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Suicide is a global health concern whose rates are soaring in many low-and-middle-income countries. Public awareness campaigns have been implemented in Brazil; however, their impact is uncertain. This was an ecological study using population data from DATA-SUS, a Brazilian official notification system, selecting only deaths that were voluntarily self-inflicted (CID-10 × 60-X84). We analyzed all available data from 2000 to 2019 to assess trends before and after the national Yellow September (YS) campaign started in 2015. Differences in trends were assessed by Joinpoint Analysis (JA) and Regression Discontinuity Analysis (RDD), unadjusted and adjusted for economic factors. Overall, there was a progressive increase in the rate of relative (per 100,000 inhabitants) number of suicides over time between 2000 and 2019 (57 % increase). The JA detected a change in the slope of the curve representing an acceleration in suicides starting in the year 2015. Adjusted RDD revealed the year that Yellow September started significantly change the slope of the association between time and rates of suicide (p interaction < 0.01), and marginal analysis detected the coefficient increased from 0.07 (95%CI 0.04–0.10) to 0.27 (95%CI -0.07-0.60) suicides/year per 100,000 inhabitants. The ecological nature of the manuscript compromises causational implications. We found an increase in suicidal trends in Brazil, against the global trend that coincides with the beginning of a large national awareness campaign. Although we cannot attribute causality, our results reinforce the need of further studies to better understand the role of awareness campaigns in suicide reduction interventions, including potential unintended effects. • Despite the implementation of the Yellow September campaign, the study reveals a worrying nationwide increase in suicide rates in Brazil. • After the implementation of Yellow September Campaign, suicides tended to cluster more closely to months following September. • The study recommends a multifaceted approach integrating awareness campaigns with concrete healthcare modifications, emphasizing the need for campaigns to focus on positive coping strategies and destigmatization. [ABSTRACT FROM AUTHOR]

• Epigenetics played a crucial role in depression with suicide ideation (DSI). • Epigenetic molecules related to DSI interacted with each other. • Peripheral epigenetic molecules were potential suicidal biomarkers for DSI. Suicide ideation (SI) is the major cause of death in persons with depression, whereas effective and accurate biomarkers for suicidal behavior of persons with depression are still lack. Recently, manifold studies in vivo revealed that epigenetic alterations including DNA methylation, non-coding RNA regulation, RNA editing and histone modification, were associated with depressive severity and SI, and peripheral epigenetic molecules may be potential biomarkers for suicidal risk of persons with depression. Therefore, we firstly reviewed recent epigenetic advancements in depression with suicide ideation (DSI) according to studies based on human tissue. Furthermore, we discussed the significance and potential of minimally-invasive peripheral epigenetic molecules to identify potential suicidal biomarkers for DSI, aiming to promote early identification and therapeutic evaluation of DSI. [ABSTRACT FROM AUTHOR]

AbstractObjectiveMethodResultsConclusionsDisclosure of self-injurious thoughts and behaviors (SITBs) can serve as a catalyst to receiving mental health and lifesaving care; yet, many young people do not disclose these experiences to their therapists. In this study we aimed to identify barriers to adolescents disclosing their SITBs to their therapists and to compare these barriers across non-disclosure of suicidal ideation, suicidal behavior, and non-suicidal self-injury.Participants (n = 292) all had lived experience of at least one SITB and were an average age of 15.55 years, with the majority identifying as cisgender girls (68.15%). Using inductive content analysis of open-ended responses, six main categories of disclosure barriers were identified.These overarching barriers were: Agency Theft, Irrelevance, Therapeutic (Mis)Alliance, Internalized Stigma, Anticipated Stigma, and Lacking Disclosure Self-Efficacy. The majority (85.29%) of subordinate barriers were common across the three SITBs.Adolescents may hesitate to disclose their SITBs to their therapists for many reasons; prioritizing the therapeutic relationship and working collaboratively with adolescents could be instrumental in not only fostering disclosure but also an overall more positive therapeutic experience. [ABSTRACT FROM AUTHOR]

AbstractFirearm availability is correlated with increased risk of suicide but its link with suicidal ideation remains unclear. Previous studies are limited by retrospective reports and prospective designs with lengthy gaps between assessments that are ill-suited for measuring fluctuations in suicidal ideation. This study used ecological momentary assessment (EMA) to repeatedly assess suicidal ideation in a sample of 138 U.S. adults (81 handgun owners, 57 non-owners). Participants received six EMA prompts per day for 28 consecutive days. Results revealed no group differences in the frequency, maximum amplitude, or variability of suicidal ideation across male and female handgun owners and non-owners. Stability of suicidal ideation significantly differed across groups, however (F(1,132) = 4.5, p = 0.036); male handgun owners had the strongest stability and male non-owners had the weakest stability. Stability of suicidal ideation was significantly lower when participants reported a firearm was nearby as compared to when no firearm was nearby (F(4,17732) = 5.6, p < 0.001). Results suggest firearm availability increases reactivity to the environment, slows recovery from acutely elevated risk states, and may increase vulnerability to sudden shifts to higher risk states characterized by increased probability of suicidal behavior. Although these effects were observed in both handgun owners and non-owners, they disproportionately impact handgun owners because they report being near firearms more often. [ABSTRACT FROM AUTHOR]

Introduction Method Results Conclusion Individuals who are depressed, have suicide attempts, and a substance use disorder (SUD) may have different patterns of suicidal thoughts and behaviors and respond differently to cues associated with suicide and death.Implicit affective reactions to visual cues suggestive of suicide and death (as well as to pleasant, unpleasant, and neutral cues), were compared among three groups of hospitalized adults: (a) depressed patients without the histories of suicidal behavior (depression only), (b) depressed patients with suicide attempts, but no current substance abuse disorder (SA), and (c) depressed patients with both suicide attempts and substance use disorder (SA + SUD).The SA group demonstrated higher positive evaluations of visual cues associated with suicide and death when compared to the SA + SUD group. The SA + SUD group demonstrated the lowest positive evaluation of suicide‐related stimuli as well as less positive evaluation of visual cues of generally unpleasant stimuli.Differences observed between SA and SA + SUD participants underscore differences in responses to cues related to suicide, which may reflect differences in mechanisms of risk. [ABSTRACT FROM AUTHOR]

Introduction: Severe depression is a prevalent psychiatric illness in children and adolescents associated with high levels of morbidity, disability, and a high risk of suicidal behavior. Cognitive factors associated with depression severity in juveniles have been poorly reported. Methods: We investigated the relationship between depression severity and intelligence quotient (IQ)with its subscales in 65 juveniles (aged 10–17 years) with a current major depressive episode evaluated at the Mood Disorder Program of Bambino Gesù Children's Hospital in Rome. Pearson's correlation analyses were followed by a Benjamini–Hochberg correction and linear multivariable regression model. Results: Depression severity measured with the total score of the Children's Depression Rating Scale-Revised (CDRS-R) was positively associated with the Verbal Comprehension Index (VCI; Pearson's r = 0.309 [0.042−0.534]; p = 0.024). The CDRS-R subscales positively associated with VCI by Pearson's correlation were depressed feelings, suicidal ideation, excessive weeping, and reduced facial expressions. Suicidal ideation was the only factor independently and significantly associated with higher VCI in the multivariable linear regression model. Discussion: Suicidal ideation was significantly and independently associated with higher verbal comprehension, indicating that depressed juveniles with better verbal ability may be at a greater risk of showing suicidal ideation. [ABSTRACT FROM AUTHOR]

Introduction: Adolescents' health and well-being are seriously threatened by suicidal behaviors, which have become a severe social issue worldwide. Suicide is one of the leading causes of mortality for adolescents in low and middle-income countries, with approximately 67,000 teenagers committing suicide yearly. Although an association between sleep disturbances (SDs) and suicidal behaviors has been suggested, data are still scattered and inconclusive. Therefore, to further investigate this association, we conducted a meta-analysis to verify if there is a link between SDs and suicidal behaviors in adolescents without diagnosed psychiatric disorders. Methods: PubMed, CENTRAL, EMBASE, and PsycINFO were searched from inception to August 30th, 2024. We included studies reporting the estimation of suicidal behaviors in adolescents from 12 to 21 years of age, with SDs and healthy controls. The meta-analysis was based on odds ratio (OR, with a 95% confidence interval ([CI]), estimates through inverse variance models with random-effects. Results: The final selection consisted of 19 eligible studies from 9 countries, corresponding to 628,525 adolescents with SDs and 567,746 controls. We found that adolescents with SDs are more likely to attempt suicide (OR: 3.10; [95% CI: 2.43; 3.95]) and experience suicidal ideation (OR: 2.28; [95% CI 1.76; 2.94]) than controls. Conclusion: This meta-analysis suggests that SDs are an important risk factor for suicidal ideation and suicide attempts in healthy adolescents. The findings highlight the importance of early identification of SDs to prevent suicidal behaviors in this population. Systematic review registration: PROSPERO, identifier CRD42023415526. [ABSTRACT FROM AUTHOR]

