Suicidality is a complex phenomenon influenced by genetic,environmental,and epigenetic factors.Current tools to estimate suicide risk are insufficient,and there is an increasing need for reliable biomarkers to complem...Suicidality is a complex phenomenon influenced by genetic,environmental,and epigenetic factors.Current tools to estimate suicide risk are insufficient,and there is an increasing need for reliable biomarkers to complement clinical approaches.Growing evidence suggests that immune system dysregulation contributes to the pathophysiology of psychiatric disorders and suicidal behavior.Epigenetic mechanisms,including DNA methylation,histone modifications,and non-coding RNAs,regulate gene expression and may act as a bridge between environmental stressors and(neuro)inflammatory responses.In this review,we examine the evidence of peripheral and central inflammation in suicide completers and individuals with suicidal behavior.Next,we review current knowledge from various studies on suicide-associated epigenetic alterations.Furthermore,we evaluate the mechanisms by which early life adversity and chronic stress contribute to suicide diathesis,focusing on their association with epigenetic modifications and inflammatory pathways.We also examine future prospects and limitations of immunology-related biomarkers and the possibilities of therapeutic interventions targeting the immune system and epigenetic regulation.While challenging,research on epigenetic and immune alterations in suicidality shows promise for identifying suicide risk subtypes and advancing personalized psychiatry.展开更多
Background: The many dangers and stressors associated with police work often place police officers at a great risk of a variety of mental health morbidity, including suicidality. The causation of suicidality is multi-...Background: The many dangers and stressors associated with police work often place police officers at a great risk of a variety of mental health morbidity, including suicidality. The causation of suicidality is multi-dimensional, however, there are insufficient studies which have examined the burden and risk factors of suicidality in Nigerian police officers. Objective: To determine the prevalence and predictors of suicidality among police officers in Lagos, Nigeria. Methods: This was a cross-sectional study of 600 police officers who were selected using a non-probability sampling method. Questionnaires used were: Suicide Behaviour Questionnaire-Revised (SBQ-R), State-Trait Anxiety Inventory (STAI), and a Socio-Demographic Questionnaire. Results: Prevalence of suicidality was 14%, and the predictors of suicidality were: state anxiety (p 0.001), trait anxiety (p 0.001), substance use (p = 0.03), being unmarried (p = 0.03), and female gender (p = 0.02). Conclusion: Suicidality is prevalent among Nigerian police officers, with a higher risk in those who are vulnerable. The creation of government policies and infrastructure which promote mental health in police officers is necessary.展开更多
Background:Major depressive disorder(MDD)is associated with high risk of suicide,but the biological under-pinnings of suicidality in MDD patients are far from conclusive.Previous neuroimaging studies using voxel-based...Background:Major depressive disorder(MDD)is associated with high risk of suicide,but the biological under-pinnings of suicidality in MDD patients are far from conclusive.Previous neuroimaging studies using voxel-based morphometry(VBM)demonstrated that depressed individuals with suicidal thoughts or behaviors exhibit specific cortical structure alterations.To complement VBM findings,surface-based morphometry(SBM)can pro-vide more details into gray matter structure,including the cortical complexity,cortical thickness and sulcal depth for brain images.Objective:This study aims to use SBM to investigate cortical morphology alterations to obtain evidence for neuroanatomical alterations in depressed patients with suicidality.Methods:Here,3D T1-weighted MR images of brain from 39 healthy controls,40 depressed patients without suicidality(patient controls),and 39 with suicidality(suicidal groups)were analyzed based on SBM to estimate the fractal dimension,gyrification index,sulcal depth,and cortical thickness using the Computational Anatomy Toolbox.Correlation analyses were performed between clinical data and cortical surface measurements from patients.Results:Surface-based morphometry showed decreased sulcal depth in the parietal,frontal,limbic,occipital and temporal regions and decreased fractal dimension in the frontal regions in depressed patients with sui-cidality compared to both healthy and patient controls.Additionally,in patients with depression,the sulcal depth of the left caudal anterior cingulate cortex was negatively correlated with Hamilton Depression Rating Scale scores.Conclusions:Depressed patients with suicidality had abnormal cortical morphology in some brain regions within the default mode network,frontolimbic circuitry and temporal regions.These structural deficits may be associated with the dysfunction of emotional processing and impulsivity control.This study provides insights into the underlying neurobiology of the suicidal brain.展开更多
BACKGROUND Appropriate care for individuals who attempt suicide and are admitted to the emergency department(ED)can prevent future suicidal behavior.It is vital to understand their sociodemographic characteristics and...BACKGROUND Appropriate care for individuals who attempt suicide and are admitted to the emergency department(ED)can prevent future suicidal behavior.It is vital to understand their sociodemographic characteristics and the effects of targeted psychological care.AIM To analyze sociodemographic characteristics of suicide attempters treated in the ED and evaluate the efficacy of psychological care.METHODS Data from 239 suicide attempters treated in the ED of the Central Hospital of Enshi Tujia and Miao Autonomous Prefecture(Hubei Province,China)between January 2021 and February 2025 were divided into 2:Control(n=108)and psychological care(n=131).The demographic characteristics and effects of the psychological care were analyzed.RESULTS The mean(±SD)age of the 239 patients[114 male(47.7%),125 female(52.3%)]was 26.25±9.3 years,of whom 122(45.2%)were single,117(48.9%)were married,and 106(44.4%)had secondary education.Thirty-eight(15.9%)patients had suicidal intent,with a mean of 1.26±0.59 suicide attempts each.Twenty-two(9.21%)patients had a family history of suicide,while 8(3.34%)had a family history of suicide attempt(s).Before intervention,mean Suicidal Intent Scale scores in the psychological nursing and control groups were 21.57±5.28 and 19.86±5.92,respectively(P>0.05).After 1 month of nursing intervention,the respective scores were 10.09±1.11 and 16.48±0.87(P<0.001);and the re-suicide rates were 11.45%(15/131)and 24.07%(26/108)(P<0.001).CONCLUSION Psychological care significantly reduces suicide risk;EDs should provide comprehensive mental health care.展开更多
Recently,inflammatory cytokine profiles have been linked to suicide risk in adolescents with non-suicidal self-injury,highlighting a promising biological dimension of suicide risk assessment.Clinical translation of th...Recently,inflammatory cytokine profiles have been linked to suicide risk in adolescents with non-suicidal self-injury,highlighting a promising biological dimension of suicide risk assessment.Clinical translation of the cytokine profiles into practice will require frontline engagement of the workforce.Mental health nurses are frequently the most accessible professionals in schools,communities,and low-resource settings and are prime candidates to bridge this gap.By integrating psychosocial evaluation with emerging biomarker data,they can deliver systematic risk assessment,continuous monitoring,and timely intervention.This role would not replace psychiatric expertise;it would extend the reach of psychiatric services,embedding suicide prevention across the continuum of care.For health systems,nurse-led integration may enhance capacity,equity,and resilience in responding to adolescent suicide risk.This editorial demonstrates that empowering nurses to operationalize biomarker-informed strategies is needed for advancing effective and sustainable suicide prevention in this vulnerable population.展开更多
