Suicide Attempts Research Articles

When Hope Fades: Considering Self-Esteem, Depression, Social Support, Loneliness in The Context of Suicide Prevention

Individuals engaging in suicidal ideation or making suicide attempts are a substantial demographic group to investigate preventive mental health due to inherent high risks associated with potential outcomes of suicidal behaviors for public health. Factors increasing the likelihood of suicide might include self-esteem, depression, social support, loneliness, or certain demographic profiles, and the purpose of this study is to synthesize these variables to advocate for effective strategies to intervene in cases of suicide. Specifically, this commentary aims to identify suicidal coping mechanisms and psychological resilience factors among suicidal individuals through the enhancement of self-esteem, intervention of depressive symptoms, and promotion of connectedness. Through discussing the determinants that might play a role in the onset of suicidal thoughts and suicide attempts, this paper has important implications for suicide prevention strategies and the identification of psychological resilience factors that can predict suicidal thoughts and suicide attempts in individuals.

Psychotic Experiences and Risk of Suicidal Thoughts and Behaviors: A Systematic Review and Meta-Analysis of Longitudinal Population Studies.

Since a prior systematic review and meta-analysis reported an association between psychotic experiences (PEs) and suicidal thoughts and behaviors, a large number of new studies have been published on the topic, including several novel studies on the association between PEs and transition from suicidal ideation to attempt. Two authors independently searched PubMed, Embase, CINAHL, and PsycINFO databases from inception until July 2023, conducted data extraction, and assessed study quality using the Newcastle-Ottawa Quality Assessment Scale. Random-effects models were used to calculate pooled odds ratios (ORs) for the association of PEs and subsequent suicide ideation, suicide attempts, suicide death, and transition from suicidal ideation to attempt, first for the total population, and second stratified by age group. Secondary analyses assessed the mediating role of co-occurring psychopathology. Twenty studies from 18 different samples (n = 81,861) were identified. Individuals who reported PEs had increased odds of subsequent suicidal ideation (k = 12, OR = 1.90, 95% CI = 1.65-2.19), suicide attempt (k = 13, OR = 2.95, 95% CI = 2.21-3.94), transition from suicidal ideation to suicide attempt (k = 3, OR = 2.83, 95% CI = 1.60-4.99), and suicide death (k = 1, OR = 4.39, 95% CI = 1.63-11.80). This heightened risk was stable across childhood, adolescence, and adulthood. PEs predicted suicide attempts over and above co-occurring psychopathology (k = 8, OR = 2.85, 95% CI = 2.06-3.95). Individuals reporting PEs are at increased risk of all types of suicidal thoughts and behaviors. In addition, PEs are particularly important risk markers for future suicidal behaviors, including in individuals already reporting suicidal ideation. This risk is in excess of what is explained by co-occurring psychopathology.

Mental health, risk behaviors, and social life factors in relation to adolescents' suicide ideation, plans and attempt.

This study investigated differences in mental health and well-being, risk behaviors, and social life factors among adolescents who experienced different forms of suicidality. We examined 18-years-olds in the Danish National Birth Cohort (N = 47,852). Suicidality was defined with mutually exclusive categories ranging from no suicidality, self-reported suicide ideation, plans, and attempt as well as hospital-recorded suicide attempt. The proportion of adolescents with self-reported poor mental health and well-being, risk behaviors, and social life factors were compared across forms of suicidality. Sample weights were applied. Depressive symptoms were reported by 14% (95% CI 13%;14%) of girls with no suicidality, 44% (95% CI 43%;45%) of girls with suicide ideation, and 68% (95% CI 65%;72%) 66% (95% CI 60%;72%) of girls with self-reported suicide attempt or hospital-recorded suicide attempt respectively. Among boys, depressive symptoms were reported by 5% (95% CI 4%;5%) of those with no suicidality, 27% (95% CI 26%;28%) of those with suicide ideation, and 51% (95% CI 45%;57%) and 40% (95% CI 22%;58%) of those with self-reported suicide attempt or hospital-recorded suicide attempt respectively. Likewise, other aspects of poor mental health and well-being gradually increased relative with more severe forms of suicidality, while no notable differences were identified between adolescents with self-reported and hospital-recorded suicide attempt. Similar tendencies were observed for risk behaviors and social life factors. These findings suggest that adolescents with suicidality, including the large proportion with suicide ideation only, faces challenges across several parameters of mental health and well-being, risk behavior, and social life factors. This emphasizes the need for community-based interventions to identify and support the large group of adolescents experiencing both more and less severe forms of suicidality. Clinicians should prioritize comprehensive psychiatric intervention to address the complex needs of suicidal adolescents effectively.

