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 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
Objectives:Suicidal ideation is a strong predictor of suicide deaths,which refers to the consideration or desire to give up one's own life.Left-behind children in rural China are more vulnerable to psychological p...Objectives:Suicidal ideation is a strong predictor of suicide deaths,which refers to the consideration or desire to give up one's own life.Left-behind children in rural China are more vulnerable to psychological problems and suicidal ideation compared to their non-left-behind peers.The aim of the current study was to examine two potential protective factors,negotiable fate belief and coping self-efficacy,and to test the mediating role of coping self-efficacy in the relationship between negotiable fate belief and suicidal ideation.We also analyzed gender differences in this mediation model.Methods:Across-sectional survey was conducted in rural areas ofChina.A sample of 526 left-behind children(285 males,54.18%;241 females,45.82%;Meanage=13.29 years,SD=0.97 years)was recruited to complete the Negotiable Fate Belief Scale,Coping Self-Efficacy Scale,and the Positive and Negative Suicide Ideation Inventory-Negative Scale.We used structural equation modeling to test the mediation model and multigroup analysis to test the moderation effect of gender.Results:Negotiable fate belief is negatively correlated with suicidal ideation(r=-0.13,p<0.01).Moreover,coping self-efficacy mediates the relationship between negotiable fate belief and suicidal ideation(β=-0.06,95%confidence interval(CI)[-0.12,-0.02]),accounting for 35.29%of the total effect.Finally,the mediating effect of coping self-efficacy was found to be significant only for female left-behind children(male:95%CI[-0.09,0.07];female:95%CI[-0.16,-0.01]).For female left-behind children,the mediating effect was complete,with a coefficient of-0.06,accounting for 85.71%of the total effect.Conclusions:The relationship between negotiable fate belief and suicidal ideation among rural left-behind children is mediated by coping self-efficacy,and this mediation effect was moderated by gender.This study provides a theoretical explanation for how cultivating the belief in negotiable fate and coping self-efficacy is effective for reducing suicidal ideation of rural left-behind children.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
Dear Editor,Major depressive disorder(MDD)is associated with a high rate of suicide attempts(SA).Previous reports have identified risk factors for SA in MDD patients,including sex and metabolic disorders[1].However,to...Dear Editor,Major depressive disorder(MDD)is associated with a high rate of suicide attempts(SA).Previous reports have identified risk factors for SA in MDD patients,including sex and metabolic disorders[1].However,to our knowledge,the impact of sex differences on the association between body mass index(BMI)status and SA in patients with MDD has not been investigated.Th is study aimed to investigate:1)the sex diff erence in the prevalence of recent SA in Chinese drug-naïve fi rst-episode(DNFE)MDD patients,and 2)the eff ect of sex diff erence on the relationship between higher BMI(overweight or obese)and recent SA.Patients were recruited from the First Clinical Medical College of Shanxi Medical University from January 2015 to December 2017.All patients met the inclusion and exclusion criteria described in previous studies[2].展开更多
To the editor:Non-suicidal self-injury(NSSI)is an array of directly prepense or repetitive self-harm behaviours without suicidal intent.Individuals engage in self-injurious behaviours to reduce negative mental and cog...To the editor:Non-suicidal self-injury(NSSI)is an array of directly prepense or repetitive self-harm behaviours without suicidal intent.Individuals engage in self-injurious behaviours to reduce negative mental and cognitive states or evoke positive emotions.展开更多
Background Non-suicidal self-injury(NSSI)is a significant health concern among adolescents and young adults,often resulting from adverse childhood experiences(ACEs).Dissociation,post-traumatic symptoms and attachment ...Background Non-suicidal self-injury(NSSI)is a significant health concern among adolescents and young adults,often resulting from adverse childhood experiences(ACEs).Dissociation,post-traumatic symptoms and attachment style may have a role in shaping such associations.Aims This study aims to provide a unified model of the impact of ACEs on NSSI,exploring complex post-traumatic stress disorder(cPTSD)symptoms and dissociation as potential mediators and the role of the predominant attachment style in affecting such associations.Methods 1010 young individuals attending the last year of high school participated in this cross-sectional study.ACEs,cPTSD,dissociation and NSSI were evaluated using self-report questionnaires.We fitted a path model of NSSI,with ACEs as exogenous variables and cPTSD and dissociation as sequential mediators.Secure,fearful and preoccupied attachment styles were modelled as grouping variables.Results Our findings showed that dissociation mediated the impact of ACEs on NSSI in subjects with a fearful attachment style,as opposed to those with a preoccupied attachment for whom cPTSD symptoms mediated the ACEs-NSSI association.Conclusions Attachment styles moderate the relationship between ACEs and NSSI,with either dissociation or post-traumatic symptomatology mediating the impact of ACEs on NSSI,depending on the predominant attachment style.Our results highlight the importance of attachment as a pathway modifier in the relationships between different psychopathology dimensions,providing a useful framework to better conceptualise the ACEs-NSSI association.展开更多
