Many researches have identified that adverse childhood experiences (ACEs) are associated with non-suicidal self-injury (NSSI) and suicidality. However, most studies have been restricted to a few types of ACEs. This study aims to investigate associations of 13 common types of ACEs with NSSI, suicidal ideation (SI) and suicide attempt (SA), as well as the mediation of depressive and anxiety symptoms therein. A total of 1771 students aged 11-16 years who participated in the baseline survey of the Chinese Adolescent Health Growth Cohort study were included for the analysis. ACEs, SI, SA, depressive and anxiety symptoms were recorded by standard questionnaire. Of included participants, 92.0% reported one or more category of ACEs. Smoking, parent-child separation, emotional abuse, physical abuse and being bullied were positively associated with NSSI, with the adjusted odds ratio (aOR) of 2.41(95%CI, 1.01-5.75), 1.80(1.28-2.54), 1.69(1.21-2.37), 2.08(1.44-3.01) and 1.87(1.35-2.59), respectively; smoking (4.03, 1.66-9.81), parent-child separation (1.42, 1.07-1.90), emotional abuse (1.91, 1.41-2.59), physical abuse (1.80, 1.27-2.57), emotional neglect (1.78, 1.28-2.49) and being bullied (2.08, 1.54-2.81) were positively associated with SI; smoking(4.30, 1.67-11.10), emotional abuse (2.42, 1.58-3.72) and being bullied (1.75, 1.17-2.60) were positively associated with SA. The associations of ACEs with NSSI, SI and SA were each partially or completely mediated through depressive and anxiety symptoms. Children and adolescents who had experiences of smoking, physical abuse and being bullied during childhood are consistently and independently associated with NSSI and suicidality, and these associations may be largely mediated through depressive and anxiety symptoms.

Suicide remains a persistent global health challenge, resisting widespread prevention efforts. According to previous findings, toxoplasmosis is particularly associated with altered deci-sion-making, which could lead to risk-taking behavior thereby increasing the likelihood for sui-cidal behavior (SB). In addition, discussion about the role of microbiome in psychiatric disorders has emerged lately, which also makes it relevant to investigate its role in the context of SB. Therefore, the current review aimed to comprehensively summarize existing knowledge regard-ing the association between microbial pathogens and SB. We conducted a systematic search with keywords including suicide and Toxoplasma gondii (Suicid* AND Toxoplasm*) and microbiome (Microbiome AND Suicid*) throughout PubMed to retrieve the related studies up to 09.11.2023. Most results reported significant association between toxoplasmosis and SB, suggesting a higher likelihood of SB in the infected population. Regarding the microbiome, only very few studies in-vestigated an association between SB and alterations in microbiota. Based on those few studies, changes in the microbiome were significantly associated with SB. The cognitive aspects of deci-sion-making in T. gondii infected individuals with SB should be further investigated to unravel underlying mechanisms. Further sufficiently powered studies are needed to establish a link be-tween SB and gut microbiota.

Aim: To analyse recommended interventions for the safe and responsible dissemination of suicidal behaviour in the media. An umbrella review was conducted. Background: Suicide is a serious public health problem that leads to more than 700,000 deaths per year, which translates into one death every forty seconds. The media are channels of information that reflect the real world. Because of its active role in the construction of reality, the way in which the media report and expose suicidal behaviour has the capacity to influence the population in either a preventive or harmful way. Design: An umbrella review was carried out and the report was written according to the Preferred Reporting Items for Overviews of Reviews.

Contrary to what has been happening in most countries in the world, suicide mortality in Brazil has been increasing since 2016. To identify the epidemiological profile that may be associated with this increase in suicidal behavior in the population, we looked for a city with low rates of suicide mortality until 2016 and in which had a detectable growing epidemic wave in recent years to better elucidate the issue. This study aims to identify factors associated with suicidal ideation, suicidal planning, suicide attempts, and suicide.A validated questionnaire was used - Kaiser-Meyer-Olkin index (KMO) = .86 (acceptable greater than .7) and intraclass correlated coefficient (ICC) = .98 (acceptable greater than .9). Data collected was obtained by sampling for the convenience of the online questionnaire with a minimum sample of 400 respondents. The general population of Marília’s city, a medium-sized city in São Paulo state of Brazil, voluntarily responded to the questionnaire. Prevalence data was described in ratios and incidence was described in tables. The association was measured by factor analysis. The state government's data information platform (DataSUS) was consulted to verify the incidence of suicides from 2016 to 2023. The prevalence ratio of suicide attempts in people with mental disorders was 8.09%. There was a 600% increase in the incidence of suicide from 2016 to 2023 among young adults. Interpersonal problems were highly prevalent in people with suicidal ideation, suicidal planning, and suicide attempts. Heroism appears to be a suicidal equivalent and may be associated with most young deaths. Heroic behavior demonstrated a prevalence of 66.1% for committing tragic suicide. We get c² of 31.4 for 18 degrees of freedom (p=0.026) of 10 representative variables in factor analysis with eight of the 10 variables demonstrating an association for one component. The young population has demonstrated epidemically growing suicide rates. Social segregation can affect young people's social lives and increase suicidal behavior.