BACKGROUND There is a possible link between depression and anxiety about suicidal ideation among parents of children with congenital heart disease(CHD).AIM To document the effects of depression and anxiety on parental...BACKGROUND There is a possible link between depression and anxiety about suicidal ideation among parents of children with congenital heart disease(CHD).AIM To document the effects of depression and anxiety on parental suicidal ideation among children with CHD and the associated factors.METHODS This was a cross-sectional study among 50 parents of children with CHD who attended the Cardiac Clinic of University of Nigeria Teaching Hospital Ituku-Ozalla.Information was obtained using the Columbia Suicide Severity Rating Scale and the Hospital Anxiety and Depression Scale.RESULTS A greater percentage of parents whose child had a heart defect had anxiety symptoms(50.0%)than did those whose child had no heart defect(24.0%),and the difference in proportions was statistically significant(χ^(2)=7.250,P=0.007).A greater percentage of parents whose child had a heart defect had suicidal ideation(28.0%)than did those whose child had no heart defect(8.0%),and the difference in proportions was statistically significant(χ^(2)=6.775 P=0.009).A positive correlation was elicited between anxiety and suicide ideation,and this correlation was statistically significant(r=0.748,P<0.001).A positive correlation was elicited between depression and suicidal ideation scores,and this was statistically significant(r=0.617,P<0.001).CONCLUSION There is strong interconnectivity between anxiety and depression with suicidal ideation.There is an urgent need to start screening for the mental health of parents of children with CHD to avert the high propensity of complete suicide.In addition,policy makers may introduce a national clinical practice guideline on the importance of psychotherapy and mental health screening and targeted interventions for parents of children with CHD.展开更多
BACKGROUND Suicide constitutes the second leading cause of death among adolescents globally and represents a critical public health concern.The neural mechanisms underlying suicidal behavior in adolescents with major ...BACKGROUND Suicide constitutes the second leading cause of death among adolescents globally and represents a critical public health concern.The neural mechanisms underlying suicidal behavior in adolescents with major depressive disorder(MDD)remain poorly understood.Aberrant resting-state functional connectivity(rsFC)in the amygdala,a key region implicated in emotional regulation and threat detection,is strongly implicated in depression and suicidal behavior.AIM To investigate rsFC alterations between amygdala subregions and whole-brain networks in adolescent patients with depression and suicide attempts.METHODS Resting-state functional magnetic resonance imaging data were acquired from 32 adolescents with MDD and suicide attempts(sMDD)group,33 adolescents with MDD but without suicide attempts(nsMDD)group,and 34 demographically matched healthy control(HC)group,with the lateral and medial amygdala(MeA)defined as regions of interest.The rsFC patterns of amygdala subregions were compared across the three groups,and associations between aberrant rsFC values and clinical symptom severity scores were examined.RESULTS Compared with the nsMDD group,the sMDD group exhibited reduced rsFC between the right lateral amygdala(LA)and the right inferior occipital gyrus as well as the left middle occipital gyrus.Compared with the HC group,the abnormal brain regions of rsFC in the sMDD group and nsMDD group involve the parahippocampal gyrus(PHG)and fusiform gyrus.In the sMDD group,right MeA and right temporal pole:Superior temporal gyrus rsFC value negatively correlated with the Rosenberg Self-Esteem Scale scores(r=-0.409,P=0.025),while left LA and right PHG rsFC value positively correlated with the Adolescent Self-Rating Life Events Checklist interpersonal relationship scores(r=0.372,P=0.043).CONCLUSION Aberrant rsFC changes between amygdala subregions and these brain regions provide novel insights into the underlying neural mechanisms of suicide attempts in adolescents with MDD.展开更多
Antidepressants are the main drugs used to treat depression,but they have not been shown to be effective in the treatment of child and adolescent depression.However,many adolescent depression treatment guidelines stil...Antidepressants are the main drugs used to treat depression,but they have not been shown to be effective in the treatment of child and adolescent depression.However,many adolescent depression treatment guidelines still recommend the use of antidepressants,especially specific serotonin re-uptake inhibitors.Previous studies have suggested that antidepressants have little therapeutic effect but many side effects,such as switching to mania,suicide,and non-suicidal self injury(NSSI),in the treatment of child and adolescent depression.In the process of developing guidelines,drug recommendations should not only focus on impro-ving symptoms,but they should also consider potential side effects.This review discusses the serious side effects of antidepressants,including switching to mania,suicide,and NSSI.展开更多
BACKGROUND Sensitivity to stress is essential in the onset,clinical symptoms,course,and prognosis of major depressive disorder(MDD).Meanwhile,it was unclear how variously classified but connected stress-sensitivity va...BACKGROUND Sensitivity to stress is essential in the onset,clinical symptoms,course,and prognosis of major depressive disorder(MDD).Meanwhile,it was unclear how variously classified but connected stress-sensitivity variables affect MDD.We hypothesize that high-level trait-and state-related stress-sensitivity factors may have different cumulative effects on the clinical symptoms and follow-up outcomes of MDD.AIM To investigate how stress-sensitivity factors added up and affected MDD clinical symptoms and follow-up results.METHODS In this prospective study,281 MDD patients were enrolled from a tertiary care setting.High-level stress-sensitivity factors were classified as trait anxiety,state anxiety,perceived stress,and neuroticism,with a total score in the top quartile of the research cohort.The cumulative effects of stress-sensitivity factors on cognitive dysfunction,disability and functional impairment,suicide risk,and depressive and anxiety symptoms were examined using an analysis of variance with linear trend analysis.Correlations were investigated further using multiple regression analysis.RESULTS Regarding high-level stress-sensitivity factors,53.40%of patients had at least one at baseline,and 29.61%had two or more.Four high-level stress-sensitivity components had significant cumulative impacts on MDD symptoms at baseline(all P<0.001).Perceived stress predicted the greatest effect sizes of state-related factors on depressive symptoms(partialη^(2)=0.153;standardizedβ=0.195;P<0.05).The follow-up outcomes were significantly impacted only by the high-level trait-related components,mainly when it came to depressive symptoms and suicide risk,which were predicted by trait anxiety and neuroticism,respectively(partialη^(2)=0.204 and 0.156;standardizedβ=0.247 and 0.392;P<0.05).CONCLUSION To enhance outcomes of MDD and lower the suicide risk,screening for stress-sensitivity factors and considering multifaceted measures,mainly focusing on trait-related ones,should be addressed clinically.展开更多
