Attitudes toward suicide are complex and multifaceted. Their predictive roles and how they interact with mental health in suicidal ideation and suicide attempts are not well understood. Elaborating on attitudes toward suicide can help contribute to suicide prevention. The current study examined whether and how attitudes toward suicide and depression levels are involved in suicidal ideation and suicide attempts among college students. A cross-sectional survey was administered to 1,427 Chinese college students (61.32% females; mean age, 22.42 years), of whom 570 reported suicidal ideation. Participants completed questionnaires to assess their endorsed attitude toward suicide, stigmatized attitude toward suicide, self-stigma toward suicide, depression, suicidal ideation, and suicide attempts. Structural equation modeling revealed that the associations between the three types of attitudes, i.e., endorsed attitude, stigmatized attitude, and self-stigma, and suicidal ideation and suicide attempts were fully or partially mediated by depression. The results suggested that attitudes toward suicide significantly influence suicidal behaviors through depression levels and future suicide prevention efforts should consider these influences.

Suicide remains one of the leading causes of death worldwide, yet psychiatry continues to assess risk primarily through suicidal ideation. This narrow focus overlooks a critical factor: sleep. A growing body of evidence demonstrates that insomnia, nightmares, and circadian disruption are consistent and potentially modifiable correlates of suicidal behavior across various diagnoses and age groups, supported primarily by longitudinal and prospective studies. Despite this, structured sleep assessment is seldom integrated into routine psychiatric care, predominantly due to cultural inertia and inadequate training. This perspective necessitates a shift: sleep assessment should be regarded alongside mood and cognition in every evaluation of suicide risk. Brief questionnaires and targeted interventions are readily accessible and feasible for implementation, thereby presenting concrete opportunities for prevention. By incorporating sleep evaluation into standard practice and future predictive models, psychiatry can advance toward more precise, actionable, and timely suicide prevention. To continue neglecting sleep is to overlook one of the most accessible and effective means of saving lives.

Major depressive disorder (MDD) is closely associated with suicide, which often begins with suicidal ideation (SI). However, the underlying neural mechanisms remain unclear. We included 73 MDD patients with SI (MDD-SI), 44 MDD patients without SI (MDD-NSI) and 78 healthy controls (HCs), then compared the amplitude of low-frequency fluctuations (ALFF), functional connectivity (FC), and effective connectivity (EC) differences across groups and analyzed their relationship with SI severity. FC and EC analyses used brain regions with ALFF differences between MDD-SI and MDD-NSI as seed points. ALFF findings were validated using the REST-meta-MDD consortium dataset (N = 1 596, 24 sites). Additionally, we explored the trend of changes in abnormal activity and connectivity of SI and suicidal behavior (SB) in MDD-SI. Compared to MDD-NSI, MDD-SI showed increased ALFF in the right anterior cingulate cortex (ACC), validated by the REST-meta-MDD consortium dataset. MDD-SI also exhibited reduced FC between the right ACC and the left inferior frontal gyrus and decreased EC from the right ACC to the right fusiform gyrus, which were negatively correlated with the Hamilton Depression Rating Scale (HAMD)-suicidality item scores. Increased EC was observed in MDD-SI from the right ACC to the right cerebellar tonsil and from the left inferior parietal lobule (IPL) to the right ACC, following a progressive increase pattern (HC < MDD-NSI < MDD-SI without SB < MDD-SI with SB). Increased activity and aberrant connectivity of the ACC may be associated with SI in MDD patients and potentially serve as biomarkers for suicide risk.

Suicidal thoughts and behaviors (STBs) among pre-adolescents are increasing at alarming rates in the United States, with notable differences based on race, ethnicity, and sex, but little is known about nonfatal STBs in the group. We conducted a retrospective analysis of STB-related encounters among youth aged 6 through 12 using nationally representative US hospital data from 2020 to 2022, drawn from the Healthcare Cost and Utilization Project Nationwide Emergency Department Sample and National Inpatient Sample. Demographic and clinical characteristics were analyzed, as were type of STB (suicidal ideation, intentional overdose, asphyxiation, etc), classified using International Classification of Diseases, Tenth Revision diagnosis codes. National-level census denominators were used to calculate trends in rates of STB-related encounters as well as national and regional rates by racial/ethnic and sex subgroups. The majority of patients with STB (78.9%) had a code indicating only suicidal ideation as the reason for the encounter. Girls were 2.10 times more likely than boys to have an ED encounter for any STB (95% CI 2.06-2.14) and were 9.14 times more likely than boys to have an ED encounter for prescription drug overdose (95% CI 8.31-10.06). Over the 3-year study period, there were increasing trends in encounter rates for all groups, but the largest increases were seen among minoritized girls. There is an urgent need for a safety net of care so that caregivers of children with suicide risk have options other than the hospital for acute treatment of suicidal ideation and behaviors. Culturally responsive services are critical to addressing this public health crisis.