The Internet has become an essential tool for adolescents. It is part of their social integration within peers and supports their identity construction. The Internet can also become a source of addiction; especially when used as a coping strategy towards unpleasant life situations. The feeling of loneliness is an emotion present during the adolescence. However, when in excess, it can lead to suicidal ideations. We questioned ourselves on the impact of an excessive use of the Internet by adolescents, with their feeling of loneliness and the risks of suicidal ideations. We attempted to find an answer to this question by performing a literature review. We found one result matching our search criteria’s, which is itself a literature review. We noted the absence of studies with regards to the interaction between the feeling of loneliness, the addiction to the Internet, and the risk of suicidal ideations amongst adolescents. We established a theoretical model which could be used as a lead for future research. We insist on the importance that studies are made in this domain, in order to enable us to establish efficient preventive measure on the risks of suicidal ideations amongst adolescents.

The impact of the COVID-19 pandemic and the quarantine measures on children and adolescents’ hospitalization psychiatric has been poorly studied, especially in Italy, the first European country to adopt social restrictions. To fill this gap, this retrospective study examined changes in admissions to our child and adolescent psychiatry ward from the emergency department during the two COVID-19 quarantine periods in Italy (March to June 2020; October 2020 to January 2021) compared with two reference periods (defined as 12 months prior to the respective quarantine periods). Specifically, we examined data on the number of inpatients and the distribution of psychopathological disorders (i.e., psychosis, mood disorder) and self-injurious behaviors. The results revealed significantly fewer admissions during the first quarantine period relative to the first reference period and, conversely, significantly more admissions during the second quarantine period relative to the second reference period. Of note, the results showed an increased frequency of mood disorders, non-suicidal self-injurious behaviors and suicidal ideation during the quarantine periods, compared to the reference periods. The findings underline the need to focus on the psychopathological profile of children and adolescents with patient-tailored therapeutic interventions and suggest the importance of developing psychological healthcare services for future emergency periods..

Abstract: Background: chronotype is generally defined as the variability of the phase angle of en-trainment, while the latter reflects the relationship between the timing of a certain rhythm (e.g., sleep-wake cycle) and the timing of an external temporal cue. Individuals can be placed on a spectrum from "morning types" (M types), to "evening types" (E types). E-chronotype has been proposed as a transdiagnostic risk factor for psychiatric conditions and associated with psycho-pathological dimensions. Eveningness seems correlated with both suicidal ideation (SI) and suicidal behavioral (SB), through several possible mediating factors. Immunological alterations also have been linked to later chronotypes and SI/SB. Objective: This narrative review aims to summarize the evidence supporting the possible association between chronotypes and suicide, with the eventual mediating role of neuroinflammation and several psychopathological dimensions. Material and methods: A search of literature (2003-2023) was conducted, using various databases: PUBMED, EMBASE, Scopus, UpToDate, PsycINFO, Cochrane Library. English-language articles were col-lected and screened for eligibility. Results: Despite the apparent absence of a direct correlation between E-chronotype and suicidality, E-chronotype promotes a chain of effects that could be in-volved in an increased risk of SB, in which with neuroinflammation possibly play an intriguing role and some psychopathological dimensions may stand out.

Introduction: Suicide is the second leading cause of death among 15 to 19-years-olds in Europe. From the beginning of COVID-19 pandemic, literature confirms a significant increase in mental health disease in children and adolescents. At Bambino Gesù Pediatric Hospital emergency department (Rome, Italy) there was a dramatic increase of suicidal attempts, and particularly a rise of suicidal jumpers. Many of these patients presented vertebral fractures. Material and Methods: This retrospective study includes all suicidal jumpers with vertebral fractures treated at our Pediatric Hospital from April 1, 2017 to March 31, 2023. We collected and compared data from three years before to three years after pandemic spreading analyzing vertebral fractures. Results: From April 1 2019 to March 31, 2020 141 cases of suicide attempt arrived at Bambino Gesù Pediatric Hospital emergency department. Five of these patients were suicidal jumpers but none had a vertebral fracture. From April 1, 2020 to March 31, 2023, 362 cases of suicide attempts arrived in the same emergency department and 19 were suicidal jumpers; 12 reported vertebral fractures and were included in this study. Mean age was 14 years. Most common level of fracture was L1. Four patients presented with preoperative neurologic impairment and two cases recovered completely. There was a transforaminal sacral fracture, a spinopelvic dissociation and an Anderson-D’Alonso C2 type II fracture. Two cases with thoracolumbar vertebral fractures were conservatively treated. Seven patients were treated by percutaneous pedicle fixation to achieve an indirect decompression and to restore a better sagittal balance. Only three patients needed an open spinal surgery by posterior approach and in two cases a posterior decompression was performed. One case with cervical fractures was treated by Halo-Vest. Conclusions: Recent literature highlights concern about the consequences of COVID-19 pandemic on pediatric population mental health. This is the first report that shows a significant increase in vertebral body fractures due to suicide jumping attempt. The comparison between three years pre and post pandemic is sufficient to demonstrate a sharp increase of these cases. This could be a new epidemiological phenomenon that could persist or even increase over time because of COVID-19 pandemic.

