Suicide Group Research Articles

The Relationship Between Attention and Suicidal Ideation Among Patients With Adult-Onset Chronic Schizophrenia.

Patients with chronic schizophrenia (SZ) have a high risk of suicide, and their cognition function is impaired. We aimed to explore the relationship between attention and suicidal ideation among patients with adult-onset chronic SZ. A total of 416 patients with adult-onset chronic SZ were enrolled in this study. We divided patients into suicidal ideation group and non-suicidal ideation group according to the evaluation results of the Beck Scale for Suicide Ideation. Psychotic symptoms were measured by Positive and Negative Syndrome Scale (PANSS), and cognitive function was measured by Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). Insomnia symptoms were measured by Insomnia Severity Index (ISI). Age was significantly different (44.28±10.58 vs. 48.46±12.23, t=10.64, p=0.001) between the two groups, and the patients with suicidal ideation were younger than patients without suicidal ideation. The positive symptom scores of the PANSS, the scores of ISI, and attention scores of RBANS were higher in patients with suicidal ideation than patients without suicidal ideation (17.30±5.67 vs. 15.58±4.90, t=9.633, p=0.002; 3.00 [1.00-6.00] vs. 2.00 [1.00-3.50], Z=-2.048, p=0.041; 81.80±14.99 vs. 76.91±13.88, t=10.101, p=0.002). In the logistic regression analysis, age (odds ratio [OR], 0.973; 95% confidence interval [95%CI], [0.955-0.992]; p=0.005), positive symptom scores of PANSS (OR, 1.063; 95%CI, [1.019-1.109]; p=0.005), ISI scores (OR, 1.098; 95%CI, [1.037-1.163]; p=0.001), and attention scores of RBANS (OR, 1.029; 95%CI, [1.013-1.047]; p=0.001) were independently associated with the occurrence of suicidal ideation among patients with adult-onset chronic SZ. High attention scores of RBANS were a risk factor for suicidal ideation among patients with adult-onset chronic SZ.

Suicidal Behavior and Personality Group Affiliation: Approaches and Research Directions

Introduction. As it follows from a number of scientific works, not only suicide rates, but also their motives and ways of committing suicide vary widely in different countries, strata of society and strata of the population. In recent decades, research on this issue has become interdisciplinary and cross-cultural. Suicidal behavior is increasingly considered in the context of the suicidal person’s belonging to a certain social group or cultural community. Objective. To analyze the impact of an individual’s membership in a large social group or cultural community on suicidal behavior. The main directions of suicidal behavior research. In the vast array of theoretical and research works the following directions of suicidal behavior study can be distinguished: existential, clinical, socio-demographic, socio-cultural and socio-psychological. Starting from E. Durkheim’s sociological etude “Suicide”, the group affiliation of an individual is considered as a leading factor of suicidal behavior. However, the sociological approach appears limited because its proponents place excessive emphasis on demographic variables rather than on the psychological significance of suicide and the values of the individual prone to suicidal behavior. A. Adler’s socio-psychological conceptualization of suicide is partly responsible for overcoming these limitations. Adler’s socio-psychological concept of suicide, which takes into account not only demographic indicators, but also how suicides perceive, evaluate and experience their own group affiliation and the values of their social group. According to A. Adler, the predictors of suicide are a sense of community (belonging) and social interests of the individual. Sense of community and group belonging as a factor of suicidal behavior. Comparison of studies conducted in three countries (Russia / USSR, Japan and the USA) allows us to identify two socio-psychological factors of suicidal behavior: 1) negative attitude to one’s own group or cultural identity; 2) hypertrophy of the sense of community and belonging, leading to a decrease in the value of one’s own personality and individual life. Discussion. As modern cross-cultural studies show, suicidal behavior can be observed both at the deficit of the sense of community and group belonging and at the high level of development of this sense. This is conditioned, on the one hand, by the attitude of a suicide victim to his/her social group and cultural identity, and, on the other hand, by the historically formed attitude of society to suicide.

Interaction Effect of Childhood Abuse History and Suicidality on 12-Month Antidepressant Response in Patients With Depressive Disorder.

