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The risk for non-lethal and lethal suicide attempts is substantially increased after discharge from inpatient psychiatric treatment initiated because of a suicide attempt or acute suicidality. Yet, empirical evidence regarding proximal risk factors predicting suicidal ideation or behavior in the short-term is limited. Such evidence is needed to develop clinical monitoring concepts or interventions. The Interpersonal Theory of Suicide (IPTS; Joiner, 2005), the Integrated Motivational-Volitional Model of Suicidal Behavior (IMV model; O’Connor, 2011), and the Suicide Crisis Syndrome (SCS; Galynker et al., 2017) postulate several variables that might serve as proximal risk factors. Central assumptions of these theories have been partially supported by empirical studies. However, prospective and fine-grained studies in high-risk samples accounting for the temporal dynamics and the interactions of these variables and analyzing the predictive power with regards to suicidal ideation and behavior directly after discharge are rare. Aim: The present study aims at empirically validating assumptions of the IPTS, the IMV-model, and the SCS. Thus, it will be investigated whether the central concepts of these theories (specifically their intensity and variability in real-time) are predictors of suicidal ideation and suicide attempts during a 6-months follow-up after discharge from inpatient psychiatric treatment (accounting for distal risk factors such as sex, previous suicide attempts, heart-rate variability). Individual trajectories of suicidal ideation will be further examined (digital phenotyping) and their predictive validity will be investigated. Methods: In Essen and Leipzig, N = 344 psychiatric inpatients receiving treatment after acute suicidality or suicide attempt will be recruited over 18 months. After an extensive baseline assessment (central constructs of suicide theories, heart-rate variability, and control variables) and briefing, all participating patients will be equipped with a wearable (Polar Unite A370) and will start the EMA-Assessment via an App installed on their smartphones. Several items covering suicidal ideation and other variables of interest will be rated four times a day by the patients starting 1–3 days before discharge and 21 days following discharge (EMA-phase 1) and subsequently for six months two days a week (EMA-phase 2). Additionally, the heart-rate will be assessed using a wearable. After EMA-phase 1, a debriefing will take place, which includes the assessment of suicide ideation, and attempts during the first EMA -phase. After EMA-Phase 2 (at 6-month FUP), all participants will undergo an interview on the occurrence of suicide ideation and behavior once again. Data will be analyzed using cox regression, multi-level models and latent profile analysis.

Background Various studies from different countries indicated that veterinarians have a significantly increased risk of depression, suicidal ideation and of death by suicide. For German veterinarians a recent study has demonstrated a three times higher rate for depression, two times higher rate for suicidal ideation and a five times higher suicide risk compared to the German general population. For veterinary students, recent studies in the US and UK indicated higher mental distress. To date, empirical studies on depression, suicidal ideation and suicide risk among veterinary students in Germany were lacking so far. This study investigates depression, suicidal ideation and suicide risk of veterinary students in Germany. Methods 913 German veterinary students (14.3% response rate, 90.7% women, mean age 23.6 years) between 18 and 46 years were included and compared with representative German general population samples from 2007 (N = 1097, 55.4% women, mean age 33.9) and 2015 (N = 1033, 56.1% women, mean age 32.8) of the same age range using the depression module of the Patient Health Questionnaire (PHQ-9) and Suicide Behaviors questionnaire-Revised (SBQ-R). The general population samples were collected with the assistance of a demographic consulting company. Results The prevalence of depression among German veterinary students was 45.9% (compared to 3.2% in the general population), suicidal ideation was 19.9% (compared to 4.5% in the general population) and suicide risk was 24.0% (compared to 6.6% in the general population). Conclusion In this study, German veterinary students have a 22.1 times higher risk to be screened positive for depression, a 4 times higher risk for reporting current suicidal ideation and they are 4.2 times more likely to have an increased suicide risk compared with the general population in Germany of the same age range.

Recent studies suggest that impulsivity fluctuates over time. It is unclear if state-impulsivity serves as a risk factor of suicidal ideation (SI) at a state level. A sample of 74 psychiatric inpatients with depression (M = 37.6 years, 72% female) and SI completed baseline measurements and an ecological momentary assessment over a 6-day period. Despite considerable within-person variance, state impulsivity was not significantly associated with clinical characteristics (depression, baseline SI, past suicide attempts). Daily variability of passive SI showed a significant prospective association with state impulsivity. Limiting factors are the small sample size and the short observation period.