Background and Objectives: Although there has been growing interest in the association of ADHD with anxiety, depression, suicidal ideation, and self-esteem, there is a lack of consistent results and these associations remain unclear. This study investigated the differential patterns of anxiety, depression, suicidal ideation, and self-esteem with regard to the presence of ADHD. Materials and Methods: The subjects were divided into a patient group and a control group. The patient group included 49 patients diagnosed with ADHD at the department of psychiatry of one university hospital. For the control group, 3,727 students were invited to complete a questionnaire. Of the 1,717 students who responded to the questionnaire, 245 were selected for patient-controlled studies. All the subjects were instructed to complete the Beck Suicide Ideation Scale, Children's Depression Inventory, Beck’s Depression Inventory, State-Trait Anxiety Inventory, and Rosenberg Self-Esteem Scale. Results: ADHD subjects experienced more anxiety, depression, and suicidal ideation as well as lower self-esteem compared to the control group comprising participants without ADHD. Conclusions: These findings suggest that ADHD symptoms may contribute to greater suicidal ideation through experienced depression, anxiety, and low self-esteem in school-aged children. Therefore, appropriate ADHD symptom management is necessary to reduce suicidal ideation among school-aged children with ADHD symptoms.

Suicide is defined as the action of harming oneself with the intention of dying. It is estimated that worldwide one suicide occurs every 40 seconds, making it a major health problem. Studies in families have suggested that suicide has a genetic component, around the world studies have been carried out in search of genetic variants associated with suicidal behavior, these variants could be useful as potential biomarkers to identify people at risk of suicide. In this area in Mexico, some studies of variants in genes related to neurotransmission and other important pathways have been carried out and a possible association of variants located in genes has been suggested: SLC6A4, SAT-1, TPH-2, ANKK1, GSHR, SCARA50, RGS10, STK33, COMT, and FKBP5. This systematic review shows the genetic studies on the Mexican population. This article contributes by compiling the existing information on genetic variants and genes associated with suicidal behavior, said variants in the future could be used as potential biomarkers to identify people at risk of suicide.

Kynurenine or tryptophan catabolite (TRYCAT) pathway contributes to the pathophysiology of major depression disorder (MDD) and major depressive episodes (MDE) in bipolar disorder and suicidal behaviors. The consequences of the overactivation of this pathway large reduced tryptophan (TRP) levels in peripheral blood and the CNS and increased levels of neurotoxic TRYCATs including kynurenine (KYN), 3-hydroxy kynurenine (3HK), quinolinic acid (QA), xanthurenic acid (XA), and picolinic acid (PA). However, other TRYCATs are protective, such as kynurenic acid (KA) and anthranilic acid (AA). Inflammation and cell-mediated immune activation along with oxidative and nitrosative stress (O&NS) may stimulate the first and rate-limiting enzyme of this pathway, namely indoleamine-2,3-dioxygenase (IDO). Therefore, during depression, balancing neuroprotective versus neurotoxic TRYCATs and balancing activation of the immune response system (IRS) versus the compensatory immune response system is crucial for achieving better treatment outcomes. Furthermore, targeting the causes of TRYCAT pathway activation (immune activation and O&NS) is probably the most effective strategy to treat depression. In the present review, we aim to provide a comprehensive explanation of the impact of TRYCATs in terms of pathophysiology and treatment of MDD and MDE.

The aim of the study was to examine the prevalence of suicide thoughts and -attempts during the early stage of the COVID-19 outbreak and examine factors associated with suicide thoughts in the general Norwegian population. A sample of 4527 adults living in Norway were recruited via social media. Data related to suicide thoughts and attempts, mental health variables, pandemic-related concerns and sociodemographic variables were collected. Associations with suicide thoughts were analyzed with logistic regression analysis. In the sample, 3.6 % reported suicide thoughts during the last month, while 0.2 % had attempted to commit suicide during the same period. Lower age (OR: 0.66, p < 0.001), daily alcohol use (OR: 3.29, p < 0.001), being in the risk group for COVID-19 complications (OR: 2.38, p < 0.01), and having economic concerns related to the pandemic (OR: 2.51, p < 0.001) were associated with having suicide thoughts. In addition to known risk factors, the study suggests that aspects specific to COVID-19 may be important for suicidal behaviors during the pandemic.