Sexual minority youth experience elevated suicide risk compared with their heterosexual peers. Identifying opportunities for intervention during adolescence (where suicide risk disparities first arise) is a priority. This study estimates the dynamic association between sexual identity disclosure ("coming out") and suicide intention, plan, and attempt. This retrospective cohort study uses data from the Generations Study (2016-2019) and fixed-effects models to identify within-person changes in suicide behaviors around the timing of coming out to a family member or a friend among sexual minorities. Identity disclosure to a family member was associated with a within-person increased risk of suicide intention (8 [95% CI:7-9]] percentage points), plan (10 [95% CI: 9-11] percentage points), and attempt (6 [95% CI: 5-6]] percentage points). Identity disclosure to a friend was associated with a within-person increased risk of suicide intention (10[95% CI: 9-11]] percentage points), plan (12 [95% CI: 11-13] percentage points), and attempt (6 [95% CI: 5-6] percentage points). Results indicated that these increases in suicide risk occurred around the timing of identity disclosure and increase in magnitude in subsequent years. Coming out is a period of increased vulnerability to suicide risk. Multilevel interventions may be especially effective in preventing suicide behavior among sexual minorities.

Suicide remains one of the leading causes of death among adolescents. Adolescence is a critical developmental period marked by increased vulnerability to emotional and social stressors. Loneliness has gained recognition as a factor linked to poor mental health outcomes, including suicidal behaviors. However, its relationship with suicidal behaviors has not been thoroughly examined. A secondary analysis was conducted using data from the 19th Korea Youth Risk Behavior Survey, which included responses from 52,880 adolescents aged 12-18 years, collected from August to October 2023. Associations between loneliness and suicidal behaviors were analyzed using complex sample multiple logistic regression. Suicidal ideation, plans, and attempts were reported by 13.5%, 5.3%, and 3.2% of adolescents, respectively, with variations by socio-demographic, mental health, and problem behavior characteristics. 81.3% of adolescents reported loneliness, with 18.2% indicating they felt 'Often' or 'Always lonely.' Loneliness was significantly associated with all forms of suicidal behavior (p < 0.001); even after controlling for 19 covariates, adolescents with moderate or high loneliness had substantially higher odds of SI, SP, and SA compared to those with no loneliness. The significant association between loneliness and suicidal behaviors highlights the importance of incorporating loneliness assessments into adolescent suicide prevention strategies. Collaborative efforts involving schools, parents, and healthcare providers are critical to address risky behaviors and provide effective mental health support. Psychiatric mental health nurses can play a pivotal role in identifying at-risk youth, delivering therapeutic interventions, and coordinating care to reduce adolescent suicide risk.

Suicidal ideation (SI) and behavior are complex phenotypes, with multiple contributing risk-factors. This study used longitudinal data from the Million Veteran Program Mental Health Survey to identify SI profiles among Veterans based on trajectories of ideation and depression severity and compared them to a non-suicidal (no-SI) control group. Latent profile analysis (LPA) was performed to identify SI profiles using data from Veterans (n = 34,322) endorsing SI in their electronic health record. LPA identified four highly reproducible SI profiles: mild ideators with and without depression, variable ideators, and persistent ideators. Veterans across the SI profiles were significantly more likely to have diagnoses of suicidal ideation or behavior, mental disorders, and TBI compared to Veterans with no-SI. The variable ideators showed higher rates of comorbid conditions. The mild ideators without depression and persistent ideators had a significantly higher proportion of deaths by suicide than the no-SI Veterans. European and African American GWAS and pan-ancestry meta-analyses of SI profiles compared to no-SI controls were also performed, which identified genome-wide significant loci across all SI profiles proximal to genes implicated in auditory and vestibular functioning, Alzheimer's, diabetes, and asthma. In summary, SI profiles identified were associated with novel genetic variants not identified by previous suicide GWAS studies. Additionally, Veterans within the mild SI profile that did not present with high-risk comorbidities had the highest rate of suicide deaths, indicating the need for upstream suicide risk prevention interventions across the SI risk continuum.