Adult ADHD is associated with increased risk for suicide attempts, as indicated by investigations of population- and community-based cohorts. However, there is little data regarding suicide attempts in a clinical setting. To address this, we used a comprehensively phenotyped clinical adult ADHD (aADHD) cohort to assess to which extent comorbidity, psychosocial adversity, personality, and ADHD symptoms contribute to suicidal behavior in ADHD. Furthermore, we investigated a triallelic variation in the serotonin transporter-linked polymorphic region (5-HTTLPR), which has previously been associated with suicidal behavior. Depression, substance use, eating, and posttraumatic stress disorders were independently associated with past suicide attempts, whereas anxiety, somatoform, and obsessive–compulsive spectrum disorders showed no association. Pulmonary diseases also showed an association with suicidal behavior. Psychosocial factors including occupational status, marital status/living situation, externalizing behavior and psychiatric family history were strongly associated with past suicide attempts. ADHD symptoms of inattention and hyperactivity/impulsivity were not associated with past suicide attempts after adjustment for psychiatric comorbidity and psychosocial adversity. However, the personality trait of neuroticism fully mediated the association between depression and suicidal behavior. 5-HTTLPR was not associated with suicidal behavior, but an interaction with ADHD symptoms and subtype was found. Our data suggest that psychiatric comorbidity and psychosocial adversity are key factors for suicidal behavior in aADHD, with neuroticism representing a critical mediator of the association between depression and suicidality. Further research, preferentially with longitudinal study designs is needed to better understand causal factors for suicidal behavior to enable effective preventive action. [ABSTRACT FROM AUTHOR]

Introduction Methods Results Discussion Suicidal thoughts and behaviors often onset during adolescence, constituting a major public health concern. Despite rising rates in youth, psychotherapeutic and pharmacological treatment outcomes remain meager, indicating a need to identify modifiable risk factors. Experts suggest sleep may serve as a promising clinical indicator of risk and treatment progress, yet few studies have examined acute temporal associations between sleep and suicidal ideation.Participants were depressed and suicidal adolescents (age 13–19, n = 311) attending an intensive outpatient program (IOP). Patients completed weekly self‐report assessments of sleep, depression, and suicidal ideation throughout IOP, with an average of 5 assessments over 30 days.Greater overall sleep difficulties, as well as within‐person increases in sleep difficulties, were predictive of greater depression severity and suicidal ideation at subsequent assessments, above and beyond previous levels of symptoms. The reverse associations were not found. Inclusion of within‐person changes in sleep difficulties significantly improved model fit compared to inclusion of overall sleep difficulties alone.This study provides additional evidence for a prospective relationship between worsening sleep difficulties and suicidal ideation in an IOP youth sample. Worsening sleep may be an important clinical indicator of subsequent depression and suicide risk among adolescents in treatment. [ABSTRACT FROM AUTHOR]

Objective: Describe the epidemiology of cluster headache (CH) using Veterans Health Administration (VHA) Electronic Health Record (EHR) data. Background: Epidemiologic studies of CH at the population level are difficult because it has a prevalence of ~0.1%. Hospital system‐wide studies are an attractive alternative as they have large numbers of patients and broader populations than headache or neurology clinic‐based studies. The VHA is an ideal hospital‐based system in which to study CH because it is nationwide, predominantly male, has a strong focus on mood disorders and suicidality, and has accessible individual medical records. Here, we report the first headache study based on an ongoing longitudinal cohort of patients with CH using VHA EHR data. Methods: The VHA EHR data were accessed from Fiscal Year 2008 to 2019. Patients with CH consisted of all patients with at least one outpatient visit containing a CH diagnosis code from the International Classification of Diseases (ICD)‐9 or ‐10. We extracted data on demographic features, incidence, and prevalence, as well as pain and psychiatric comorbidities. Results: Of the 1,524,960 distinct patients who presented for headache treatment in the VHA between Fiscal Year 2008–2019, 24,131 had at least one visit with a CH diagnosis. The 1‐year period prevalence of a CH diagnosis in the VHA ranges from 0.08% to 0.10% for women and 0.10% to 0.18% for men. A larger proportion of women versus men received a diagnosis of unspecified CH (59.6% [1412/2368] vs. 53.6% [11,663/21,763], p < 0.001). Most patients with CH had both comorbid headache and non‐headache pain diagnoses. Headache not‐otherwise‐specified was the most common comorbid headache disorder at 70.0% (16,885/24,131) and was more common in women (76.1%, 1801/2368) compared to men (69.3%, 15,084/21,763). Other common comorbidities included migraine, depression, tobacco use, and obstructive sleep apnea. Rates of suicidal ideation or attempt were almost 50% higher in women (5‐year proportion 9.4%, 222/2368) with CH compared to men (6.6%, 1433/21,763). Conclusions: To our knowledge this is the largest hospital system study of CH to date and reinforces several previous studies. Pain, mental health, and sleep disorders comorbidities are particularly prevalent in this group and were often more common in women compared to men with CH. Future work should examine gender and race stratified prevalence estimates within the VHA and other healthcare systems. Plain Language Summary: This study describes the epidemiology of cluster headache among all Veterans Health Administration (VHA) enrollees using electronic medical record data from the VHA. We found that during any given 1‐year period, between 0.08–0.10% of women and 0.10–0.18% of men in the VHA were treated for cluster headache. Many of these patients also had co‐occurring disorders including other headache disorders and depression, so more research is needed to find the best ways to treat these patients. [ABSTRACT FROM AUTHOR]

The article presents a study on electronic cigarette (e-cigarette) use by female versus male U.S. high school students. Topics discussed include e-cigarette use by sex among U.S. high school students using National Youth Tobacco Survey (NYTS) data, weighted percentage of U.S. high school students using e-cigarettes, and implication of findings for clinicians and researchers.

Background: The association between Attention-deficit hyperactivity disorder (ADHD) and suicidality has been subject of growing interest for research in the latest years. Suicidality was generally assessed categorically and without the use of validated instruments, leading to heterogeneous or even conflicting evidence. The prevalence of both suicidal ideation and attempts varies considerably, and the associated risk factors remain unclear. Our study investigated suicidality in ADHD using a dimensional approach and a validated and internationally recognized instrument. Our primary aim was to evaluate the prevalence of suicidal ideation (SI), severe suicidal ideation (SSI), suicidal behavior (SB) and non suicidal self-injury behavior (NSSIB) in a sample of adult patients with ADHD. The second objective was to identify sociodemographic and clinical features associated with increased risk of suicidality in these patients. Methods: The sample included 74 adult patients with clinical diagnosis of ADHD. Suicidality was assessed by administering the Columbia-Suicide Severity Rating Scale. Logistic regressions were used to examine predictors of SI, SSI, SB and NSSIB. Results: The lifetime prevalence of SI and SSI were 59.5% and 16.2%, respectively. The 9.5% of patients showed lifetime SB, while NSSIB was found in 10.8% of the subjects. Lifetime SI was associated with severity of inattentive symptoms during adulthood, low self-esteem and impairment in social functioning. Lifetime SSI appeared related to severity of inattentive symptoms during childhood, attentional impulsiveness and number of hospitalizations, while physical activity appeared to be protective. The prevalence of lifetime SB and NSSIB did not appear significantly related to any socio-demographic or clinical feature. Conclusions: Adults with ADHD should be considered at risk of suicide and it is important to determine which patients are at higher risk, in order to guide preventive interventions. The association between ADHD and suicidal ideation did not appear to be influenced by psychiatric comorbidities, but rather by inattention itself, which represents the core symptom of ADHD. [ABSTRACT FROM AUTHOR]