Background: Mental health has a special relevance in adolescence. Therefore, this study aimed to analyze the possible association between emotional distress and suicidal ideation among adolescents. Methods: The article presents the results of a survey of secondary school students (N=1419) in the city of Tarragona, Spain. The aim of the analysis was to verify the existence of an association between suicidal ideation and risk factors such as emotional distress and low self-esteem. All the data were also analysed to determine the existence of statistically significant differences between girls and boys. Bivariate analyses were performed with chi-square, point-biserial coefficient and non-parametric tests for independent groups. Logistic regression analysis was also performed to calculate the probability of suicidal ideation. Results: These analyses showed that both emotional distress and low self-esteem increase the likelihood of suicidal ideation among adolescents. This was more evident among boys with high levels of emotional distress. Conclusion: Schools should develop suicide ideation prevention programs for adolescents based on situations that cause emotional distress.

The connection between marital status and suicidal behavior has been poorly assessed in South Asia. We aimed to see the proportion of marital status in individuals in suicidal behavior in South Asian countries. We followed PRISMA guidelines and registered the protocol in advance (PROSPERO 2023 CRD42023399906). A systematic search was conducted in Medline, Embase, and PsycINFO. Meta-analyses were performed to pool the proportion of married individuals with suicidal behavior (total, suicide, and suicide attempt) in South Asian countries. Our search identified 47 studies for this review from six countries published from 1999 to 2022 with a sample size ranging from 27 to 89178. The proportion of married individuals was 55.4% (95% CI 50.1-60.5) for suicidal behavior, 52.7% (95% CI 44.5 – 60.7) for suicides, and 43.1 (95% CI 32.9 – 53.9) for suicide attempts. The proportion of married persons among suicide attempts varied significantly across countries (p=0.016) which was highest (61.8%; 95% CI: 57.2 – 66.2) in India, followed by Bangladesh (52.5%; 95% CI 41.8% - 62.9%) and Pakistan (45.1%; 95% CI 30.9 – 59.9). As the current study did not assess any cause-and-effect association, a cautious interpretation is warranted while considering married marital status as a risk factor.

Previous incidental findings of an increase of suicidal risk among subjects with low cholesterol levels have drawn attention to the role of lipids in suicidal behavior. To date, multiple lines of evidence acquired from clinical studies have confirmed an association between low cholesterol levels and suicidal behavior, but the involvement of dimensional traits including impulsivity and aggression in this association remains elusive. In this narrative review, we aimed to address and synthesize the literature regarding the involvement of lipids in the neurobiology of suicidal behavior and its underlying psychological substrates, impulsivity and aggression. An electronic database search was performed using different combinations of relevant keywords. Both preclinical and clinical studies matching the scope of this article were reviewed and filtered through an inspection of the abstracts to recruit the most suitable articles that contributed essential and substantial findings to the literature. Although subject characteristics and study designs vary across studies, current research has demonstrated that impulsivity and aggression might have shared neurobiologic substrates involved in altered serotonergic neurotransmission. Despite the association between low serum lipid levels and suicidal behavior being well documented, the involvement of lipid subtypes in the pathophysiology of impulsive and aggressive traits remains elusive. Further work is warranted to recognize the roles of lipids in neuronal membrane functions and serotonin metabolism, promote a greater appreciation of identifying biomarkers that could be used to determine at-risk individuals, and develop potential interventions to disrupt the pathogenesis of behavioral phenotypes of suicide.

Developmental, clinical, and epidemiological research have demonstrated the salience of perceived racial discrimination (PRD) as a contributor to negative mental health outcomes in adolescence. This article summarizes secondary analyses of cross-sectional data from a large-scale youth survey within a predominantly rural state to estimate the prevalence and strength of association between PRD and serious psychological distress, suicidal ideation, and prior suicidal attempts. Data from 93,812 students enrolled in Grades 6, 8, 10, and 12 within 129 school districts across Kentucky were examined to determine prevalence rates for subgroups within the cohort. Logistic regression analyses assessed differences and established comparative strength of association among these variables for racial/ethnic subgroups. PRD was self-reported at high rates across several demographic subgroups and was most evident among Black (24.5%) and Asian (22.1%) students. Multiracial students experienced the highest rates of both SPD and suicidality. Both for the entire cohort and for each racial/ethnic subgroup, PRD was significantly associated with increased likelihood of negative mental health outcomes, although the strength of these associations varied across subgroups and developmental levels. Implications for early intervention and prevention are discussed.

