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Summary: Background: Predicted increases in suicide were not generally observed in the early months of the COVID-19 pandemic. However, the picture may be changing and patterns might vary across demographic groups. We aimed to provide a timely, granular picture of the pandemic's impact on suicides globally. Methods: We identified suicide data from official public-sector sources for countries/areas-within-countries, searching websites and academic literature and contacting data custodians and authors as necessary. We sent our first data request on 22nd June 2021 and stopped collecting data on 31st October 2021. We used interrupted time series (ITS) analyses to model the association between the pandemic's emergence and total suicides and suicides by sex-, age- and sex-by-age in each country/area-within-country. We compared the observed and expected numbers of suicides in the pandemic's first nine and first 10-15 months and used meta-regression to explore sources of variation. Findings: We sourced data from 33 countries (24 high-income, six upper-middle-income, three lower-middle-income; 25 with whole-country data, 12 with data for area(s)-within-the-country, four with both). There was no evidence of greater-than-expected numbers of suicides in the majority of countries/areas-within-countries in any analysis; more commonly, there was evidence of lower-than-expected numbers. Certain sex, age and sex-by-age groups stood out as potentially concerning, but these were not consistent across countries/areas-within-countries. In the meta-regression, different patterns were not explained by countries’ COVID-19 mortality rate, stringency of public health response, economic support level, or presence of a national suicide prevention strategy. Nor were they explained by countries’ income level, although the meta-regression only included data from high-income and upper-middle-income countries, and there were suggestions from the ITS analyses that lower-middle-income countries fared less well. Interpretation: Although there are some countries/areas-within-countries where overall suicide numbers and numbers for certain sex- and age-based groups are greater-than-expected, these countries/areas-within-countries are in the minority. Any upward movement in suicide numbers in any place or group is concerning, and we need to remain alert to and respond to changes as the pandemic and its mental health and economic consequences continue. Funding: None.

Stigma, javna ali samostigma, zaviralno vpliva na iskanje pomoči v primeru duševne stiske. Lahko je prisotna med aktivno epizodo duševne bolezni ali pa jo posameznik predvideva, če bi se duševna bolezen razvila (predvidena stigma). Pomembna in ranljiva skupina za razvoj duševnih bolezni, ki je žal velikokrat spregledana, so strokovnjaki na področju duševnega zdravja. Na vzorcu strokovnjakov iz Slovenije (N = 93), ki se pri svojem delu srečujejo z vsebinami duševnega zdravja, smo raziskovali, kako se osebne izkušnje s težavami v duševnem zdravju in samomorilnim vedenjem povezujejo z različnimi vrstami predvidene samostigme (samostigme duševnih bolezni in iskanja pomoči). V preteklosti je 49 % udeležencev imelo težave na področju duševnega zdravja ali se je z njimi soočalo v času raziskave (56 % je poiskalo pomoč); 16 % udeležencev je v preteklosti imelo samomorilne misli ali se je z njimi soočalo v času raziskave (20 % jih je poiskalo pomoč). Spol ni bil opazno povezan z nobeno vrsto predvidene stigme. Starost je nizko negativno korelirala z izkušnjo težav v duševnem zdravju in predvideno samostigmo duševnih težav. Udeleženci z osebnimi izkušnjami duševnih težav so izkazovali več predvidene samostigme duševnih težav kot udeleženci, ki teh izkušenj nimajo. S samostigmo duševnih težav je bila nizko povezana tudi samostigma iskanja pomoči. Na osnovi rezultatov zaključujemo, da so pri strokovnjakih za duševno zdravje lastne izkušnje težav v duševnem zdravju povezane z višjo samostigmo duševnega zdravja, ta pa z višjo samostigmo iskanja pomoči. Zato bi bile tudi pri njih potrebne specifične intervencije, usmerjene v destigmatizacijo duševnih težav in iskanja pomoči, predvsem pa nadaljnje raziskave na tem področju.

BackgroundMental health has been heavily affected during the COVID-19 pandemic. In this study we compared the prevalence of flourishing and languishing mental health during the pandemic and examined which factors are associated with either category of positive mental health respectively.MethodsData from two cross-sectional surveys with nationally representative samples of adult population in Slovenia conducted in 2019 (n = 9,047) and in 2021 (n = 3,429) are used. Positive mental health was measured with Mental Health Continuum–Short Form instrument. Logistic regression was used to examine the associations between flourishing and languishing mental health and relevant COVID-19 specific and other health-related factors.ResultsThere was a substantial decrease in the prevalence of flourishing and an increase in the prevalence of languishing mental health during the pandemic. Distribution of both flourishing and languishing mental health followed the socio-economic gradient. Resilience, COVID-19 literacy and changes in family relations, social interactions, and dietary habits were associated with both flourishing and languishing mental health.ConclusionPositive mental health of the population worsened during the pandemic, more so in traditionally disadvantaged populations. Public health efforts need to be focused appropriately with an increased emphasis on strengthening resilience and health literacy.

