Longitudinal machine learning prediction of non-suicidal self-injury among Chinese adolescents: A prospective multicenter Cohort study.

Amongst the correctional worker population, a wide range of demographic characteristics shape mental health outcomes, organizational stigma, and treatment-seeking, including gender and/or sex differences. Yet, considerations of the relationship between gender and especially sex and mental health in correctional systems internationally remain understudied and have not been investigated on a national scale. In the current national study, we quantitatively analyze Canadian provincial and territorial correctional workers' (n = 3,740) sex correlates with other sociodemographic variables, and examine the prevalence of potentially psychologically traumatic events (PPTEs), correctional-specific PPTEs, occupational stressors, suicide-related behaviour (ideation, plan, and attempt), and several mental health disorders. Survey findings indicate statistically significant sex differences in exposure to all types of PPTEs, with the exception of captivity and life-threatening illness or injury. Males reported higher odds of being exposed to all types of PPTEs than females, with the exception of sexual assault and other unwanted or uncomfortable sexual experiences, which females had higher odds of experiencing. Statistically significant sex differences were also evident in exposure to all types of correctional-specific PPTEs, except for instances where a person died while under their supervision. Other significant relationships found are discussed and reiterate the necessity of incorporating concerns for gender and/or sex equality and balance in correctional settings into mental health training regimen, as well as highlight several areas for future research.

Suicide is the third leading cause of death among adolescents and young adults (aged 10-24). Among sexual minorities, various forms of bullying victimization are strongly associated with suicide. This review aimed to explore the relationship between school bullying and suicide-related behaviors among sexual minority adolescents. We searched PubMed, Web of Science, EMBASE, Cochrane, Scopus, APA PsycInfo, and ProQuest databases from inception to June 16, 2025. A meta-analysis was performed to combine odds ratios (ORs) with 95% CIs. The heterogeneity of the studies was assessed using the I2 statistic. Publication bias was evaluated using a funnel plot analysis and Egger's test. A meta-regression model was developed to examine the associations between school bullying and suicide-related behaviors. This systematic review and meta-analysis included 11 studies, involving a sample of 113,039 sexual minority students. The results revealed that, among sexual minorities, bullying was positively associated with suicidal ideation (OR 2.36, 95% CI 1.65, 3.36, p < .001) and suicide attempts (OR 2.30, 95% CI 1.71, 3.11, p < .001) but was not significantly associated with self-harm (OR 1.56, 95% CI 0.82, 2.96, p = .06). Sexual minorities who reported being bullied in schools are at a higher risk of suicidal ideation, suicide attempts, and suicide plan. This finding suggests that, to reduce suicide risk in sexual minority students, it is crucial to focus on and prevent school bullying.

Autistic adults have increased risks of trauma, suicide, and poor mental health compared to non-autistic adults, with 1 in 4 autistic adults attempting suicide. We administered an anonymized, self-report survey to 424 autistic and 345 non-autistic adults through a convenience sampling framework. Binomial logistic regression models identified whether trauma and autism diagnosis were related to (i) self-harm, (ii) suicide attempts, (iii) suicide plans, (iv) a mental health condition that impacts daily life, and (v) substance use to cope. Heatmaps were generated to identify traumas that frequently co-occur with psychological distress and SRB. After accounting for trauma and demographic differences, autism remained a significant predictor of all outcomes, except whether individuals used substances to cope (OR: 0.78, 95% CI: 0.54-1.12, p = 0.18). Autistic people were more likely to report self-harm (OR: 2.71, 95% CI: 1.85-4.00, p < 0.01), suicide attempts (OR: 2.45, 95% CI: 1.65-3.68, p < 0.01), suicide plans (OR: 2.00, 95% CI: 1.41-2.83, p < 0.01), and experiencing a mental health condition that impacts daily life (OR: 3.58, 95% CI: 2.42-5.33, p < 0.01) than non-autistic people. Among autistic people, childhood victimization co-occurred with a mental health condition that impacts daily life, self-harm, and suicide plans most frequently. This study provides evidence of complex relationships between autism, trauma, self-harm, suicide attempts, suicide plans, and a mental health condition that impacts daily life. Focusing on the prevention of trauma, coping strategies, and recovery from traumatic events through safeguarding and support may be critical tools for suicide prevention among autistic people.