Background Pain sensitivity is critical for preventing non-suicidal self-injury(NSSI)behaviours;however,individuals engaging in such behaviours often exhibit decreased pain sensitivity,which may undermine this natural...Background Pain sensitivity is critical for preventing non-suicidal self-injury(NSSI)behaviours;however,individuals engaging in such behaviours often exhibit decreased pain sensitivity,which may undermine this natural safeguard.The dorsolateral prefrontal cortex(DLPFC)is a key region involved in pain regulation,and recent approaches using transcranial direct current stimulation(tDCS)to target the DLPFC have shown potential for modulating pain processing and restoring normal pain perception for individuals engaging in NSSI behaviours.Aims This study aimed to explore the immediate and short-term effects of a single session of tDCS on pain sensitivity in individuals with NSSI,as well as its secondary effects on mood and NSSI-related factors.Methods In this randomised,double-blind,parallel,sham-controlled clinical trial,participants with a history of NSSI were randomly assigned to receive either active or sham tDCS.The intervention consisted of a single 20 min tDCS session targeting the left DLPFC.The primary outcome was pain sensitivity,measured by the pressure pain threshold(PPT)and heat pain score(HPS).Secondary and additional outcomes included NSSI urges,NSSI resistance,self-efficacy in resisting NSSI,mood-related variables and exploratory cognitive-affective processes such as rumination,self-criticism and self-perceived pain sensitivity,assessed at baseline,immediately post-intervention,and at 24 hours,1 week and 2 weeks follow-ups.Results For the primary outcomes,no significant differences between groups were observed for pain sensitivity(PPT,padj=0.812;HPS,padj=0.608).However,an exploratory sensitivity analysis treating each trial as an individual observation revealed a significant effect on HPS(padj=0.036).For the secondary and additional outcomes,although there were initial improvements in joyful feelings and reductions in negative affect at 2 weeks post-intervention,these effects did not remain significant after multiple comparison corrections.Notably,reductions in rumination were statistically significant at both 1-week and 2-week follow-ups(1 week,p_(adj)=0.040;2 weeks,p_(adj)=0.042).There were no significant effects on NSSI urges,NSSI resistance,self-efficacy in resisting NSSI or self-criticism.Conclusions A single session of tDCS over the left DLPFC did not produce significant changes in pain sensitivity in individuals with NSSI.A sensitivity analysis indicated an effect on heat pain sensitivity,possibly reflecting changes in brain activity,warranting confirmation through neuroimaging.These findings suggest that tDCS warrants further investigation for its potential to influence pain-related cognitive-affective processes in individuals with NSSI.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
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
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
Suicide risk constitutes a complex set of interacting demographic, clinical, psychobiological and environmental variables. Impulsivity is a long-known risk factor for suicide attempts. However, research based on clear...Suicide risk constitutes a complex set of interacting demographic, clinical, psychobiological and environmental variables. Impulsivity is a long-known risk factor for suicide attempts. However, research based on clearer conceptual refinement in this area is imperative. One emerging field of study is that of decision-making. Impulsivity involves a failure of higher-order control, including decision-making. Using standardized operational definitions that take into consideration relevant aspects of impulsivity, including state- and trait-components and a deeper understanding of the process of decision-making in the suicidal mind, we may come a step closer to understanding suicidality and winning the fight in this scourge of human suffering.展开更多
BACKGROUND Major depressive disorder is a common mental illness among adolescents and is the largest disease burden in this age group.Most adolescent patients with depression have suicidal ideation(SI);however,few stu...BACKGROUND Major depressive disorder is a common mental illness among adolescents and is the largest disease burden in this age group.Most adolescent patients with depression have suicidal ideation(SI);however,few studies have focused on the factors related to SI,and effective predictive models are lacking.AIM To construct a risk prediction model for SI in adolescent depression and provide a reference assessment tool for prevention.METHODS The data of 150 adolescent patients with depression at the First People's Hospital of Lianyungang from June 2020 to December 2022 were retrospectively analyzed.Based on whether or not they had SI,they were divided into a SI group(n=91)and a non-SI group(n=59).The general data and laboratory indices of the two groups were compared.Logistic regression was used to analyze the factors influencing SI in adolescent patients with depression,a nomogram prediction model was constructed based on the analysis results,and internal evaluation was performed.Receiver operating characteristic and calibration curves were used to evaluate the model’s efficacy,and the clinical application value was evaluated using decision curve analysis(DCA).RESULTS There were differences in trauma history,triggers,serum ferritin levels(SF),highsensitivity C-reactive protein levels(hs-CRP),and high-density lipoprotein(HDLC)levels between the two groups(P<0.05).Logistic regression analysis showed that trauma history,predisposing factors,SF,hs-CRP,and HDL-C were factors influencing SI in adolescent patients with depression.The area under the curve of the nomogram prediction model was 0.831(95%CI:0.763–0.899),sensitivity was 0.912,and specificity was 0.678.The higher net benefit of the DCA and the average absolute error of the calibration curve were 0.043,indicating that the model had a good fit.CONCLUSION The nomogram prediction model based on trauma history,triggers,ferritin,serum hs-CRP,and HDL-C levels can effectively predict the risk of SI in adolescent patients with depression.展开更多