Background Globally,suicide is the third leading cause of death among girls aged 15-19 years.However,there is a growing concern that suicide research has paid lttle attention to pregnant adolescent girls,particularly ...Background Globally,suicide is the third leading cause of death among girls aged 15-19 years.However,there is a growing concern that suicide research has paid lttle attention to pregnant adolescent girls,particularly in lowincome and middle-income countries,including Ghana,where nearly one in seven adolescents experiences(unwanted)pregnancy.Aims To assess the prevalence and correlates of suicidal ideation and suicide attempt and the self-reported reasons for attempted suicide among pregnant adolescent girls in Ghana.Methods We collected cross-sectional data(between August 2022 and December 2023)using structured anonymous questionnaires from a sample of 449 pregnant adolescent girls(aged 14-19 years)drawn from the three geographical zones of Ghana.We applied bivariable and multivariable analysis techniques to the data.Results Overall,28.51%(95%confidence interval(Cl)24.37%to 32.93%)reported suicidal ideation,and 18.04%(95%Cl 14.59%to 21.91%)reported suicide attempt during the current pregnancy.Participants who reported attempted suicide endorsed more interpersonal reasons(eg,to communicate distress,to seek help or to influence others)than intrapersonal reasons for their attempted suicide.In the final adjusted logistic regression models,food insecurity(adjusted odds ratio(aOR)=2.69;95%Cl 1.34 to 5.41;p=0.005)was uniquely associated with increased odds of suicidal ideation.Adverse childhood experiences(a0R=3.04;95%CI 1.33 to 6.97;p=0.008),history of attempted suicide before current pregnancy(a0R=3.47;95%CI 1.27 to 9.47;p=0.015)and depression(measured by the 5-item World Health Organization Well-Being Index;aOR=0.31;95%CI 0.12 to 0.77;p=0.012)were uniquely associated with increased odds of suicide attempt.Five variables were commonly associated with increased odds of both suicidal ideation and suicide attempt:conflict with parents,alcohol use,pregnancy-related anxiety,history of attempted suicide and intimate partner violence.While being in junior high school was uniquely associated with reduced odds of suicidal ideation,intimate partner's acceptance of paternity was commonly associated with reduced odds of both suicidal ideation and suicide attempt.Conclusions Although the prevalence estimates of suicidal ideation and suicide attempt in this study are comparable with known rates among non-pregnant adolescent girls in Ghana,additional research is needed to nuance our understanding of the correlates identified in this study.The evidence aiso highlights a need for both routine antepartum primary care mental health screening for suicidality and related risks and targeted prevention and intervention programmes.展开更多
Objectives:Suicidal ideation(SI)among university students is a growing concern,influenced by anxiety,depression,and bullying.However,family closeness and peer support may act as protective factors,reducing the risk of...Objectives:Suicidal ideation(SI)among university students is a growing concern,influenced by anxiety,depression,and bullying.However,family closeness and peer support may act as protective factors,reducing the risk of SI.Therefore,this study aims to investigate the key factors influencing SI among university students,focusing on the effects of anxiety,depression,and bullying,along with the roles of family closeness and peer support.The research also explores the interactions and mechanisms between these variables.Methods:A sample of 318 university students was surveyed,evaluating six main factors:anxiety,depression,bullying,family closeness,peer support,and SI.Using the Structural Equation Modeling(SEM)and Artificial Neural Networks(ANN)approach,both compensatory and non-compensatory relationships were examined.Results:Anxiety,depression,and bullying significantly contribute to SI,with depression mediating the link between anxiety,bullying,and SI.Additionally,family closeness moderates the effects of anxiety and bullying on SI,while peer supportmoderates the effects of depression and bullying.Themultilayer perceptron analysis identifies peer support as the most influential predictor,followed by bullying,family closeness,depression,and anxiety.Conclusion:The study identifies anxiety,depression,and bullying as key factors influencing suicidal ideation(SI)among university students.Family closeness and peer support act as protective factors,moderating the effects of these variables on SI.展开更多
This study tested a chain mediation model on whether hopelessness and nostalgia play a mediating role in psychache and suicidal ideation of firefighters.A total of 652 firefighters participated in the survey(male=94.9...This study tested a chain mediation model on whether hopelessness and nostalgia play a mediating role in psychache and suicidal ideation of firefighters.A total of 652 firefighters participated in the survey(male=94.94%;mean age=23.71 years,SD=4.18 years).The firefighters completed the Chinese Revised Psychache Scale(PAS),Beck Hopelessness Scale(BHS),Southampton Nostalgia Scale(SNS),and Columbia-Suicide Severity Rating Scale(CSSRS).The path analysis results indicated that psychache positively predicted suicidal ideation.Hopelessness plays a significant mediating role between psychache and suicidal ideation further strengthening this relationship.In contrast,nostalgia mediates and weakened the relationship between psychache and suicidal ideation.Hopelessness and nostalgia jointly constructed a chain mediating effect between psychache and suicidal ideation,for higher suicidal ideation with higher hopelessness and lower nostalgia.The findings align with the Three-Step Theory of Suicide,which proposes that suicidal ideation results from the combination of pain and hopelessness and that connectedness is a key protective factor against escalating ideation.Therefore,interventions to reduce suicidal ideation in firefighters should aim to enhance their nostalgia,while reducing sense of hopelessness.展开更多
Objective:Non-suicidal self-injury(NSSI)is a mental health problem that often occurs in adolescents in Indonesia.Even though NSSI does not have the intention of suicide,some cases result in death.This research aimed t...Objective:Non-suicidal self-injury(NSSI)is a mental health problem that often occurs in adolescents in Indonesia.Even though NSSI does not have the intention of suicide,some cases result in death.This research aimed to identify the predisposition and precipitation factors associated with the dynamics of NSSI behaviors among adolescents.Methods:This research is an explanatory research design with a cross-sectional study.Out of 4000 students,904 students from State High School and Vocational School in Central Java Province were selected as respondents using non-probability sampling and a purposive sampling approach.This research was carried out using Google Forms from September to November 2023.The instrument used was the Self-Harm Inventory(SHI).Data analysis in this study used the chi-squared test.Results:The results of this study indicate that the most significant predisposition factors of NSSI behaviors experienced by respondents in this study are introverted personality and the environment that supports NSSI behaviors.In contrast,the precipitation factors are bullying and deep disappointment.Otherwise,based on the data analysis,the maladaptive coping mechanism(P-value=0.029)has become a predisposition factor related to the dynamics of NSSI behaviors.In contrast,bullying(P-value=0.000)and deep disappointment(P-value=0.000)still become precipitation factors related to the dynamics of NSSI behaviors.Conclusions:The results of this study can be evidence-based for stakeholders to provide interventions,especially for the vulnerable population affected by NSSI behaviors.展开更多
To the editor:“A recent systematic review shows that the risk of death by suicide is 100 times higher in people living with HIV than in the general population”—World Health Organization,2022 The estimate that the r...To the editor:“A recent systematic review shows that the risk of death by suicide is 100 times higher in people living with HIV than in the general population”—World Health Organization,2022 The estimate that the risk of suicide is 100-fold higher in people with HIV(PWH)than in the general population is widely cited,including in the World Health Organization’s(WHO’s)World Mental Health report from which the above quote is taken.1 This figure originates from a systematic review and meta-analysis by Pelton and colleagues,who estimated the‘lifetime incidence’of suicide among PWH2 and directly compared this measure to the WHO’s annual global suicide mortality rate.展开更多
Rationale:Advances in sleep research have introduced medications like lemborexant,a dual orexin receptor antagonist.While effective for regulating sleep,overdoses are a concern,especially in suicide attempts.However,l...Rationale:Advances in sleep research have introduced medications like lemborexant,a dual orexin receptor antagonist.While effective for regulating sleep,overdoses are a concern,especially in suicide attempts.However,limited data exist on lemborexant overdose,prompting this case report to elucidate its clinical course.Patient’s Concern:A 91-year-old Japanese woman with multiple comorbidities,including insomnia and chronic kidney disease,was admitted after ingesting 315 mg of lemborexant in a suicide attempt.Diagnosis:Lemborexant overdose.Interventions:Supportive care with 500 mL of Ringer’s acetate solution at the emergency room.Outcomes:She gradually regained full consciousness with no residual deficits.Due to persistent suicidal ideation,she was transferred to a psychiatric hospital after seven days of supportive care.Lessons:A review of four lemborexant overdose cases managed at our hospital revealed that overdoses primarily induce altered consciousness and are unlikely to cause organ dysfunction.Supportive care is generally sufficient for management.However,given the limited data,further case accumulation is needed to enhance clinical understanding.展开更多