ABSTRACT This study examines the relationship between workplace bullying and mental health outcomes among gay and bisexual (GB) male workers in Japan, based on the minority stress framework. Prior research has shown that lesbian, gay, bisexual, transgender, queer, and other populations with diverse sexual orientations are more vulnerable to mental health problems and suicide, yet few studies have focused specifically on workplace bullying as a distal stressor. Using an anonymous web-based survey conducted in 2020, data were collected from 1,202 employed GB men aged 20–69. Logistic regression analyses, including Firth’s penalized likelihood method for rare events, assessed associations between bullying and psychological distress, suicidal ideation, and suicide attempts, adjusting for sociodemographic, employment, and workplace factors. Results showed that 8.8% of respondents reported bullying due to sexual orientation. Bullying was significantly associated with higher odds of psychological distress, suicidal ideation, and suicide attempts. These associations remained significant after controlling for confounders. The findings indicate workplace bullying is not only linked to psychological distress but also extends to suicide-related behaviors. This highlights the urgent need for organizational interventions, legal protections, and inclusive workplace cultures in Japan. Future research should adopt longitudinal designs and address intersectionality to strengthen empirical evidence and policy relevance.

Profiles of suicide reasons and their associations with suicide-related behaviour in South Korea.

Long-term mental health disorders and suicidal behaviors linked to excessive vomiting during pregnancy: Evidence from the UK biobank.

ObjectivesTo examine state-level variation in mental health screening practices for high school athletes in the USA and evaluate associations between screening protocols and adolescent depression-related and suicide-related outcomes.DesignCross-sectional study of preparticipation examination (PPE) forms and Youth Risk Behaviour Surveillance System (YRBSS) data.SettingHigh school athletics across all 50 US states and the District of Columbia.Participants732 676 high school students who completed the 2021 YRBSS survey (grades 9–12).Primary and secondary outcome measuresPrevalence of depressive symptoms and suicide-related behaviours, measured using YRBSS items on sadness/hopelessness, suicide ideation, planning, attempts and suicide attempts resulting in injury. State-level PPE forms were reviewed for presence and depth of mental health screening, including Patient Health Questionnaire-4 (PHQ-4) and eating disorder (ED) risk questions.ResultsScreening practices varied widely, ranging from no mention of mental health in some states to required evaluations with formal referral protocols in others. Of 732 676 students, 503 861 (68.7%) reported feeling sad or hopeless, 608 416 (83.0%) seriously considered suicide and 64 072 (8.8%) attempted suicide in the past year. States with required screening protocols had higher reported rates of depressive symptoms (71.0% vs 68.7%, p<0.001) but lower suicide attempt rates (8.0% vs 8.8%, p<0.001) compared with states with no screening. Use of PHQ-4 and ED risk questions was associated with lower suicide attempt prevalence (8.4% vs 8.8%, p<0.001).ConclusionsHigh school athletes represent a vulnerable group in need of structured and standardised mental health screening. State-level screening policies were associated with lower suicide attempt rates, though causal inference is limited by the cross-sectional design. Standardised use of validated mental health tools may support early identification and intervention for at-risk adolescents.