U-shaped relationship between triglyceride glucose-body mass index and suicide attempts in Chinese patients with untreated first-episode major depressive disorder.

An alternative metric for evaluating insulin resistance (IR) is the triglyceride glucose-body mass index (TyG-BMI). However, it is yet unclear how TyG-BMI and suicide attempts (SA) are related. The objective of this research was to explore the correlation between the TyG-BMI index and SA in individuals with untreated first-episode (UFE) major depressive disorder (MDD) in Shanxi Province. This cross-sectional study was conducted from September 2016 to December 2018 in the psychiatric outpatient clinic of Taiyuan General Hospital and included 1718 patients with UFE MDD, with a mean age of 34.9 ± 12.4years. The relationship between TyG-BMI and SA was assessed using logistic regression modeling. We investigated threshold effects using a two-piecewise linear regression model. Taking into consideration the potential influence of confounding variables, a comprehensive multivariate logistic regression analysis was conducted, which demonstrated the absence of a statistically significant association between the TyG-BMI index and the occurrence of SA, as evidenced by P-values that were all greater than 0.05. On the other hand, the visual analysis of the smoothed plots revealed a U-shaped relationship between the TyG-BMI index and the incidence of SA, with a notable inflection occurring at a TyG-BMI value of around 210. It was observed that the effect sizes flanking the inflection point, accompanied by their 95% confidence intervals, were 0.985 (95% CI: 0.972 to 0.999, P = 0.031) and 1.012 (95% CI: 1.003 to 1.047, P = 0.005), respectively. In UFE MDD patients, a U-shaped link was observed between TyG-BMI and SA, with the minimal SA incidence noted at a TyG-BMI level of 210, signifying that an augmented risk for SA might be connected to both diminished and augmented TyG-BMI levels.

Personality Dimension, Suicidal Intent, and Lethality: A Cross-sectional Study of Suicide Attempters with or Without Personality Disorders

Background: Although personality disorders (PD) are known risk factors for suicide attempts, studies on personality dimension are scarce, which may provide further insights for interventions. Methods: The relationship between personality dimension, lethality, intent, and quality of life (QOL) was studied in suicide attempters with or without PD. We used the international personality disorder examination (IPDE) dimensional score, the scale for assessment of lethality of suicide attempt (SALSA), suicide intent scale (SIS), and WHOQOL-BREF QOL scale, to assess a sample of suicide attempters admitted to a general hospital. Results: PD was present in 43.2% and 57.9% of them had more than one PD. Comparison of attempters with or without PD suggested that the lethality of attempts and QOL were comparable, whereas self-reported suicide intent was significantly low in patients with PD. A higher proportion of PD patients reported relational problems as the reason for the attempt. The personality dimensional score was significantly higher for female attempters from urban backgrounds than for those with previous attempt histories. It was negatively correlated with the lethality of attempts and suicide intent. Conclusion: It is important to explore the personality dimension of the suicide attempters, along with PD, that may highlight additional risks and suggest the need for specific support.

Emerging Adults With a Suicide Attempt History Text More Emotionally With Peers than Family Members

Emotional communication is central to strong interpersonal relationships and mental health. For emerging adults, much of their interpersonal communication happens via texting, but we know little about how and with whom their emotional texting occurs. Understanding these patterns may be especially critical for emerging adults experiencing mental health crises (e.g., suicidality). This study examined how the emotional tone of texts (sent and received) varies based on texting partner (i.e., peers, which includes friends and significant others, vs. family) and within-person suicide risk. Participants were 27 emerging adults with prior, non-lethal suicide attempt(s). Linguistic Inquiry Word Count was used to label 75,928 texts. While there was variation in the specific interactions, results overall indicated that participants exchanged texts containing all emotion category words at greater rates with peers (vs. family), and this pattern generally held across within-person suicide risk level. Implications for suicide prevention/intervention efforts are discussed.