HIV diagnosis and poor HIV management have various detrimental impacts on the lives of people living with HIV (PLHIV). As part of a large qualitative study investigating HIV risk factors and impacts, with the suicide topic not being a focus, this paper describes factors contributing to suicidal ideation and attempts that arose naturally in the stories of women living with HIV (WLHIV) in Yogyakarta and Belu districts, Indonesia. The participants were recruited using the snowball sampling technique. Guided by a qualitative data analysis framework, the data were thematically analysed. Findings indicated participants experienced immense psychological challenges due to the infection, spousal transmission, fear of mother-to-child transmission, and losing a child due to AIDS, which triggered suicidal ideation and attempts. The women’s lack of awareness of HIV management strategies resulted in them feeling trapped and overwhelmed. Associated negative thoughts and the anticipation and experience of stigma relating to their HIV status were influencing factors for thoughts of suicide among participants. Lack of social support from family and friends during the early stage of HIV diagnosis, compounded with pre-existing financial difficulties, lack of income, unemployment, and feeling overburdened, also triggered the women’s thoughts of suicide. Other influencing factors for suicidal ideation and attempts among the women were family breakdown following HIV diagnosis and this was reflected in family disputes, husband-wife separation or divorce, mother-child separation by other family members, reported concern about future relationships, and fear of being rejected or abandoned by their partner due to their HIV positive status. The findings indicate the need for a nuanced approach to counselling within HIV care interventions for couples to support the acceptance of each other’s HIV status whilst maintaining psychological wellbeing. Additionally, the findings indicate the importance of HIV education and awareness among community members for the de-stigmatisation of HIV and to increase the acceptance of PLHIV within families and communities.

Background: We attempted to find if there were gender differences in different types of Negative life events and Suicidal ideation among Chinese adolescents, then analyze the relationship between different types of Negative life events and Suicidal ideation among these young students. Methods: Based on the data from 6 middle-schools and 3 universities in 3 cities of Western China, the gender difference in different types of Negative life events and Suicidal ideation and their related factors were investigated and analyzed in the study. Results: Gender differences were found during different types of Negative life events and Suicidal ideation; Negative life events could predict the intensity of Suicidal ideation by gender, to some specific types. Conclusions: Negative life events were proved to be risk factors of adolescents’ Suicidal ideation regardless of different gender stereotypes, but the specific classification of negative life events which had significant impact on adolescents’ Suicidal ideation also indicated significant gender divisions. For males, negative life events of punishment and adaptation had a significant and boosting impact on their Suicidal ideation, the higher the scores of punishment and adaptation negative life events had, the greater intensity of male adolescents were to have Suicidal ideation. Thus, the above two types of negative life events may be the main stressors predicting male adolescents' Suicidal ideation; For females, in addition to punishment, other types of negative life events all had significant impacts on their Suicidal ideation, which can be treated as the main stressors to trigger female adolescents' Suicidal ideation; Additionally, parents’ marital status of remarriage and divorce were proved to be significant indicators to adolescents’ Suicidal ideation, the age variable was proved to be strongly correlated with Suicidal ideation among female adolescents.

Suicide is a global public health concern that has enormous social and psychological 1 implications for individuals, families, and communities affected. While the rate of suicide in the 2 UK has remained steady over the years mainly due to the various approaches to detection and 3 management of suicidal ideation, it is still one of the main causes of mortality amongst people 4 between the age of 20 – 34 years. The recent global events such as the COVID-19 pandemic, global 5 warming, war, and various environmental catastrophes means that suicide and suicidal ideation 6 is expected to increase especially among younger people. Thus, evidence-based, population-wide 7 preventative approach will be needed to ameliorate the predicted increase in suicide. Also, to 8 understand the effects of some of the suicide prevention approaches, objective and universal risk 9 assessment approach is required. However, there is no universally accepted preventative approach 10 or tools of assessment. This review examines current advances in suicide prevention in the United 11 Kingdom. It examines the epidemiology, risk factors, as well as the strengths and limitations of 12 the various suicide risk assessment and prevention tools currently in use. We hope to obtain a 13 deeper understanding of how these approaches have evolved and their impact on enhancing mental 14 health and preventing suicide ideation in the UK. We present an in-depth review of existing suicide 15 prevention research and policies, while proposing areas for future research and improvement.16

OBJETIVE: This study analyses the views of four groups of healthcare professionals who may play a role in the management of suicidal behaviour. The goal was to identify key factors for suicide prevention in different areas of the healthcare system. METHODOLOGY: Qualitative research was conducted using focus groups made up of different healthcare professionals who participated in the identification, management and prevention of suicidal behaviour. Professionals included were primary care physicians, psychologists, psychiatrists and emergency physicians. RESULTS: ‘Suicide’ was amongst the most relevant terms that came up in discussions most of the times it appeared associated with words such as ‘risk’, ‘danger’ or ‘harm’. In the analysis by categories, the four groups of professionals agreed that interventions in at-risk behaviours are first in importance. Prevention was the second main concern with greater significance among psychiatrists. DISCUSSION: Primary care professionals claim for more time to address patients at risk for suicide and an easier access to and communication with the mental health network. Emergency care professionals have a lack of awareness of their role in the detection of risk for suicide in patients who seek attention at emergency care facilities for reasons of general somatic issues. Mental health care professionals are in high demand in case of self-harm but they would like to receive specific training in dealing with g suicidal behaviour.