Objective: Transient suicide thoughts are common to some people throughout the course of HIV disease and often do not indicate significant risk of suicide. However, persistent suicidal thoughts with associated feeling...Objective: Transient suicide thoughts are common to some people throughout the course of HIV disease and often do not indicate significant risk of suicide. However, persistent suicidal thoughts with associated feelings of hopelessness and intent to die are very serious and must be assessed promptly and carefully. The aim of this study, therefore, was to examine the relationship between depression, hopelessness, psychosocial stressors and suicidal ideation in PLWHAs. Methods: This was a hospital based, cross sectional, descriptive study, of one hundred and seventy depressed adult HIV/AIDS patients of Kwara State Specialist Hospital, Ilorin. Depression and suicidal assessment were evaluated using the PHQ-9 scale. A score of >9 or any affirmative response to question 9 of the PHQ-9 scale necessitated suicidal risk assessment. The social determinant questionnaire was used to evaluate social cohesion and negative life events. Results: The prevalence of depression among the HIV/AID patient was 56.7%. Twenty nine (17.1%) were hopeless, twenty eight (16.5%) had at one time or the other thought of taking their lives, six (3.5%) had plan to take their lives. There was strong statistical association between depression, hopelessness (p-value = 0.000) thought of taking life (p-value = 0.000) and plan to take their lives (p-value = 0.030). Conclusion: The significant correlations between hopelessness, depression and suicidal ideation are important markers that should alert clinicians to underlying suicide risk in HIV-positive patients. In addition, low social cohesion and stressful life events were found to be risk factors for depression and suicide. Clinicians should routinely enquire about suicidality in PLWHAs to assist early diagnosis and intervention.展开更多
Introduction: Sickle cell anaemia is a hereditary disease that combines physical and psychological manifestations, including suicidal tendencies. So far, to our knowledge, no study has been conducted on suicidal behav...Introduction: Sickle cell anaemia is a hereditary disease that combines physical and psychological manifestations, including suicidal tendencies. So far, to our knowledge, no study has been conducted on suicidal behaviours among people with sickle cell disease in Cameroon. This is what justifies our study on the prevalence and factors related to suicidal behaviors in our study population. Methods: We conducted a cross-sectional, analytical study of 171 sickle cell patients aged from 12 years upwards who came to the sickle cell disease care service of the Laquintinie Hospital in Douala, over a period of 6 months, that is, from 1 January to 31 June 2022. Data were collected using a structured questionnaire with questions on suicidal behaviours based on the “MINI” (Mini International Neuropsychiatric Interview). The data were processed using the SPSS 26.0 software. The related factors were studied in both a bivariate and multivariate analysis. Results: Female sickle cell patients accounted for 60.2% of the sample. The mean age was 23.36 ± 8.42 years. Suicidal ideation was prevalent in 56% of cases and 13% attempted suicide. The factors most associated with suicidal ideation were: primary level of education (OR = 0.08 (0.09 - 0.79);p = 0.03), feeling unworthy of life (OR = 0.40 (0.08 - 1.96);p = 0.02), not often being considered by those around them (OR = 2.97 (1.26 - 6.99);p = 0.01), lack of family support (OR = 0.34 (0.15 - 0.77);p = 0.01). Meanwhile, the factors associated with suicide attempts were: the fact of being rarely exposed to suicide-related media (OR = 4.17 (1.40 - 71.80);p = 0.03), and a constant feeling of sadness when returning home (OR = 18.02 (1.59 - 20.55);p = 0.01). Conclusion: More than half of sickle cell patients had had suicidal thoughts and 1/6 had made at least one suicide attempt, women and young adults being the most concerned. It is therefore necessary to ensure optimum psychological care for patients with sickle cell disease.展开更多