Background The inexplicable thought of jumping from a bridge, driving into oncoming traffic or walking in front of an oncoming train is known as the Call of the Void (COV) phenomenon. Previous studies have only focused on one COV aspect: the high place phenomenon (HPP), that is a sudden urge to jump when in a high place. In this study, we aimed to develop and validate the Call of the Void Scale (COVS) to measure the prevalence of a variety of these thoughts, their ego-dystonic character and associated safety behaviors. Methods The study sample comprised N = 476 participants (71% female, mean age = 30.85 years, standard deviation = 11.5; age range: 18–67 years). Individuals completed the COVS between August 2023 and February 2024 in an anonymous online survey. We analyzed the scale´s factor structure, reliability, and validity through exploratory and confirmatory factor analyses. Bivariate correlations with existing measures of depression, stress, anxiety and suicidal ideation and behavior were calculated to assess convergent validity. Results Using exploratory factor analysis on half of the sample ( n 1 = 238), we derived a five-factor structure, which was interpreted as representing the frequency of COV in different situations (“frequency HPP”, “frequency car”, “frequency train”), the ego-dystonic character of the thoughts (“ego-dystonia”), and behavior to suppress or manage the thoughts (“safety behavior”). Confirmatory factor analysis on the other half of the sample ( n 2 = 238) showed a good fit for the five-factor solution. The subscales frequency HPP, frequency car, frequency train and safety behavior were positively correlated with depression, stress, anxiety and suicidal ideation and behavior. The ego-dystonia subscale was only correlated with the safety behavior subscale. Conclusion The COVS seems to be a valid tool for the assessment of the Call of the Void phenomenon, measuring the prevalence of these thoughts, their ego-dystonic character and associated safety behaviors. The limitations of this study and implications for future research are discussed.

Suicidal behaviours and self-harm among adolescents: Results from a school-based mental health survey in the Philippines

Although a substantial body of researchhas documented the adverse mental health impacts of discrimination, few studies have examined these outcomes and their association with ethnicity. This study characterizes variation in experiences of race-related bullying and adverse mental health symptoms among a sample of ethnically diverse Black adolescents. We describe experiences of racially motivated bullying and associated protective factors across Black 8th,9th, and 11th grade youth (n=8,201) in the 2022Minnesota Student Survey, using multivariate logistic regression. Over a quarter of youth (29.5%)across all Black ethnic subgroups reported bullying based on their racial identity. Nigerian, Multiethnic Black, and Multiracial youth reported the highest rates of race-related bullying (40.0%, 35.2%, and 35.2%). We find that Oromo Ethiopian(OR=0.51 CI=0.36-0.72; p<0.001), non-Oromo Ethiopian (OR=0.69; CI=0.50-0.95;p<0.05) and Somali (OR=0.63; CI=0.53-0.75; p<0.001) identities were associated with lower reported odds of depression compared to their African American peers. Oromo(OR=0.60; CI=0.43-0.85; p<0.01), Nigerian (OR=0.6; CI=0.45-0.95; p<0.05) , and Somali (OR=0.65; CI=0.54-0.78; p<0.001) youth reported lower odds of anxiety symptoms while Multiracial youth reported greater (OR=1.3; CI= 1.13-1.51; p<0.001)even when controlling for race-related bullying. Similar patterns were seen for suicidal thoughts and behaviors. There exists a considerable amount of heterogeneity within Black adolescent populations, with regards to race-based bullying experience and mental health. These findings support the development of culturally or ethnically tailored interventions to address adverse mental health outcomes for Black youth.

Evaluating the extent to which targets are achieved in national suicide prevention strategies.