Objectives The Basic Act on Suicide Prevention was enacted in 2006, and 2026 will mark the 20th anniversary of this act. To commemorate this milestone, a symposium titled "20th Anniversary of the Basic Act on Suicide Prevention: Understanding the Reality of Suicide" was held at the 83rd Annual Meeting of the Japanese Society of Public Health. The aim was to reflect on Japan's suicide prevention efforts to date through collaboration with experts.Methods: To accelerate suicide prevention efforts in Japan, we identified and organized the key challenges involved in understanding the reality of suicide.Results Considering the history of suicide prevention, we carefully reviewed the issues surrounding the Basic Act on Suicide Prevention and the Act on the Promotion of Research and Studies on Suicide. We conclude that revisions are necessary where appropriate. It is also important to incorporate measures for cultivating specialized professionals across various fields into the Basic Act on Suicide Prevention that will be responsible for suicide prevention in the next generation, as well as mechanisms that enable suicide-bereaved families to participate in policymaking. In terms of statistical issues, there has been a significant "apparent change" in the suicide statistics between 2021 and 2022 due to the revision of original data, which requires careful attention. There is an upward trend in deaths from external causes, including suicide and deaths from unknown causes, and it is necessary to analyze these trends carefully. In addition, municipalities can use police statistics to understand the realities of regional suicides. However, when analyzing municipal-level data, it is important to consider the underlying processes that lead to self-harm and suicide attempts, using regional suicide profiles as a reference. In addition, conducting independent surveys and research at the municipal level, separate from national statistics, is crucial for suicide prevention.Conclusion Suicide-related behavior is a complex issue influenced by various factors. It is essential to coordinate national measures with local initiatives. The following proposals are suggested to enhance future suicide prevention efforts:1. A review of the legal frameworks and establishment of support systems involving diverse stakeholders.2. Training of specialized personnel, including bereaved families, in the policymaking process.3. Conducting a thorough analysis of the statistical changes.4. Encouraging independent research and studies at the municipal level.By continuously updating our knowledge and fostering interdisciplinary discussions, we aim to ensure that these efforts are effectively implemented.

Adolescent cannabis use is a substantial public health concern given its associations with adverse mental and physical health outcomes. Understanding how distinct use patterns are associated with medical care utilization in young adulthood is critical for prevention. To examine the association between patterns of adolescent cannabis use and medical care utilization for mental and physical health conditions in young adulthood. This population-based birth cohort study linked to population-wide administrative medical care databases was conducted in the Province of Québec, Canada. Participants included individuals recruited for the Québec Longitudinal Study of Child Development, followed up from birth (1997-1998) to 23 years of age (2021). Data were analyzed November 2023 to February 2025. Self-reported past 12-month cannabis use at ages 12, 13, 15, and 17 years. Medical care utilization for any mental disorder (including common mental disorders and substance-related disorders), suicide-related behaviors, and any physical health condition (including respiratory diseases, injuries and poisoning, and other physical diseases) between ages 18 and 23 years. Analyses were adjusted for 32 individual, family, and community-level confounders measured from birth to younger than 12 years of age using overlap weights. Data for 1591 individuals (818 female [51.4%]; mean [SD] age at first exposure assessment, 12.1 [0.3] years) were analyzed. Three distinct adolescent cannabis use patterns were identified via group-based trajectory modeling: nonuse (948 [59.6%]), late-onset use (318 [20.0%], initiating after age 15 years), and early-onset and frequent use (325 [20.4%], initiating before age 15 years). In fully adjusted analyses, individuals with early-onset and frequent use had significantly higher odds of medical care utilization for any mental disorder (odds ratio [OR], 1.51 [95% CI, 1.10-2.08]), common mental disorders (OR, 1.57 [95% CI, 1.12-2.21]), any physical health condition (OR, 1.86 [95% CI, 1.30-2.67]), injuries and poisoning (OR, 1.41 [1.05-1.89]), and other physical diseases (OR, 1.47 [95% CI, 1.08-1.98]), compared with individuals with no use. Individuals with late-onset use did not differ significantly from those with nonuse for mental health outcomes (OR, 1.13 [95% CI, 0.80-1.58]) but had higher odds of medical care utilization for any physical health condition (OR, 1.63 [95% CI, 1.16-2.28]). Findings of this birth cohort study indicated that early-onset and frequent cannabis use was associated with greater medical care utilization for both mental and physical health conditions in young adulthood. These findings support the relevance of delaying initiation and reducing intensity of cannabis use during adolescence.