BACKGROUND Non-suicidal self-injury(NSSI)in adolescents is a strong predictor of suicide and a significant mental health problem worldwide.Previous studies have identified various risk factors for NSSI.However,studies...BACKGROUND Non-suicidal self-injury(NSSI)in adolescents is a strong predictor of suicide and a significant mental health problem worldwide.Previous studies have identified various risk factors for NSSI.However,studies have not explored the association between inflammatory factors and NSSI in adolescents.AIM To investigate inflammatory marker changes post-antidepressant treatment and their association with suicide risk in NSSI adolescents.METHODS The study enrolled 68 adolescents with NSSI behaviors.The participants were divided into high and low suicide risk groups(n=38 and n=30,respectively)based on their scores on the Suicide Risk Factors Assessment Scale.Symptom severity was assessed at baseline and after six weeks of treatment.Blood samples were obtained to monitor for inflammatory factors.RESULTS The high suicide risk group exhibited higher levels of interferon(IFN)-αand interleukin(IL)-10 than the low suicide risk group.Scores on the Hamilton Anxiety Rating Scale,Hamilton Depression Rating Scale,and Insomnia Severity Index decreased significantly post-treatment.Tumor necrosis factor-α,IL-10,IL-6,IL-1,and IL-12 levels decreased,whereas IFN-γ,IL-4,and IFN-αlevels increased.IL-10 levels were correlated with the severity of suicide risk factors.CONCLUSION Adolescents with NSSI exhibit distinct inflammatory markers based on suicide risk,which change following treatment.Moreover,IL-10 levels are associated with suicide risk.These biomarkers may help assess suicide risk in clinical settings.展开更多
Suicide is defined as the act of a person attempting to take their own life by causing death.Suicide is a complex phenomenon that is influenced by a multitude of factors,including psychosocial,cultural,and religious a...Suicide is defined as the act of a person attempting to take their own life by causing death.Suicide is a complex phenomenon that is influenced by a multitude of factors,including psychosocial,cultural,and religious aspects,as well as genetic,biochemical,and environmental factors.From a biochemical perspective,it is crucial to consider the communication between the endocrine,immune,and nervous systems when studying the etiology of suicide.Several pathologies involve the bidirectional communication between the peripheral activity and the central nervous system by the action of molecules such as cytokines,hormones,and neurotransmitters.These humoral signals,when present in optimal quantities,are responsible for maintaining physiological homeostasis,including mood states.Stress elevates the cortisol and proinflammatory cytokines levels and alter neurotransmitters balance,thereby increasing the risk of developing a psychiatric disorder and subsequently the risk of suicidal behavior.This review provides an integrative perspective about the neurochemical,immunological,and endocrinological disturbances associated with suicidal behavior,with a particular focus on those alterations that may serve as potential risk markers and/or indicators of the state preceding such a tragic act.展开更多
BACKGROUND Depression,non-suicidal self-injury(NSSI),and suicide attempts(SA)often co-occur during adolescence and are associated with long-term adverse health outcomes.Unfortunately,neural mechanisms underlying self-...BACKGROUND Depression,non-suicidal self-injury(NSSI),and suicide attempts(SA)often co-occur during adolescence and are associated with long-term adverse health outcomes.Unfortunately,neural mechanisms underlying self-injury and SA are poorly understood in depressed adolescents but likely relate to the structural abnormalities in brain regions.AIM To investigate structural network communication within large-scale brain networks in adolescents with depression.METHODS We constructed five distinct network communication models to evaluate structural network efficiency at the whole-brain level in adolescents with depression.Diffusion magnetic resonance imaging data were acquired from 32 healthy controls and 85 depressed adolescents,including 17 depressed adolescents without SA or NSSI(major depressive disorder group),27 depressed adolescents with NSSI but no SA(NSSI group),and 41 depressed adolescents with SA and NSSI(NSSI+SA group).RESULTS Significant differences in structural network communication were observed across the four groups,involving spatially widespread brain regions,particularly encompassing cortico-cortical connections(e.g.,dorsal posterior cingulate gyrus and the right ventral posterior cingulate gyrus;connections based on precentral gyrus)and cortico-subcortical circuits(e.g.,the nucleus accumbens-frontal circuit).In addition,we examined whether compromised communication efficiency was linked to clinical symptoms in the depressed adolescents.We observed significant correlations between network communication efficiencies and clinical scale scores derived from depressed adolescents with NSSI and SA.CONCLUSION This study provides evidence of structural network communication differences in depressed adolescents with NSSI and SA,highlighting impaired neuroanatomical communication efficiency as a potential contributor to their symptoms.These findings offer new insights into the pathophysiological mechanisms underlying the comorbidity of NSSI and SA in adolescent depression.展开更多
Depression is a severe mood disorder characterized by complex suicide mechanisms that involve a multitude of psychosocial and biological fac-tors.This paper presents a comprehensive analysis of the psychosocial factor...Depression is a severe mood disorder characterized by complex suicide mechanisms that involve a multitude of psychosocial and biological fac-tors.This paper presents a comprehensive analysis of the psychosocial factors influencing suicidal behavior in depression,including social support,life events,depressive symptoms,and personality traits,as well as biological factors such as brain-derived neurotrophic factor(BDNF),erotonin(5-TH)system dysfunction,and hypothalam-ic-pituitary-adrenal(HPA)axis abnormalities.Collectively,these factors significantly influence an individual’s risk of suicide,with biological factors serving as potential biomarkers for suicidal actions and psychosocial factors underscoring the impact of environmental and individual experiences.Understanding the interaction of these factors is crucial for comprehending and preventing suicidal behavior in depression.Despite considerable progress,current studies have limitations,particularly regarding the unclear interaction mechanisms between psychosocial and biological factors and a predominant focus on adult populations,with insufficient comprehensive studies on adolescents.展开更多
Suicide is a major and urgent issue in the field of mental health,and the United Nations has set“reducing global suicide mortality by one third by 2030”as one of its sustainable development goals.Suicide literacy re...Suicide is a major and urgent issue in the field of mental health,and the United Nations has set“reducing global suicide mortality by one third by 2030”as one of its sustainable development goals.Suicide literacy refers to an individual’s ability to recognize,manage,and prevent suicide-related problems.This article offers a comprehensive review of the concepts,assessment tools,factors,and interventions of suicide literacy,with the goal of helping individuals to better understand suicidal behaviors and providing a scientific basis for developing effective suicide prevention strategies and measures to advance the progress of suicide prevention.展开更多
基金Supported by Slovenian Research and Innovation Agency Program,No.P1-0390 and No.N3-0349Slovenian Research and Innovation Agency Program,Young Researcher Grant(toŠmon J).
