Suicidal Depression Research Articles

Genome-wide methylome-based molecular pathologies associated with depression and suicide.

Major depressive disorder (MDD) is a debilitating disorder. Suicide attempts are 5-times higher in MDD patients than in the general population. Interestingly, not all MDD patients develop suicidal thoughts or complete suicide. Thus, it is important to study the risk factors that can distinguish suicidality among MDD patients. The present study examined if DNA methylation changes can distinguish suicidal behavior among depressed subjects. Genome-wide DNA methylation was examined in the dorsolateral prefrontal cortex of depressed suicide (MDD+S; n = 15), depressed non-suicide (MDD-S; n = 17), and nonpsychiatric control (C; n = 16) subjects using 850 K Infinium Methylation EPIC BeadChip. The significantly differentially methylated genes were used to determine the functional enrichment of genes for ontological clustering and pathway analysis. Based on the number of CpG content and their relative distribution from specific landmark regions of genes, 32,958 methylation sites were identified across 12,574 genes in C vs. MDD+/-S subjects, 30,852 methylation sites across 12,019 genes in C vs. MDD-S, 41,648 methylation sites across 13,941 genes in C vs. MDD+S, and 49,848 methylation sites across 15,015 genes in MDD-S vs. MDD+S groups. A comparison of methylation sites showed 33,129 unique methylation sites and 5451 genes in the MDD-S group compared to the MDD+S group. Functional analysis suggested oxytocin, GABA, VGFA, TNFA, and mTOR pathways associated with suicide in the MDD group. Altogether, our data show a distinct pattern of DNA methylation, the genomic distribution of differentially methylated sites, gene enrichment, and pathways in MDD suicide compared to non-suicide MDD subjects.

The relationship between intersectional discrimination and mental health outcomes among LGBTQ+ Asians in New York City: an exploratory, mixed-methods study

ABSTRACT LGBTQ+ Asians face increased mental health risks due to intersectional discrimination and minority stress. This mixed-methods study examined associations between minority stress, intersectional discrimination, and mental health outcomes among LGBTQ+ Asians. Between 2022 and 2023, 136 LGBTQ+ Asian residents of New York City were surveyed. Adjusted logistic regression models compared the odds of clinically-significant depressive symptoms, anxiety symptoms, and suicide risk by self-reported measures of discriminatory experiences towards LGBTQ+ Asians. A subsample of 24 individuals completed semi-structured interviews in English, and thematic content analysis was utilised to understand contextual factors and discriminatory experiences influencing mental health. Individuals experiencing higher levels of everyday discrimination had increased odds of reporting clinically-significant depressive symptoms, anxiety symptoms, and high suicide risk. Individuals experiencing higher levels of racialised and LGBTQ-related microaggressions had increased odds of reporting clinically-significant depressive and anxiety symptoms. Interviews revealed themes including social isolation, anticipated stigma attributed to discriminatory experiences within LGBTQ+ and Asian communities, and pervasive impacts of racial and LGBTQ+ discrimination on mental health. These findings underscore mental health disparities among LGBTQ+ Asians associated with varying levels of discrimination and targeted microaggressions. More research is needed to understand the causal mechanisms by which intersectional discrimination impacts LGBTQ+ Asians’ mental health.

Extended-Release Lithium Sulfate in Adolescents with Bipolar Disorder: Results from a Longitudinal Prospective Cohort Study.

Objectives: Bipolar disorder (BD) in adolescence often associates with risky conducts, nonsuicidal self-injury (NSSI), and suicidal ideation. Lithium salts represent the first-line choice for BD in youth to manage manic symptoms and prevent both manic and depressive relapses. Our study aimed to assess efficacy and tolerability of extended-release lithium sulfate (ERLS) in youths with BD. Methods: A longitudinal perspective intervention study was thus conducted on a single cohort of 36 patients with BD aged 12-17 years treated with ERLS and followed up for 1 year. ERLS was titrated up to reach optimal plasma concentrations during the 3 months before baseline visit (T0). Then, patients underwent five follow-up visits after 1, 2, 3, 5, and 11 months and were administered with a battery of self- and parent-rated questionnaires and interviews to evaluate, at each timepoint, ERLS-related side effects, manic and depressive symptoms, emotional dysregulation (ED), NSSI and suicidality, and aggressiveness. Regular clinical assessments were also conducted, as well as blood tests, urinalysis, and EKG. Regression models were applied to examine the time course of outcome variables. Results: Twenty-four patients completed the follow-up. Regressions showed a significant reduction of most dependent variables included in the models, including depressive symptoms (β = -0.0006; adj-p = 0.0007), aggressiveness (β = -0.0031; adj-p < 0.0001), ED (β = -0.0002; adj-p = 0.0497), and unstructured suicidal ideation (β = -0.0058; adj-p = 0.0340). Fine distal tremor, increased thirst, and diuresis were among the most frequently reported side effects. Conclusions: Findings from the present study support the use of ERLS as an effective and well-tolerated agent for the management of BD in youth, with a beneficial effect on associated severe symptoms, including NSSI and suicidality.