Study ObjectivesSleep problems have been identified as a risk factor for suicidal thoughts and behaviors during adolescence, yet a lack of longitudinal mechanistic investigation into contributing factors (e.g. cognitive functioning) limits understanding of the temporality and specificity of this relationship. This study investigates the impact of sleep problems on subsequent reported suicide attempt, and whether risk-taking and decision-making moderate this relationship.MethodsThis analysis utilized data from waves 6 (14 years) and 7 (17 years) in the Millennium Cohort Study (MCS; n = 8524, female = 4369 [51.26 per cent]), a UK population-representative longitudinal study of youth born between 2000 and 2002. Self-reported sleep items assessed at 14 years were used to calculate total time in bed on school and non-school nights, social jetlag, sleep onset latency, and frequency of night awakenings. Self-reported attempting suicide was measured at 17 years. The Cambridge Gambling Task assessed risk-taking and decision-making at 14 years.ResultsShorter total time in bed on school days (OR = 0.88; 95% CI = 0.80 to 0.96; p = .004) and more frequent night awakenings (OR = 1.15; 95% CI = 1.07 to 1.23; p ≤ .001) were prospectively associated with subsequent reported suicide attempt, even when controlling for demographic and clinical covariates. Rational decision-making (OR = 2.12; 95% CI = 1.33 to 3.37; p = .002) moderated the association between night awakenings and attempted suicide.ConclusionsShorter total time in bed and more frequent night awakenings heightened suicide risk in adolescents, and this latter relationship was modified by rational decision-making. These results provide insight into the etiology of adolescent suicide behavior and highlight sleep deprivation and fragmentation as potential preventative targets for suicide attempts.Statement of SignificanceThe development of adolescents coincides with the emergence of sleep problems and suicide-related behavior. Nevertheless, the influence of poor sleep on prospective adolescent suicide risk and relevant contributing factors remains unclear. This is the first longitudinal study examining the interrelationships between sleep, risk-taking and decision-making, and adolescent suicide attempts. Suicide attempt history at 17 years was associated with more frequent night awakenings and shorter total time in bed on school days at 14 years, and rational decision-making moderated this former association. These findings can inform suicide preventative interventions, highlighting the relevance of assessing and treating sleep deprivation and fragmentation. Future prospective studies utilizing multiple data waves should further examine the moderating mechanisms on the relationship between poor sleep and suicide risk.

Research suggests that there may be an association between prescribed opioid use and suicide-related behaviours. This 15-year retrospective population-based cohort study examines the relationship between opioid use, self-harm and suicide. The study was based on the POPPY II study, a population-based cohort of 3 268 282 adults who initiated a prescription opioid between 1 July 2003 and 31 December 2018, in Australia. Prescription dispensing data were linked to hospitalisation, death and other data collections. Opioid use was defined as current opioid exposure, cumulative duration of exposure and estimated daily dose. Outcomes were self-harm hospitalisation and suicide mortality, categorised as overall and according to the method (opioid poisoning, non-opioid substance poisoning and other methods). Time-varying generalised estimating equations were used to assess the relationship with self-harm hospitalisation, and Cox proportional hazard models were used to assess the relationship with suicide mortality, controlling for known suicide-related risk factors. There were 49 215 self-harm hospitalisations at a crude rate of 262 per 100 000 person-years and 3087 suicide deaths at a crude rate of 16.5 per 100 000 person-years. Intentional opioid poisoning was the least common method for both self-harm hospitalisation and suicide. Following multivariable adjustment, current opioid exposure, longer cumulative duration and higher doses were significantly associated with a greater risk of opioid-related self-harm or suicide. In adjusted models, associations for other methods of self-harm and suicide were not as strong or consistent. Opioid poisoning was the least common method of self-harm and suicide. Despite this, for the minority of people prescribed high doses and/or a long duration of prescription opioids, there is an increased risk for opioid-related self-harm and suicide after controlling for known covariates. Suicide-related behaviours should be screened and monitored in people prescribed opioids, particularly among those on long-term and/or high-dose opioids.