Brief CBT for suicide prevention, delivered remotely, can reduce suicide attempts

Brief cognitive behavioral therapy (BCBT) delivered remotely to patients — historically, considered high‐risk and inappropriate candidates for virtual therapy — reveals that therapists can see these patients safely and effectively via video telehealth, say researchers of the first‐ever randomized clinical trial using telehealth for suicide prevention.

Repurposing Semaglutide and Liraglutide for Alcohol Use Disorder.

Preliminary studies suggest that glucagon-like peptide-1 receptor (GLP-1) agonists, used to treat type 2 diabetes and obesity, may decrease alcohol consumption. To test whether the risk of hospitalization due to alcohol use disorder (AUD) is decreased during the use of GLP-1 agonists compared with periods of nonuse for the same individual. This cohort study was an observational study conducted nationwide in Sweden using data from January 2006 to December 2023. The population-based cohort was identified from registers of inpatient care, specialized outpatient care, sickness absence, and disability pension. Participants were all residents aged 16 to 64 years who had a diagnosis of AUD. The primary exposure was use of individual GLP-1 agonists (compared with nonuse of GLP-1 agonists), and the secondary exposure was medications with indication for AUD. The primary outcome was AUD hospitalization analyzed in a Cox regression within-individual model. Secondary outcomes were any substance use disorder (SUD)-related hospitalization, somatic hospitalization, and suicide attempt. The cohort included 227 866 individuals with AUD; 144 714 (63.5%) were male and 83 154 (36.5%) were female, with a mean (SD) age of 40.0 (15.7) years. Median (IQR) follow-up time was 8.8 (4.0-13.3) years. A total of 133 210 individuals (58.5%) experienced AUD hospitalization. Semaglutide (4321 users) was associated with the lowest risk (AUD: adjusted hazard ratio [aHR], 0.64; 95% CI, 0.50-0.83; any SUD: aHR, 0.68; 95% CI, 0.54-0.85) and use of liraglutide (2509 users) with the second lowest risk (AUD: aHR, 0.72; 95% CI, 0.57-0.92; any SUD: aHR, 0.78; 95% CI, 0.64-0.97) of both AUD and SUD hospitalization. Use of any AUD medication was associated with a modestly decreased risk (aHR, 0.98; 95% CI, 0.96-1.00). Semaglutide (aHR, 0.78; 95% CI, 0.68-0.90) and liraglutide (aHR, 0.79; 95% CI, 0.69-0.91) use were also associated with decreased risk of somatic hospitalizations but not associated with suicide attempts (semaglutide: aHR, 0.55; 95% CI, 0.23-1.30; liraglutide: aHR, 1.08; 95% CI, 0.55-2.15). Among patients with AUD and comorbid obesity/type 2 diabetes, the use of semaglutide and liraglutide were associated with a substantially decreased risk of hospitalization due to AUD. This risk was lower than that of officially approved AUD medications. Semaglutide and liraglutide may be effective in the treatment of AUD, and clinical trials are urgently needed to confirm these findings.

Evaluation of a youth-focused suicide prevention HOPE aftercare service: protocol for a non-randomized hybrid effectiveness-implementation type I design.