Considering Developmental Phenotypes of Suicidality for Young Black Children

ABSTRACTSuicide is currently the 5th leading cause of death among children aged 5–11, a rate that has more than tripled in the last decade, and one that has increased significantly more among Black compared to White children. Specifying early childhood phenotypes of suicidality is critical for prevention of suicidal behavior. Such phenotypes need to be culturally relevant and rigorously tested in Black youth to yield data that will inform prevention science. We used the Interpersonal Theory of Suicide, to guide both the development of a theoretical model and a research protocol to conduct a study on suicidality in young Black children. The model was informed by an ecological adaptation which considers the context of structural, systemic, and interpersonal racism as critical for conceptualizing suicidal risk and identifying factors that reduce the likelihood of suicidal ideation and behaviors among Black youth. Developmental adaptations of IPTS components were based on existing research supporting associations between theoretically similar constructs and early childhood depression and/or later suicidality. Model components include loneliness and lack of family connectedness, low self‐worth and hopelessness, and impulsivity. The components are measured via questionnaires and reactivity to behavioral probes as measured by facial emotion, heart rate variability, and self‐reported mood. Risk and protective factors include exposure to racism and discrimination and racial identity and socialization, respectively. An accelerated, longitudinal design, enrolling 5–9‐year‐old children for 6 repeated assessments over 45 months will allow us to test stability from early childhood to early adolescence. Conducting robust tests of early risk and stability of suicidality in the context of culturally relevant risk factors (e.g., racism) and protective factors (e.g., racial socialization and identity) will contribute to efforts to reverse recent trends in Black youth suicide.

Investigating psychiatric morbidity, hopelessness and suicide risk in patients with 22q11.2 deletion syndrome: a case-control study

Background The psychiatric phenotype of the 22q11.2 deletion syndrome (22q11DS) has been largely described. Objectives With a case-control study design, we now compared a sample of 22q11DS patients with a psychiatric diagnosis with a sample of psychiatric patients without 22q11DS to investigate possible differences between groups for depression severity, hopelessness, and suicide. Patients with 22q11DS were divided into two groups according to the levels of hopelessness to evaluate the relationship between hopelessness and the severity of the 22q11DS, the level of disability, functional impairment, physical frailty, and autonomy level. Results Results showed that suicide risk evaluated with the C-SSRS was similar in the two groups of patients and that a diagnosis of 22q11DS does not appear to be a risk factor for suicide; however, 22q11DS patients had more severe hopelessness. Patients with a more severe clinical presentation and worse overall functioning have higher levels of depressive symptoms and hopelessness. Conclusions The results suggest the need to assess and monitor psychiatric symptoms in patients with 22q11DS.

An examination of levels of depression, the probability of suicide, and autistic traits in medical faculty students: A cross-sectional study.