We aimed to identify the individual and interactive effects of childhood abuse and suicidal ideation on antidepressant treatment response in 12 months. In this prospective research, 1,262 depressive patients were asked about their childhood abuse history, suicidal ideation, and other clinical characteristics and socio-demographic features at baseline, and 1,015 of them were followed during 1 year of stepwise pharmacotherapy. The individual and interactive relationships of the childhood abuse history and suicidal ideation on 12-month antidepressant non-remission were explored by logistic regression with relevant covariates. Having a childhood abuse history and higher suicidal ideation significantly predicted a non-remission state in 12 months respectively. The interaction term of childhood abuse and suicidal ideation was also significantly related to a non-remission state at 12 months. To be specific, in the low suicidal ideation group, depressive patients with a childhood abuse history were more likely to be in a non-remission state after 12 months of medication. In the high suicidal ideation group, however, childhood abuse history was not significantly associated with the non-remission state at 12 months. The childhood abuse history and the level of suicidal ideation are informative factors predicting the long-term results of antidepressant treatment, especially when they are combined. Clinicians may consider antidepressants with a higher affinity for patients with childhood abuse history even if they don't have suicidal ideation. The cognitive intervention for suicidal ideation might be helpful in addition to pharmacological treatment.

Path to Suicidality in Korean Adolescents: Mediating Role of Self-Esteem, Somatic Symptoms, and Self-Harm Amid Depressive Symptoms

This study explored the relationship between depressive symptoms and suicidality among community-dwelling adolescents aged 10–18 years, examining whether self-esteem, somatic symptoms, and self-harm mediate this relationship. Utilizing a pre-existing dataset from a nationwide adolescent mental health survey conducted in Korea in 2021, data were collected using several standardized self-administered instruments: the Korean version of Rosenberg’s self-esteem scale, Korean Children’s Somatization Inventory, Korean version of the Self-Harm Inventory, Mental Health Screening for Depressive Disorders, and Mental Health Screening for Suicide Risk. A path model was constructed and validated, followed by path analysis to assess the effects. Data from 6689 adolescents, including 5937 students and 752 out-of-school adolescents, revealed that 18.7% were in the suicidality group, 11.8% experienced depressive symptoms, 57.9% exhibited somatic symptoms, and 27.4% engaged in self-harm. Depressive symptoms had a positive direct effect on suicidality (β = 0.166, p < 0.001, 95% confidence interval = 0.159–0.172). Bootstrapping tests showed a statistically significant indirect effect of self-esteem, somatic symptoms, and self-harm on the relationship between depressive symptoms and suicidality (β = 0.021, 95% confidence interval = 0.013–0.029). Our findings suggest that self-esteem, somatic symptoms, and self-harm mediate the relationship between depressive symptoms and suicidality, and comprehensive mental health management strategies addressing these factors are recommended.

The resilience mediation effect on the relationship of suicide risk and psychological pain in nursing students: Structural equation modelling.

INTRODUCTION: Nursing students are a high-risk group for suicide. Psychiatric nurses should investigate risk factors for suicide. The aim of this study was to examine the resilience mediation effect in the relationship of suicide risk and psychological pain in nursing students. This cross-sectional study was conducted between March and May 2021 with 619 students in the Akdeniz University Faculty of Nursing. A Descriptive Information Form, the Suicide Probability Scale, the Psychache Scale and the Brief Resilience Scale were used to collect data. The structural equation model approach was used to examine the resilience mediating effect on the relation between suicide risk and psychological pain, and Path Analysis was performed. The reporting of the study was conducted according to STROBE. A semi-mediatory effect of resilience was found between psychological pain and the risk of suicide, and the effect size was determined to be broad (0.57). Resilience can be considered as a protective factor for suicide prevention in psychiatric nursing practices. Resilience has an effect on the relationship between psychological pain and suicide risk. The results of this study may guide psychiatric nursing practices in reducing and preventing suicide risk.

The relationship between bereavement-related guilt and suicide ideation in Turkish bereaved adults

This study investigates risk factors for suicidal ideation among Turkish bereaved adults, focusing on bereavement-related guilt. Utilizing the Prolonged Grief Scale, Bereavement Guilt Scale, and Beck Depression Inventory’s suicide item, 570 bereaved participants were assessed. Suicidal ideation prevalence was found to be 20.2%. Higher rates of low income, single status, and unnatural death, as well as younger ages of the bereaved and deceased, were observed in the suicidal ideation group. Additionally, significantly elevated scores on the Prolonged Grief Scale and Bereavement Guilt Scale subscales were found in this group. After controlling for other risk factors, scores for survivor guilt and perceived responsibility for the death significantly increased the likelihood of belonging to the suicidal ideation group. These findings underscore the critical role of addressing feelings of guilt in psychological interventions aimed at mitigating suicidal ideation among bereaved individuals.