The mental health of workers is an important issue that affects not only individuals and their families but also workplaces and communities.Therefore,it is necessary to regularly evaluate and analyze workers’mental h...The mental health of workers is an important issue that affects not only individuals and their families but also workplaces and communities.Therefore,it is necessary to regularly evaluate and analyze workers’mental health status,including levels of stress,depression,and addictive behaviors to apply thesefindings in creating mental health promotion programs.This study aims to provide basic data that would facilitate early intervention for workers’mental health problems by analyzing factors such as stress,depression,and problem drinking that can affect suicidal ideation.From April 15 to October 25,2019,a survey was conducted with 165 workers across six workplaces in a Korean city.Analysis was performed using descriptive statistics,correlation,and simple and multiple regression analyses using the R statistics program 4.0.3.There was no difference in suicidal ideation scores based on the participants’general characteristics,while there was a significant positive correlation among stress,depression,problem drinking,and suicidal ideation.In addition,severe depression,severe stress,and severe problem drinking had significant effects on suicidal ideation,and among the subitems of stress,somatic symptoms had an effect on suicidal ideation.In addition,severe stress,somatic symptoms,depression,and severe problem drinking had a significant effect on suicidal ideation in males but not in females.It is necessary to identify the effects of stress,depression,drinking problems,and suicide on workers’mental health,and evaluate their mental health systemati-cally and regularly to recognize whether active psychiatric treatment and nursing intervention are necessary as well as preventive management.In addition,it is meaningful to pay attention to the suicide ideation of adult workers and provide basic data to promote systematic public health policies on mental health.展开更多
Background: Self-efficacy has been widely studied in suicide, both in its causality and treatment effects. However, the evidence of causality is still ambiguous and there is a lack of generalizability. The aim of this...Background: Self-efficacy has been widely studied in suicide, both in its causality and treatment effects. However, the evidence of causality is still ambiguous and there is a lack of generalizability. The aim of this study was to examine the relationship between self-efficacy and suicidal ideation through a population cohort study. Methods: The community-based household survey using a self-administered questionnaire was conducted in a rural area of Japan, Happo Town, in Akita Prefecture with community residents aged 30 and over at two respective time points by local health volunteers. The baseline survey was conducted in 2010 with a response rate of 88.9% (n = 6044). Among them, 3812 residents met the inclusion criteria for the follow-up survey in 2012 where the response rate was 75.3% (n = 2869). Exposure variables to suicidal ideation included demographic details, depression and self-efficacy. The Institutional Review Board and the Ethics Committee of Akita University approved the study protocol and all subjects signed informed consent. Results: A total number of 2105 participants (76.4%) without suicidal ideation in the baseline study were enrolled into the follow-up study, and 8.2% of them had developed suicidal ideation. These participants with suicidal ideation were significantly less likely to be married/cohabitant;they had worse subjective health, poorer self-perceived economic status, stronger depressive mood, and lower self-efficacy scores. The odds ratio of the self-efficacy scores at follow-up survey for participants who had developed suicidal ideation were about 2 times lower than at baseline (95% confidence interval = 1. 53 - 3.06). After adjusting for all confounding factors, the association was still significant (OR = 1.66, 95% CI = 1.15 - 2.42). Conclusion: This result suggests that suicidal ideation may be prevented by increasing self-efficacy. We suggest that self-efficacy can be an effective tool for identifying people with suicidal ideation, and increasing self-efficacy can be strategically beneficial for larger suicide prevention.展开更多
One of the important dimensions of violence is suicide, or violence directed toward self that many people suffer from nowadays. In the meantime, adolescents and especially girls are more likely to be harmed. The purpo...One of the important dimensions of violence is suicide, or violence directed toward self that many people suffer from nowadays. In the meantime, adolescents and especially girls are more likely to be harmed. The purpose of this study was to evaluate the effect of group training with non-violent communication (NVC) method on suicidal ideations and coping with stress styles of adolescent girls. The target community in this research was availably selected from the charity centers of Tehran suburbs. In this study, 15 adolescent girls were in the experimental group and 15 in the control group. The criteria for entering the research were students aged 11 to 19 years and the vulnerable socio-economic income. Eight training sessions of NVC were presented for the experimental group in the pre-test and post-test intervals, while no intervention was performed for the control group. Data collection instruments were Beck’s scale for suicidal ideation (BDI) and Endler & Parker’s coping inventory for stressful situations (CISS). After statistical analysis, the effectiveness of this training was investigated on dependent variables by multivariate analysis of covariance. Eventually, the results showed a significant difference between the experimental and control groups (p < 0.05). The finding of the study showed that NVC training can reduce suicidal ideations in adolescent girls who are socially and economically vulnerable. According to the findings, non-violent communication training has a higher effect on emotion-focused coping style compared to other stress coping styles.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.