Depression and suicide attempts are reported to be high among medical students. It has also been reported that depression, suicide attempts, and autistic traits may be significantly related. The aim of this study was to determine the suicide probability and autistic traits of medical students with and without depression symptoms, and to examine the relationship between depression symptoms, suicide probability, and autistic traits together in these students. This cross-sectional study was conducted among 313 medical students, 206 female, and 107 male, who, according to the sociodemographic form, did not have any current psychiatric diagnosis, chronic medical or neurological disorders requiring treatment, or regular use of psychotropic medications, and who completed the forms in full. All the study participants completed a sociodemographic form, the Beck depression inventory (BDI), the suicide probability scale (SPS), and the autism spectrum quotient (ASQ).The entire study sample was divided into 2 groups: students with and without symptoms of depression, based on BDI scores. In the multivariate analysis, independent predictors of depression symptoms were examined using logistic regression analysis. The BDI total points (z = -13.99, P < .001), SPS total points (z = 10.61, P < .001), and subscale points of hopelessness (z = -9.28, P < .001), suicidal ideation (z = 8.48, P < .001), negative self-evaluation (z = -9.26, P < .001), and hostility (z = -8.10, P < .001), and the ASQ subscale points of communication (z = -5.05, P < .001), social skills (z = -6.05, P < .001), imagination (z = -3.27, P = .001), attention shifting (z = -4.35, P < .001), and ASQ total points (z = -6.64, P < .001) were significantly higher for the participants with BDI total points above the cutoff value compared to those with BDI total points below the cutoff value. Statistically significant positive correlations were found between BDI total points and SPS total points (R = 0.710, P < .001), ASQ total points (R = 0.451, P < .001), and between ASQ total points and SPS total points (R = 0.534, P < .001). The contribution of age, gender, ASQ, and SPS total points to explaining depression symptoms was evaluated using logistic regression analysis. This analysis showed that the SPS total points could be a significant predictor of depression symptoms (B = 0.112, P < .001). The findings of this study showed that the probability of suicide and the ASQ total and subscale points of communication, social skills, imagination, and attention shifting were significantly higher in medical students with symptoms of depression compared to those without depressive symptoms. Given the important relationship between symptoms of depression, suicidality, and autistic traits, it is crucial to raise awareness of these issues among medical education departments, health practitioners, medical students, and to provide the necessary guidance and clinical support for medical students to address these problems.

Strategic Treatment and Assessment for Youth (STAY): A Theoretically-Driven, Culturally-Tailored MBC Approach.

Racial and ethnic minoritized (REM) youth are at greater risk for depression and suicide than their White peers. Despite this, REM youth are much more likely than their White peers to prematurely dropout of treatment. Culturally tailored and scalable engagement models to improve mental health treatment retention among REM youth with depressive symptoms and suicidal thoughts and behaviors (STB) are urgently needed. Strategic Treatment Assessment for Youth (STAY) is a theoretically-driven, culturally tailored measurement-based care (MBC) approach to treatment engagement for REM youth with depressive symptoms and suicide risk. Specifically, STAY uses MBC feedback processes to reduce perceptual barriers to treatment, thus improving treatment retention and ultimately, client outcomes among REM youth. In addition to standard MBC components, STAY includes a greater emphasis on providing a client-centered rationale for MBC which includes assessing and discussing treatment expectations, the use of individualized progress measures and alliance measures, and cultural competence training. The goal of this manuscript is to describe the STAY model based on initial theoretical development and preliminary clinician-informed refinements. Further, a case example of STAY is presented with a particular focus on the use of feedback processes. Finally, the current and future directions to empirically examine STAY as a treatment retention strategy with REM populations are provided.

Misdiagnosis of Primary Eating Disorder in an Individual With Major Depressive Disorder and Comorbid Catatonic Syndrome.

Catatonia is a neuropsychiatric syndrome affecting movement, emotion, speech, and behavior, which commonly occurs secondary to medical or psychiatric disorders and with comorbid illnesses. We report the case of an 18-year-old male with a history of depression, anxiety, attention-deficit/hyperactivity disorder, polysubstance use, and previous suicide attempts who presented to the hospital from a residential eating disorders treatment facility, due to psychomotor slowing. The patient scored 3 or lower on the Bush-Francis Catatonia Rating Scale (BFCRS), but he showed marked improvement following 2mg of intravenous lorazepam. The patient was referred for ECT, experienced dramatic improvement, and was discharged at his baseline functioning. His discharge diagnosis was catatonic syndrome secondary to severe melancholic depression. Catatonia may present a diagnostic challenge as no single catatonia screener captures all possible phenotypes. The patient consistently scored low on the BFCRS but he had a clear response to standard-of-care catatonia treatment. Psychomotor slowing is common in catatonia but is not designated as a catatonic feature in either the DSM-5 or the BFCRS. This case also presented diagnostic complexity as the patient initially presented with malnutrition and concern about a possible eating disorder. This report highlights that diagnosing catatonia is challenging, particularly in the context of medical complexity, and that there are discrepancies between diagnostic tools. When suspicion of catatonia is high, despite low individual screening scores, clinicians may consider alternative screening instruments or empiric treatment.