Suicide is the fourth leading cause of death among young people aged 15-29 worldwide. Young people often present to emergency departments (EDs) with self-harm and suicide-related behaviors. The period following discharge from the ED is recognized as one of elevated risk for both repeated self-harm and suicide. During this critical time, suicide prevention aftercare services are recommended. Despite their increased popularity, evidence demonstrating the effectiveness of these models is very limited. Using a hybrid effectiveness-implementation type I design, this evaluation will assess the effectiveness and implementation of a suicide prevention aftercare (Hospital Outreach Post-suicidal Engagement; HOPE) service designed to reduce risk of self-harm and suicide in young people aged 12-25 who are referred to the service following an ED presentation for self-harm or suicide attempt. Two complementing theoretical frameworks will guide this evaluation, specifically the design, data collection, analysis, and interpretation of results. The RE-AIM evaluation framework will be used to assess Reach, Effectiveness (including cost-effectiveness), Adoption, Implementation and Maintenance of the HOPE aftercare service. The PRISM implementation framework will be used to assess multi-level contextual factors hypothesized to affect the RE-AIM outcomes. Several data sources will be used to assess the changes in primary and secondary outcomes from baseline to post-intervention, and at follow-up, including user and provider self-report surveys, semi-structured interviews, and routinely collected hospital data. An historical control study will also be conducted using data from the Self-Harm Monitoring System for Victoria to examine the impact of the service on rates of self-harm and suicide-related presentations to ED, and compare trends prior to and following commencement of the HOPE aftercare service. In addition, dynamic systems modelling will be used to assess the future scalability of the service. Findings from this evaluation will determine the effectiveness, including cost-effectiveness, of the HOPE aftercare service and describe the implementation context. They will inform the future development and sustainability of this and other similar services across Australia and internationally. This trial was prospectively registered with the Australian New Zealand Clinical Trials Registry (ANZCTR) on the19th December 2023 (Registration number ACTRN12623001332617). We do not foresee any amendments to this protocol however, if any unforeseen modifications are required, they will be submitted to ANZCTR. Orygen, 35 Poplar Road, Parkville, VIC, 3052, Australia.

Examining suicidality in relation to the menopause: A systematic review

Suicide is one of the leading causes of deaths worldwide, with an estimated 1 in 100 deaths being attributable to suicide. Whilst rates of suicide are higher in men, evidence suggests that suicide attempts are more frequent in women. Suicidality data indicates that deaths by suicide in women are highest in those in midlife, warranting investigation into the relationship between the menopause and suicidality. The current study aimed to review the existing literature examining the relationship between suicidality and the menopause using a systematic review approach. A systematic literature search of MEDLINE, Cochrane Library, Scopus Web of Science, PsycINFO, and Embase databases was conducted in October 2023. Two authors independently screened the titles and abstracts of identified articles against the eligibility criteria. Any inconsistencies were discussed and resolved. This process was subsequently repeated with the articles’ full-text. Risk of bias was assessed using the Quality Assessment Tool for Studies with Diverse Designs (QATSDD). Relevant data were extracted and summarised in both a tabulated and narrative form. A total of 28 studies met the inclusion criteria, with the findings revealing a complex relationship between the menopause and suicidality. Several studies highlighted that the perimenopause period shows a higher prevalence of suicidal thoughts compared to pre-menopausal and post-menopausal stages. Conversely, some studies indicated increased suicidality during the post-menopausal phase, while others noted elevated suicidality in pre-menopausal individuals and those with primary ovarian insufficiency. Critically, several studies found no link between hormonal status and suicidality. The quality of the studies also varied, with a lack of involvement from individuals with relevant lived experience being a consistent methodological flaw across all the included studies. Overall, the current evidence on menopause and suicidality is mixed. Further research is needed to unravel the relationship between menopause and suicidality.

Epidemiological Evaluation of Suicidal Deaths due to Hanging: A Retrospective Medicolegal Study in Sylhet

Background: Suicidal hanging is the most common method of suicide in developing countries, especially among young people. During conventional autopsies, it is one of the significant causes of unnatural deaths in Bangladesh. This study was performed to determine the epidemiological evaluation of suicidal deaths due to suicidal hanging at the mortuary of the Forensic Medicine Department of Sylhet MAG Osmani Medical College, Sylhet. Materials and methods: An autopsy record-based retrospective study carried out to ascertain the epidemiological evaluation of 340 cases of suicidal hanging deaths from January 2015 to December 2018 in the Department of Forensic Medicine, Sylhet MAG Osmani Medical College, Sylhet. Results: Hanging was more common in the age ranges of 10-19 years (33.0%) and 20-29 years (29.1%), accounting for nearly two-thirds (62.1%) of all deaths. The incidence was higher in females (59.3%) than males (46.7%). Gowainghat (12.1%) and Kotwali (9.5%) had the highest incidences of victims. The most common autopsy findings were that the subcutaneous tissues underneath the ligature mark were found to be pale, white, hard and glistening in 94.2% of cases, cyanosis was found in 89.8% of cases, dribbling of saliva was seen in 66.3% of cases and subconjunctival petechial haemorrhage was observed in 46.0% of cases. Asphyxia (93.3%) was the most common cause of suicidal hanging deaths identified during autopsy. Conclusion: The majority of victims were female and young individuals were especially vulnerable to suicidal ideation, attempts and suicide by hanging. To reduce suicides, awareness programs, psychological counseling andsuicidal behavioral treatment are recommended. IAHS Medical Journal Vol 7(1), June 2024; 13-16