文摘Suicidality is a complex phenomenon influenced by genetic,environmental,and epigenetic factors.Current tools to estimate suicide risk are insufficient,and there is an increasing need for reliable biomarkers to complement clinical approaches.Growing evidence suggests that immune system dysregulation contributes to the pathophysiology of psychiatric disorders and suicidal behavior.Epigenetic mechanisms,including DNA methylation,histone modifications,and non-coding RNAs,regulate gene expression and may act as a bridge between environmental stressors and(neuro)inflammatory responses.In this review,we examine the evidence of peripheral and central inflammation in suicide completers and individuals with suicidal behavior.Next,we review current knowledge from various studies on suicide-associated epigenetic alterations.Furthermore,we evaluate the mechanisms by which early life adversity and chronic stress contribute to suicide diathesis,focusing on their association with epigenetic modifications and inflammatory pathways.We also examine future prospects and limitations of immunology-related biomarkers and the possibilities of therapeutic interventions targeting the immune system and epigenetic regulation.While challenging,research on epigenetic and immune alterations in suicidality shows promise for identifying suicide risk subtypes and advancing personalized psychiatry.
文摘Background: The many dangers and stressors associated with police work often place police officers at a great risk of a variety of mental health morbidity, including suicidality. The causation of suicidality is multi-dimensional, however, there are insufficient studies which have examined the burden and risk factors of suicidality in Nigerian police officers. Objective: To determine the prevalence and predictors of suicidality among police officers in Lagos, Nigeria. Methods: This was a cross-sectional study of 600 police officers who were selected using a non-probability sampling method. Questionnaires used were: Suicide Behaviour Questionnaire-Revised (SBQ-R), State-Trait Anxiety Inventory (STAI), and a Socio-Demographic Questionnaire. Results: Prevalence of suicidality was 14%, and the predictors of suicidality were: state anxiety (p 0.001), trait anxiety (p 0.001), substance use (p = 0.03), being unmarried (p = 0.03), and female gender (p = 0.02). Conclusion: Suicidality is prevalent among Nigerian police officers, with a higher risk in those who are vulnerable. The creation of government policies and infrastructure which promote mental health in police officers is necessary.
基金supported by the National Natural Science Foundation(Grant Nos.81971595,81621003,81820108018,81801681 and 81801357)the Science and Technology Department of Sichuan Province(No.2020YFS0118)the 1•3•5 Project for Disciplines of Excellence–Clinical Research Incubation Project,West China Hospital,Sichuan University(Grant No.2020HXFH005).
文摘Background:Major depressive disorder(MDD)is associated with high risk of suicide,but the biological under-pinnings of suicidality in MDD patients are far from conclusive.Previous neuroimaging studies using voxel-based morphometry(VBM)demonstrated that depressed individuals with suicidal thoughts or behaviors exhibit specific cortical structure alterations.To complement VBM findings,surface-based morphometry(SBM)can pro-vide more details into gray matter structure,including the cortical complexity,cortical thickness and sulcal depth for brain images.Objective:This study aims to use SBM to investigate cortical morphology alterations to obtain evidence for neuroanatomical alterations in depressed patients with suicidality.Methods:Here,3D T1-weighted MR images of brain from 39 healthy controls,40 depressed patients without suicidality(patient controls),and 39 with suicidality(suicidal groups)were analyzed based on SBM to estimate the fractal dimension,gyrification index,sulcal depth,and cortical thickness using the Computational Anatomy Toolbox.Correlation analyses were performed between clinical data and cortical surface measurements from patients.Results:Surface-based morphometry showed decreased sulcal depth in the parietal,frontal,limbic,occipital and temporal regions and decreased fractal dimension in the frontal regions in depressed patients with sui-cidality compared to both healthy and patient controls.Additionally,in patients with depression,the sulcal depth of the left caudal anterior cingulate cortex was negatively correlated with Hamilton Depression Rating Scale scores.Conclusions:Depressed patients with suicidality had abnormal cortical morphology in some brain regions within the default mode network,frontolimbic circuitry and temporal regions.These structural deficits may be associated with the dysfunction of emotional processing and impulsivity control.This study provides insights into the underlying neurobiology of the suicidal brain.
文摘BACKGROUND Appropriate care for individuals who attempt suicide and are admitted to the emergency department(ED)can prevent future suicidal behavior.It is vital to understand their sociodemographic characteristics and the effects of targeted psychological care.AIM To analyze sociodemographic characteristics of suicide attempters treated in the ED and evaluate the efficacy of psychological care.METHODS Data from 239 suicide attempters treated in the ED of the Central Hospital of Enshi Tujia and Miao Autonomous Prefecture(Hubei Province,China)between January 2021 and February 2025 were divided into 2:Control(n=108)and psychological care(n=131).The demographic characteristics and effects of the psychological care were analyzed.RESULTS The mean(±SD)age of the 239 patients[114 male(47.7%),125 female(52.3%)]was 26.25±9.3 years,of whom 122(45.2%)were single,117(48.9%)were married,and 106(44.4%)had secondary education.Thirty-eight(15.9%)patients had suicidal intent,with a mean of 1.26±0.59 suicide attempts each.Twenty-two(9.21%)patients had a family history of suicide,while 8(3.34%)had a family history of suicide attempt(s).Before intervention,mean Suicidal Intent Scale scores in the psychological nursing and control groups were 21.57±5.28 and 19.86±5.92,respectively(P>0.05).After 1 month of nursing intervention,the respective scores were 10.09±1.11 and 16.48±0.87(P<0.001);and the re-suicide rates were 11.45%(15/131)and 24.07%(26/108)(P<0.001).CONCLUSION Psychological care significantly reduces suicide risk;EDs should provide comprehensive mental health care.
文摘Recently,inflammatory cytokine profiles have been linked to suicide risk in adolescents with non-suicidal self-injury,highlighting a promising biological dimension of suicide risk assessment.Clinical translation of the cytokine profiles into practice will require frontline engagement of the workforce.Mental health nurses are frequently the most accessible professionals in schools,communities,and low-resource settings and are prime candidates to bridge this gap.By integrating psychosocial evaluation with emerging biomarker data,they can deliver systematic risk assessment,continuous monitoring,and timely intervention.This role would not replace psychiatric expertise;it would extend the reach of psychiatric services,embedding suicide prevention across the continuum of care.For health systems,nurse-led integration may enhance capacity,equity,and resilience in responding to adolescent suicide risk.This editorial demonstrates that empowering nurses to operationalize biomarker-informed strategies is needed for advancing effective and sustainable suicide prevention in this vulnerable population.