Purpose: There is a dearth of research on suicidal ideation (SI) that occurs specifically in the context of drinking alcohol. Alcohol use and binge drinking are both elevated among college students, among whom sexual and gender minority (SGM) students are at particular risk for SI. This manuscript examines alcohol use, SI, and SI specifically in the context of alcohol use among a large sample of undergraduate students and examines differences across sexual and gender minority groups. Methods: Data were drawn from ~ 300,000 students who completed the American College Health Association National College Health Assessment (ACHA-NCHA) between Spring 2019 and Fall 2022. Participants reported identity variables and information about drinking behaviors and suicidal ideation over the past year. Multilevel models were used for all analyses. Results: Risky drinking behaviors and higher blood alcohol content during the last episode of social drinking were associated with higher odds of SI while drinking. Rates of risky drinking behaviors, SI, and SI while drinking were elevated among SGM students with SGM men and nonbinary students reporting the highest rates across groups. Conclusion: SI while drinking, which is seldom assessed in measures of either measures of suicidal thoughts or alcohol use behavior, is an important construct for further research to improve our understanding of high risk states for suicide. Given elevated rates of alcohol use and SI among college students, providing education and resources to reduce SI while drinking is a critical target for universities, particularly to reduce risk among vulnerable SGM students. [ABSTRACT FROM AUTHOR]

Purpose: Suicidal thoughts and behaviors (STB) have been increasing among US college students. Accurate measurement of STB is key to understanding trends and guiding suicide prevention efforts. We aimed to compare the prevalence estimates of STB among college students from two campus-based surveys (the National College Health Assessment [NCHA] and the Healthy Minds Study [HMS]) and one general population study (the National Survey on Drug Use and Health [NSDUH]). Methods: Estimates were generated from the three surveys for past year suicidal ideation (PYSI) and past year suicide attempts (PYSA) among 18- to 22-year-old full-time college students. Data were combined from each survey to develop bivariate and multivariate regression models for odds of PYSI and PYSA. Results: Estimates for PYSI varied between the three surveys: 34.3% for NCHA, 15.0% for HMS, and 10.7% for NSDUH. Estimates for PYSA were 2.6% for NCHA, 1.6% for HMS, and 1.7% for NSDUH. After adjusting for demographic and educational characteristics, odds of PYSI remained significantly lower for HMS participants (aOR 0.31, 95% CI 0.29–0.33) and NSDUH participants (aOR 0.19, 95% CI 0.19–0.30) compared to NCHA participants. The odds of PYSA for HMS participants were lower than those for NCHA participants (aOR 0.63, 95% CI 0.54–0.73). Conclusion: Estimates of PYSI and PYSA vary between leading sources of data on college student mental health. The differences are likely related to question wording, survey implementation, as well as institutional and individual representation. Accounting for these differences when interpreting estimates of STB can help guide suicide prevention efforts. [ABSTRACT FROM AUTHOR]

AbstractSuicidal behaviors are a significant concern in Latin American countries. However, validated scales in Brazil do not address all behaviors on the suicide spectrum. We aimed to adapt the Suicidal Behaviors Questionnaire-Revised (SBQ-R) for Brazil. The SBQ-R was independently translated, back-translated, and evaluated by experts—two thousand eight hundred ninety-eight participants (68.30% women; M = 27.42; A = 18–69) from Brazil. The SBQ-R items presented adequate reliability (ω = .86). Confirmatory factor analysis (CFA) confirmed the construct validity (χ2(df) = 52.707(2), p<.001; CFI = .997; TLI = .992; RMSEA = .052; SRMR = .024). Multigroup CFA indicated that the SBQ-R is invariant for gender, sexual orientation, race, and education level. The SBQ-R has convergent validity for depression (r = 0.61), anxiety (r = 0.49), stress (r = 0.49), impulsivity (r = 0.40), hopelessness (r = 0.60) and divergent validity, with gender and sexual minorities showing higher levels of suicidal behaviors. The Brazilian SBQ-R is designated for use by Brazilian adults. Future studies must investigate the predictive validity of the SBQ-R in clinical samples. [ABSTRACT FROM AUTHOR]

Background: Suicidal behavior is a public health problem whose incidence has increased recently. The Suicide Risk Attention Program (ARSUIC) is developed for the detection and prevention of suicidal behavior. The data obtained allow us to study suicidal behavior. The aim of this study is to analyze predictive variables of clinical outcomes. Method: A quantitative and associate design with a retrospective viewpoint was carried out. Data from 459 adults, children, and adolescents referred to the ARSUIC program from 2018 to 2022 were collected. The analysis was conducted using SPSS and R. Results: The number of appointments, social support, and attempted suicide explain the abandonment of the program; the number of appointments, psychiatric history, and suicide attempts the permanence in the program; and finally, clinical discharge was explained by the number of appointments, a psychiatric personal history, social support, and past psychological violence. Conclusions: This is the first study analyzing predictive variables of outcomes in the ARSUIC program. Increasing our knowledge about this is necessary to improve clinical interventions and reduce dropouts. [ABSTRACT FROM AUTHOR]

Previous epidemiological studies have reported a short-term association between ambient temperature and suicide risk. To gain a clearer understanding of this association, it is essential to differentiate the risk factors for intentional self-harm (ISH) from those specifically associated with suicide deaths. Therefore, this study aims to examine whether the association between daily temperature and ISH or suicide deaths differs by age and sex. Between 2014 and 2019, cases of emergency room visits related to ISH and suicide deaths in Seoul were identified. A time-stratified case-crossover design was used to adjust for temporal trends and seasonal variation. A distributed lag nonlinear model was used to analyze the nonlinear and time-delayed effect of ambient temperature on ISH and suicide deaths. Positive associations were observed between temperature and both ISH and suicide deaths. For ISH, the relative risk (RR) was high at 1.17 (95% confidence interval (CI): 1.03, 1.34) for a temperature of 25.7 °C compared with 14.8 °C. The RR for suicide death was higher than those for ISH, at 1.43 (95% CI: 1.03, 2.00) for a temperature of 33.7 °C. These associations varied by age and sex, with males and females aged 35–64 years showing increased susceptibility to suicide deaths. This study provides detailed evidence that unusually high temperatures, both anomalous and out of season, may trigger suicidal behaviors, including both ISH and suicide deaths. [ABSTRACT FROM AUTHOR]

Background: Previous studies demonstrate a link between irritability and suicidal thoughts and behaviors (STBs) in youth samples. However, they have mostly assessed irritability in community samples and as a largely dispositional (i.e. trait‐like) construct. Thus, it remains unclear to what extent links between irritability and STBs reflect within‐person processes of elevated risk in clinically meaningful time periods. Methods: The present study used clinical data from 689 adolescents aged 12–19 years attending a total of 6,128 visits at a specialty Intensive Outpatient Program for depressed and suicidal youth to examine patterns in weekly assessments of irritability and STBs throughout treatment, including associations among trends and fluctuations departing from these trends via multilevel structural equation modeling. Youth completed self‐report measures of irritability, depression, and STBs weekly as part of standard IOP clinical care. Results: Overall, two‐thirds of variance in weekly irritable mood was accounted for by between‐person differences and the remaining portion by weekly fluctuations. After controlling for depression, during weeks when youth were more irritable they experienced increased STBs. Rates of change in irritability and STBs tended to track together at early stages of treatment, but these effects were generally accounted for by depression severity. Conclusions: Our results suggest that although changes in STBs are best accounted for by depression, irritability can be understood as a specific, proximal risk factor for youth STBs that exacerbates youth STBs in clinically informative timeframes above and beyond depression. [ABSTRACT FROM AUTHOR]

This article uses data from a doctoral thesis concerning service users' views on what works for them in relation to their mental health wellness following a suicidal ideation/attempt in Aotearoa New Zealand. In particular, it focuses on the experiences of service users regarding mental health crisis team responses and what they wanted from their crisis teams specifically. Participants indicated that what they wanted was to feel heard, respected and not judged, consistent with the core conditions of therapeutic alliance within such professions as social work, counselling and psychology. Social work has a valuable role to play in emphasising and advocating for social, contextual and non-medical responses within crisis teams and service delivery. [ABSTRACT FROM AUTHOR]