To assess the magnitude and associated factors of suicidal behaviour and non-suicidal self-injury (NSSI) among youth of the Gurage Zone, Southern Nations, Nationalities, and Peoples Regional, Ethiopia, 2024. A community-based cross-sectional study was conducted. This research was carried out in the Gurage Zone. This study was conducted among 719 Gurage Zone youths from 1 January 2024 to 1 February 2024. Suicidal behaviours and non-suicidal self-injury were assessed using a pretested, interviewer-administered, structured questionnaire. Data were entered in EpiData V,3.1 and exported to SPSS V.25 for analysis. A binary logistic regression model was used to identify significant factors associated with suicidal behaviours and NSSI. Variables with a p-value less than 0.05 and adjusted ORs with 95% CI were used to declare association with the outcome variable in the final model. Out of the total 820 study participants, 719 participants participated in the study, giving a response rate of 88%. Among 719 respondents 465 (64.7%) were males. The prevalence of high risk of suicidal behaviours was 11.7% (95% CI 8.14 to 14.30) and it is significantly associated with substance use in the last 3 months (adjusted OR (AOR)=6.84; 95% CI 3.48 to 13.47), having moderate insomnia (AOR=3.09; 95% CI 1.30 to 7.31) and having depression (AOR=6.84; 95% CI 3.48 to 13.47).The prevalence of NSSI among youths was 38% (95% CI 34.52 to 41.86). Substance use in the last 3 months (AOR=2.459; 95% CI 1.59 to 3.81), youths having depression (AOR=3.348; 95% CI 2.29 to 4.91), youths who were exposed to stressful life events (AOR=9.86; 95% CI 6.46 to 15.07) were significantly associated with NSSI. Nearly 1 in 10 youths in the Gurage Zone exhibited high-risk suicidal behaviour, and over one-third reported NSSI. Suicidal behaviour was significantly associated with substance use, depression and moderate insomnia, while NSSI was significantly associated with substance use, depression and exposure to stressful life events. These findings highlight the prevalence of self-harm and the key factors associated with these behaviours among youth in this region.

ABSTRACT This study examined associations between bullying victimization and suicidal behaviors among US high school adolescents using seven waves of Youth Risk Behavior Surveillance System data (2011–2023; N = 110,409). Logistic regression analyses showed that bullying victimization and depressive symptoms significantly increased the odds of suicidal behaviors. In contrast, higher grade level and physical activity (PA) were associated with lower odds of suicidal behaviors. Moderated mediation analyses demonstrated that depressive symptoms mediated the effects of bullying victimization on suicidal behaviors, while PA buffered the indirect effects of school bullying on suicidal behaviors through depressive symptoms. Sex moderated direct effects, with stronger associations observed among females. These findings emphasize the importance of interventions that address bullying victimization, depressive symptoms, and PA to reduce suicidal behaviors among US high school adolescents.

Understanding suicidal thoughts and behaviors in Black youth within the child welfare system: An exploration of protective factors.

Mediating roles of bullying and depression in the link between body weight and suicidality in adolescents.

Suicidal thoughts and behaviors in adolescents with mood disorders: Insights from a nationally representative sample.

The suicide rate has increased over the past 20 years, as has the pace of research studies focused on suicide prediction, yet the ability to accurately predict suicidal behavior has not improved. There has been significant debate in the field over the past several decades regarding the use of clinical versus statistical prediction. Clinical prediction, rooted in clinicians' judgment and intuition, allows for contextual sensitivity and the detection of anomalies, whereas statistical prediction offers standardized, bias-resistant models derived from observed data. This article suggests that suicide prediction will advance most quickly and effectively through a synthesis of clinical AND statistical methods. Key avenues for future work toward this end are described, including those focused on quantifying effective clinical practices (eg, studying clinicians who excel at prediction, natural language processing of clinician notes) and testing the utility of combining statistical predictions with clinician decision-making practices. Creating and testing hybrid models may improve accuracy, increase clinician use, and ultimately reduce suicide deaths.

Objective: This study examines pathways for suicide ideation identification and suicidal behavior intervention among Chinese young adults. Methods: It used qualitative comparative analysis (QCA) to analyze the cases of 47 Chinese young people (aged 18–28) with suicidal experiences. The outcome variables are suicide ideation identification and suicidal behavior intervention, and condition variables include psychological disorders, suicidal history, suicidal communication, suicidal time, suicidal location, suicidal methods, family support, peer support, and school support. Results: There are two successful identification pathways and five effective intervention pathways, contrasted with four failed identification pathways and one failed intervention pattern. These results reveal that continuous supervision of individuals with psychological disorders and multi-group participation in intervention are important to decrease the suicide risk of Chinese young people. Meanwhile, a lack of proactive identification of individuals without warning signals, insufficient attention from families and communities to young people with psychological disorders, and inadequate physical limitations on fatal suicidal behaviors are major risk factors. Conclusions: This study highlights the measures of strengthening continuous attention to suicide signals among high-risk youth groups, limiting lethal suicide methods, promoting network monitoring and suicide risk warning, increasing psychological services in the community, and improving the collaborative synergy of peers, families, and schools.

Subtypes of suicidal ideation among university students - An ecological momentary assessment study.

Stopping suffering: An exploration of suicidal ideation and its clinical, cognitive and relational correlates among women with a diagnosis of endometriosis.