文摘BACKGROUND There is a possible link between depression and anxiety about suicidal ideation among parents of children with congenital heart disease(CHD).AIM To document the effects of depression and anxiety on parental suicidal ideation among children with CHD and the associated factors.METHODS This was a cross-sectional study among 50 parents of children with CHD who attended the Cardiac Clinic of University of Nigeria Teaching Hospital Ituku-Ozalla.Information was obtained using the Columbia Suicide Severity Rating Scale and the Hospital Anxiety and Depression Scale.RESULTS A greater percentage of parents whose child had a heart defect had anxiety symptoms(50.0%)than did those whose child had no heart defect(24.0%),and the difference in proportions was statistically significant(χ^(2)=7.250,P=0.007).A greater percentage of parents whose child had a heart defect had suicidal ideation(28.0%)than did those whose child had no heart defect(8.0%),and the difference in proportions was statistically significant(χ^(2)=6.775 P=0.009).A positive correlation was elicited between anxiety and suicide ideation,and this correlation was statistically significant(r=0.748,P<0.001).A positive correlation was elicited between depression and suicidal ideation scores,and this was statistically significant(r=0.617,P<0.001).CONCLUSION There is strong interconnectivity between anxiety and depression with suicidal ideation.There is an urgent need to start screening for the mental health of parents of children with CHD to avert the high propensity of complete suicide.In addition,policy makers may introduce a national clinical practice guideline on the importance of psychotherapy and mental health screening and targeted interventions for parents of children with CHD.
基金Supported by Suzhou Clinical Medical Center for Mood Disorders,No.Szlcyxzx202109Suzhou Key Laboratory,No.SZS2024016Multicenter Clinical Research on Major Diseases in Suzhou,No.DZXYJ202413.
文摘BACKGROUND Suicide constitutes the second leading cause of death among adolescents globally and represents a critical public health concern.The neural mechanisms underlying suicidal behavior in adolescents with major depressive disorder(MDD)remain poorly understood.Aberrant resting-state functional connectivity(rsFC)in the amygdala,a key region implicated in emotional regulation and threat detection,is strongly implicated in depression and suicidal behavior.AIM To investigate rsFC alterations between amygdala subregions and whole-brain networks in adolescent patients with depression and suicide attempts.METHODS Resting-state functional magnetic resonance imaging data were acquired from 32 adolescents with MDD and suicide attempts(sMDD)group,33 adolescents with MDD but without suicide attempts(nsMDD)group,and 34 demographically matched healthy control(HC)group,with the lateral and medial amygdala(MeA)defined as regions of interest.The rsFC patterns of amygdala subregions were compared across the three groups,and associations between aberrant rsFC values and clinical symptom severity scores were examined.RESULTS Compared with the nsMDD group,the sMDD group exhibited reduced rsFC between the right lateral amygdala(LA)and the right inferior occipital gyrus as well as the left middle occipital gyrus.Compared with the HC group,the abnormal brain regions of rsFC in the sMDD group and nsMDD group involve the parahippocampal gyrus(PHG)and fusiform gyrus.In the sMDD group,right MeA and right temporal pole:Superior temporal gyrus rsFC value negatively correlated with the Rosenberg Self-Esteem Scale scores(r=-0.409,P=0.025),while left LA and right PHG rsFC value positively correlated with the Adolescent Self-Rating Life Events Checklist interpersonal relationship scores(r=0.372,P=0.043).CONCLUSION Aberrant rsFC changes between amygdala subregions and these brain regions provide novel insights into the underlying neural mechanisms of suicide attempts in adolescents with MDD.
文摘Antidepressants are the main drugs used to treat depression,but they have not been shown to be effective in the treatment of child and adolescent depression.However,many adolescent depression treatment guidelines still recommend the use of antidepressants,especially specific serotonin re-uptake inhibitors.Previous studies have suggested that antidepressants have little therapeutic effect but many side effects,such as switching to mania,suicide,and non-suicidal self injury(NSSI),in the treatment of child and adolescent depression.In the process of developing guidelines,drug recommendations should not only focus on impro-ving symptoms,but they should also consider potential side effects.This review discusses the serious side effects of antidepressants,including switching to mania,suicide,and NSSI.
基金Supported by Science and Technology Innovation 2030-Major Projects,No.2021ZD0202000National Key Research and Development Program of China,No.2019YFA0706200+2 种基金National Natural Science Foundation of China,No.82371535Science and Technology Innovation Program of Hunan Province,No.2023RC3083Fundamental Research Funds for the Central Universities of Central South University,No.2023ZZTS0838.
文摘BACKGROUND Sensitivity to stress is essential in the onset,clinical symptoms,course,and prognosis of major depressive disorder(MDD).Meanwhile,it was unclear how variously classified but connected stress-sensitivity variables affect MDD.We hypothesize that high-level trait-and state-related stress-sensitivity factors may have different cumulative effects on the clinical symptoms and follow-up outcomes of MDD.AIM To investigate how stress-sensitivity factors added up and affected MDD clinical symptoms and follow-up results.METHODS In this prospective study,281 MDD patients were enrolled from a tertiary care setting.High-level stress-sensitivity factors were classified as trait anxiety,state anxiety,perceived stress,and neuroticism,with a total score in the top quartile of the research cohort.The cumulative effects of stress-sensitivity factors on cognitive dysfunction,disability and functional impairment,suicide risk,and depressive and anxiety symptoms were examined using an analysis of variance with linear trend analysis.Correlations were investigated further using multiple regression analysis.RESULTS Regarding high-level stress-sensitivity factors,53.40%of patients had at least one at baseline,and 29.61%had two or more.Four high-level stress-sensitivity components had significant cumulative impacts on MDD symptoms at baseline(all P<0.001).Perceived stress predicted the greatest effect sizes of state-related factors on depressive symptoms(partialη^(2)=0.153;standardizedβ=0.195;P<0.05).The follow-up outcomes were significantly impacted only by the high-level trait-related components,mainly when it came to depressive symptoms and suicide risk,which were predicted by trait anxiety and neuroticism,respectively(partialη^(2)=0.204 and 0.156;standardizedβ=0.247 and 0.392;P<0.05).CONCLUSION To enhance outcomes of MDD and lower the suicide risk,screening for stress-sensitivity factors and considering multifaceted measures,mainly focusing on trait-related ones,should be addressed clinically.