The coronavirus infection 2019 (COVID-19) pandemic has affected on mental health and contributed to increased depression and anxiety. We assessed the impact of the COVID-19 pandemic on suicide-related the emergency department (ED) visits. We compared the characteristics of suicide-related patients who visited the ED between the "COVID-19 period" and the "pre-COVID-19 period". The mean age of patients was younger after COVID-19 pandemic. In comparison by age group, the proportion of patients during the COVID-19 period increased in their teens and 20s, and the rest of the age groups decreased. The proportion of patients who requested help was higher during the COVID-19. The authenticity of suicide attempts showed a higher proportion of patients during the pre-COVID-19. Therefore, during the pandemic, attention should be paid to worsening mental health problems, such as anxiety or depression, rather than the lethality of suicide attempts. [ABSTRACT FROM AUTHOR]

Evidence suggests that child maltreatment is a risk factor for adolescent suicidal behavior. However, the differential influence of distinct forms of child maltreatment on adolescent suicide attempts is understudied and the factors that might exacerbate or ameliorate these associations warrant attention. We examined the associations between two distinct forms of child maltreatment (threat and deprivation) and suicide attempt history, and investigated whether executive function domains moderated these associations. Participants were 119 adolescents (M = 15.24, SD = 1.46, 72.3% female) recruited from an inpatient psychiatric hospital during hospitalization for suicidal thoughts and behaviors. Results indicated that the executive function domains of initiation, shifting, and planning/organization moderated the associations between threat and suicide attempt history. Associations between threat and suicide attempt history were significant only when initiation and shifting T-scores were lower (OR = 1.22, p =.03 and OR = 1.32, p =.01, respectively). The association between threat and suicide attempt history trended toward significance when planning/organization T-scores were lower (OR = 1.15, p =.10). None of the executive function domains moderated the link between deprivation and suicide attempt history. Findings highlight the need for research investigating whether initiation, shifting, and planning/organization might be amendable to intervention in the context of threat-related child maltreatment. [ABSTRACT FROM AUTHOR]

Suicidal ideation (SI) assumes a pivotal role in predicting suicidal behaviors. The incidence of SI among high (junior and senior) school students is significantly higher than that of other age groups. The aim of this study is to explore the gender differences in SI among high school students in Yunnan Province. A total of 6180 students in grades 7–12 in Yunnan province, China from May 2021 to May 2022 participated in this survey. Univariate analysis was employed to describe the influencing factors of male and female students' SI. Subsequently, data were stratified by gender. Adopting machine learning technique, including Least Absolute Shrinkage and Selection Operator (Lasso) and Boruta algorithm, and logistic regression model to estimate the direction and effect magnitude of the influencing factors. The prevalence of SI was significantly higher for females (31.34 %) than males (16.73 %). The logistic regression model was established using the variables screened by Boruta algorithm, indicated that anxiety, depression, suffering emotion abuse or emotion neglect in childhood, non-suicidal self-injury, evening chronotype are common risk factors for SI in male and female students. Notably, female students who exhibited aggressive behavior, have experienced bullying, and were in the junior high school learning stage were more likely to report SI than their male counterparts. Females showed more vulnerability to SI than males especially among females in junior high school, reporting aggressive behavior and bullying experiences. Tailored prevention strategies, informed by these gender-related distinctions, should be developed and implemented. • Females who exhibit aggressive behaviors and experience campus bullying face a heightened risk of suicidal ideation compared to males. Prevention strategies for suicidal ideation based on gender-specific risk factors are proposed. [ABSTRACT FROM AUTHOR]

Background: Suicide remains a major global public health concern, ranking among the leading causes of death worldwide. Healthcare professionals play a crucial role in preventing suicide, yet their attitudes and beliefs about suicidal behavior can significantly impact the quality of care provided to individuals at risk. Objective: This study aimed to analyze the attitudinal beliefs of Colombian healthcare professionals regarding suicidal behavior and their attitudes toward suicide attempts. Methods: A cross-sectional study was conducted with 354 healthcare professionals, including interns, from fields such as medicine, nursing, and nursing assistance. Participants completed the Attitudinal Beliefs Questionnaire about Suicidal Behavior (CCCS-18) and the Attitudes Towards Suicide Attempt Scale (ASETSA). Descriptive and inferential statistical analyses were performed to examine the relationship between professional experience and attitudes toward suicidal behavior. Results: The findings revealed that many participants exhibit attitudes that legitimize suicide in cases of extreme suffering, such as in terminal illness. However, there were significant gaps in comprehensive approaches to suicide prevention, with varying levels of commitment to individual and institutional support. Clinical experience was identified as a key factor in shaping these attitudes, with more experienced professionals showing a nuanced understanding of suicide triggers and prevention. Conclusions: The results underscore the importance of ongoing training programs that not only improve technical knowledge but also address misconceptions and stigmas related to suicide. These findings have direct implications for developing targeted interventions and educational programs within the Colombian healthcare context to ensure more compassionate and effective care for individuals at risk of suicide. [ABSTRACT FROM AUTHOR]

The results of the empirical stage statistically proved that phototherapy is one of the effective tools of psycho-pedagogical assistance to adolescents who experience difficulties associated with emotional identification. We diagnosed the level of formation of this phenomenon within the sample of 240 respondents who are university and school students aged 17 to 20 years female and male. A number of psycho-diagnostic methods were used in the study: the method 'Toron to alexithymia scale (TAS-26)" and the questionnaire "self-attitude." Summarizing the results, we state that most of the studied sample is in a state of emotional well-being but emotional discomfort occurs among some respondents with certain levels of propensity for alexithymia (22.5%). The research proves the positive impact of phototherapy on adolescents' emotional identification development through photographing and creating visual pictures or direct perception and interpretation of images. [ABSTRACT FROM AUTHOR]

Objective: Surveys conducted in the past two decades in Iran indicate an increase in suicide and attempted suicide rates. This study aimed to determine the effectiveness of cognitive hypnotherapy on subjective pain and guilt in individuals with a history of suicide attempts. Methods and Materials: This quasi-experimental study employed a pre-test, post-test, and follow-up design with a control group. The statistical population comprised all individuals with a history of suicide attempts who visited the Nikandish psychiatric clinic in Sari during 2020-2021. A total of 30 patients were selected through convenience sampling and randomly assigned to either the experimental or control group. Data collection instruments included the Beck Depression Inventory (Beck, Steer, & Brown, 2001), Psychological Pain Assessment Questionnaire (Holden, Mehta, Cunningham, & McLeod, 2001), and Eysenck Guilt Questionnaire (Eysenck & Wilson, 1975). The experimental group underwent cognitive hypnotherapy in eight 90-minute sessions. Data were analyzed using repeated measures ANOVA via SPSS-21 software. Findings: The findings revealed that cognitive hypnotherapy significantly reduced subjective pain (F=19.65, p<.001) and guilt (F=10.80, p<.001) in individuals with a history of suicide attempts. Conclusion: Cognitive hypnotherapy is effective in alleviating mental pain and guilt among individuals with a history of suicide attempts. This therapeutic approach may be utilized to mitigate psychological issues in this population. [ABSTRACT FROM AUTHOR]

Women living with HIV face high social and structural inequities that place them at heightened risk for gender-based violence and mental health conditions, alongside health services access inequities, with almost no research done to better understand access to mental health services. This study therefore examined social and structural factors associated with barriers to counselling or therapy amongst women living with HIV who experienced lifetime physical and/or sexual violence in Metro Vancouver, Canada. Bivariate and multivariable logistic regression using generalized estimating equations (GEE) were used and adjusted odds ratios (AOR) and 95% Confidence Intervals ([95%CIs] are reported). From Sept/15-Aug/21, 1695 observations were collected among 279 participants. In multivariable analysis, with all variables measured in the last six months, experiencing any barriers to counselling or therapy was significantly associated with having thoughts or attempts of suicide (AOR:1.64 [1.02–2.66]), lacking coverage for health care (AOR:1.60 [1.17–2.18]), and everyday discrimination (AOR:1.02 [1.00-1.04]) and anticipated (AOR:1.57 [1.04–2.36]), enacted (AOR:1.48 [1.02–2.16]) or internalized (AOR:1.53 [1.07–2.20]) HIV stigma. Access to interdisciplinary mental health care services should be improved. Social and structural interventions to reduce HIV stigma and discrimination are urgently needed. [ABSTRACT FROM AUTHOR]