Sleep Disturbances Are Associated With Depressive Symptoms and Suicidality Among Adolescents in Pediatric Primary Care

Sleep Disturbances Are Associated With Depressive Symptoms and Suicidality Among Adolescents in Pediatric Primary Care

Clinical indicators of the suicide crisis and response to ketamine

BackgroundThis analysis sought to identify potential clinical targets for the suicide crisis. Characteristics of a useful clinical target include elevation at the time of suicide crisis and responsiveness to rapid-acting interventions. Suicidal ideation (SI), depression, and hopelessness were hypothesized to meet these criteria. MethodsParticipants were 118 adults across the continuum of suicide risk, including 14 high-risk (HR) individuals who had attempted or seriously considered suicide within the last two weeks. Clinical characteristics were evaluated by: 1) comparing individuals with a recent crisis state to those whose suicide crises had resolved; 2) quantifying responses to a semi-structured interview about the time just before a suicide crisis; and 3) comparing symptomatology before and after an open-label ketamine infusion (0.5 mg/kg) in a subset of the HR group (n = 10). ResultsAs hypothesized, SI, depression, and hopelessness were elevated just after a suicide crisis and responded to ketamine, although findings were mixed depending on the assessment used. Psychological pain and traumatic stress symptoms were also associated with the suicide crisis and responded to ketamine. Participants reported high levels of SI, depression, and anxiety just before their suicide attempt. LimitationsLimitations include the small sample size, inconsistent assessments across analyses, and that ketamine was the only intervention examined. ConclusionsThese results underscore the importance of SI, depression, hopelessness, psychological pain, and traumatic stress in this population, all of which were elevated during the suicide crisis and responded to ketamine. A multifactorial and longitudinal approach is indicated to assess and treat suicide risk.

Therapeutic alliance and suicidal ideation in brief cognitive behavioral therapy for outpatients

ObjectiveThe therapeutic alliance is central to psychotherapy. However, research on the relationship between alliance and suicidality is scarce. We examined whether pretreatment suicidality is associated with an impaired alliance formation in brief cognitive behavioral therapy (CBT) and whether the therapeutic alliance is associated with change in suicidal ideation (difference between pretreatment and posttreatment assessment).MethodsN = 643 outpatients (64% female; age: M[SD] = 37.09[13.15], range: 18–73 years), received 12 sessions of manual-based short-term CBT for primary diagnosis treatment. Using self-report questionnaires, suicidal ideation and behavior were assessed before and after therapy, patient-rated therapeutic alliance was assessed after the fourth session and posttreatment. We performed correlation analyses and two hierarchical linear regressions, unadjusted and adjusted for possible confounding variables (age, gender, lifetime suicide attempts and depression).ResultsPretreatment suicidal ideation was not predictive of the quality of the early alliance. In addition, the therapeutic alliance was not predictive of change in suicidal ideation.ConclusionsIn the outpatient setting, no association was found between therapeutic alliance and suicidality. Future studies should investigate therapeutic alliance as a predictor of prospective suicidal behavior in different clinical settings.

Intersecting Epidemics: Examining the Impact of Internalized Homophobia and Depression Symptoms on HIV Testing ThroughaSuicide Syndemic Among Young Black Men Who Have Sex with Men.

Young Black men who have sex with men (BMSM) in the USA face disproportionate rates of HIV incidence. Mental health vulnerabilities, including depression, anxiety, substance use, and trauma, further exacerbate the HIV epidemic among this population. Internalized homophobia, discrimination, and depression contribute to elevated rates of suicidal behavior among young BMSM, which in turn may influence engagement in HIV prevention behaviors, such as HIV testing. However, limited research has examined the interplay among suicidal behaviors, internalized homophobia, depression, and HIV testing among young BMSM. This study utilized syndemic theory to explore the relationships among these factors in a sample of 400 young BMSM ages 18-29. Results indicate alarming rates of suicidal behavior among young BMSM, with significant associations among internalized homophobia, depression symptoms, suicidal behavior, and HIV testing. The findings underscore the urgent need for targeted mental health interventions and HIV prevention services tailored to address the unique challenges faced by young BMSM. Comprehensive, multi-level, community-centered interventions are essential to address the syndemics affecting young BMSM, promoting holistic health and well-being while improving outcomes across the HIV prevention continuum.