Risk Factors for Non-Communicable Diseases in Refugees, Asylum Seekers, and Subsidiary Protection Beneficiaries Resettled or Relocated in Portugal Between 2015 and 2020

Non-communicable diseases, previously thought of as a problem of high-income countries, now coexist in low- and middle-income countries, including the countries of origin for many refugees traveling to Europe. We aimed to describe the prevalence of risk factors for non-communicable diseases among refugees, asylum seekers, and subsidiary protection beneficiaries resettled or relocated in Portugal between 2015 and 2020 and compare these to the prevalence of risk factors in the 12 months before they left their country of origin. A cross-sectional study was conducted between 2019 and 2020 of all refugees, asylum seekers, and subsidiary protection beneficiaries attending a Lisbon, Portugal refugee center. Behavioral and biological risk factors were assessed using the WHO STEPwise modified questionnaire. A descriptive statistical analysis was conducted, which included 80 respondents, mainly men, with an average age of of 30.3 ± 9.8 years. The prevalence of several behavioral risk factors for non-communicable diseases among refugees, asylum seekers, and subsidiary protection beneficiaries was higher at the time of the study than in the 12 months before leaving the country of origin. Differences between men and women were noted in tobacco (49.1% vs. 25.9%) and alcohol use (43.4% vs. 18.5%) in the receiving country. Overweight and obesity also showed differences by gender (7.5% vs. 11.1% and 39.6% vs. 48.1%). The prevalence of suicidal ideation and suicidalplanning was high, and varied from 6.3% and 20% in the country of origin to 16.3% and 38.5% respectively in the receiving country, however the prevalence of suicide attempts was lower in the receiving country (66.7%) compared to the country of origin (100.0%). Information on health and social determinants is critical to identify priorities and increase access to access to gender-specific health and community level interventions, including mental health, to reduce risk factors associated with refugee relocation and resettlement.

Explainable machine learning methods to predict postpartum depression risk

Postpartum depression (PPD) is a type of depression that mothers have following childbirth due to hormonal changes, psychological transition to parenting, and exhaustion. This depression strikes either during/or in the first year following childbirth. It is also a frequently disregarded medical condition that must be treated right away as it might have major repercussions. Machine learning (ML) and artificial intelligence (AI) are tools that healthcare professionals can utilize to anticipate this condition more rapidly and correctly. Consequently, we have demonstrated how to use explainable artificial intelligence (XAI) methods and heterogeneous classifiers to predict postpartum depression in mothers who have recently given birth. The K-Nearest Neighbor (KNN) model and the customized stack model outperformed all other classifiers. KNN model obtained 97% accuracy, 98% recall, and 95% precision and the stack model obtained 97% accuracy, 100% recall, and 94% precision, respectively. A set of frameworks and resources known as explainable artificial intelligence (XAI) facilitates the comprehension and interpretation of predictions made by machine learning algorithms. Four distinct XAI techniques: ELI5, Shapley Additive Values (SHAP), Local Interpretable Model-agnostic Explanations (LIME), and Anchor – have been used to interpret the model predictions. Explainability, interpretability, accountability, and transparency are crucial parameters of XAI, ensuring that machine learning models provide understandable and trustworthy results to users and stakeholders. The goal of this interdisciplinary research is to develop an automated diagnosis framework with tools that can transform therapy for postpartum depression leading to suicide attempts and empower medical professionals to offer mothers individualized, high-quality care.