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.
基金funded by the 2023Laibin City Philosophy and Social Science Research Project(No.2023LBZS035)2024Guangxi Student Innovation and Entrepreneurship Training Program Project(No.S202411546046X)2025 Research Project of Guangxi Science&Technology Normal University(No.GXKS2025YB020).
文摘Objectives:Suicidal ideation is a strong predictor of suicide deaths,which refers to the consideration or desire to give up one's own life.Left-behind children in rural China are more vulnerable to psychological problems and suicidal ideation compared to their non-left-behind peers.The aim of the current study was to examine two potential protective factors,negotiable fate belief and coping self-efficacy,and to test the mediating role of coping self-efficacy in the relationship between negotiable fate belief and suicidal ideation.We also analyzed gender differences in this mediation model.Methods:Across-sectional survey was conducted in rural areas ofChina.A sample of 526 left-behind children(285 males,54.18%;241 females,45.82%;Meanage=13.29 years,SD=0.97 years)was recruited to complete the Negotiable Fate Belief Scale,Coping Self-Efficacy Scale,and the Positive and Negative Suicide Ideation Inventory-Negative Scale.We used structural equation modeling to test the mediation model and multigroup analysis to test the moderation effect of gender.Results:Negotiable fate belief is negatively correlated with suicidal ideation(r=-0.13,p<0.01).Moreover,coping self-efficacy mediates the relationship between negotiable fate belief and suicidal ideation(β=-0.06,95%confidence interval(CI)[-0.12,-0.02]),accounting for 35.29%of the total effect.Finally,the mediating effect of coping self-efficacy was found to be significant only for female left-behind children(male:95%CI[-0.09,0.07];female:95%CI[-0.16,-0.01]).For female left-behind children,the mediating effect was complete,with a coefficient of-0.06,accounting for 85.71%of the total effect.Conclusions:The relationship between negotiable fate belief and suicidal ideation among rural left-behind children is mediated by coping self-efficacy,and this mediation effect was moderated by gender.This study provides a theoretical explanation for how cultivating the belief in negotiable fate and coping self-efficacy is effective for reducing suicidal ideation of rural left-behind children.
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.
基金supported by the Guangzhou Municiple Health Commission(2023 C-TS26)the Opening Foundation of Jiangsu Key Laboratory of Neurodegeneration,Nanjing Medical University(KF202202)+1 种基金the Plan on Enhancing Scientific Research in Guangzhou Medical University(02-410-230221XM,GMUCR2024-02025)the Project of Guangzhou Municipal Science and Technology Bureau(2023A03J0835).
文摘Dear Editor,Major depressive disorder(MDD)is associated with a high rate of suicide attempts(SA).Previous reports have identified risk factors for SA in MDD patients,including sex and metabolic disorders[1].However,to our knowledge,the impact of sex differences on the association between body mass index(BMI)status and SA in patients with MDD has not been investigated.Th is study aimed to investigate:1)the sex diff erence in the prevalence of recent SA in Chinese drug-naïve fi rst-episode(DNFE)MDD patients,and 2)the eff ect of sex diff erence on the relationship between higher BMI(overweight or obese)and recent SA.Patients were recruited from the First Clinical Medical College of Shanxi Medical University from January 2015 to December 2017.All patients met the inclusion and exclusion criteria described in previous studies[2].
基金the Innovation 2030-Major Project of Brain Science and Brain-lnspired Intelligence Technology(2021ZD0200600)Shanghai Science and Technology Committee(22YF1439100,YDZX20213100001003)National Natural Science Foundation of China(82201678).
文摘To the editor:Non-suicidal self-injury(NSSI)is an array of directly prepense or repetitive self-harm behaviours without suicidal intent.Individuals engage in self-injurious behaviours to reduce negative mental and cognitive states or evoke positive emotions.
基金supported by #NEXTGENERATIONEU(NGEU)and funded by the Ministry of University and Research(MUR),National Recovery and Resilience Plan(NRRP),project MNESYS(PE0000006)-(DN.155311.10.2022)supported by Sapienza Grant 2021(RM12117A60BDF685).
