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Introduction: The Interpersonal Theory of Suicide posits that thwarted belongingness (TB) and perceived burdensomeness (PB) are proximal causes of current suicidal desire, while the acquired capability predicts suicide attempts (Joiner, 2005). Objectives: This study examined the psychometric properties of the Interpersonal Needs Questionnaire (INQ-15-I), as a measure of the two constructs, on a sample of 458 Italian university students. Methods: After examining the socio-demographic, clinical and psychosocial characteristics of the sample, we tested the differences in current suicidal ideation and lifetime suicide risk among students. We conducted a confirmatory factor analyses to identify the latent structure of the INQ-15-I and we tested the reliability, criterion concurrent validity and convergent/discriminant validity. Results: The socio-demographic, clinical and psychosocial features of the sample are in line with the literature on the topic. A two-factor related model with 15 item, showed a good fit to the data and subscales showed excellent internal consistencies (α ≥ 0.84). TB, but mostly PB, were mainly correlated with concurrent suicidal ideation and less with suicidal risk. Divergent validity has emerged with the constructs of the acquired capability. Convergent validity is supported for similar constructs such as depression, low reasons for living, anxiety, interoceptive awareness, psychological pain, loneliness, absence of social support and low self-esteem. Conclusions: INQ-15-I provides a valid measure of the interpersonal needs among Italian university students by indirectly investigating suicidal risk factors. It also suggest specific clinical intervention areas in suicide prevention. Thus it may be included in suicide risk assessment protocols in Italy. [ABSTRACT FROM AUTHOR]

In the frame of the interpersonal psychological theory of suicide (IPTS), Interpersonal Needs Questionnaire (INQ-15) assesses thwarted belongingness (TB) and perceived burdensomeness (PB), related to suicidal ideation (SI); Acquired Capability for Suicide Scale-Fearlessness About Death (ACSS-FAD) measures this component which contributes to lethal self-harm. The objective was to evaluate the psychometric properties of INQ-15 and ACSS-FAD in a population of Italian university students. Since the Italian INQ-15 was already validated, we translated ACSS-FAD through a multistage procedure and administered both to 1,665 Italian university students. Factor analysis confirmed a two-factor-related model of INQ-15, one factor of ACSS-FAD, and good reliability for both. We proved the association between INQ-15 and current SI and between ACSS-FAD and lifetime suicidal planning and/or suicide attempt. The convergent and discriminant validities were in line with those of previous studies. Both tools are valid and reliable to assess the constructs associated with suicide outcomes according to IPTS., Competing Interests: Declaration of Conflicting InterestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Many suicidal people do not receive professional assistance due to economic problems, the desire to autonomously solve the problem, or the stigma. Internet and Mobile-based Interventions (IMIs) can overcome many of these obstacles, offering flexible and accessible interventions. We conducted a narrative literature review about the characteristics of IMIs focused on suicide risks. We studied their efficacy and some examples of applications and websites used to prevent and treat suicide risk., Method: Literature research was conducted on Pub Med and PsycINFO databases., Results: IMIs are a viable alternative to traditional treatments and several studies supported their effectiveness in reducing suicidal ideation and behaviors. Most IMIs are based on cognitive-behavioral therapy, which is very structured and easily transferable to digital format. Empowerment, reinforcement mechanisms and human support are the main features that promote the change of the individual and her or his adherence to the treatment. Some IMIs developed for suicide prevention are Stay Alive (UK), Virtual Hope Box (USA), This way up (Australia), and Jaspr Health (USA)., Conclusions: IMIs can be considered a valid aid in suicide prevention. It is necessary to continue the research supporting their effectiveness and implement their interventions in Italy.

Suicide in cancer patients has always been a subject of clinical studies, but the contribution of forensic pathology to this phenomenon is poorly reported. With the aim of at least partially filling this gap in information, at the Institute of Forensic Medicine of Milan, Italy, we assessed all suicides that occurred in cancer patients. A descriptive and retrospective analysis was carried out by examining the database of the Institute and autopsy reports. We included 288 suicide cases with proven cancer diseases. For each suicide, sex, age, country of origin, body area affected by cancer, further pathological history, medications, previous suicide attempts and suicidal communications, as well as the place where the suicide occurred, were assessed. Furthermore, from a forensic point of view, we considered the chosen suicide method and any involved means. The majority of cases were male older adults affected by lung, colon and prostate cancer. Violent suicide methods were prevalent, and the most represented suicide method was falling from height regardless of the body area affected by cancer. Such data may be of clinical use for clinicians engaged in the front lines in order to address suicide risk prevention strategies among cancer patients.

Europe was the second most affected continent by the 2019 coronavirus disease (COVID-19) pandemic, with Italy paying very high death tolls, especially in Lombardy, a region in Northern Italy. The pandemic profoundly impacted mental health and the world's rates of suicide since its outbreak. COVID-19-related suicide rates nonetheless followed a non-linear trend over the pandemic, decreasing after the COVID-19 outbreak, then raising during an extended follow-up period. Thus, we aimed to further assess the suicide rates in Lombardy. We carried out a retrospective analysis of all the autopsies performed in the year 2020 and within the first four months of the year 2021 through the database of the Institute of Forensic Medicine in Milan. In the year 2020, the recorded suicides decreased in comparison to 2016-2019 (21.19-22.97% of the autopsies), being 98 (18.08% out of 542 autopsies), while, in the first 4 months of the year 2021, 35 suicides were documented (185 autopsies, overall). Since the region of Lombardy was severely affected by COVID-19 since the early months of the year 2020, the extended retrospective follow-up allowed for firmer conclusions and insights about the need to extend the follow-up of COVID-19 pandemic beyond the first months after the outbreak, worldwide. This is with special emphasis towards the need to allocate the proper funds for mental health prevention for the general population as well as the most vulnerable ones, such as people with severe mental illness and caregivers, frontline health workers, and others bereaved by COVID-19., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