Telehealth Brief Cognitive Behavioral Therapy for Suicide Prevention: A Randomized Clinical Trial.

Suicide rates continue to increase in the US. Evidence-based treatments for suicide risk exist, but their effectiveness when delivered via telehealth remains unknown. To test the efficacy of brief cognitive behavioral therapy (BCBT) for reducing suicide attempts and suicidal ideation among high-risk adults when delivered via telehealth. This 2-group parallel randomized clinical trial comparing BCBT with present-centered therapy (PCT) was conducted from April 2021 to September 2023 with 1-year follow-up at an outpatient psychiatry and behavioral health clinic located in the midwestern US. Participants reporting suicidal ideation during the past week and/or suicidal behavior during the past month were recruited from clinic waiting lists, inpatient service, intermediate care, research match, and direct referrals from clinicians. A total of 768 participants were invited to participate, 112 were assessed for eligibility, and 98 were eligible and randomly assigned to a treatment condition. Data analysis was from April to September 2024. Participants received either BCBT, an evidence-based suicide-focused treatment that teaches emotion regulation and reappraisal skills, or PCT, a goal-oriented treatment that helps participants identify adaptive responses to stressors. Participants were randomized using a computerized stratified randomization algorithm with 2 strata (sex and history of suicide attempts). The primary outcome was suicide attempts as measured by the Self-Injurious Thoughts and Behaviors Interview-Revised. The secondary outcome was severity of suicidal ideation as measured by the Scale for Suicide Ideation. Participants included 96 adults (mean [SD] age, 31.8 [12.6] years; 64 female [66.7%] and 32 male [33.3%]), with 51 receiving BCBT and 45 receiving PCT. Of all participants, 85 (88.5%) completed at least 1 session. From baseline to 12 months, 12 participants receiving PCT (estimated percentage, 35.6%) made 56 suicide attempts and 11 participants receiving BCBT (estimated percentage, 30.0%) made 36 suicide attempts. Participants randomized to BCBT made significantly fewer suicide attempts than participants randomized to PCT (mean [range], 0.70 [0.00-8.00] attempts per participant vs 1.40 [0.00-10.00] per participant) and had a 41% reduced risk for suicide attempts (hazard ratio, 0.59; 95% CI, 0.36-0.96; P = .03). Severity of suicidal ideation significantly decreased in both treatments (F4,330 = 50.1; P < .001) but did not differ between groups (F4,330 = 0.2; P = .91). The findings of this randomized clinical trial suggest that BCBT delivered via video telehealth is effective for reducing suicide attempts among adults with recent suicidal thoughts and/or behaviors. ClinicalTrials.gov Identifier: NCT04844294.

Prevalence of depressive symptoms in adolescents living with HIV in Johannesburg, South Africa

Background: Adolescents living with HIV (ALWHIV) are more vulnerable to developing depressive symptoms. Despite this knowledge, the screening for depression is not routinely integrated into HIV treatment programmes.Aim: The study aimed to determine the prevalence of depressive symptoms among ALWHIV.Setting: The study was carried out in the primary healthcare clinics and an antiretroviral clinic situated in a district hospital, West Rand District, Johannesburg.Methods: This was a cross-sectional study of 125 ALWHIV. The modified Patient Health Questionnaire for Adolescents (PHQ-A) was used to screen for depressive symptoms with a score of ≥ 5 deemed significant. A distress protocol was used for immediate psychological intervention.Results: The prevalence of depressive symptoms was 44.8% and the majority of ALWHIV reported mild-moderate symptoms (36.8%). Overall, 25.6% of adolescents had suicidal behaviours. Those with psychosocial difficulties and those who reported a previous suicide attempt were 3.6 (adjusted odds ratio [aOR] 3.59, 95% confidence interval [CI]:1.17–11.03) and 6.9 (aOR 6.93, 95% CI:1.39–34.55) times likely to develop depressive symptoms, respectively.Conclusion: A high prevalence of depressive symptoms was found in ALWHIV. Psychosocial difficulties and previous suicide attempts were predictive factors for depressive symptoms. This highlights the unmet need for the integration of mental health screening and overall mental health services into adolescent HIV programmes.Contribution: This study emphasises an urgent need for routine mental health screening and prompt psychosocial support in ALWHIV.

