling for age, gender, a comorbid depressive disorder, the severity of borderline manifestations, and other personality traits from the Big Five taxonomy, significantly lower levels of extraversion were observed in participants with SI compared to non-suicidal participants (OR = 0.27, 95% CI 0.10–0.72) but not in SA participants. In contrast, higher levels of extraversion were associated with SA when compared to SI (OR = 3.52, 95% CI 1.33–9.32). Other Big Five traits were not independently associated with suicide-outcomes. ConclusionsOf the Big Five traits, the introversion-extraversion dimension most clearly distinguishes individuals with SI from non-suicidal individuals, as well as those with a SA in the past from those with SI only. Prospective studies are required to investigate if this personality trait can predict the progression from being non-suicidal to having SI and from having SI to performing an attempt.

Suicide attempts in people with severe schizophrenia. Psychosocial and pharmacological integrated community program, case managed vs. standard treatment.

The International Journal of Integrated Care (IJIC) is an online, open-access, peer-reviewed scientific journal that publishes original articles in the field of integrated care on a continuous basis.IJIC has an Impact Factor of 5.120 (2020 JCR, received in June 2021)

An investigation on the frequency of thoughts, readiness and suicide attempt in individuals with thalassemia

Background and Aim: Thalassemia major is one of the most common chronic genetic diseases in the world and in Iran that can impose many adverse effects on the self and society. Psychologically, patients with thalassemia are under stress. According to the World Health Organization (WHO), suicide is one of the leading causes of death worldwide. It is important to identify the people who have the highest risk factors for suicide. The present research investigates the frequency of thoughts, readiness and suicide attempts in people with thalassemia. Methods: This was a cross-sectional study. Its sample was 150 patients with thalassemia in the age range of 10 to 46 years whom we selected through census by sampling at convenience. We gave to patients a standardized Beck Suicide Thought Assessment Questionnaire. We analyzed the research data using descriptive and inferential statistical tests. Results: From among 150 patients with thalassemia in this study, 57.3% of the respondents were male and 42.7% were female. The results showed that there was a negative and significant relationship between suicide thoughts and attempts and age (-0.234) (P <0.05). The mean prevalence of suicide in men (1.89) was significantly higher compared to women (0.79) (P <0.05). We did not observe significant difference in prevalence of suicide thoughts and attempts between married and single groups with a mean difference (0.69) (P <0.05) and, in different educational groups, no significant difference was reported (P> 0.05). Conclusion: The findings of this research showed that among patients with thalassemia, the prevalence of suicidal ideation has a significant percentage. Since suicidal ideation provides a platform for preparation and attempt to commit suicide, so by providing mental health services and regular screening, we can take an effective step to prevent this problem among patients with thalassemia. Keywords: Thalassemia, Suicidal ideation, Suicide.

Serum lipids and suicidal risk among patients with schizophrenia spectrum disorders: Systematic review and meta-analysis.

A systematic review of literature was conducted to determine the association between serum lipids and suicidality in people with schizophrenia spectrum disorders. We undertook a systematic search of multiple databases for studies that ascertained an association between serum lipids and suicidality in adult patients with schizophrenia spectrum disorders (18-65years) from database inception to 2 September 2020. Qualitative analysis was done using National Institute of Health (NIH) scales. The standard mean difference (SMD) and 95% confidence intervals (CI) were calculated for each study and standardized relative to the study. Adjusted p-value, Z-test, and heterogeneity were calculated, as well as testing for publication bias. Of 1262 records identified, 17 studies (n=3113) were included in our systematic review, while 11 studies were included in the meta-analysis. The majority of studies (11) rated fair on qualitative analysis. Data from seven studies (n=1597) revealed a medium effect size for an association between low total cholesterol and suicide attempts (SMD -0.560; 95% CI: 0.949-0.170; p = 0.005). People with history of suicide attempt had a mean cholesterol value 0.56 SD lower than the mean in those without suicide attempts. There were differences in how a suicide attempt was defined and there was high heterogeneity (I2 = 83.3%). No significant association was found between any of the serum lipid parameters and suicide ideation. Funnel-plot analysis suggested small study effects with publication bias. Suicide attempts in people with schizophrenia spectrum disorders are associated with low mean total cholesterol levels.

Suicide and dementia: Systematic review and meta-analysis

IntroductionTo analyze the possible relationship between dementia in the elderly and the subsequent development of suicide ideation, attempts and/or completed suicides. MethodsSystematic review and meta-analysis. Selection criteria: studies that analyzed the relationship between dementia and suicide. Search strategy: (i) in PubMed, EMBASE, CINAHL, IME and Lilacs until December 2018; (ii) manual search of the bibliography of selected articles; (iii) contact with leading authors. Article selection and data extraction according to a predefined protocol, including bias risk assessment, were performed by independent peer reviewers. The effect size index was calculated using Odds Ratio (OR) and its 95% confidence interval (random-effects model). Heterogeneity was evaluated with forest plots, Cochran's Q and I2 index. Assessment of publication bias using funnel plots (“trim-and-fill” method) and the Egger test. The analysis of moderating variables was performed using a multiple meta-regression under a mixed-effects model. Results37 studies and 47 basic units of study were identified. Effect size of the association of dementia with: Suicidal Ideation OR=1.37 (95% CI: .78–2.39); Suicide Attempt: OR=2.24 (95% CI: 1.01–4.97); and Completed Suicide: OR=1.28 (95% CI: .77–2.14). Possible publication bias was ruled out. ConclusionsA trend toward suicidal events is identified, especially suicide attempts in people with dementia. Greater attention and care are recommended after a recent diagnosis of dementia, especially with adequate assessment of comorbidities, which could influence the occurrence and outcome of suicidal events.