Adult mental health outcomes of adolescent depression and co-occurring alcohol use disorder: a longitudinal cohort study

AbstractDepression and alcohol use disorder (AUD) are frequently co-occurring in adolescence, which often goes undetected in routine care. While this may potentially compromise treatment effectiveness and lead to a less favourable long-term prognosis, few longitudinal studies have followed this group into adulthood. The aim of this study was to explore the risk for adult depression, anxiety disorders, suicidality, and AUD in adolescents with concurrent depression and AUD. The study was based on the Uppsala Longitudinal Adolescent Depression Study (ULADS), a Swedish prospective cohort study. Diagnostic interviews were conducted in adolescence (age 16-17) and adulthood (around age 30). Adolescents with concurrent depression and AUD (n = 38) were compared with peers having only depression (n = 189) or neither of the conditions (n = 144). Logistic regression was used to calculate adjusted odds ratios (aORs) with 95% confidence intervals (CIs). Adolescents with concurrent depression and AUD were more likely than their non-affected peers to experience adult depressive episodes (aOR, 5.33; 95% CI, 2.22–12.83), anxiety disorders (4.05; 1.77–9.27), suicidality (5.37; 2.28–12.66), and AUD (7.68; 2.59–22.81). Notably, 34% of adolescents with both depression and AUD subsequently experienced both these conditions as adults, compared to 7% of adolescents with only depression. Adolescents suffering only from depression were less likely than those with both conditions to experience suicidality (0.44; 0.21–0.95) and AUD in adulthood (0.18; 0.07–0.44). These findings underscore the clinical imperative to identify adolescents with this comorbidity. Recognition of the poor long-term prognosis can inform targeted interventions for this vulnerable group, ultimately improving health and well-being throughout the life course.

Domestic Violence Experience, Past Depressive Disorder, Unplanned Pregnancy, and Suicide Risk in the First Year Postpartum: Mediating Effect of Postpartum Depression.

This study aimed to examine the relationship between domestic violence, past depressive disorder, unplanned pregnancy, suicide risk, and postpartum depression among Korean women using a mediation model approach. A web-based, cross-sectional survey was performed from September 21 to September 30, 2022. Participants included 1,486 women in their first year postpartum from Chungnam Province, South Korea. The generalized linear model mediation was analyzed using the R-based Jamovi 2.3.21 version program. Of all participants, 8.7% had domestic violence experience, 7.5% had been diagnosed with depressive disorder by the doctor in the past, 33.0% had reported that the last pregnancy was unplanned, 39.9% had postpartum depression, and 11.2% of the participants had a suicide risk. Among the participants with a high risk of suicide, 34.4%, 37.5%, 53.1%, and 96.9% reported experiencing domestic violence, past depressive disorder, an unplanned pregnancy, and postpartum depression, respectively. Postpartum depression partially mediated the relationship between domestic violence, past depressive disorder, and suicide risk and completely mediated the relationship between unplanned pregnancy and suicide risk. Our findings highlight the necessity for screening and early intervention for suicide risk and postpartum depression from pregnancy to the first year postpartum.

Enacted and Anticipated Stigma Are Associated With Mental Ill-Health Among LGBT+ People in Malaysia: A Brief Report

This brief report contributes crucial empirical evidence to the fledgling literature on mental health status and minority stressors among LGBT+ people in Malaysia, where LGBT+ identities remain criminalized by laws. Drawing data from the 2023 Kami Survey (n= 640), we explore the associations between enacted stigma (measured using the Experiences of Discrimination Scale [EDS]), proximal stressors including anticipated stigma (negative future expectations) and internalized LGBT-phobia, and mental health variables (depression, nonsuicidal self-injury [NSSI], suicidal ideation, and suicide attempts). Participants who were Malay or Indigenous in the Malay Peninsula (compared with Chinese), questioning sexual orientation (compared with gay or lesbian participants), trans men, trans women, or nonbinary participants (compared with cis men), and intersex individuals (compared with those without intersex characteristics) scored significantly higher on the EDS. Multivariate regression analyses, adjusting for demographic characteristics, revealed that enacted stigma predicted elevated risks of depressive symptoms, NSSI, and suicide attempts. Furthermore, negative future expectations were significantly associated with increased risks of NSSI and suicidal ideation. Our findings provide preliminary support for the minority stress model in Malaysia, emphasizing the need to eradicate systemic and institutional injustices promoting enacted stigma and stressful environments for LGBT+ people. Further longitudinal research is warranted to complement our cross-sectional findings by exploring the nuanced impacts of different forms of enacted stigma and proximal stressors on LGBT+ mental health, specifically within the LGBT-criminalization context of Malaysia and broader Southeast Asia.