Objective: The therapeutic alliance is central to psychotherapy. However, research on the relationship between alliance and suicidality is scarce. We examined whether pretreatment suicidality is associated with an impaired alliance formation in brief cognitive behavioral therapy (CBT) and whether the therapeutic alliance is associated with change in suicidal ideation (difference between pretreatment and posttreatment assessment). Methods: N = 643 outpatients (64% female; age: M[SD] = 37.09[13.15], range: 18–73 years), received 12 sessions of manual-based short-term CBT for primary diagnosis treatment. Using self-report questionnaires, suicidal ideation and behavior were assessed before and after therapy, patient-rated therapeutic alliance was assessed after the fourth session and posttreatment. We performed correlation analyses and two hierarchical linear regressions, unadjusted and adjusted for possible confounding variables (age, gender, lifetime suicide attempts and depression). Results: Pretreatment suicidal ideation was not predictive of the quality of the early alliance. In addition, the therapeutic alliance was not predictive of change in suicidal ideation. Conclusions: In the outpatient setting, no association was found between therapeutic alliance and suicidality. Future studies should investigate therapeutic alliance as a predictor of prospective suicidal behavior in different clinical settings. [ABSTRACT FROM AUTHOR]

AbstractNon-suicidal self-injury (NSSI) and suicidal behavior in adolescence are global mental health concerns. These behaviors are often interconnected, but can also manifest independently. This study aimed to assess the predictive abilities of neuroticism, emotional competencies, and the school social climate on four typologies based on the presence of NSSI and levels of suicidal behavior. The study included 713 participants aged 11–16 years who completed questionnaires assessing suicidal behavior, NSSI, neuroticism, emotional competencies, and the school social climate. The data were analyzed using logistic regression techniques. The findings revealed that adolescents with high levels of neuroticism and emotion perception, low levels of emotion expression and regulation and an inadequate school social climate were more likely to belong to typologies characterized by NSSI and/or high suicidal behavior. This study underscores the importance of enhancing the school social climate as a crucial step toward reducing the likelihood of NSSI and suicidal behavior. [ABSTRACT FROM AUTHOR]

AbstractBackgroundObjectiveMethodsResultsConclusionsFew studies to date have examined the number of comorbid substances used alongside Prescription Opioid Misuse (POM) to predict suicidal behaviors among US young adults.This study investigated the relationship between comorbid substance use with POM and suicidal behaviors among the US young adults.Data were from individuals aged 18–25 (N = 69,204, 51.8% female) in the 2015–2019 National Surveys on Drug Use and Health (NSDUH). The final analytic sample for logistic regression was 36,892 young adults.After controlling for key covariates, the combination of POM and three or more illicit drugs were at the greatest odds of suicidal ideation (OR = 2.57, 95% CI = 1.61 − 4.11, p < 0.001) and attempts (OR = 3.57, 95% CI = 1.89 − 6.76, p < 0.001) compared to those without POM or drug use.The study provides evidence of a dose-response relationship between the number of illicit drugs uses alongside POM and the suicide risk as a clinically important phenomenon with implication for intervention. Findings highlight that POM, with or without illicit drug use, can serve as a behavioral and clinical indicator for identifying young adults at heightened risk of suicidality. This group warrants prioritized intervention targets to ensure timely access to developmentally appropriate clinical treatment, aiming to mitigate addiction progression and prevent harm and mortality. [ABSTRACT FROM AUTHOR]

Background: Admission to the university changes life conditions and thereby increases mental pressure. If the students cannot bear the psychological pressure of being a student, that may lead to suicide among the vulnerable persons. Therefore, in this research, we would like to investigate the prevalence and associated factors of suicide-related behaviors in Iranian students. Methods: This online, cross-sectional survey was performed from March 18 to April 15, 2023, in Iran. The questionnaires were completed by 2181 students. In this study, Perceived Stress Scale (PSS-4), Meaning in Life Questionnaire (MLQ), Generalized Anxiety Disorder Scale (GAD-7), and Suicidal Behaviors Questionnaire-Revised (SBQ-R), and Oslo Social Support Scale (OSSS-3) were used. Finally, we identified the factors associated with suicide-related behaviors using univariate and multiple regression. Results: The prevalence of suicidal behaviors in students was 57.95%. According to the results, male gender, marriage, having meaning in life, occasional smoking, sleeping after 1 a.m., and having social support were associated with a reduced risk of suicide. In addition, a history of sexual abuse, more anxiety, and higher perceived stress were associated with an increased risk of suicide. Conclusions: The prevalence of suicide-related behaviors in Iranian students was higher than expected. Urgent interventions should be considered to prevent students from committing suicide. Helping students find meaning in life, as well as eliminating the causes of students' anxiety and stress, may be effective in this respect. Additionally, teaching students how to control anxiety and stress may be helpful. [ABSTRACT FROM AUTHOR]

Background: Suicide is a global public health problem. In childhood, the risk factors are less clear, highlighting family and individual factors. This study aims to investigate the prevalence and sociodemographic, social, family, and individual factors associated with suicide ideation and attempts in pre-adolescents in a Brazilian city. Methods: The sample comes from a cohort of 500 schoolchildren of a city in Rio de Janeiro/Brazil. The data are analyzed cross-sectionally. The research incorporated data from the years 2005, 2006, and 2008 to evaluate suicide ideation and attempts in childhood, as reported by parents/caregivers, teachers and children. A hierarchical logistic model evaluated the association between the explanatory variables related to sociodemographic, social, family, and individual factors and the outcome. Results: 22.2% of the children (95% CI 18.0%-27.0%) had suicide ideation/attempts, reported either by their mothers, teachers, or the child at some point in a cohort. The following variables were associated with suicidal ideation/attempts in the final adjusted model: regular or poor quality of relationship with friends (OR = 1.84; 95% CI 1.31–2.58), having a family member incarcerated (OR = 1.44; 95% CI 1.07–1.92) and having worse performance in portuguese or mathematics than other students (OR = 2.05; 95% CI 1.29–3.26). Conclusion: Suicidal behavior in childhood is severe and affects everyone around the case, demanding to promote friendships, helping with school activities, and providing greater support and attention to children at risk. Bad relationships with friends and incarcerated family members are particularly key risk factors for suicide ideation and attempts. It is essential to improve prevention policies and to disseminate protective behaviors. There is a critical need to augment community mental health resources, mainly in less developed countries and regions that lack these services. [ABSTRACT FROM AUTHOR]

This large community-based cohort study investigates the impact of glucagon-like peptide-1 receptor agonists (GLP-1 RAs), specifically Liraglutide and Semaglutide, on the risk of developing psychiatric conditions such as depression, anxiety, and suicidal behaviors in patients with obesity. Utilizing post-marketing data, this research compares patients prescribed GLP-1 RAs (cases) with those not taking these medications (controls). The analysis spanned data from January 1, 2015, to December 31, 2023. To minimize selection bias, we employed 1:1 propensity score matching to account for demographic factors such as age, sex, race, and comorbidities. After matching, the study included 162,253 case and control patients. This study showed a significant association between GLP-1 RA treatment and an 98% increased risk of any psychiatric disorders. Notably, patients on GLP-1 RAs exhibited a 195% higher risk of major depression, a 108% increased risk for anxiety, and a 106% elevated risk for suicidal behavior. These findings underscore the critical need for physicians to thoroughly assess patient history before prescribing GLP-1 RAs and highlight the urgent requirement for further prospective clinical trials to fully understand the implications of GLP-1 RA use on mental health in the obese patient population. [ABSTRACT FROM AUTHOR]