基金the Global WACh Rising Star Seed Award by the Department of Global Health,University of Washington,Seattle,USA(Grant No:UW/GWACh/RSA/2023-01)。
文摘Background Globally,suicide is the third leading cause of death among girls aged 15-19 years.However,there is a growing concern that suicide research has paid lttle attention to pregnant adolescent girls,particularly in lowincome and middle-income countries,including Ghana,where nearly one in seven adolescents experiences(unwanted)pregnancy.Aims To assess the prevalence and correlates of suicidal ideation and suicide attempt and the self-reported reasons for attempted suicide among pregnant adolescent girls in Ghana.Methods We collected cross-sectional data(between August 2022 and December 2023)using structured anonymous questionnaires from a sample of 449 pregnant adolescent girls(aged 14-19 years)drawn from the three geographical zones of Ghana.We applied bivariable and multivariable analysis techniques to the data.Results Overall,28.51%(95%confidence interval(Cl)24.37%to 32.93%)reported suicidal ideation,and 18.04%(95%Cl 14.59%to 21.91%)reported suicide attempt during the current pregnancy.Participants who reported attempted suicide endorsed more interpersonal reasons(eg,to communicate distress,to seek help or to influence others)than intrapersonal reasons for their attempted suicide.In the final adjusted logistic regression models,food insecurity(adjusted odds ratio(aOR)=2.69;95%Cl 1.34 to 5.41;p=0.005)was uniquely associated with increased odds of suicidal ideation.Adverse childhood experiences(a0R=3.04;95%CI 1.33 to 6.97;p=0.008),history of attempted suicide before current pregnancy(a0R=3.47;95%CI 1.27 to 9.47;p=0.015)and depression(measured by the 5-item World Health Organization Well-Being Index;aOR=0.31;95%CI 0.12 to 0.77;p=0.012)were uniquely associated with increased odds of suicide attempt.Five variables were commonly associated with increased odds of both suicidal ideation and suicide attempt:conflict with parents,alcohol use,pregnancy-related anxiety,history of attempted suicide and intimate partner violence.While being in junior high school was uniquely associated with reduced odds of suicidal ideation,intimate partner's acceptance of paternity was commonly associated with reduced odds of both suicidal ideation and suicide attempt.Conclusions Although the prevalence estimates of suicidal ideation and suicide attempt in this study are comparable with known rates among non-pregnant adolescent girls in Ghana,additional research is needed to nuance our understanding of the correlates identified in this study.The evidence aiso highlights a need for both routine antepartum primary care mental health screening for suicidality and related risks and targeted prevention and intervention programmes.
文摘Objectives:Suicidal ideation(SI)among university students is a growing concern,influenced by anxiety,depression,and bullying.However,family closeness and peer support may act as protective factors,reducing the risk of SI.Therefore,this study aims to investigate the key factors influencing SI among university students,focusing on the effects of anxiety,depression,and bullying,along with the roles of family closeness and peer support.The research also explores the interactions and mechanisms between these variables.Methods:A sample of 318 university students was surveyed,evaluating six main factors:anxiety,depression,bullying,family closeness,peer support,and SI.Using the Structural Equation Modeling(SEM)and Artificial Neural Networks(ANN)approach,both compensatory and non-compensatory relationships were examined.Results:Anxiety,depression,and bullying significantly contribute to SI,with depression mediating the link between anxiety,bullying,and SI.Additionally,family closeness moderates the effects of anxiety and bullying on SI,while peer supportmoderates the effects of depression and bullying.Themultilayer perceptron analysis identifies peer support as the most influential predictor,followed by bullying,family closeness,depression,and anxiety.Conclusion:The study identifies anxiety,depression,and bullying as key factors influencing suicidal ideation(SI)among university students.Family closeness and peer support act as protective factors,moderating the effects of these variables on SI.
文摘This study tested a chain mediation model on whether hopelessness and nostalgia play a mediating role in psychache and suicidal ideation of firefighters.A total of 652 firefighters participated in the survey(male=94.94%;mean age=23.71 years,SD=4.18 years).The firefighters completed the Chinese Revised Psychache Scale(PAS),Beck Hopelessness Scale(BHS),Southampton Nostalgia Scale(SNS),and Columbia-Suicide Severity Rating Scale(CSSRS).The path analysis results indicated that psychache positively predicted suicidal ideation.Hopelessness plays a significant mediating role between psychache and suicidal ideation further strengthening this relationship.In contrast,nostalgia mediates and weakened the relationship between psychache and suicidal ideation.Hopelessness and nostalgia jointly constructed a chain mediating effect between psychache and suicidal ideation,for higher suicidal ideation with higher hopelessness and lower nostalgia.The findings align with the Three-Step Theory of Suicide,which proposes that suicidal ideation results from the combination of pain and hopelessness and that connectedness is a key protective factor against escalating ideation.Therefore,interventions to reduce suicidal ideation in firefighters should aim to enhance their nostalgia,while reducing sense of hopelessness.
文摘Objective:Non-suicidal self-injury(NSSI)is a mental health problem that often occurs in adolescents in Indonesia.Even though NSSI does not have the intention of suicide,some cases result in death.This research aimed to identify the predisposition and precipitation factors associated with the dynamics of NSSI behaviors among adolescents.Methods:This research is an explanatory research design with a cross-sectional study.Out of 4000 students,904 students from State High School and Vocational School in Central Java Province were selected as respondents using non-probability sampling and a purposive sampling approach.This research was carried out using Google Forms from September to November 2023.The instrument used was the Self-Harm Inventory(SHI).Data analysis in this study used the chi-squared test.Results:The results of this study indicate that the most significant predisposition factors of NSSI behaviors experienced by respondents in this study are introverted personality and the environment that supports NSSI behaviors.In contrast,the precipitation factors are bullying and deep disappointment.Otherwise,based on the data analysis,the maladaptive coping mechanism(P-value=0.029)has become a predisposition factor related to the dynamics of NSSI behaviors.In contrast,bullying(P-value=0.000)and deep disappointment(P-value=0.000)still become precipitation factors related to the dynamics of NSSI behaviors.Conclusions:The results of this study can be evidence-based for stakeholders to provide interventions,especially for the vulnerable population affected by NSSI behaviors.
基金supported by the Swiss National Science Foundation(grant numbers 193381 and 189498)the US National Institutes of Health(the National Institute of Allergy and Infectious Diseases,the Eunice Kennedy Shriver National Institute of Child Health and Human Development,the National Cancer Institute,the National Institute of Mental Health,the National Institute on Drug Abuse,the National Heart,Lung,and Blood Institute,the National Institute on Alcohol Abuse and Alcoholism,the National Institute of Diabetes and Digestive and Kidney Diseases and the Fogarty International Center)(grant numbers U01AI069924 and 1K43TW012840-01).
文摘To the editor:“A recent systematic review shows that the risk of death by suicide is 100 times higher in people living with HIV than in the general population”—World Health Organization,2022 The estimate that the risk of suicide is 100-fold higher in people with HIV(PWH)than in the general population is widely cited,including in the World Health Organization’s(WHO’s)World Mental Health report from which the above quote is taken.1 This figure originates from a systematic review and meta-analysis by Pelton and colleagues,who estimated the‘lifetime incidence’of suicide among PWH2 and directly compared this measure to the WHO’s annual global suicide mortality rate.