Background: Recent research suggests a concerning trend of non-suicidal self-injury (NSSI) and suicidal behaviors emerging at younger ages (as early as age 12). Early onset of NSSI is linked to more severe outcomes. While universal school-based prevention programs have shown promise in addressing suicidal behaviors, there's limited research on their effectiveness in preventing NSSI onset among adolescents. This study aims to evaluate the efficacy of a universal prevention program in schools for NSSI and mental complaints while enhancing resilience and mental health in 11-14-year-old adolescents. Methods: In total, 329 Flemish secondary school students (55.6% female), aged 11 to 14 years, participated in a 4-hour classroom universal prevention, with a focus on emotion regulation, mental health, and specific strategies to prevent NSSI and reduce stigma. For both the intervention and control group (N = 124), a pre-, post- and one-month follow-up questionnaire was administered, containing reliable and valid measures for NSSI and suicidality, emotion regulation, help-seeking behaviors, well-being, and psychological distress. Results: The prevention program effectively reduced NSSI and psychological distress, particularly for adolescents with a history of NSSI. Conclusions: These findings support previous research on the effectiveness of school-based programs in reducing mental complaints and suggest promising outcomes for NSSI prevention.

Bipolar disorder (BD) is a high suicide-risk mental disorder. The purpose of this study was to identify the relationship between temperament and character traits with suicide probability, suicide attempt and perceived stress level in patients with BD. A total of 39 euthymic patients with bipolar disorder who had a history of suicide attempt and 39 euthymic patients without a history of suicide attempt were included in this study. Sociodemographic and clinical data form, Hamilton Depression Rating Scale (HDRS), Young Mania Rating Scale (YMRS), The Structured Clinical Interview for DSM-5-Clinician Version (SCID-5/CV), Temperament and Character Inventory (TCI), Perceived Stress Scale (PSS), Suicide Probability Scale were used for obtaining the data. HDRS, PSS and SPS scores of the group comprised of patients who attempted suicide were higher than the other group. There was no significant difference between the group of patients who had attempted suicide and the other group in terms of temperament characteristics. In the group of patients who had attempted suicide, self-directedness (SD) and cooperativeness (CO) scores were lower and self-transcendence (ST) score was higher than the other group. HA and ST were positively and SD negatively associated with SPS scores. In the regression analysis for suicide risk, the factors most associated with suicide risk were high HDRS and low CO score. Low SD in BD, high ST with CO may be associated with suicide attempt. Alongside low SD, high HA and ST may be associated with suicidal ideation. Treating residual depressive symptoms can reduce the risk of suicide.

Background: The study aimed to assess the prevalence and correlates of suicidal ideation, plans and attempts among middle school students in Sierra Leone. Method: Data from 2,798 adolescents (15 years of median age) that responded to the cross-sectional “2017 Sierra Leone Global School-Based Student Health Survey (GSHS)” were analysed. Results: The prevalence of past 12-month suicidal ideation was 14.2%, suicide plans 16.0%, and suicide attempts 19.1%. In adjusted logistic regression analysis, worry-induced sleep disturbance (Adjusted Odds Ratio-AOR: 1.84, 95% Confidence Interval-CI: 1.32-2.57), bullied (AOR: 2.90, 95% CI: 1.77-4.74), trouble from alcohol use (AOR: 1.90, 95% CI: 1.03-3.50), and leisure-time sedentary behaviour (AOR: 2.42, 95% CI: 1.18-4.98) were associated with suicidal ideation. Bullied (AOR: 2.40, 95% CI: 1.46-3.95) and current cannabis use (AOR: 2.48, 95% CI: 1.51-4.09) were associated with suicide plans in the past 12 months. No close friends (AOR: 2.63, 95% CI: 1.46-4.72) loneliness (AOR: 1.69, 95% CI: 1.08-2.66), bullied (AOR: 2.33, 95% CI: 1.66-3.28), trouble from alcohol use (AOR: 4.01, 95% CI: 2.25-7.13) and current cannabis use (AOR: 2.93, 95% CI: 1.37-6.25) were positively and school attendance (AOR: 0.62, 95% CI: 0.42-0.92) negatively associated with suicide attempts in the past 12 months. Conclusion: Almost one in five students had made suicide attempts in the past 12 months and several associated variables were discovered that can assist in designing interventions.