Background: Worldwide, suicide is one of the leading causes of death among adolescents and young adults. Given that suicide in this age group is common within vocational students, this study aims to provide insights into the prevalence, course, and risk factors of suicidal ideation (SI) and suicide attempts (SA) among students in vocational education over the past 10 years. Methods: This study has a repeated cross-sectional design, utilizing data from 2013 to 2023 provided by the 'Testjeleefstijl' foundation in the Netherlands ('Test Your Lifestyle'). In total, 101,182 students in vocational education completed a web-based standardized questionnaire. Univariate logistic regression was used to test the predictive value of risk factors separately (anxiety and depression, gender, age and school year) on SI and SA. In addition, a machine learning model (Berkelmans et al., 2023) ​was used for high-risk identification of combined risk factors (multivariate models). Results: Within vocational students, 12-month SI and SA prevalence increased from respectively 17.7% and 2.3% in schoolyear 2013–2014 to 23% and 3.2% in 2022–2023. Although female gender significantly predicted SI and SA in the univariate analyses, the multivariate models revealed that female gender decreased the likelihood of both SI (OR 0.9) and SA (OR 0.7). A high risk for anxiety and depression was the strongest predictor in the multivariate models for SI (OR 42.8) and SA (OR 19.0). Conclusion: Over the past decade, the prevalence of SI and SA increased in students in vocational education, with the risk of anxiety and depression being the strongest contributing factor. While females had a higher prevalence of anxiety and depression, the results suggest these conditions tend to lead to SI and SA more quickly among male students. Early intervention in suicide prevention is crucial, highlighting the need to identify and address anxiety and depression. Vocational education schools have a critical role in this, emphasizing early screening and intervention, with specific attention to gender-specific factors. [ABSTRACT FROM AUTHOR]

Background: Despite suicide's public health significance and global mental health awareness, current suicide prevention efforts show limited impact, posing a challenge for low- and middle-income countries. This study aimed to develop a dynamic simulation model that could be used to examine the potential effectiveness of alternative interventions for reducing youth mental health problems and suicidal behavior in Bogotá, Colombia. Methods: A system dynamics model was designed using a participatory approach involving three workshops conducted in 2021 and 2022. These workshops engaged 78 stakeholders from various health and social sectors to map key mental health outcomes and influential factors affecting them. A model was subsequently developed, tested, and presented to the participants for interactive feedback, guided by a moderator. Simulation analyses were conducted to compare projected mental health outcomes for a range of intervention scenarios with projections for a reference scenario corresponding to business-as-usual. Results: A total of 6670 suicide attempts and 347 suicides are projected among 7 − 17-year-olds from January 1, 2023, to early 2031 under the business-as-usual scenario. Mental health issues among 12 − 17-year-olds are projected to increase from 18.9% (2023) to 27.8% (2031), and substance use issues from 2.29 to 2.49% over the same period. School-based suicide prevention and gatekeeper training are the most effective strategies, reducing total numbers of suicide attempts and suicides by more than 20% (i.e., compared to business-as-usual). However, discontinuous funding significantly hinders these effective suicide prevention efforts. Conclusions: Systems modelling is an important tool for understanding where the best strategic financial and political investments lie for improving youth mental health in resource-constrained settings. [ABSTRACT FROM AUTHOR]

Introduction Methods Results Conclusion Suicidal ideation has high rates among individuals at Clinical High Risk for Psychosis (CHR‐P). CHR‐P mental states are currently defined as attenuated psychotic symptoms, brief intermittent psychotic symptoms, or genetic risk and functioning deterioration syndrome. However, the relationship between psychotic experiences and suicidality in CHR‐P subjects is still not fully understood. Research emphasizes the need to address suicidality in CHR‐P individuals due to its incidence and severe socio‐economic impact. This study aimed to assess the baseline prevalence and 2‐year incidence rates of suicidal thinking and behaviors in an Italian CHR‐P sample, investigate the stability of suicidal ideation over 2 years, and examine its associations with treatment outcomes, sociodemographic characteristics, and clinical factors.CHR‐P participants were treated in an “Early Intervention in Psychosis” program and completed the PANSS and the GAF scale at baseline and every 12 months.180 CHR‐P individuals were enrolled (92 with suicidal ideation [SI+]). SI+ subjects had a higher baseline prevalence of past suicide attempts. Over 2 years, a decrease in suicidal ideation severity was observed in the total group. Longitudinal improvement in disorganized symptoms was a key predictor of the decrease in suicidal ideation. Participants with a history of suicide attempts were more likely to attempt again.Addressing disorganization is crucial for suicide prevention in the CHR‐P population. Continuous risk monitoring and preventive actions are needed for those with past suicide attempts. [ABSTRACT FROM AUTHOR]

The overriding aim of this study was to conduct a side‐by‐side comparative evaluation of two online suicide prevention gatekeeper‐training programs: Question, Persuade, Refer (QPR) and Making Educators Partners in Youth Suicide Prevention (MEP). Specific aims included identifying program components, instructional methods, and technology elements that are well received by school personnel and that increase knowledge and self‐efficacy. QPR and MEP were directly assessed following levels one and two of Kirkpatrick's Model (i.e., reactions to training, program efficacy), and indirectly assessed at levels three and four (i.e., future gatekeeper behaviors, potential school community impact). QPR and MEP produced positive outcomes with respect to reactions, knowledge, and self‐efficacy (i.e., Kirkpatrick levels one and two). MEP and QPR also produced partial support with respect to behavior and impact (i.e., Kirkpatrick levels three and four), given the limited objective data demonstrating consistent application of gatekeeper skills that reduce community suicidal behaviors. Taken together, future research should evaluate inclusion of innovative pedagogical approaches and strategic online classroom design, which may enhance learning motivation, attitudes, and self‐efficacy. Research should also objectively evaluate intermediate and longer‐term behavioral outcomes to identify population‐level impact. [ABSTRACT FROM AUTHOR]

Suicidal thoughts and behaviors often emerge in a predictable sequence, with suicidal ideation (SI) preceding planning, and planning preceding actions. Few studies, however, have considered the timing and duration of non-suicidal self-injury (NSSI) in these transitions. Accordingly, this study examined: 1) the developmental sequencing of NSSI, SI and suicide attempts, and 2) whether age of onset or duration predict transitions from NSSI to other SITB, and from SI to NSSI. 704 first-year students from a mid-sized Canadian university (Sample 1) and 2095 adults from an online research volunteer panel (Sample 2) completed the Self-Injurious Thoughts and Behaviors Interview self-report, which assessed the presence, age of onset, and recency of SITB. NSSI and SI typically onset before age 15, while suicide planning and attempt usually began at or after age 15. Transition from NSSI to SI was likeliest in the first year after NSSI onset. Transition from NSSI to suicide attempt was likeliest in the second and third year after NSSI onset in Sample 1, and up to four years after NSSI onset in Sample 2. Early (before age 13) and late (after age 16) onsets of NSSI predicted higher odds of transitioning from NSSI to SI or attempt. Transition from SI to NSSI was likeliest in the first two years after SI onset and when SI began before age 13. The first year after NSSI or SI onset are critical for transitions to other SITB. Targeted prevention and monitoring should be considered for people who recently initiated NSSI. • NSSI and suicidal ideation (SI) typically begin within 1–2 years of each other • Transition from NSSI to SI was likeliest in the first year after NSSI onset • Transition risk from NSSI to attempt persisted for 3+ years after NSSI onset • NSSI onset before age 13 or after 16 predicted transitioning to SI or attempt • Onset of SI before age 13 predicted transition to NSSI [ABSTRACT FROM AUTHOR]

A relatively small number of studies have researched the relationship between sleep duration and suicidal ideation, attempts, and behavior. This research aims to investigate the link between sleep duration and suicide in Chinese adolescents, and to examine the role of depression as a mediating factor. Data were collected from 3315 students using a multi-stage random cluster sampling method and self-administered questionnaires. The study applied logistic regression to investigate the relationship between sleep duration and various forms of suicidal behavior, and mediation analysis to understand how depression might influence this relationship. The average sleep duration among the adolescents was 7.25 h (±0.20), with 59.67 % reporting insufficient sleep. The logistic regression analysis showed that longer sleep duration is linked with lower risks of suicidal ideation (OR: 0.753, 95% CI : 0.696 to 0.814), suicidal attempts (OR: 0.830, 95% CI : 0.748 to 0.922), and suicidal behavior (OR: 0.841, 95% CI : 0.713 to 0.992). Analysis using restricted cubic spline plots indicated the connection between sleep duration and these suicidal factors was not linear. The study found that depression plays a partial mediating role between sleep duration and suicidal ideation, with an effect of 52.29 %. The cross-sectional study design could not prove causation. There is a clear non-linear association between sleep duration and suicidal tendencies in adolescents, with depression acting as a mediator. This suggests that future research could focus on sleep and mood management as ways to address suicide risk in this age group. • Long sleep duration was only positively association with suicidal ideation. • Short sleep duration was positively association with suicidal attempt and suicidal behavior, and long sleep would cause adverse effects. • The study calculated the mediating effect of depression between sleep and suicide. [ABSTRACT FROM AUTHOR]