Objective This study investigates the prevalent characteristics of suicidality in college students with borderline personality (BP) features. In addition, it explores the relationship between BP features and suicidality and analyzes related psychological mechanisms.Methods The study encompassed 6,854 college students from 12 universities in Southern China from October to December 2020. The subjects completed a general information questionnnaire, Personality Diagnostic Questionnaire 4+, ruminative responses scale, 10 items in the Connor-Davidson resilience scale, and an assessment for suicidality.Results Among all participants, subjects with BP features reported higher rates of suicidal ideation and suicidal attempt than those without BP features, and the differences were statistically significant (all p<0.05). Logistic regression analysis demonstrated that resilience served as a significant protective factor against both suicidal ideation and suicidal attempt in both females and males (all p<0.05). Higher borderline personality disorder (BPD) score emerged as risk factor for suicidal ideation and suicidal attempt in both females and males (all p<0.001). Symptom rumination was a risk factor for suicidal ideation in both females and males (all p<0.001). Reflection was a risk factor for suicidal attempt in both males and females (all p<0.05). Resilience and symptom rumination mediated the relationship between BPD score and suicidal ideation in both females and males. Resilience mediated the relationship between BPD score and suicidal attempt only in males.Conclusion College students with BP features exhibit an elevated rate of suicide-related behaviors. The relationship between BP features and suicidality is mediated by rumination and resilience.

Suicidal planning and ideation among US Adolescents: Differences by sexual identity, 2023.

Influenza causes approximately 3-5 million severe cases and 290,000-650,000 deaths annually, and oseltamivir is considered the first-line pharmacotherapy. Recent reports on neuropsychiatric events (NPEs) associated with the use of oseltamivir necessitated a systematic safety profile review. To systematically review and meta-synthesize the evidence on the associations of oseltamivir with adverse NPEs and behavioral events. We conducted a systematic review and meta-analysis following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines using the PubMed/Medline, Embase, and Cochrane Library databases from inception through October 31, 2024. Studies comparing oseltamivir with other control groups for NPEs were analyzed. Outcomes were categorized into (1) affective disorders, (2) neuropsychiatric symptoms, (3) anxiety disorders, (4) schizophrenic/psychotic disorders, and (5) suicide-related behaviors. 9 studies with 1,139-3,352,015 patients were identified. Oseltamivir significantly associated with a lower overall NPE incidence (risk ratio [RR] = 0.83; 95% CI = 0.72-0.97), except in patients younger than 20years. Subgroup analyses showed significant association with a lower incidence risk in suicide attempts across all ages (RR = 0.60; 95% CI = 0.46-0.77) and in schizophrenia/psychotic disorders for patients younger than 20years (RR = 0.75; 95% CI = 0.61-0.93). This is the first comprehensive meta-analysis examining the associations of oseltamivir with various NPEs and behavioral adverse events, and we found no evidence supporting increased risks of these adverse events with oseltamivir use.

Youth on the autism spectrum hospitalized for suicide related thoughts and behaviors: Characteristics and perspectives from the field.

The COVID-19 pandemic led to major disruptions in society across many spheres, including healthcare, the economy and social behaviours. While early predictions warned of an increased risk of suicide during and after the COVID-19 pandemic, rates of suicide deaths remained stable or decreased over that period for most countries. In contrast, the prevalence of suicidal ideation doubled and suicide attempts slightly increased during the COVID-19 pandemic in the adult general population worldwide, accompanied by a higher prevalence of major depressive disorder and anxiety disorders. While these data can tell us what happened, they cannot tell us why. Qualitative suicide research seeks to understand experiences of individuals with suicide-related thoughts and behaviours, provides an in-depth exploration of their lives and interactions with others and centres their views and unique context. There is little qualitative research focusing on suicidality during the pandemic. This study will use a qualitative approach to explore the extent and impact of the COVID-19 pandemic on Canadians who experienced suicidality and review their experiences of accessing mental healthcare to identify key components in supporting safety and recovery. This study will involve approximately 100 semistructured interviews with participants across four Canadian provinces and will explore experiences with suicide-related thoughts and behaviours during the COVID-19 pandemic. Transcripts will be analysed through qualitative analysis informed by constructivist grounded theory. The study was approved by the Research Ethics Board of the Centre for Addiction and Mental Health, Toronto Academic Health Sciences Network (for JZ: CAMH REB No 104-2022). In addition to traditional peer-reviewed presentations and publications, a report will make study findings accessible to policy makers, media and the public.