Neuroimaging and natural language processing-based classification of suicidal thoughts in major depressive disorder

Suicide is a growing public health problem around the world. The most important risk factor for suicide is underlying psychiatric illness, especially depression. Detailed classification of suicide in patients with depression can greatly enhance personalized suicide control efforts. This study used unstructured psychiatric charts and brain magnetic resonance imaging (MRI) records from a psychiatric outpatient clinic to develop a machine learning-based suicidal thought classification model. The study included 152 patients with new depressive episodes for development and 58 patients from a geographically different hospital for validation. We developed an eXtreme Gradient Boosting (XGBoost)-based classification models according to the combined types of data: independent components-map weightings from brain T1-weighted MRI and topic probabilities from clinical notes. Specifically, we used 5 psychiatric symptom topics and 5 brain networks for models. Anxiety and somatic symptoms topics were significantly more common in the suicidal group, and there were group differences in the default mode and cortical midline networks. The clinical symptoms plus structural brain patterns model had the highest area under the receiver operating characteristic curve (0.794) versus the clinical notes only and brain MRI only models (0.748 and 0.738, respectively). The results were consistent across performance metrics and external validation. Our findings suggest that focusing on personalized neuroimaging and natural language processing variables improves evaluation of suicidal thoughts.

Suicide contagion and psychosocial risks among Nepali youth through a near-hanging case study.

The phenomenon of suicide contagion: some individuals, especially vulnerable young people, exhibit increased susceptibility to suicidal ideation when exposed to the suicide of other people. Significant research suggests that exposure to media portrayals, suicide groups and peer suicides may lead to suicide contagion. Prevalent psychosocial and cultural factors in Nepal such as interpersonal conflict, domestic violence, gender inequity and social exclusion probably contribute to suicidal behaviour. This case study investigates a high school student in a rural mountainous community in Nepal, who attempted suicide by hanging following his girlfriend's suicide, and demonstrates how peer suicide exposure prompts imitative behaviour in a vulnerable young person and confirms suicide grief as an underrepresented risk factor. Prompt, supportive interventions for high-risk grievers and societal prevention strategies tailored to adolescents are essential to curb imitative deaths.

Development and validation of a nomogram for suicide attempts in patients with first-episode drug-naïve major depressive disorder.

The risk of suicide can be decreased by accurately identifying high-risk suicide groups and implementing the right interventions. The aim of this study was to develop a nomogram for suicide attempts (SA) in patients with first-episode drug-naïve (FEDN) major depressive disorder (MDD). This study undertook a cross-sectional analysis of 1,718 patients diagnosed with FEDN MDD, providing comprehensive clinical data from September 2016 to December 2018. Data on anthropometric and sociodemographic factors were gathered, and the severity of depression and anxiety was evaluated using the 17-item Hamilton Depression Scale (HAMD-17) and the Hamilton Anxiety Scale (HAMA), respectively. Additionally, thyroid hormone levels, lipid profile parameters, and fasting blood glucose (FBG) were measured. Suicide attempt (SA) history was verified based on an amalgamation of medical records, patient interviews, and family interviews. Participants were randomly divided into a training group (70%, n = 1,204) and a validation group (30%, n = 514). In the training group, LASSO analysis and multivariate regression were used to identify variables associated with SA. A nomogram was then constructed using the identified risk factors to estimate the likelihood of SA within the training group. To assess the accuracy, the area under the receiver operating characteristic curve (AUC) was utilized, and calibration plots were employed to evaluate calibration. Additionally, decision curve analysis (DCA) was performed to assess the precision of the model. Finally, internal validation was carried out using the validation group. A practical nomogram has been successfully constructed, incorporating HAMD, HAMA, thyroid stimulating hormone (TSH), thyroid peroxidase antibody (TPOAb), and systolic blood pressure (SBP) parameters, to estimate the probability of SA in Chinese patients diagnosed with FEDN MDD. The pooled area under the ROC for SA risk in both the training and validation groups was found to be 0.802 (95% CI: 0.771 to 0.832) and 0.821 (95% CI: 0.774 to 0.868), respectively. Calibration analysis revealed a satisfactory correlation between the nomogram probabilities and the actual observed probabilities. The clinical applicability of the nomogram was confirmed through decision curve analysis. To enhance accessibility for clinicians and researchers, an online version of the nomogram can be accessed at https://doctorjunjunliu.shinyapps.io/dynnomapp/. We constructed and validated a nomogram for the early detection of FEDN MDD patients with a high risk of SA, thereby contributing to the implementation of effective suicide prevention programs.