Gender differences in clinical characteristics and influencing factors of suicide attempts in first-episode and drug-naïve major depressive disorder patients with comorbid metabolic syndrome.

Patients with major depressive disorder (MDD) have a high rate of metabolic syndrome (MetS), which could worsen disease progression. One of the most serious progressions in MDD is suicide attempts (SAs). Previous studies have found gender differences in MetS and SAs among MDD patients respectively. Therefore, we aimed to explore gender differences of SAs in first-episode and drug-naïve (FEDN) MDD patients with comorbid MetS. 1718 outpatients with FEDN MDD were recruited. Depression, anxiety and psychotic symptoms were evaluated using the Hamilton Depression Scale (HAMD), Hamilton Anxiety Scale (HAMA) and Positive and Negative Syndrome Scale (PANSS) positive subscale, respectively. Blood sugar, blood fat, blood pressure and body mass index (BMI) were measured to evaluate MetS. 34.4% patients with FEDN MDD were diagnosed as MetS and those subjects with or without MetS differed in the distribution of SAs and gender. In MetS subgroup, 29.5% and 29.7% of male and female subjects had SAs respectively, without significant differences. However, compared with non-suicide attempters, suicide attempters had higher level of blood pressure in female subjects, while there are no differences in any clinical variables in male subjects. Additionally, the influencing factors for SAs differed by gender. The HAMA scores and BMI were variables associated with SAs in male patients while HAMA scores, marital status and systolic blood pressure (SBP) were associated with SAs in female patients. Furthermore, the receiver operating characteristics (ROC) curves, demonstrating the combination all influencing factors by gender, showed good performance and model accuracy. In FEDN MDD patients with comorbid MetS, there were no gender differences in SAs. However, clinical characteristics and influencing factors of SAs differed in different gender groups.

Suicidal risk among Chinese parents of autistic children and its association with perceived discrimination, affiliate stigma and social alienation

BackgroundCaring for autistic children becomes challenging and may lead to negative psychological outcomes, even increasing the suicide risk (SR). Researchers have studied the SR among parents of autistic children in Western nations, but little is known about it in China and how it relates to perceived discrimination (PD), affiliate stigma (AS), and social alienation (SA). The current study aimed to reveal the SR prevalence rate among Chinese parents of autistic children, and clarify whether AS and SA may play mediating roles in the association between SR and PD.MethodsA total of 645 Chinese parents of autistic children were recruited to complete a series of scales to evaluate SR, SA, AS, and PD using the Suicidal Behaviors Questionnaire-Revised (SBQ-R), Perceived Discrimination Scale for Parents of Children with Autism Spectrum Disorders (PDS-FP), Affiliate Stigma Scale (ASS), and General Social Alienation Scale (GSAS), respectively. Then, the SR prevalence rate among Chinese parents of autistic children was evaluated; and the multiple mediation analysis and structural equation modeling with the bootstrap method were conducted to test the mediating effects of AS and SA in the association between SR and PD.Results34.6% Chinese parents of autistic children had high SR. In particular, the incidence rate of suicide ideation, suicide plans, suicide attempts, and suicide likelihood during the previous year were 49.8%, 11.9%, 2.5%, and 13.8%, respectively. Additionally, PD was positively associated with SR (r = .40, p < .01); and AS and SA showed significant mediating effects on the association between PD and SR (p < .01).ConclusionsThe current study evaluated the SR prevalence rate among Chinese parents of autistic children, and clarified the mediating effects of AS and SA in the association between SR and PD. Findings might bring new insights and guidance for intervention of suicidality among Chinese parents of autistic children.