BackgroundStigma about mental illness—both public and self—is one of the most important factors hindering help-seeking. Stigma can occur during an acute episode of mental illness or be anticipatory. One group affected by stigma, but often neglected, is mental health professionals. This study examined the anticipated form of mental-illness and help-seeking self-stigma and the anticipated form of public stigma of suicidal behavior among members of the International Association for Suicide Prevention. We hypothesized that suicidologists with a history of suicidality or mental illness would anticipate greater stigma from the public and self.MethodsThe study received ethical approval from the Commission for Medical Ethics of the Republic of Slovenia. Data from 83 participants who completed an online survey (February to May 2020) with informed consent were analyzed using path analysis. We tested a model predicting help-seeking self-stigma based on (i) personal experience of mental illness using anticipated self-stigma of mental illness as a mediating variable and (ii) history of suicidal behavior using anticipated public stigma of suicidal behavior as a mediating variable.ResultsPersonal experience of mental illness predicted anticipation of self-stigma of mental illness (β = 0.26). History of suicidality predicted anticipation of public stigma of suicidal behavior (β = 0.29). Anticipated self-stigma of mental illness proved to be a stronger predictor of help-seeking self-stigma (β = 0.40) than anticipated public stigma of suicidal behavior (β = 0.07).ConclusionsIt is important to intentionally support the mental health of suicide prevention professionals, as they are not immune to mental illness or various types of stigma. Because our sample was small and diverse, further research to better understand stigma concepts in this population is warranted.

Suicidal behaviour is a consequence of simultaneous influences of many factors. Basically it can be regarded as a consequence of an interplay of two risk factors, namely genetic and environmental, which express themselves in the form of sociological, biological and psychological factors. It is difficult to find a theory of suicidal behaviour which would cover or consider all factors, and although present theories are overlapping, they emphasize different risk factors. More recent studies are focusing on neuropsychological and cognitive functioning of suicidal persons. The most cited psychological theory of suicidal behaviour is the Cry of Pain model which understands the suicidal behaviour as a consequence of a situation signaling defeat, entrapment and no rescue, which subsequently can lead to feelings of hopelessness. The psychobiological theory of two vulnerability components of sucidal behaviour extends existing psychological theories and helps to understand why some persons with depressive disorder engage in suicidal behaviour and the other don't. Both theories imply impaired cognitive abilities in suicidal persons. It is still not entirely understood if these cognitive impairments can be regarded as a state or a trait feature. What happens with cognitive functions after the initial crisis is over, explains the Theory of differential activation. The purpose of the present paper is to introduce and combine these theories and discuss their practical implications.

The purpose of the study was to identify changes in cognitive abilities that affect patients with relapsing remitting form of multiple sclerosis (MS) and to find out which instrument manifests them best. The performance of MS patients was compared to a matched group of healthy people using three neuropsychological tests: Wisconsin card sorting test (WCST), Stroop color and word test and Trail making test (TMT part B). Results on all three tests indicate general cognitive impairments in the group of patients. Compared to the group of healthy people patients with MS exhibited impaired ability of abstract reasoning (WCST), impaired cognitive flexibility and less resistance to irrelevant stimuli (Stroop color and word test), slowed information processing and impaired ability of shifting attention from one symbol to another (TMT). The largest differences between groups occured in Stroop color and word test as well as in TMT. The estimation of cognitive abilities of MS patients is of high importance and sistematicaly observing of changes in those abilities should be considered.

Background: For many years, discussions about mental health evolved only around its negative aspects, i.e. mental diseases, symptoms and disorders. Positive mental health was given much less attention. This overview, which is based on numerous studies regarding mental health, is intended to present at least a few of the most outstanding data on negative as well as positive mental health of the Slovene population. The data show that a majority of visits on the primary and secondary levels of health care are associated with depression, anxiety and schizophrenia. Hospitalizations due to mental health problems are the longest among all hospitalizations. 9 % of all prescriptions issued in an outpatient clinic were intended for the treatment of mental disorders. Another allarming fact is that people take medicines even without consulting a physician. Data reagrding positive mental health are much more scarce, but nevertheless, they show that the Slovene people have a high self-esteem and sense of mastery and at the same time a low level of vitality and energy. Numerous data reveal that in mental health too there are obvious health inequalities regarding the socio-economic status and gender.