文摘Rationale:Advances in sleep research have introduced medications like lemborexant,a dual orexin receptor antagonist.While effective for regulating sleep,overdoses are a concern,especially in suicide attempts.However,limited data exist on lemborexant overdose,prompting this case report to elucidate its clinical course.Patient’s Concern:A 91-year-old Japanese woman with multiple comorbidities,including insomnia and chronic kidney disease,was admitted after ingesting 315 mg of lemborexant in a suicide attempt.Diagnosis:Lemborexant overdose.Interventions:Supportive care with 500 mL of Ringer’s acetate solution at the emergency room.Outcomes:She gradually regained full consciousness with no residual deficits.Due to persistent suicidal ideation,she was transferred to a psychiatric hospital after seven days of supportive care.Lessons:A review of four lemborexant overdose cases managed at our hospital revealed that overdoses primarily induce altered consciousness and are unlikely to cause organ dysfunction.Supportive care is generally sufficient for management.However,given the limited data,further case accumulation is needed to enhance clinical understanding.
基金Supported by the Natural Science Basic Research Program of Shaanxi Province,No.2022SF526 and No.2022SF509the National Natural Science Foundation of China,No.82301737.
文摘BACKGROUND Non-suicidal self-injury(NSSI)in adolescents is a strong predictor of suicide and a significant mental health problem worldwide.Previous studies have identified various risk factors for NSSI.However,studies have not explored the association between inflammatory factors and NSSI in adolescents.AIM To investigate inflammatory marker changes post-antidepressant treatment and their association with suicide risk in NSSI adolescents.METHODS The study enrolled 68 adolescents with NSSI behaviors.The participants were divided into high and low suicide risk groups(n=38 and n=30,respectively)based on their scores on the Suicide Risk Factors Assessment Scale.Symptom severity was assessed at baseline and after six weeks of treatment.Blood samples were obtained to monitor for inflammatory factors.RESULTS The high suicide risk group exhibited higher levels of interferon(IFN)-αand interleukin(IL)-10 than the low suicide risk group.Scores on the Hamilton Anxiety Rating Scale,Hamilton Depression Rating Scale,and Insomnia Severity Index decreased significantly post-treatment.Tumor necrosis factor-α,IL-10,IL-6,IL-1,and IL-12 levels decreased,whereas IFN-γ,IL-4,and IFN-αlevels increased.IL-10 levels were correlated with the severity of suicide risk factors.CONCLUSION Adolescents with NSSI exhibit distinct inflammatory markers based on suicide risk,which change following treatment.Moreover,IL-10 levels are associated with suicide risk.These biomarkers may help assess suicide risk in clinical settings.
基金Supported by CONAHCYT Project,No.CF-2023-I-2663Instituto Nacional de Psiquiatría Project,No.NC24208.0(to Pérez-Sánchez G,Pavón L,Sánchez-Huerta K,Maldonado-García JL,Chin-Chan JM,Ponce-Regalado MD,Arreola R,Contis-Montes de Oca A,and Moreno-Lafont MC).
文摘Suicide is defined as the act of a person attempting to take their own life by causing death.Suicide is a complex phenomenon that is influenced by a multitude of factors,including psychosocial,cultural,and religious aspects,as well as genetic,biochemical,and environmental factors.From a biochemical perspective,it is crucial to consider the communication between the endocrine,immune,and nervous systems when studying the etiology of suicide.Several pathologies involve the bidirectional communication between the peripheral activity and the central nervous system by the action of molecules such as cytokines,hormones,and neurotransmitters.These humoral signals,when present in optimal quantities,are responsible for maintaining physiological homeostasis,including mood states.Stress elevates the cortisol and proinflammatory cytokines levels and alter neurotransmitters balance,thereby increasing the risk of developing a psychiatric disorder and subsequently the risk of suicidal behavior.This review provides an integrative perspective about the neurochemical,immunological,and endocrinological disturbances associated with suicidal behavior,with a particular focus on those alterations that may serve as potential risk markers and/or indicators of the state preceding such a tragic act.
基金Supported by the National Natural Science Foundation of China,No.81871081 and No.62201265the Fundamental Research Funds for the Central Universities,No.NJ2024029-14the Talent Support Programs of Wuxi Health Commission,No.BJ2023085,No.FZXK2021012,and No.M202358.
文摘BACKGROUND Depression,non-suicidal self-injury(NSSI),and suicide attempts(SA)often co-occur during adolescence and are associated with long-term adverse health outcomes.Unfortunately,neural mechanisms underlying self-injury and SA are poorly understood in depressed adolescents but likely relate to the structural abnormalities in brain regions.AIM To investigate structural network communication within large-scale brain networks in adolescents with depression.METHODS We constructed five distinct network communication models to evaluate structural network efficiency at the whole-brain level in adolescents with depression.Diffusion magnetic resonance imaging data were acquired from 32 healthy controls and 85 depressed adolescents,including 17 depressed adolescents without SA or NSSI(major depressive disorder group),27 depressed adolescents with NSSI but no SA(NSSI group),and 41 depressed adolescents with SA and NSSI(NSSI+SA group).RESULTS Significant differences in structural network communication were observed across the four groups,involving spatially widespread brain regions,particularly encompassing cortico-cortical connections(e.g.,dorsal posterior cingulate gyrus and the right ventral posterior cingulate gyrus;connections based on precentral gyrus)and cortico-subcortical circuits(e.g.,the nucleus accumbens-frontal circuit).In addition,we examined whether compromised communication efficiency was linked to clinical symptoms in the depressed adolescents.We observed significant correlations between network communication efficiencies and clinical scale scores derived from depressed adolescents with NSSI and SA.CONCLUSION This study provides evidence of structural network communication differences in depressed adolescents with NSSI and SA,highlighting impaired neuroanatomical communication efficiency as a potential contributor to their symptoms.These findings offer new insights into the pathophysiological mechanisms underlying the comorbidity of NSSI and SA in adolescent depression.
文摘Depression is a severe mood disorder characterized by complex suicide mechanisms that involve a multitude of psychosocial and biological fac-tors.This paper presents a comprehensive analysis of the psychosocial factors influencing suicidal behavior in depression,including social support,life events,depressive symptoms,and personality traits,as well as biological factors such as brain-derived neurotrophic factor(BDNF),erotonin(5-TH)system dysfunction,and hypothalam-ic-pituitary-adrenal(HPA)axis abnormalities.Collectively,these factors significantly influence an individual’s risk of suicide,with biological factors serving as potential biomarkers for suicidal actions and psychosocial factors underscoring the impact of environmental and individual experiences.Understanding the interaction of these factors is crucial for comprehending and preventing suicidal behavior in depression.Despite considerable progress,current studies have limitations,particularly regarding the unclear interaction mechanisms between psychosocial and biological factors and a predominant focus on adult populations,with insufficient comprehensive studies on adolescents.
文摘Suicide is a major and urgent issue in the field of mental health,and the United Nations has set“reducing global suicide mortality by one third by 2030”as one of its sustainable development goals.Suicide literacy refers to an individual’s ability to recognize,manage,and prevent suicide-related problems.This article offers a comprehensive review of the concepts,assessment tools,factors,and interventions of suicide literacy,with the goal of helping individuals to better understand suicidal behaviors and providing a scientific basis for developing effective suicide prevention strategies and measures to advance the progress of suicide prevention.