Psychosocial Factors Distinguishing Men Who Have Attempted Suicide From Men With Suicidal Ideation and Non-suicidal Men: Findings From a Global Survey

This study addresses our limited understanding of male suicide risk psychology. 2763 men participated in a global survey examining associations between suicidal history and measures of emotions, psychological pain, feelings towards self, and interpersonal connections. Results from multinomial logistic regression analyses indicated that higher levels of loneliness and mental health diagnosis increased the odds of being in the suicidal ideation group compared to controls. A mental health diagnosis and being non-heterosexual increased the odds of being in the suicide attempt group compared to controls. Higher levels of financial strain, mental health diagnosis, being non-heterosexual, having more restrictive attitudes to emotional expression, and lower levels of mattering to others, increased the odds of suicide attempt group membership compared to suicidal ideation.

Specific effects of cumulative childhood trauma on suicidality among youths

BackgroundSuicidality was very high among individuals who suffered from childhood trauma. The distribution of cumulative childhood trauma among youths remains unclear, as well as the specific effects of cumulative childhood trauma on suicidality. This study attempted to explore the distribution of cumulative childhood trauma and examine the specific effects of cumulative childhood trauma on suicidality. MethodsA cross-sectional design was employed in this study, with 117,769 college students recruited from 63 universities in Jilin Province, China. All variables were measured by corresponding self-report questionnaires. The Venn diagram was used to represent the distribution of single and cumulative childhood trauma. ANOVA and chi-square tests were conducted to identify the high-risk suicide groups. Multiple linear regression analysis was performed to examine risk factors for suicidality for overlapping subtypes. Results27,671 (23.5%) participants reported suffering from childhood trauma, of which 49.5% were male (Mage = 19.59, SD = 1.76). The “physical neglect” group accounted for the largest proportion (31.5%). Suicidality was the highest in the “overlap of childhood neglect, emotional abuse, and physical abuse” group (2.0%). Depression, obsessive-compulsive disorder, and post-traumatic stress disorder were common risk factors for suicidality. LimitationsThis study was limited by cross-sectional studies and self-report bias. ConclusionsThe childhood trauma subtype group with the largest proportion was not necessarily the highest suicidality. Both the largest group and the highest-risk suicide group require special attention to their respective risk factors.

Can neurocognition, brain neurotrophic factor, triglyceride, and total cholesterol predict suicidal ideation in first-episode Han Chinese patients with schizophrenia?

Previous studies have suggested that the suicide rate of patients with schizophrenia is high. This study investigates factors influencing suicidal ideation in first-episode schizophrenia patients, focusing on cognitive function, brain-derived neurotrophic factor (BDNF), triglyceride (TG), and total cholesterol (TC) in patients with first-episode schizophrenia. A total of 123 patients with first-episode schizophrenia and 38 healthy controls were included in the study. The patients were divided into suicidal and nonsuicidal ideation groups based on the Beck Scale for Suicidal Ideation, and they were assessed with Positive and Negative Syndrome Scale(PANSS). Cognitive function was assessed using the Chinese version of the MATRICS consensus cognitive battery (MCCB) and the serum BDNF, TG, and TC were detected. The main statistical methods include t-test, χ2 test, multivariate logistic regression analysis, receiver operating characteristic (ROC) curve analysis, and the DeLong test. 26.02% of patients exhibited suicidal ideation. Higher PANSS and TC levels were risk factors, while higher MCCB scores and BDNF levels were protective factors. ROC analysis indicated AUCs of 0.630, 0.724, and 0.762 for serum BDNF, PANSS, and MCCB, respectively, with a combined AUC of 0.870. Serum BDNF level, PANSS score, and MCCB score can be used as auxiliary predictors of suicidal ideation in schizophrenic patients. Combining these three indicators can effectively predict suicidal ideation in schizophrenic patients.