文摘Background Non-suicidal self-injury(NSSI)is a significant health concern among adolescents and young adults,often resulting from adverse childhood experiences(ACEs).Dissociation,post-traumatic symptoms and attachment style may have a role in shaping such associations.Aims This study aims to provide a unified model of the impact of ACEs on NSSI,exploring complex post-traumatic stress disorder(cPTSD)symptoms and dissociation as potential mediators and the role of the predominant attachment style in affecting such associations.Methods 1010 young individuals attending the last year of high school participated in this cross-sectional study.ACEs,cPTSD,dissociation and NSSI were evaluated using self-report questionnaires.We fitted a path model of NSSI,with ACEs as exogenous variables and cPTSD and dissociation as sequential mediators.Secure,fearful and preoccupied attachment styles were modelled as grouping variables.Results Our findings showed that dissociation mediated the impact of ACEs on NSSI in subjects with a fearful attachment style,as opposed to those with a preoccupied attachment for whom cPTSD symptoms mediated the ACEs-NSSI association.Conclusions Attachment styles moderate the relationship between ACEs and NSSI,with either dissociation or post-traumatic symptomatology mediating the impact of ACEs on NSSI,depending on the predominant attachment style.Our results highlight the importance of attachment as a pathway modifier in the relationships between different psychopathology dimensions,providing a useful framework to better conceptualise the ACEs-NSSI association.
基金supported by National Natural Science Foundation of China(82471564)YT is supported by National Natural Science Foundation of China(32322035,32171078).
文摘Background Pain sensitivity is critical for preventing non-suicidal self-injury(NSSI)behaviours;however,individuals engaging in such behaviours often exhibit decreased pain sensitivity,which may undermine this natural safeguard.The dorsolateral prefrontal cortex(DLPFC)is a key region involved in pain regulation,and recent approaches using transcranial direct current stimulation(tDCS)to target the DLPFC have shown potential for modulating pain processing and restoring normal pain perception for individuals engaging in NSSI behaviours.Aims This study aimed to explore the immediate and short-term effects of a single session of tDCS on pain sensitivity in individuals with NSSI,as well as its secondary effects on mood and NSSI-related factors.Methods In this randomised,double-blind,parallel,sham-controlled clinical trial,participants with a history of NSSI were randomly assigned to receive either active or sham tDCS.The intervention consisted of a single 20 min tDCS session targeting the left DLPFC.The primary outcome was pain sensitivity,measured by the pressure pain threshold(PPT)and heat pain score(HPS).Secondary and additional outcomes included NSSI urges,NSSI resistance,self-efficacy in resisting NSSI,mood-related variables and exploratory cognitive-affective processes such as rumination,self-criticism and self-perceived pain sensitivity,assessed at baseline,immediately post-intervention,and at 24 hours,1 week and 2 weeks follow-ups.Results For the primary outcomes,no significant differences between groups were observed for pain sensitivity(PPT,padj=0.812;HPS,padj=0.608).However,an exploratory sensitivity analysis treating each trial as an individual observation revealed a significant effect on HPS(padj=0.036).For the secondary and additional outcomes,although there were initial improvements in joyful feelings and reductions in negative affect at 2 weeks post-intervention,these effects did not remain significant after multiple comparison corrections.Notably,reductions in rumination were statistically significant at both 1-week and 2-week follow-ups(1 week,p_(adj)=0.040;2 weeks,p_(adj)=0.042).There were no significant effects on NSSI urges,NSSI resistance,self-efficacy in resisting NSSI or self-criticism.Conclusions A single session of tDCS over the left DLPFC did not produce significant changes in pain sensitivity in individuals with NSSI.A sensitivity analysis indicated an effect on heat pain sensitivity,possibly reflecting changes in brain activity,warranting confirmation through neuroimaging.These findings suggest that tDCS warrants further investigation for its potential to influence pain-related cognitive-affective processes in individuals with NSSI.
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 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 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Suicide risk constitutes a complex set of interacting demographic, clinical, psychobiological and environmental variables. Impulsivity is a long-known risk factor for suicide attempts. However, research based on clearer conceptual refinement in this area is imperative. One emerging field of study is that of decision-making. Impulsivity involves a failure of higher-order control, including decision-making. Using standardized operational definitions that take into consideration relevant aspects of impulsivity, including state- and trait-components and a deeper understanding of the process of decision-making in the suicidal mind, we may come a step closer to understanding suicidality and winning the fight in this scourge of human suffering.