Background/Objectives: Schizophrenia (SZ) is a severe psychiatric disorder characterized by a complex interplay of genetic, developmental, and environmental factors that significantly increase the risk of suicidal ideation (SI) and suicide attempts (SAs). This systematic review synthesizes current research on the developmental predictors of SI in individuals with SZ, aiming to delineate the multifactorial etiology of suicide within this population. Methods: A comprehensive search across Medline, PsycINFO, and EMBASE databases identified 23 eligible studies, emphasizing the varied methodological approaches and the global distribution of research efforts. Results: These studies demonstrate a robust association between early life adversities, particularly childhood trauma such as physical neglect, emotional abuse, and sexual abuse, and the increased prevalence of SI and SAs in SZ. This review also highlights the significant genetic factors associated with development of suicidality in SZ, suggesting that polymorphisms in inflammation-related genes and neurodevelopmental abnormalities may influence susceptibility to SI. Notably, family history of psychiatric conditions may exacerbate the risk of SI through both hereditary and environmental mechanisms. Environmental factors, including socioeconomic status and social support, are also implicated, underscoring the role of broader socio-environmental conditions influencing outcomes. Conclusions: This review supports the integration of biopsychosocial models in understanding SI in SZ, advocating for interventions addressing the complex interplay of risk factors and the need for longitudinal studies to elucidate the dynamic interactions between risk factors over time. This comprehensive understanding is crucial for developing targeted preventative strategies and enhancing the clinical management of SZ, aiming to reduce suicidality in this vulnerable population.

Available research findings suggest that non-suicidal self-injury (NSSI) constitutes an important public health issue, with identified risk factors for NSSI having been found to include exposure to adverse childhood experiences (ACEs) and comorbidity with various mental disorders. However, available findings have, to the large part, been based on the experiences of individuals living in high-income countries, and it is not clear whether these findings can be confidently generalized to individuals living in low-resourced countries. As such, this cross-sectional study assessed risk factors for NSSI in a non-clinical sample of 636 South African adolescents (12-18-years-old), with data being analysed using a multi mediation analysis. ACEs were assessed using a revised version of the ACEs Questionnaire, NSSI was assessed using items adapted from the Self-Harm subscale of the Risk-Taking and Self-Harm Inventory for Adolescents, with emotion dysregulation, depression and PTSD being considered as possible mediators. High prevalence rates for NSSI and exposure to five or more ACEs were reported by participants, with the mediation analysis indicating that significant direct effects of adverse childhood experiences on NSSI were partially mediated by emotion dysregulation. These findings are discussed with respect to their implications for primary, secondary, and tertiary prevention.

(1) This study aimed to examine the prevalence of depression and its correlation with acculturative Stress and Social Connectedness among domestic and overseas students in Japan International University. (2) Methods: A Web-based survey was distributed among students of International University, which resulted in 263 responses. On the survey together with socio-demographic data, a nine-item tool from the Patient Health Questionnaire (PHQ-9), was used to measure the prevalence of Depression and its relationship with socio-demographic data, Social Connectedness Scale was used to measure Social Connectedness, and Acculturative Stress Scale for International Students (ASSIS) was used to measured acculturative stress. (3) Results: Depression was significantly high in international and domestic students (37.81% and 29.85% respectively). English language proficiency and students age (20 years old) showed a significant correlation with depression among domestic students (β=-1.63, p=0.038 and β=2.24, p=0.048). Stay length (third year) also displayed a significant correlation with depression among international students (β=1.08, p=0.032). Among international and domestic students statistically significant positive correlation between depression and acculturative stress, negative associations of social connectedness with depression and acculturative stress were also found. Suicidal or self-hurting ideation thoughts are found among around 20% of all students. (4) Conclusions: These findings indicate a relatively high prevalence of depression among students of International University, and overseas students are more affected. Depression, Acculturation stress and Social Connectedness show statistically strong intercorrelation, which highlights the need of host University to recognise the role of Acculturation and Social Connectedness in the development of Depression among students.

Non-suicidal self-injurious behavior (NSSI), prevalent in patients with non-psychotic mental disorders (NPMD), is associated with numerous adverse outcomes. Despite active research into the clinical and psychological aspects of NSSI, the underlying biological mechanisms remain obscure. Early adverse experiences are believed to induce long-lasting changes in neuroendocrine mechanisms of stress control playing a key role in NSSI development. The aim of the study was to evaluate parameters potentially predicting development of NSSI in female patients with NPMD. Eighty female patients over 18 years with NPMD and suicidal ideation (40 with and 40 without NSSI) and 48 age matching women without evidence of mental illness (healthy controls) were enrolled. Diagnostic interviews and self-report measures were used to assess childhood maltreatment, presence, frequency, and characteristics of suicidal and self-injurious thoughts and behaviors, the Beck Depression Inventory scale to assess severity of depression. Hypothalamic-pituitary-adrenal axis markers, hormones, and neurotrophic factors were measured in blood serum. The likelihood of developing NSSI in patients with NPMD was associated with early adverse family history and elevated adrenocorticotropic hormone levels. Dysregulation of hypothalamic-pituitary-adrenal axis as a result of early chronic stress experiences may represent critical biological mechanism promoting the development of NSSI behaviors in patients with NPMD.