Prospective mortality in patients with non-fatal deliberate self-harm: a national cohort study

IntroductionDeliberate self-harm (DSH) is a strong indicator of psychological distress and constitutes a significant risk factor for subsequent mortalities.ObjectivesIn this study we want to gain insights into cause-specific mortalities in self-harming patients and to disentangle important factors differentiating the risks so that to inform follow-up care and mortality prevention.MethodsRetrospective data from nationwide registries were interlinked to follow all patients presenting to specialist healthcare with non-fatal DSH from January 2008 through December 2018. Data on cause of death, personal socioeconomic status, clinical features of DSH and other medical covariates were retrieved. The Fine and Gray competing risks model was used to identify significant factors impacting subsequent mortality risk by specific causes of death in the cohort.ResultsThe cohort of 43153 DSH patients comprised 24286 females and 18867 males, with 45.3% being 10-34 years old, 38.1% being 35-64 years old and 16.6% above 65 years old at index DSH episode. Of these patients, 7041 died during the follow-up period, including 2290 within the first 1-year, corresponding to a mortality rate of 31.9 per 1000 person-years in the follow-up period and 54.9 per 1000 person-years in the first year. Common causes of death included suicide (n=911), other external causes (n=1020), cancer (n=896), cardiovascular diseases (n=1523), respiratory disease (n=787) and mental and substance misuse disorders (n=463), but the causes of death varied greatly by age groups and other factors. The risk of dying by suicide was highly associated with middle-age, male gender, tertiary education, psychiatric history, and DSH by injury, clear intent of self-harm, comorbid affective or personality disorder, referral to psychiatric treatmen, as well as DSH repetition during the period of follow-up. Significant risk factors for death by other external causes included male gender, old or middle age, single marital status, lowest quartile income, history of psychiatric treatment, and DSH by injury and comorbid substance misuse. For death by natural causes, the relative risk was highest among the elderly and the middle-aged, with other significant risk factors including male gender, single marital status, low education, lowest quartile income, and comorbid substance misuse. Attendance in psychiatric treatment after DSH appeared to be beneficial reducing the risk for mortality by suicide, other external causes and natural causes as well.ConclusionsPatients with DSH represent a high-risk group for suicide, other external and natural cause mortalities. Mental healthcare is essential in follow-up care and personalized care should take into account patients´ socio-demographic background and clinical features of self-harm.Disclosure of InterestNone Declared

Sleep disturbance and suicidal ideation among youth with depression

BackgroundSleep disturbance may exacerbate the risk of suicide among youth with depression, but whether this association is independent of psychopathology requires further study. MethodsThis cross-sectional study included 576 youths (13–25 years old) recruited from January 2022 to May 2023. The patients were first divided into two groups by the presence of suicidal ideation according to the Columbia-Suicide Severity Scale (C-SSRS). Sleep quality was assessed by the Athens Insomnia Scale (AIS) and mental health with the Hamilton Depression Rating Scale (HAMD) and Hamilton Anxiety Rating Scale (HAMA). Logistic regression was conducted to analyze the association between sleep disturbance and suicidal ideation, adjusted for depressive symptoms severity. ResultsThe suicidal ideation group exhibited more severe sleep disturbances, anxiety symptoms, and depressive symptoms than the non-suicidal ideation group. Pearson correlation showed that sleep disturbance (AIS) was significantly correlated with the severity of anxiety symptoms, depressive symptoms, and suicidal ideation. Logistic regression analysis revealed that the AIS factor “daytime dysfunction” (β = 0.145; OR = 1.156, 95 % CI: 1.02, 1.309; p = 0.023) was significantly associated with suicidal ideation after adjusting for demographic characteristics and depressive symptoms severity. LimitationsDue to the cross-sectional nature of the data, no causal inference can be made regarding the observed associations between sleep disturbance and suicidal ideation. ConclusionSleep disturbance, particularly in the realm of daytime dysfunction, is associated with increased suicidal ideation among depressed youth. Clinicians need to assess and manage sleep disturbance in the context of suicidal ideation for young depression patients.