Correlations between problematic internet use and suicidal behavior among Chinese adolescents: a systematic review and meta-analysis

BackgroundProblematic Internet Use (PIU) has been increasingly linked to suicidal behavior among adolescents, raising significant public health concerns, particularly in Chinese youth. This study aimed to systematically review and meta-analyze the correlation between PIU and suicidal behavior in Chinese adolescents to provide a clearer understanding of this association.MethodsA comprehensive search was conducted across seven databases up to July 1, 2024. Studies investigating the relationship between PIU and suicidal behavior among Chinese adolescents were included. A random-effects meta-analysis was employed to assess pooled effect sizes, with subgroup analyses conducted to explore potential moderators, such as geographic region, age, gender, assessment tools for PIU and suicidal ideation, and the presence of depression. Data analysis was performed using STATA software (version 16).ResultsThis meta-analysis, comprising 23 studies with 353,904 participants, identified significant associations between PIU and suicidal behavior among Chinese adolescents. PIU was associated with increased risks of suicidal ideation (OR = 1.72, 95% CI: 1.45, 2.03), suicidal plans (OR = 1.50, 95% CI: 1.02, 2.20), and suicidal attempts (OR = 1.48, 95% CI: 1.16, 1.89). Subgroup analyses indicated higher risks in specific groups: adolescents from Central China (OR = 1.84, 95% CI: 1.46, 2.32), college students (OR = 2.09, 95% CI: 1.66, 2.62). The risk of suicidal ideation was particularly elevated when depression was not controlled (OR = 1.86, 95% CI: 1.53, 2.25). These findings underscore the need for targeted interventions in vulnerable populations.ConclusionThis meta-analysis demonstrated significant associations between PIU and suicidal behaviors among Chinese adolescents. The findings emphasize the need for targeted interventions, particularly for adolescents from Central and Western China, college students, and those with untreated depression. Focused strategies are required to mitigate the risks associated with PIU and to effectively address suicidal behaviors in these high-risk populations.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42024577593, identifier CRD42024577593.

PERFIL EPIDEMIOLÓGICO DE ADOLESCENTES COM TRANSTORNOS PSIQUIÁTRICOS ATENDIDAS EM UM PRONTO SOCORRO INFANTIL

The study investigates the epidemiological profile of adolescents with psychiatric disorders treated in a pediatric emergency room, identifying clinical and socioeconomic characteristics of the main psychiatric disorders, based on the assumption of adolescents' vulnerability to mental health issues. A retrospective analytical documentary study was conducted using electronic medical records of patients treated between January 2019 and December 2021 at the Regional Hospital of Taguatinga. Data on age, sex, reasons for attendance, diagnoses, and comorbidities were analyzed to identify patterns and correlations, contributing to the improvement of care and prevention in mental health. A total of 2000 attendances were evaluated for ages 0 to 17 years. Information was collected from the electronic medical records of patients aged 2 to 17 years. A total of 183 hospitalizations were identified over the studied period, with frequent psychotic episodes occurring in adolescents, especially at ages 12 and 13. These episodes often involved aggression, hallucinations, and self-harm, requiring multidisciplinary interventions. Anxiety disorders were also significant, with adolescents displaying early physical symptoms. Suicide attempts commonly involved medication overdose and were linked to family conflicts and trauma. The conclusion emphasizes the need for a multidisciplinary approach and early interventions to minimize risks and promote mental health.

Emotional Disorders, Distress Tolerance and Suicide Risk: A Mediation Model.

Background: Suicide has been linked to psychopathology, particularly emotional disorders. This study seeks to investigate the mediating role of distress tolerance in the relationship between emotional symptoms and suicide risk. Method: The sample included 1014 adults (33.82% male; M = 33.0, SD = 15.15). Four mediation analyses were performed, controlling for sex, for depressive, anxious, somatizing and obsessive symptoms measured with the Brief Symptom Checklist as the independent variable, distress tolerance, measured with the Distress Tolerance Scale as the mediating variable, and the risk of making a suicide attempt, measured with Risk of Suicide, as the dependent variable. Results: Distress tolerance partially mediated the relationship between emotional symptoms and suicide risk, with Appraisal and Absorption scales positively mediating, and Tolerance negatively mediating. Conclusions: Tolerance of distress plays a role in risk of suicide attempts. Distress tolerance needs to be addressed as a key transdiagnostic factor in reducing suicidal risk.