The current study uses a nationally representative longitudinal dataset of sexual minority adults in the US to investigate the pathways from adverse childhood experiences (ACEs) to adulthood suicidal thoughts and behaviors. ACEs were measured at year one, potential mediators at year two, and suicidal thoughts and behaviors (suicidal ideation, intent, plan, and attempt) at year three. We conducted an exploratory mediation analysis to identify potential mediating factors linking ACEs to suicidal thoughts and behaviors. Ten candidate mediators were examined: social well-being, felt stigma, experiences of everyday discrimination, social support, psychological distress, alcohol and drug use, importance of sexual identity, community connection, and internalized homophobia. Participants were 1518 adults who identified as lesbian or gay (n = 833; 55 %), bisexual (n = 493; 33 %), or with other sexual minority identities (n = 181; 12 %) and were on average 36.48 years (SD = 14.7) of age. Psychological distress served as a common mediator between ACEs and suicidal ideation, intent, plan, and attempt. Additionally, experiences of everyday discrimination emerged as a specific mediator leading to suicidal intent, whereas social support uniquely mediated the relation between ACEs and suicide plan. Potential recall bias due to retrospective reporting of ACEs may be a limitation. Future studies should broaden the measurement scope of ACEs and implement intersectional methods. The current findings underscore the urgent need for targeted interventions that address the specific mental health needs of sexual minority individuals, particularly focusing on mitigating psychological distress, combating systemic discrimination, and enhancing social support. • Psychological distress is a universal mediator linking adverse childhood experiences to suicidal thoughts and behaviors. • Everyday discrimination and social support are specific mediators for suicidal intent and plan, respectively. • Pathways related to suicide attempts are less stable compared to other forms of suicidal thoughts and behaviors. [ABSTRACT FROM AUTHOR]

Suicide ranks as a leading cause of premature death among adolescents globally. Understanding the trends and key determinants of suicidal behavior in youth are critical for implementing educational policies and supporting preventive strategies in schools. This retrospective study examined all hospitalizations due to suicidal behavior in children and adolescents aged 11 to 18 years in Spain, using data from the Spanish National Registry of Hospital Discharges spanning 2000 to 2021. Over the 22-year study period, there were 2,015,589 hospitalizations among adolescents in Spain, with 118,609 (5.9 %) cases involving mental disorders. There were 2855 admissions with suicidal behavior, constituting 2.4 % of the hospitalizations among youth with mental disorders. Girls represented 73.4 % of all hospitalizations, with a median age of 16 years. Admissions for suicidal behavior saw a four-fold increase during the last decade (p < 0.001). The in-hospital mortality rate for adolescents with suicidal behavior doubled that of those hospitalized for other mental disorders. During the first year of the COVID-19 pandemic, admissions of adolescents with suicidal behavior decreased, only to surge by 2.5-fold during 2021. Hospital admissions for suicidal behavior among adolescents have risen in Spain over the last two decades. Girls represented 73.4 % of these admissions, yet in-hospital mortality was more frequent in boys. • A total of 2855 hospitalizations in adolescents with suicidal behavior were recorded in Spain from 2000 to 2021. • They represented 2.4 % of admissions due to mental disorders in youth. • Girls represented 73.4 % of hospitalizations with suicidal behavior, with a median age of 16 years. • In-hospital mortality was more frequent in boys than girls. • Admissions for suicidal behavior in youth saw a 4-fold increase during the last decade [ABSTRACT FROM AUTHOR]

AbstractThe present review explored the prevalence and factors of mental health conditions among lesbian, bisexual, and other sexual minority women (LBSW) in Southeast Asia. It found that the rates of significant depression and depressive symptoms range from 10% to 93.2%, with a median of 27.7%. This wide range can be due to a study conducted during the COVID-19 pandemic, which found elevated depression, stress, and anxiety rates. Studies also highlight high levels of sadness, hopelessness, sleep and eating problems, fatigue, and suicidal thoughts among LBSW. Suicide rates indicate that LBSW have higher odds of suicidal ideations and attempts than their heterosexual peers in the region. Additionally, bisexual and polysexual women report higher rates of depressive symptoms and suicidal behaviors than lesbian women, necessitating tailored mental health interventions. Substance use among LBSW is also notable, including smoking and heavy drinking, though some rates are below the global average. Factors influencing mental health include openness about sexuality, coping styles, and discrimination. Discrimination is linked to various mental health issues, supporting the minority stress model’s applicability in the region. Aging-related factors also affect mental health among LBSW, with older age being possibly protective against depression. Overall, this review highlights the urgent need for more inclusive mental health research and interventions in the region. Recommendations include training healthcare providers, developing tailored mental health programs, adopting suicide prevention initiatives, enacting anti-discrimination laws, and addressing substance use. Future research should focus on underrepresented regions and older LBSW. [ABSTRACT FROM AUTHOR]

Suicidal ideation assessment can help reduce the suicide rate among people in prison. Studies for the assessment of suicidal ideation and risk factors for suicide among inmates have been done in Western countries, but in India, data is lacking regarding the assessment of suicidal ideation among the people in prison.1. To assess the prevalence of suicidal ideationin people in prison.2. To identify aggravating factors for suicidal behavior.It was a cross Sectional Observational Study at a district jail, Lajpore, Surat, Gujarat. After permission from the jail authority, people in prison with or without conviction, who were willing to give consent for participation, were enrolled in the study. Semi-structured questionnaires are used to assess socio-demographic profiles. Modified Suicide Ideation scale (MSSI) and General Health Questionnaire (GHQ) and PatientHealth Questionnaire (PHQ) scales were used as materials to assess suicidal ideation and psychiatric comorbidity. Frequency analysis and Pearson correlation among various factors with the use of appropriate statistical methods. Descriptive and qualitative analysis of data was done on 140 incarcerated persons in prison. Analysis showed that 10 (7.1%) people in prison had moderate suicidal ideation in the last 48 hours while 58 (41.4%) people in prison had suicidal ideation at any point in their life. The prevalence of depressive symptoms was high among people in prison. 57.9% had minimal depressive symptoms, while 9.3% had moderate to severe symptoms. Non-convicted inmates from urban areas were having significantly more psychological distress and depressive symptoms than other inmates. Advanced ageof the inmates, negative impact of imprisonment on life, depressive symptoms, and psychosocial distress emerged as risk factors correlated with suicidal ideation. During suicide risk assessment, inmate’s age, the impact of imprisonment, psychosocial distress, and depressive symptoms should be considered as risk factors among people in prison. [ABSTRACT FROM AUTHOR]

AbstractA rapidly growing literature highlights a critical need for targeted suicide prevention and risk mitigation strategies for veterans navigating the military-to-civilian transition. Although various risk correlates of suicidal thoughts and behavior among transitioning veterans have been identified, how and why these correlates occur and interact to affect suicidality remains unclear. Guided by the 3 Step Theory of Suicide, 10 recently discharged United States military veterans with a history of post-discharge suicide thoughts, urges, or behaviors completed interviews on the military-to-civilian transition and suicidal thoughts and behaviors occurring during this time. Thematic analysis highlighted an overarching theme of transition whiplash comprising four subthemes: unpreparedness, economic vulnerability, identity disruption, and social alienation. Veterans’ recommendations for improving suicide-prevention efforts included providing a primary contact to provide personalized support and guidance throughout transition and increasing accessibility of peer support. Results provide nuanced insight into experiences that may underlie suicide risk during the military-to-civilian transition. [ABSTRACT FROM AUTHOR]