Risks of suicide attempts after prescription of zolpidem in people with depression: a nationwide population study in South Korea.

To investigate the association between zolpidem prescription and suicide attempts in people with depression. A nationwide, population-based electronic medical records database from the Health Insurance Review & Assessment Service of South was used to investigate the incidence rate ratios (IRRs) of suicide attempts and probable suicide attempts in people with depression before and after zolpidem prescription using self-controlled case series design. In a total of 445 people who attempted suicide and 23 141 people who attempted probable suicide attempt, the IRRs of suicidal behavior during the risk periods before and after zolpidem prescription increased compared with those at the baseline. The IRRs gradually increased and peaked immediately before the prescription of zolpidem. The IRR was 70.06 (95% CI: 25.58-191.90) on day 2 before zolpidem prescription and 63.35 (95% CI: 22.99-174.59) on day 1 after zolpidem prescription in the suicide attempt group. The IRR was 24.07 (95% CI: 20.50-28.26) on the day before zolpidem prescription and 14.96 (95% CI: 12.21-18.34) on the day after zolpidem prescription in the probable suicide attempt group. The ratios declined eventually after zolpidem was prescribed. Although zolpidem prescription was associated with an increased risk of suicide attempts in people with depression, the risk increased and peaked immediately before zolpidem prescription. The risk declined gradually thereafter. This result indicates that the risk of suicide attempts increases at the time of zolpidem prescription. However, zolpidem prescription does not contribute to additional increase in the risk of suicide attempts.

Suicide attempts in people with schizophrenia before and after participating in an intensive case managed community program: A 20-year follow-up

Lack of treatment compliance in patients with schizophrenia is a risk factor that leads to illness-relapse, hospitalization and potentially strengthens suicidal behavior. The purpose of this investigation was to assess treatment adherence, reasons for treatment discharge, suicidal behaviour and impact of route of antipsychotics administration in a group of patients with schizophrenia treated in a comprehensive, community-based, intensive case managed program for people with severe mental illness. And to compare it to previous standard treatment received in mental health units (MHU).An observational, longitudinal, mirror-image study of patients with severe schizophrenia (N = 344) was carried out: ten years of follow-up (Program) and ten years retrospective (MHU).Reasons for treatment discharge, suicide attempts and antipsychotic (AP) medication were recorded. Treatment adherence during the Program was higher than in MHU (abandonment of treatment: 12.2% vs. 84.3% of patients). Forty patients died during follow-up, five of them due to suicide. Suicidal attempts significantly decreased during Program treatment compared to the standard one (7.6% vs. 38.9% of patients). Long-acting injectable (LAI) AP medication was significantly related to this outcome. A combination of intensive case-managed and LAIAP treatment helped to improve compliance and to reduce suicidal behavior compared to standard treatment in patients with severe schizophrenia.

Does media influence suicide attempt in people from the rural background?

Introduction: Suicide is a serious public health problem. Many factors are known to influence suicide. Much has been studied about the influence of media on suicide attempters. Less studied is the effect of media from a rural background. Aim: To study the profile of suicide attempters from a rural background and the role of media. Materials and Methods: This study was undertaken in a General Hospital Psychiatry unit attached to Government Medical College. Total of 189 medically stable suicide attempters with the rural background was included in the study. The profile of the participants influenced by media was studied. SPSS version 20.0, was used for descriptive and inferential statistics. Results: One hundred and eighty-nine participants were included. Based on the type of influence, three groups were formed [influenced by media (television) (n=37) / influence by other attempters (n=57) / own inner feelings (n=95)] who differed significantly with respect to age (?2= 4.134, p=0.018) and type of attempt (?2= 6.619, p=0.037). Regression analysis showed the presence of adjustment disorder predicting the person to be influenced by internal feelings to attempt suicide. Conclusion: One in five was influenced by media. Majority of the participants were influenced by their own internal feelings. Influence of media was higher in the younger age group. There is a dire need to spread mental health awareness to prevent suicide attempts/suicides and to improve appropriate help-seeking behavior. Television was the common source of influence, hence using this media would help to create awareness in rural population. Keywords: Suicide attempt, Media influence, Rural.

Suicidal ideation and suicide attempts in persons with gender dysphoria.

The little research there is about suicidal behaviour in those with gender dysphoria indicates that they are at a much higher risk of death by suicide and suicidal behaviour than the general population. The objective of this research is to analyse the prevalence of suicidal ideation and suicide attempts reported by people who attended consultations at the Gender Identity Treatment Unit between 2007 and 2017 presenting complaints related to gender dysphoria. An ex-post facto study with a sample of 151 people who were clients at the unit, 97 in the male to female trans group, 54 female to male. Clinical evaluations were carried out assessing variables of suicidal ideation and attempts, along with a possible psychiatric diagnosis. Almost half (48.3%) reported suicidal ideation, 23.8% had attempted suicide. There are higher levels of suicidal ideation and suicide attempts in people with gender dysphoria than in the general population. No differences were seen between groups in terms of gender/sex. Psychiatric morbidity was not an influential variable for suicidal behaviour. This suggests that suicidal ideation is one of the best indicators of the risk of suicidal behaviours.