Network analysis of correlations between suicide exposure, depression, and anxiety symptoms in adolescents.

Adolescents with a history of suicide exposure, defined as experiencing the suicide death of a family member, friend, or other acquaintances, are more likely to experience mental health issues such as depression or anxiety. This study aimed to explore prevalence rates and the network of adolescents' suicide exposure, depression, and anxiety symptoms, and to clarify the correlations between suicide exposure and symptoms of depression and anxiety. A total of 8,957 adolescents were included in this cross-sectional study. Data regarding general information, symptoms of depression and anxiety, and suicide exposure were collected from mid-September to early October 2021. Network analysis was employed to assess relationships between suicide exposure and individual symptoms of both depression and anxiety. Central symptoms were identified by strength; the flow network was visualized to identify symptoms directly related to suicide exposure. The prevalence rates of suicide exposure, depression, and anxiety were 5.28%, 12.87%, and 10.48%. Results indicated that suicide exposure was associated with both depression and anxiety, and had the strongest positive association with suicidal ideation. Central symptoms of the network were sad mood, nervousness, fatigue, irritability, and uncontrollable worry. Bridge symptoms were suicidal ideation and irritability. Appetite changes, suicidal ideation, uncontrollable worry, sleep difficulties, and irritability were symptoms directly related to suicide exposure. There were significant inter-symptom associations between suicide exposure, depression, and anxiety in adolescents. It is recommended that future studies explore whether targeted interventions and long-term monitoring concerning these inter-symptom associations can protect adolescents with suicide exposure.

Comparative Outcomes of Three School-Based Cognitive-Behavioral Interventions for Adolescent Suicide Prevention in Hong Kong.

Background/Objectives: This study assessed the effectiveness of a school-based suicide prevention program in Hong Kong. Methods: 105 secondary school students aged 14-16, identified as having high levels of depression and suicidal ideation. Participants were divided into three intervention groups: one for adolescents only, another for adolescents with peers, and a third for adolescents with parental involvement. All groups engaged in weekly online exercises. Repeated measures ANOVA was used to analyze the within-group and between-group differences in the levels of adolescents' suicidal ideation, depression and anxiety. Results: The results indicated a statistically significant reduction in suicidal ideation, depression and anxiety levels after participation in all three groups. No statistically significant between-group differences were identified, meaning the effects of the three interventions on the measured outcomes were similar. Conclusions: This study demonstrates the promise of implementing school-based suicide prevention programs in the Hong Kong context.

Anxio-depressive disorders, traumatic symptoms, and suicidality among limb amputees: A cross-sectional and prospective study

IntroductionLimb amputation represents an ultimate therapeutic option in certain severe or progressive pathologies. We conducted this study to describe anxio- depressive disorders, traumatic symptoms, and suicidality among limb amputees, as well as factors associated with their occurrence. Materials and MethodsThis was a cross-sectional and prospective descriptive and analytical study conducted over a two-year period from October 2020 to October 2022, at the following departments of the Mohammed VI University Hospital Center in Oujda: Traumatological and Orthopedic Surgery departements A and B, and Peripheral Vascular Surgery departement, involving 122 patients. ResultsThe average age of our patients was 46.42 ± 14.76 years, with a predominance of males (male-to-female ratio of 2.21). Preoperative assessment of patients occurred 6 to 24 h before amputation. Immediate postoperative evaluation took place on average 2.18 ± 1.53 days after surgery, ranging from 1 to 8 postoperative days. The prevalence of anxio-depressive disorders according to the MINI scale was 77 %, comprising Depression (9 %), Adjustment Disorder (36.9 %), Acute Stress Disorder (20.5 %), Post-Traumatic Stress Disorder (6.6 %), and Anxiety Disorders (10.7 %), with suicide attempts reported in 16.4 % of cases. The mean score on the Hamilton Depression Rating Scale for our patients was 10.81 ± 3.27, on the Hamilton Anxiety Rating Scale was 16.33 ± 5.54, and on the Ducher Suicide Risk Scale was 0.82 ± 1.33. ConclusionThe occurrence of postoperative anxio-depressive disorders, traumatic symptoms, and suicidal behavior is associated with the following factors: male sex, personal history of depression, family history of psychiatric disorders, quality of diagnostic disclosure, postoperative sleep disturbances, postoperative panic attacks, psychological support, and socio-professional reintegration.