Features of the Dermatoglyphic Foot Pattern in Suicider Males

Since suicide is one of the most common types of violent death among people of working age (including military personnel) and children, it is necessary to conduct in-depth studies of the structure of skin patterns in a group of people with completed suicide in order to develop methods of active suicide prevention. In order to determine the propensity to commit suicide, the dermatoglyphs of the distal phalanges and metacarpal pads of the toes of 138 male subjects aged 18 to 59 years who committed suicide and 100 control subjects aged 18 to 59 years were studied. The type of pattern (arc, tibial or fibular loop, curl, complex pattern), delta and comb counts were determined. It was found that the suicide group differs from the control group mainly in a higher number of interruptions (ending X) of the main plantar lines A, B and C; an increase in the frequency of arc patterns on most toes of both feet with a degree of reliability; a decrease in the frequency of curls on the third toe of the left foot to 44.5±11.2 (p<0.001) and an increase in the frequency of this pattern on the second toes of both feet; an increase in the value of the comb count in the area of the tibial edge of the foot, with a decrease in the values near the fibular edge of the foot.

Suicide among national university graduate students in Japan from 2002 to 2021.

Graduate students are exposed to various types of stress. Thus, they are prone to mental health problems, and the most devastating result is suicide. The aim of this paper is to reveal the status of suicide among graduate students in Japan for 20 years. We analyzed cumulative data on suicide among national university graduate students from annual surveys on causes of non-graduation in Japan for the 2002-2003 through 2021-2022 academic years. We asked all national universities with graduate schools to complete the surveys, and the participation rate was 91.1%. The total number of students in the surveys was 2,383,858, and the number of deaths by suicide was 347 (292 males, 55 females). Chi-squared test results showed significantly higher suicide mortality rates for the following groups: male (p < 0.001), temporary leave (p < 0.001), repeating the same year (p = 0.006), master's level (p = 0.005), and majoring in engineering (p < 0.001). Psychiatric diagnoses were detected among 44 students (12.7%). The largest distribution (27 cases) of International Classification of Diseases, Tenth Revision (ICD-10) codes among those whose diagnoses were evident was F3, mood disorders. Estimated motives for suicide were reported for only 36 students (10.4%), of which the most prevalent was job search failure. The most prevalent suicide method was hanging (151 cases, 43.5%). Our findings indicate that student support facilities should recognize higher-risk groups for suicide among graduate students. Our study adds suggestions for suicide prevention on campus during future pandemics.

Defeat, entrapment and suicidal ideation in a Turkish community sample of young adults: an examination of the Integrated Motivational-Volitional (IMV) model of suicidal behaviour

The present study examines the relationships between defeat, entrapment, suicidal ideation, thwarted belongingness, and perceived burdensomeness through the Integrated Motivational-Volitional (IMV) Model of Suicidal Behaviour in a sample of Turkish young adults. The sample consisted of 451 individuals (72.5% females, M age= 25.20). The correlation analyses revealed significant relationships between defeat, entrapment, suicidal ideation, thwarted belongingness, perceived burdensomeness in the expected directions. Mediation and moderation analyses partly confirmed the assumptions of the motivational phase of the IMV model; entrapment played a mediating role between defeat and suicidal ideation, and thwarted belongingness (but not perceived burdensomeness) had a moderating role in the pathway between entrapment and suicidal ideation. These findings add a new dimension to the understanding of suicide risk and potential protective factors through the IMV model, which was tested for the first time in the Turkish population. It is anticipated that this study will contribute to suicide prevention intervention strategies, especially for young adults, at-risk group for suicide in Turkey.

Histological Changes in Adrenal Glands in Suicidal and Sudden Death Cases: A Postmortem Study.