文摘BACKGROUND Major depressive disorder is a common mental illness among adolescents and is the largest disease burden in this age group.Most adolescent patients with depression have suicidal ideation(SI);however,few studies have focused on the factors related to SI,and effective predictive models are lacking.AIM To construct a risk prediction model for SI in adolescent depression and provide a reference assessment tool for prevention.METHODS The data of 150 adolescent patients with depression at the First People's Hospital of Lianyungang from June 2020 to December 2022 were retrospectively analyzed.Based on whether or not they had SI,they were divided into a SI group(n=91)and a non-SI group(n=59).The general data and laboratory indices of the two groups were compared.Logistic regression was used to analyze the factors influencing SI in adolescent patients with depression,a nomogram prediction model was constructed based on the analysis results,and internal evaluation was performed.Receiver operating characteristic and calibration curves were used to evaluate the model’s efficacy,and the clinical application value was evaluated using decision curve analysis(DCA).RESULTS There were differences in trauma history,triggers,serum ferritin levels(SF),highsensitivity C-reactive protein levels(hs-CRP),and high-density lipoprotein(HDLC)levels between the two groups(P<0.05).Logistic regression analysis showed that trauma history,predisposing factors,SF,hs-CRP,and HDL-C were factors influencing SI in adolescent patients with depression.The area under the curve of the nomogram prediction model was 0.831(95%CI:0.763–0.899),sensitivity was 0.912,and specificity was 0.678.The higher net benefit of the DCA and the average absolute error of the calibration curve were 0.043,indicating that the model had a good fit.CONCLUSION The nomogram prediction model based on trauma history,triggers,ferritin,serum hs-CRP,and HDL-C levels can effectively predict the risk of SI in adolescent patients with depression.
文摘Objective: Transient suicide thoughts are common to some people throughout the course of HIV disease and often do not indicate significant risk of suicide. However, persistent suicidal thoughts with associated feelings of hopelessness and intent to die are very serious and must be assessed promptly and carefully. The aim of this study, therefore, was to examine the relationship between depression, hopelessness, psychosocial stressors and suicidal ideation in PLWHAs. Methods: This was a hospital based, cross sectional, descriptive study, of one hundred and seventy depressed adult HIV/AIDS patients of Kwara State Specialist Hospital, Ilorin. Depression and suicidal assessment were evaluated using the PHQ-9 scale. A score of >9 or any affirmative response to question 9 of the PHQ-9 scale necessitated suicidal risk assessment. The social determinant questionnaire was used to evaluate social cohesion and negative life events. Results: The prevalence of depression among the HIV/AID patient was 56.7%. Twenty nine (17.1%) were hopeless, twenty eight (16.5%) had at one time or the other thought of taking their lives, six (3.5%) had plan to take their lives. There was strong statistical association between depression, hopelessness (p-value = 0.000) thought of taking life (p-value = 0.000) and plan to take their lives (p-value = 0.030). Conclusion: The significant correlations between hopelessness, depression and suicidal ideation are important markers that should alert clinicians to underlying suicide risk in HIV-positive patients. In addition, low social cohesion and stressful life events were found to be risk factors for depression and suicide. Clinicians should routinely enquire about suicidality in PLWHAs to assist early diagnosis and intervention.
文摘Introduction: Sickle cell anaemia is a hereditary disease that combines physical and psychological manifestations, including suicidal tendencies. So far, to our knowledge, no study has been conducted on suicidal behaviours among people with sickle cell disease in Cameroon. This is what justifies our study on the prevalence and factors related to suicidal behaviors in our study population. Methods: We conducted a cross-sectional, analytical study of 171 sickle cell patients aged from 12 years upwards who came to the sickle cell disease care service of the Laquintinie Hospital in Douala, over a period of 6 months, that is, from 1 January to 31 June 2022. Data were collected using a structured questionnaire with questions on suicidal behaviours based on the “MINI” (Mini International Neuropsychiatric Interview). The data were processed using the SPSS 26.0 software. The related factors were studied in both a bivariate and multivariate analysis. Results: Female sickle cell patients accounted for 60.2% of the sample. The mean age was 23.36 ± 8.42 years. Suicidal ideation was prevalent in 56% of cases and 13% attempted suicide. The factors most associated with suicidal ideation were: primary level of education (OR = 0.08 (0.09 - 0.79);p = 0.03), feeling unworthy of life (OR = 0.40 (0.08 - 1.96);p = 0.02), not often being considered by those around them (OR = 2.97 (1.26 - 6.99);p = 0.01), lack of family support (OR = 0.34 (0.15 - 0.77);p = 0.01). Meanwhile, the factors associated with suicide attempts were: the fact of being rarely exposed to suicide-related media (OR = 4.17 (1.40 - 71.80);p = 0.03), and a constant feeling of sadness when returning home (OR = 18.02 (1.59 - 20.55);p = 0.01). Conclusion: More than half of sickle cell patients had had suicidal thoughts and 1/6 had made at least one suicide attempt, women and young adults being the most concerned. It is therefore necessary to ensure optimum psychological care for patients with sickle cell disease.