AbstractBackgroundMethodsFindingsConclusion\nHIGHLIGHTSThe objectives of this study were to investigate the relationship between perinatal risk factors and suicidal ideation and attempts in young adults in Pelotas, Brazil.The data were collected from the 1993 Pelotas Birth Cohort study. Every pregnant woman who gave birth in one of the hospitals in Pelotas Brazil in 1993 was invited to participate in the study. The current study uses perinatal data collected in 1993, and follow-ups at ages 18 and 22. The primary outcome was lifetime suicide attempts with past month suicide ideation a secondary outcome. The association between perinatal predictors and suicidal ideation or lifetime suicide attempts was investigated using hierarchical logistic regression.There was an analytic sample size of 3493. The perinatal factors association with lifetime suicide attempts were sex (OR = 2.25 CI: 1.76–2.89), paternal education at birth (OR = 0.60, 95%CI: 0.36–0.99), maternal education (9–11 years OR = 2.81, 95%CI: 1.41–5.59, & 0–8 years OR = 2.21, 95%CI: 1.07–4.58), support from friends or neighbors at birth (OR = 0.36 95%CI: 0.17–0.77), and maternal smoking during pregnancy (OR = 1.41, 95%CI: 1.10–1.79). Patterns of associations were broadly similar with suicidal ideation. Interactions between sex and the perinatal factors paternal education, maternal education, smoking and support from friends were assessed and found to be not significant.Several factors during the perinatal period are associated with risk of lifetime suicide attempts and ideation in young adults in Brazil. Early-life factors associated with suicide-related concerns in early adulthood were similar to those observed in studies from high-income settings.Perinatal factors associated with suicidal behaviour were determined using data from upper-middle income setting.Maternal education, and maternal smoking are associated with risk of lifetime suicide attempts.Perinatal factors associated with suicidal ideation were similar to those of suicide attempts, including sex, maternal education, and maternal smoking.Perinatal factors associated with suicidal behaviour were determined using data from upper-middle income setting.Maternal education, and maternal smoking are associated with risk of lifetime suicide attempts.Perinatal factors associated with suicidal ideation were similar to those of suicide attempts, including sex, maternal education, and maternal smoking. [ABSTRACT FROM AUTHOR]

Background: Given the limited research focusing on psychotherapeutic interventions for suicide attempters, it is noteworthy that the Attempted Suicide Short Intervention Program (ASSIP) has demonstrated promising results in previous studies. In this investigation, we aim to evaluate the effectiveness of ASSIP across diverse healthcare settings, outlining the study design and planned evaluation. Methods: Using a Randomized Controlled Trial (RCT) design with four assessment points (baseline, 3, 12- and 24-month follow-up), we aim to assess the effect of the 3-session psychotherapeutic intervention and hereafter brief contact via structured letters during 2 years in a clinical sample of recent suicide attempters (suicide attempts within three months before inclusion). Participants are randomly assigned to one of two groups; treatment as usual plus ASSIP or the control condition, treatment as usual. Assessments include measures of suicidal intent, coping, symptoms of depression, quality of life, self-stigma, and sick leave. The primary outcome is suicide attempt(s) within 3, 12, and 24 months and the secondary outcome is suicidal ideation within the same time frames after study inclusion. Discussion: Findings from this study will provide novel insights regarding the effects of ASSIP on not only subsequent suicidal behavior but also other outcomes including self-stigma, quality of life, social network, sick leave, and symptoms of depression. Trial registration: The trial was registered at ClinicalTrial.gov NCT04746261 on 2020-10-15. [ABSTRACT FROM AUTHOR]

The present study aimed to examine the association between the presence, number, and type of positive psychotic symptoms (PPS) and clinical severity in adolescent patients. Five hundred-six patients aged 11–17 years were assigned to either the noPPS (n = 341), the delusional beliefs only (del; n = 32), the hallucinations only (hall; n = 80), or the delusional beliefs and hallucinations (del&hall; n = 53) group. Generalized Structural Equation Modeling was applied to identify the best-fitting model representing clinical severity indicated by psychiatric diagnoses, depressivity, personality pathology, non-suicidal self-injury, suicide attempts, perceived stress, and psychosocial impairments, assessed by interviews and questionnaires. The groups were compared concerning the final model's factors. The final model consisted of three factors representing psychopathology and functional impairments, self-harming behavior, and perceived stress (BIC difference to reference model: 103.99). Participants with any PPS scored higher on all factors than the noPPS group (differences in SD: 0.49–1.48). Additionally, the del&hall group scored 1.31 SD higher on psychopathology and functional impairments than the hall group, and 1.16 SD higher on self-harming behavior compared to the del group. Finally, the hall group scored 0.84 SD higher on self-harming behavior than the del group, with no group differences in the other factors. In adolescent patients, the presence of PPS may represent a marker for a more severe form of mental disorder, with hallucinations being indicative of self-harming behavior. Early transdiagnostic assessment of PPS seems indicated as it may inform treatment in the context of clinical staging. [ABSTRACT FROM AUTHOR]

There might be differential characteristics between those who have attempted suicide once in their lifetime (single attempters) and those who have attempted suicide two or more times (multiple attempters). We aimed to identify the factors that differentiate single and multiple attempters in child and adolescents. This study was conducted following the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines, and the review protocol was registered in PROSPERO. We conducted a systematic literature search in three databases to identify original studies exploring the characteristics of single attempters vs. multiple attempters among adolescents. We considered a wide range for the definition of adolescent, following most recent recommendations: 10–24 years. We carried out a meta-analysis. Fourteen studies were included in the systematic review and 13 in the meta-analysis with a total sample of with a total of 4286 participants. The factors statistically significantly associated with being a multiple attempter in the meta-analysis were: anxiety disorders, depression severity, alcohol abuse, substance abuse, aggressiveness, and hopelessness. Multiple attempters have a more severe clinical profile, with greater severity of symptoms. Knowledge of the risk factors associated with being a multiple attempter could help us to predict which patients are more likely to reattempt suicide and need further monitoring and a tailored treatment. Prevention programs tailored for the adolescent population, along with identification of early risk factors, could help to prevent suicidal behavior among this vulnerable population. [ABSTRACT FROM AUTHOR]

Resumen: Antecedentes: La adolescencia es un periodo importante del desarrollo en el que pueden aparecer problemas psicológicos, incluyendo conducta suicida. Además, experimentar acontecimientos vitales estresantes (AVEs) puede contribuir a su aparición, aunque el impacto de distintos tipos de AVEs ha sido escasamente examinado. Este estudio pretende analizar asociaciones entre diferentes AVEs, problemas psicológicos, bienestar subjetivo y conducta suicida en adolescentes. Se desarrolló un nuevo instrumento -Stressful Life Events Checklist for Adolescents (SLECA)- donde los AVEs se clasificaron como: leves/graves, dependientes/independientes, interpersonales/no-interpersonales y crónicos/episódicos. Método: Se incluyeron dos oleadas. 5.610 adolescentes participaron en la primera y 2.312 en la segunda. Resultados: Los AVEs graves-dependientes-interpersonales-episódicos se asociaron fuertemente a problemas exteriorizados; los AVEs graves-dependientes-no-interpersonales-episódicos mostraron la más alta relación con problemas de atención e hiperactividad; y los AVEs graves-independientes-crónicos se asociaron tanto a bajo bienestar subjetivo como a problemas interiorizados. Los AVEs académicos y relacionados con problemas con los iguales se relacionaron con problemas psicológicos y bajo bienestar subjetivo. Controlando por variables de salud mental, la conducta suicida se asoció a AVEs graves-independientes-crónicos y los relacionados con la victimización y problemas con la sexualidad. Conclusiones: El SLECA es un instrumento útil para evaluar AVEs en adolescentes, desenredando las interrelaciones entre AVEs, salud mental y conducta suicida. [ABSTRACT FROM AUTHOR]

Background: Suicide behavior represents a major public health problem for the older population. Within the continuum of suicidal behavior, suicidal ideation may lead to a suicide attempts/death. Risk factors for developing suicidal ideation include mobility limitations, lack of social participation and loneliness. However, there is a need for longitudinal studies to examine these relationships over time. Method: 50423 older people from three waves of the SHARE project formed the sample (60 years in the first wave; M ± SD = 71.49 ± 8.15; 55% female). Results: A series of nested Cross-Lagged Panel Models (CLPM) of suicidal ideation, mobility limitations, social participation and loneliness were tested. The best fitting model was that with equal autoregressive and cross-lagged effects across waves ((2 = 1220.56, CFI =.982, RMSEA =.028, SRMR =.024). The autoregressive effects showed high stability across waves. The cross-lagged effects between suicidal ideation and mobility limitations were strong, while the cross-lagged effects between suicidal ideation and social participation were comparatively smaller. In the case of loneliness, statistical significance was not achieved. Conclusions: These findings highlight the importance of promoting mobility programs and social activities to prevent suicidal ideation among older adults. [ABSTRACT FROM AUTHOR]