Introduction Various studies have linked suicidal behavior, stress, affective disorders, and dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis resulting from chronic stress. Chronic stress has been shown to cause enlargement of the adrenal glands, altering their function and potentially leading to suicidal behaviors in individuals with depression. This study aimed to compare the histological changes in the adrenal glands of individuals who died by suicide with those who experienced sudden death. Suicide victims are exposed to chronic stress, while individuals with sudden deaths face acute stress related to the act of dying. Methods This analytical study, approved by the Institutional Ethics Committee (IEC), was conducted in the Department of Forensic Medicine and Toxicology at Gandhi Medical College, Bhopal. The study included 100 confirmed cases of suicide, irrespective of gender, aged 15-60 years, with notable autopsy findings, relevant history, no signs of decomposition, and varying survival periods (including immediate deaths within 24 hours). Additionally, 20 controls were selected, involving individuals who died suddenly from causes other than suicide within 24 hours of the incident. Informed consent was obtained using a prescribed proforma from relatives and the police. Histological examination slides of the adrenals were prepared and analyzed. Data were collected and statistically analyzed using GraphPad software and Epi Info 7. Results Capsular hemorrhage was observed in 98% of suicide cases and 40% of controls. Nodulation was present in 48% of suicidal cases and 20% of controls. Zonal extension of zona fasciculata was specific to chronic stress in suicidal cases. In 25% of suicidal cases, a prominent extension of the medulla was noted. Irregular thinning of zona glomerulosa with shrunken cells and increased nuclear density in 88% of cases were considered specific to chronic stress conditions and suicide, not observed in controls. Lipid depletion was observed in all suicidal cases, with diffuse depletion in 47% and focal depletion in 53% of cases. In contrast, 45% of those exposed to the acute stress of dying showed focal depletion, with none exhibiting diffuse depletion. Suicidal cases displayed dilated prominent sinusoids in all three zones and the adrenal medulla (98-99%), absent in controls. Adrenal hemorrhage and necrosis were specific to chronic stress conditions, with 7%, 8%, 32%, and 16% of cases showing hemorrhage in all three zones and adrenal medulla, respectively, and none in controls. Conclusion Histological changes observed in acute stress conditions included focal lipid depletion, capsular hemorrhage, nodular hyperplasia, and hemorrhage and necrosis with edema. However, the proportion and severity of these changes were lower than those observed in the suicidal group, suggesting that these findings may be considered non-specific for differentiating between acute and chronic stress.

Repetitive negative thinking as a unique transdiagnostic risk factor for suicidal ideation

Repetitive negative thinking (RNT) is a transdiagnostic symptom observed across mood and anxiety disorders and is characterized by frequent, distressing thoughts that are perceived as uncontrollable. Specific forms of RNT have been linked to increased suicide risk. However, most work examining links between RNT and suicide has been conducted within specific disorders and subtypes of RNT (e.g., rumination in individuals with depression). The present study aimed to investigate associations between transdiagnostic RNT and suicidal ideation. We hypothesized RNT would be associated with suicide risk beyond disorder-specific clinical symptoms. Fifty-four participants with mood, anxiety, and/or traumatic stress disorders completed an interview assessing suicidal risk (Columbia-Suicide Severity Rating Scale (C-SSRS)) and self-report questionnaires assessing transdiagnostic RNT, depression, and anxiety. Based on C-SSRS, we divided participants into high or low suicide risk groups. We analyzed the relationship between suicidal risk group and RNT and found that RNT was uniquely associated with suicidal risk group, controlling for depression and anxiety severity. Our results suggest including assessments of RNT may have clinical utility for understanding the degree of suicide risk in individuals and point to the potential utility of including clinical interventions to target this symptom for those at high risk of suicide.

Suicidal ideation and attempt among young people living in gosiwons in South Korea.

Young people living in gosiwons could be at high risk for suicide owing to inadequate living conditions and the social stigma towards them. However, this topic has not received adequate academic attention. Gosiwon is a type of small residence consisting of several tiny rooms densely packed together and usually does not meet minimum housing standards. However, gosiwons are favored by low-income groups, especially young people, because they are cheaper than other residences. This study aimed to examine the factors that increase the risk of suicidal ideation and attempt among young people living in gosiwons. A sample of 300 young people aged 19-34 years living in gosiwons for over 6 months was analyzed. A set of multinomial logistic regression was conducted to examine the factors that differentiate the suicidal ideation and attempt group from the no-suicidal risk group. Approximately 30% of the study participants experienced suicidal ideation or attempted suicide. Among several risk factors, social exclusion and depressive symptoms distinguished the group with suicidal ideation from the no-risk group. Depressive symptoms were the only factor that differentiated the group with suicide attempts history from the no-risk group. The results emphasize the need to focus on social exclusion and depressive symptoms among young people living in poor housing conditions. Interventions to address social exclusion and depressive symptoms may help prevent suicide risk among young people exposed to housing exclusion.