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Introduction: The Interpersonal Psychological Theory of Suicide (IPTS) (Joiner, 2005) is one of the most recent models that can explain suicide risk in psychiatric patients. Objective: We investigated the risk factors associated with lifetime suicide attempts (SA) and current suicidal ideation (SI), in 32 psychiatric patients recruited in two therapeutic communities of Lombardy, in Italy. Methods: We assessed through questionnaires socio-demographic, clinical, psychosocial and somatic pain measures, testing the differences between subjects with and without lifetime SA and with and without current SI. From the comparison and consistently with the theory, we inserted variables in regressions models. Results: Some of the features (e.g. anxiety, psychological pain and Thwarted Belongingness (TB)) were associated with both SA and SI. Concerning regression models, Survival and Coping Beliefs (SCB) reduced the likelihood of SA and current SI levels. Beyond TB, mental and physical pain, SCB and Perceived Burdensomeness explained respectively 20.8% and 21.8% of the total variance of SI. Conclusions: Significant clinical implications have emerged as the identified suicidal risk factors, according to IPTS, could inform risk assessment, prevention and treatment in psychiatric patients.

There are several approached to suicide prevention based on various psychotherapeutic interventions, which are effective, especially when these are matched to the given psychiatric patient population, environment and context. In this paper the possibilities of psychotherapeutic methods of suicide prevention and intervention are described along with their indications. The following interventions are discussed: Cognitive Behavioral Therapy for Suicide Prevention (CBT-SP), Cognitive Therapy for Suicide Prevention (CT-SP), Brief Cognitive-Behavioral Therapy for Suicide Prevention (BCBT), Problem Solving Therapy (PST), Problem Adaptation Therapy (PATH), Dialectial Behavior Therapy (DBT), Schema-Focused Therapy (SFT), Mindfulness-Based Cognitive Therapy (MBCT), Mindfulness-Based Stress Reduction (MBSR), Acceptance and Commitment Therapy (ACT), Mentalization-Based Treatment (MBT), Interpersonal Psychotherapy (IPT), Transference-Focused Psychotherapy (TFP), Collaborative Assessment and Management of Suicidality (CAMS), Teachable Moment Brief Intervention (TMBI), Motivational Interviewing (MI), Attempted Suicide Short Intervention Program (ASSIP) and other Interned-Based Interventions (IBI). The effectiveness of the above methods may vary, however, they focus on the psychological processes playing a role in the emergence of suicidal behaviours including cognitive processes, as well as difficulties of problem solving and emotion regulation. As the efficacy of these interventions are supported by clinical trials, their use is recommended in case of this vulnerable patient population. The importance of using such methods in the clinical work with suicidal patients should be prioritized in our effort to provide a complex treatment for suicidal behaviour based on the most optimal and appropriate intervention considering the given patient.

Introduction Available meta-analytic evidence suggests an increased risk of suicide among cancer patients, although most of the reports focused on the sole suicide death (SD) outcome and they are usually hampered by significant between-study heterogeneity. Objectives The present meta-analysis aimed at assessing the prevalence and risk rates of SD, suicide attempt (SA), and suicidal ideation (SI) among cancer patients. Methods Systematic search up to April 2021 of observational studies documenting cancer and suicide outcomes associations. Pooled prevalence estimates, odd ratios (ORs), risk ratios (RRs), and hazard ratios (HRs) of SD, SA, and SI were computed according to the random-effects model. SD prevalence underwent cumulative and sub-group analyses for different variables. Risk estimates underwent sensitivity analysis for study design. Results Overall, thirty-nine studies were included. A higher risk of SD based on HR, SA based on OR and HR, and SI based on each measure was recorded among cancer patients versus controls. OR and RR of SD were not significant. Pooled prevalence rates of SD, SA and SI among cancer patients were 1.9% (1.1-3.1%), 1.4% (0.3-7.1%), and 9.1% (5.8-14.0%), respectively. Although high between-study heterogeneity held upon sensitivity and sub-group analyses, the overall message brought by risk analyses likewise held true. Age, country, study design, cancer type, sample size, cases type and comparison affected SD prevalence estimates in cancer patients. SD prevalence decreased over time. Conclusions Cancer patients face higher risk for SA and SI versus controls. SD’ results were controversial. Cancer patients have higher prevalence rates of suicide outcomes compared to the general population. Disclosure No significant relationships.

Suicide is a public health problem having important consequences also for people who survive to the suicide of a loved one – the suicide loss survivors. Since suicide bereavement can have a lasting and significant psychosocial impact on the bereaved individuals, psychosocial treatments are needed (postvention). Many countries have included postvention in their suicide prevention policies. This is a narrative review aiming to investigate the bereavement experience of suicide loss survivors, the associated symptoms, and to describe adequate treatments to properly reduce survivors’ grief and help them to adapt to the loss. Method. Literature review of peer reviewed literature (PubMed, PsycINFO), books about bereavement, suicide, postvention and postvention guidelines. Results. Suicide loss survivors may have an increased risk of developing psychiatric disorders such as post-traumatic stress disorder, depressive disorders, anxiety, and substance abuse; an increased risk of suicide; increased physical complaints; and an increased risk of developing Persistent Complex Bereavement. About postvention, two measures turn out to be very important. An immediate first on-the-spot intervention that includes: specific training for general practitioner and police; to direct survivors to support services; provide proactive and practical support; psychological autopsy. The second intervention is a long-term one and can be delivered in a variety of ways: the most effective therapy for survivors appears to be Complicated Grief Therapy, but in general the therapist must be adequately trained for individual psychotherapy with survivors. Other effective interventions include: writing projects; group psychotherapy; support groups. Conclusion. A public health approach to postvention can allow to tailor interventions to the needs of survivors, and to align postvention with suicide prevention programs.