文摘The mental health of workers is an important issue that affects not only individuals and their families but also workplaces and communities.Therefore,it is necessary to regularly evaluate and analyze workers’mental health status,including levels of stress,depression,and addictive behaviors to apply thesefindings in creating mental health promotion programs.This study aims to provide basic data that would facilitate early intervention for workers’mental health problems by analyzing factors such as stress,depression,and problem drinking that can affect suicidal ideation.From April 15 to October 25,2019,a survey was conducted with 165 workers across six workplaces in a Korean city.Analysis was performed using descriptive statistics,correlation,and simple and multiple regression analyses using the R statistics program 4.0.3.There was no difference in suicidal ideation scores based on the participants’general characteristics,while there was a significant positive correlation among stress,depression,problem drinking,and suicidal ideation.In addition,severe depression,severe stress,and severe problem drinking had significant effects on suicidal ideation,and among the subitems of stress,somatic symptoms had an effect on suicidal ideation.In addition,severe stress,somatic symptoms,depression,and severe problem drinking had a significant effect on suicidal ideation in males but not in females.It is necessary to identify the effects of stress,depression,drinking problems,and suicide on workers’mental health,and evaluate their mental health systemati-cally and regularly to recognize whether active psychiatric treatment and nursing intervention are necessary as well as preventive management.In addition,it is meaningful to pay attention to the suicide ideation of adult workers and provide basic data to promote systematic public health policies on mental health.
文摘Background: Self-efficacy has been widely studied in suicide, both in its causality and treatment effects. However, the evidence of causality is still ambiguous and there is a lack of generalizability. The aim of this study was to examine the relationship between self-efficacy and suicidal ideation through a population cohort study. Methods: The community-based household survey using a self-administered questionnaire was conducted in a rural area of Japan, Happo Town, in Akita Prefecture with community residents aged 30 and over at two respective time points by local health volunteers. The baseline survey was conducted in 2010 with a response rate of 88.9% (n = 6044). Among them, 3812 residents met the inclusion criteria for the follow-up survey in 2012 where the response rate was 75.3% (n = 2869). Exposure variables to suicidal ideation included demographic details, depression and self-efficacy. The Institutional Review Board and the Ethics Committee of Akita University approved the study protocol and all subjects signed informed consent. Results: A total number of 2105 participants (76.4%) without suicidal ideation in the baseline study were enrolled into the follow-up study, and 8.2% of them had developed suicidal ideation. These participants with suicidal ideation were significantly less likely to be married/cohabitant;they had worse subjective health, poorer self-perceived economic status, stronger depressive mood, and lower self-efficacy scores. The odds ratio of the self-efficacy scores at follow-up survey for participants who had developed suicidal ideation were about 2 times lower than at baseline (95% confidence interval = 1. 53 - 3.06). After adjusting for all confounding factors, the association was still significant (OR = 1.66, 95% CI = 1.15 - 2.42). Conclusion: This result suggests that suicidal ideation may be prevented by increasing self-efficacy. We suggest that self-efficacy can be an effective tool for identifying people with suicidal ideation, and increasing self-efficacy can be strategically beneficial for larger suicide prevention.
文摘One of the important dimensions of violence is suicide, or violence directed toward self that many people suffer from nowadays. In the meantime, adolescents and especially girls are more likely to be harmed. The purpose of this study was to evaluate the effect of group training with non-violent communication (NVC) method on suicidal ideations and coping with stress styles of adolescent girls. The target community in this research was availably selected from the charity centers of Tehran suburbs. In this study, 15 adolescent girls were in the experimental group and 15 in the control group. The criteria for entering the research were students aged 11 to 19 years and the vulnerable socio-economic income. Eight training sessions of NVC were presented for the experimental group in the pre-test and post-test intervals, while no intervention was performed for the control group. Data collection instruments were Beck’s scale for suicidal ideation (BDI) and Endler & Parker’s coping inventory for stressful situations (CISS). After statistical analysis, the effectiveness of this training was investigated on dependent variables by multivariate analysis of covariance. Eventually, the results showed a significant difference between the experimental and control groups (p < 0.05). The finding of the study showed that NVC training can reduce suicidal ideations in adolescent girls who are socially and economically vulnerable. According to the findings, non-violent communication training has a higher effect on emotion-focused coping style compared to other stress coping styles.