Suicide is one of the leading causes of death among young adults. Both genetic and personality factors plausibly have a role on suicidal behavior. We focused on the catechol-O-methyltransferase gene (COMT) and we performed: a review of studies investigating the association between COMT and both suicidal behavior and personality; a meta-analysis of studies investigating the association between suicidal behavior and COMT rs4680 polymorphism; an association study investigating the link between seven COMT polymorphisms (rs737865, rs5844402, rs5993883, rs4680, rs4633, rs165599 and rs9332377) and both personality traits and suicidal behavior. For the review and the meta-analysis we performed an electronic search to identify studies focused on the association between COMT and both suicidal behavior and personality. The sample of the association study was composed of three groups: 289 German healthy controls, 111 German suicide attempters and 70 Italian mood disorder patients. From the review, the meta-analysis and the association study no relationship emerged between COMT and suicidal behavior. Nevertheless, from both review and association study several links were found between COMT and personality traits. In particular, in the association study we found a significant correlation between rs4633 and Reward Dependence (Temperament and Character Inventory). As secondary results we found an association between rs737865 and Angry Reaction (State-Trait Anger Expression Inventory) and between rs9332377 and Irritability (Questionnaire for Measuring Factors of Aggression). Our findings suggested that COMT variants may not be directly implicated in suicidal behavior, however evidence of a COMT role in the modulation of personality traits has been found., (Copyright © 2010 Elsevier Ltd. All rights reserved.)

Introduction: Serotonin has been extensively studied in relation to both personality features and suicidal behaviours., Objective: In this study, we considered the association between the serotonin receptor 1A (HTR1A) and 2C (HTR2C) SNPs and personality traits, as measured by the Temperament and Character Inventory (TCI), in a sample of suicide patients and healthy volunteers., Methods: The SNPs considered were, for HTR1A rs1423691, rs878567 and rs6295, and for HTR2C rs547536, rs2192372, rs6318, rs2428707, rs4272555 and rs1801412. The sample was composed of three groups: two German samples, consisting of a healthy control group of 289 subjects (42.6% males, mean age: 45.2+/-14.9) and a psychiatric patient group of 111 suicide attempters (38.7% males, mean age: 39.2+/-13.6), and an Italian sample, composed of 64 mood disorder patients (35.9% males, mean age: 43.0+/-14.8). In the German samples all the SNPs were investigated, while in the Italian sample only the HTR1A rs6295 and the HTR2C rs6318 SNPs were considered., Results: Controlling for sex, age and educational level, single markers and haplotypes were not or only marginally associated with personality dimensions., Conclusions: Our study does not support the role of HTR1A and HTR2C gene variants on personality traits in both healthy volunteers and mood disorder patients.

Temperamental traits, the most basic part of personality, have been largely correlated with neurotransmitter systems and are under genetic control. Among serotonin candidates, the 2A receptor (5-HT(2A)) received considerable attention. We analyzed four SNPs (rs643627, rs594242, rs6311 and rs6313) in the 5-HT(2A) gene and their association with personality traits, as measured with the Temperament and Character Inventory (TCI). The sample was composed of three sub-groups: two German sub-samples, consisting of a healthy group of 289 subjects (42.6% males, mean age: 45.2+/-14.9) and a psychiatric patient group of 111 suicide attempters (38.7% males, mean age: 39.2+/-13.6), and an Italian sub-sample, composed of 60 mood disorder patients (35.0% males, mean age: 44.0+/-14.8). Controlling for sex, age and educational level, the SNPs were not strongly associated with personality dimensions. Only the rs594242 showed an association with Self-Directedness (p=0.003) in the German sample, while rs6313 was marginally associated with Novelty Seeking (p=0.01) in the Italian sample. We conclude that 5-HT(2A) SNPs may marginally modulate personality traits but further studies are required.

It is well established that stress is a risk factor for onset of mood disorders. Emerging evidence suggests that genetic vulnerability may also moderate individual responsiveness to stress. The most compelling evidence regards the polymorphism within the promoter region of the serotonin transporter gene (SERTPR), which has been reported to moderate the risk for depression, in conjunction with life stressors. In the present paper we analysed SERTPR in the onset of mood disorders, along with adverse life events, and other candidate genes: the serotonin receptor 1A (5-HT1A), the dopamine receptor D4 (DRD4) and the catechol-O-methyltransferase (COMT). The sample was composed of 686 Italian subjects, affected by major depression and bipolar disorder. Patients were asked to report about life stressors within the year preceding onset of their first mood-disorder episode and genotyped. A 'case-only' design was employed to investigate the interaction between genes and stressors. COMT was associated with depression following exposure to stressors (chi2=13.05, d.f.=2, p=0.0015) and SERTPR also showed a positive association (chi2=6.70, d.f.=2, p=0.035), mainly among women and among major depressives. The interaction between COMT and SERTPR was also significant (p=0.0005). In our retrospective study SERTPR is hypothesized to lead to the onset of major depression via its influence on reaction to adversities, particularly in females. Moreover, COMT was risk factor for onset of both major depression and bipolar disorder, in conjunction with adversities.