BackgroundAmerican Indian (AI) young adults in urban areas have many cultural strengths but also face unique challenges. Cultural norms within their communities strongly emphasize relationships. Previous research has found that receiving occasional positive and nondemanding messages—caring text messages—can be beneficial among people experiencing suicidality.ObjectiveTo ameliorate increasing rates of suicide and suicidality among AI young adults, we implemented a caring text message intervention designed to increase social connectedness.MethodsThis 2-arm, double-blinded, randomized controlled trial is being implemented at 2 clinical sites with large AI populations. Partnering with clinics in Albuquerque, New Mexico, and Rapid City, South Dakota, we are recruiting AI adults aged 18-34 years to participate in a caring text message study. During the baseline visit, participants complete several surveys and an interview with study staff to understand their history of suicidal behavior. After completion of the baseline visit, participants are randomized to receive the intervention—approximately 30 caring text messages—or treatment as usual. The text messaging platform selected for this study allows bidirectional messaging; while there is no expectation that participants respond, they can provide feedback or seek additional resources. Participants are followed up at 6 and 12 months postbaseline. At the final 12-month follow-up visit, they complete many of the same surveys and participate in an interview to ascertain suicidality since their initial visit. The primary outcomes of interest are suicide-related behaviors—suicidal ideation, suicide planning, suicide attempt, or thoughts and actions requiring hospitalization. Secondary outcomes include social connectedness and other measures of mental health. We will use an intention-to-treat analysis with logistic and linear regression to calculate odds ratios and risk differences (95% CIs) for binary and continuous outcomes.ResultsAs of June 2025, the New Mexico site has finished recruitment and follow-up assessments. The South Dakota site is still enrolling participants and has conducted the first follow-up assessments. The project has been well-received by participants.ConclusionsThis randomized controlled trial will evaluate whether a caring text message intervention is effective in reducing suicidality among AI young adults in urban areas. Participants have received the culturally tailored caring text messages. This trial will help establish whether caring text messages are an effective strategy for reducing suicidal behaviors and promoting feelings of connectedness among AI young adults.Trial RegistrationClinicalTrials.gov NCT03136094; http://clinicaltrials.gov/show/NCT03136094International Registered Report Identifier (IRRID)DERR1-10.2196/71344

BackgroundSocial media platforms, such as TikTok, may be powerful vectors for transmission of both harmful and helpful self-harm and suicide-related content; however, this has not been rigorously studied.ObjectiveThis study aims to identify and understand the themes and overall characteristics of videos related to self-harm and suicide on TikTok.MethodsSnowball sampling was used to identify the 10 most-viewed TikTok hashtags related to self-harm and suicide, which were then used to select the most-viewed English-language posts up to June 2023. An inductive coding reliability approach to thematic analysis was iteratively applied by 2 independent coders to identify and analyze common themes within the videos.ResultsIn total, 188 videos were included in the thematic analysis. Five main themes and 2 subthemes were identified: emotional distress, hope and recovery-based messaging, grief and memorialization of those who died by suicide, social functions associated with self-harm and suicide-related content (subthemes: gallows humor and sarcasm; glamorization of self-harm and suicide-related behavior), and shame and guilt associated with self-harm and suicide-related behavior.ConclusionsSelf-harm and suicide-related content on TikTok was diverse, encompassing both potentially harmful (eg, normalization of self-harm behavior) and helpful (eg, recovery-focused messaging) characteristics. Therefore, a multifaceted and collaborative approach is needed to address the risks of potentially harmful content while leveraging the positive characteristics to promote the safety and well-being of TikTok users.

Suicide and non-suicidal self-injury among Chinese adolescents: a longitudinal study based on the social ecological perspective.