IntroductionMultiple epidemiologic and clinical studies have explored the relationship between physical pain and suicidal thoughts and behaviours.ObjectivesThe aim of this meta-analysis was to provide an update of the data already present in literature about this specific association in adults.MethodsStarting from a meta-analysis published by Calati and colleagues in 2015, 28 studies were included in this work. After searching on Pubmed (until March 2020), data were extracted from articles comparing the rates of current and lifetime suicidal thoughts and behaviours (death wish, suicidal ideation, suicidal planning, suicide attempt and suicide death: DW, SI, SP, SA, and SD) in adults with any type of physical pain and in individuals who did not report this condition. Data were analysed using Cochrane Collaboration Review Manager software (RevMan, version 5.4).ResultsAlthough high between-study heterogeneity was detected in most analyses, results suggested that adults with physical pain are more likely to report any form of suicidal outcome, except for death by suicide, compared to individuals not affected by pain. No evidence of publication bias was reported in the main analysis (lifetime SA).ConclusionsCollected data are therefore in line with previous literature on this topic, which considered physical pain an extremely relevant risk factor for suicidal thoughts and behaviours. Future studies should specifically focus on alternative types of physical pain (such as medically unexplained pain or psychogenic pain) or explore the different impact of acute versus chronic pain in terms of increased suicide risk.

Background: The World Health Organization declared the Corona Virus Disease 19 (Covid-19) a pandemic in March 2020. Psychological impact of Covid-19 can be consisent and should be prevented with adequate measures. Methods: We performed a literature mini review searching for studies in PubMed focusing on the psychological/psychiatric impact of Covid-19.Results: The selection process yielded 34 papers focusing on the relation between Covid-19 and mental health: 9 correspondence, 8 letters to the editor, 7 commentaries, 3 editorials, 4 original studies, 2 brief reports, and 1 a rapid review. The majority of the articles were performed in China. They focused on the general population and particular categories considered more fragile, e.g., psychiatric patients, older adults, international migrant workers, homeless people. Authors are unanimous in believing that Covid-19 will likely increase the risk of mental health problems and worsen existing psychiatric disorders/symptoms in patients, exposed subjects, and staff. Together with the negative emotionality related to the unpredictability of the situation, uncertainty concerning the risk, excessive fear, fear of death, loneliness, guilt, stigma, denial, anger, frustration, boredome, some symptoms might appear such as insomnia until patophobia (specifically, coronaphobia), depressive and anxiety disorders, post-traumatic stress disorder, and suicidal risk.Limitations: Literature is rapidly increasing and present results are only partial. Conclusions: Mental health care should not be overlooked in this moment. The experience of China should be of help for all the countries facing with Covid-19, among them Italy.

Environmental and genetic factors contribute to the development of posttraumatic stress disorder (PTSD). Variation in the 5-HTTLPR polymorphism of the serotonin transporter gene has been hypothesized to affect risk for PTSD. With the aim of investigating this association, we conducted a meta-analysis to shed light on prior controversial results and increase statistical power to detect smaller effect sizes. PubMed and ISI databases were searched for studies published until December 2012. Twelve studies have been included, all based on trauma-exposed samples. Data were analyzed with Cochrane Collaboration Review Manager Software (Version 5). Quality and publication bias were assessed. Metaregressions were performed using Comprehensive Meta-Analysis software, Version 2. Taking into account all studies, no association was found between 5-HTTLPR and PTSD (p= .10), with evidence of between-study heterogeneity, which could be partly explained by gender differences. In sensitivity analyses, we found an association between SS genotype and PTSD in high trauma-exposed participants (p < .001). To be a carrier of the SS genotype seems to represent a risk factor for PTSD in high trauma exposure. Further studies focusing on Gene x Environment interactions are needed to better understand the role of this polymorphism in PTSD

Our study aims at replicating our previous finding of an association between COMT rs4680 G/A polymorphism and early onset major depression (MD). We included 462 MD, 147 bipolar disorders (BD) subjects and 295 healthy controls. We could partially replicate previous findings. In particular, rs4680 GG + AG genotypes were more represented in the subgroup of early onset MD patients (p = 0.04). Additionally, we observed an association between rs737865 alleles and early onset MD (p = 0.04). Rs4680 genotype was associated with early onset BD as well (p = 0.01). In conclusion, we partially replicated our previous findings confirming a possible influence of COMT variants in MD and BD, particularly in early onset subjects, though not with the same risk genotypes. (C) 2011 Elsevier Ireland Ltd. All rights reserved.

The use of telemedicine is becoming increasingly popular in assisting with the home management of People with Dementia (PwD) by offering services to the carers that may enhance their ability to care for their relative for longer. A computerized platform, ALADDIN, was evaluated in its usefulness to reduce carer burden and distress and to improve their quality of life, in an attempt to delay institutionalization of PwD. ALADDIN offers educational material about dementia to carers and provides the opportunity to contact other carers and clinicians. ALADDIN also facilitates remote monitoring of the PwD and their carers by the clinicians to enable speedy delivery of appropriate intervention. The ALADDIN platform was piloted at three European sites, and used by thirty carers of PwD living in the community (platform group). The platform group and a control group of thirty PwD and their carers were assessed at baseline, 3 months, and 6 months. The results showed a significant improvement in the quality of life of the carers in the platform group, with some reduction in carer burden and distress. The platform was useful in monitoring the patients and facilitating contact with other professionals. Access to and use of the ALADDIN platform was rated positively by carers and clinicians. The ALADDIN platform's usefulness and applicability for prolonging the home management of PwD are discussed.