An evaluation of the efficacy and side effects of a single dose of ketamine in major depressive disorder.

This study aims to provide a comprehensive overview of the antidepressant and antisuicidal efficacy of ketamine in patients with unipolar depression, with a focus on the clinical evidence and safety profile. In our study, the data of 120 major depressive disorder patients who received single-dose ketamine infusion therapy were evaluated retrospectively, with Montgomery-Asberg Depression Rating Scale (MADRS) applied by the clinician before treatment and at the 4th and 24th hours after treatment and side effects at 4 and 24hours after treatment. There was a statistically significant difference between MADRS and MADRS-Suicide scores of all participants before the ketamine infusion (0th hour) and at the 4th and 24th hours after the ketamine infusion. Also, male and female, RAT(+) and RAT(-), and SA(+) and SA(-) participants have statistically significant differences on all three times for both MADRS and MADRS-S scores. The findings of this study are in line with those from previous research that demonstrated the rapid and robust antidepressant effects of ketamine, even in individuals with severe, treatment-resistant depression. Moreover, the observed reduction in suicidal ideation is particularly noteworthy, given the critical need for interventions that can provide rapid relief in acute suicidal crises. Key message What is already known on this topic - Ketamine is known for its rapid antidepressant and antisuicidal effects in treatment-resistant major depressive disorder, demonstrating significant symptom relief within hours of administration. What this study adds - This study provides additional evidence supporting ketamine's rapid efficacy in reducing depressive symptoms and suicidal ideation, highlighting statistically significant improvements observed at 4 and 24hours post-treatment. How this study might affect research, practice, or policy - The findings may encourage broader clinical adoption of ketamine for acute depressive episodes and suicidality, emphasizing the need for controlled medical settings to manage potential side effects, and could influence future research on optimizing dosing protocols and long-term safety.

Suicidal Ideation, Psychological Distress and Depression in Medical Students of Pakistan: Surviving or Thriving

&amp;lt;i&amp;gt;Background&amp;lt;/i&amp;gt;: In recent years, psychological stress has lead to increase in suicide cases readily among medical students of many countries. This study aims determine the prevalence of psychological stress, major depressive disorder, and suicidal ideation in Bachelor of Medicine and Bachelor of Surgery (MBBS) students of a government setup medical university in Pakistan. &amp;lt;i&amp;gt;Methods&amp;lt;/i&amp;gt;: The data was gathered using a valid questionnaire containing 10 items Kessler psychological distress scale. The scale consists of the severity of the psychological distress from well, mild, moderate, and severe. Physical health questionnaire 2(PHQ2) was used for identifying the students with major depressive illness. Suicidal ideation was assessed using item no. 9 from PHQ9 questionnaire. &amp;lt;i&amp;gt;Results&amp;lt;/i&amp;gt;: The overall prevalence of suicidal ideation, distress and major depression among 353 students of MBBS was 22.9%, 63.1%, 27.8% respectively. The students with major depression and moderate/severe distress are more probable to think about suicide. Moreover, Students who choose medicine under the family influence are more likely to have suicidal ideation. Besides this, we found that particularly females experience higher psychological distress as compared to males. &amp;lt;i&amp;gt;Conclusion&amp;lt;/i&amp;gt;: In the overall study, it is identified that suicidal ideation is strongly correlated to depression and distress. However, controlling these factors at an early stage can prevent the suicidal thoughts, which inevitably can reduce the suicide attempts not only in medical students but could also be valuable for students of different fields.