Background and Objectives: Fifty percent of individuals with borderline personality disorder (BPD) experience Non-Suicidal Self-Injury (NSSI). One of the crucial factors related to NSSI is the feeling of emptiness. Although some inner strengths, such as five precepts, meditation, and equanimity, have been identified as potential buffers against negative mental health outcomes in BPD, their role in mediating the relationship between emptiness and NSSI is not well-documented. This study aimed to explore how these inner strengths mediate the relationship between feelings of emptiness and NSSI in individuals with BPD symptoms. Materials and Methods: A total of 302 participants with BPD symptoms completed several assessments: the SCID-II Personality Disorder (Borderline PD) to assess feelings of emptiness and NSSI, the Inner-Strength-Based Inventory (i-SBI) to evaluate five precepts, meditation, and equanimity, and the Outcome Inventory Depression (OI-Dep) to assess depression. Mediation analysis was performed using IBM SPSS and AMOS, with NSSI as the outcome variable, feelings of emptiness as the predictor, and the inner strengths as mediators. Results: The participants had a mean age of 36.56, with 65.4% being female. The analysis showed that five precepts, meditation, and equanimity significantly mediated the relationship between feelings of emptiness and NSSI, with a standardized coefficient of β = 0.534 (95% CI = 0.417 to 0.647, p &lt; 0.001). The indirect effect of emptiness through these inner strengths was significant (β = 0.034, 95% CI = 0.009 to 0.075, p = 0.005). The mediation model explained 38% of the variance in NSSI with a 3% increase, albeit small but significant. Conclusions: The study highlights a negative mediating role of inner strengths in the relationship between feelings of emptiness and NSSI meaning that as these inner strengths increase, the direct impact of feelings of emptiness on NSSI decreases. This suggests that these inner strengths act as protective factors, reducing the likelihood that someone with feelings of emptiness will resort to NSSI as a coping mechanism. These findings suggest that targeting these inner strengths could be a valuable strategy in developing interventions aimed at reducing NSSI by addressing the underlying emotional challenges associated with BPD.

Background: Adolescence is a developmental stage when there is a high risk of engaging in non-suicidal self-injury (NSSI). There is recent interest in the study of thwarted belongingness and perceived burdensome as variables associated with the frequency of NSSI in adolescents. Meaning in life (MIL) could be negatively associated with thwarted belongingness and perceived burdensome. To date, no studies have analyzed whether thwarted belongingness and perceived burdensomeness could be associated with the frequency of NSSI in adolescents. On the other hand, no studies have analyzed the buffering role of MIL in the association between thwarted belongingness and perceived burdensomeness and the frequency of NSSI. Aims: a) to test whether thwarted belongingness and perceived burdensomeness are associated with NSSI frequency; b) to test whether MIL moderates the association between thwarted belongingness and NSSI frequency; and c) to test whether MIL moderates the association between perceived burdensomeness and NSSI frequency. Method: The sample consisted of N = 1531 participants between 12 and 18 years old from Spain. The participants filled out the Inventory of Statements about Self-Injury, Purpose-In-Life Test-Adolescents Version, and Interpersonal Needs Questionnaire. Moderation analysis were performed. Results: Thwarted belongingness and perceived burdensomeness were positively associated with the frequency of NSSI in Spanish adolescents. MIL was a moderating variable between thwarted belongingness and the frequency of NSSI, and between perceived burdensomeness and the frequency of NSSI. Conclusion: Thwarted belongingness and perceived burdensomeness could be a risk factor for NSSI and MIL could be a protective factor against NSSI, and adding these variables to current descriptive theories of NSSI in adolescents would allow us to improve the assessment and treatment protocols for adolescents with NSSI.

Suicide and suicidal behavior are major public health concerns and affect 3-9% of the population worldwide. Despite growing evidence, there are still few effective interventions available to reduce suicide risk. In this article, we describe theoretical models of suicide ideation and behavior and propose to examine the possible effectiveness of a new and innovative preventive strategy. A model of suicidal intrusion (mental imagery related to suicide, also referred to as suicidal flash-forwards) is presented describing one of the assumed mechanisms in the etiology of suicide and the mechanism of therapeutic change. We provide a brief rationale for an Eye Movement Dual Task (EMDT) treatment for suicidal intrusions describing techniques that can be used to target these suicidal mental images and thoughts to reduce overall behavior. Based on the available empirical evidence for the mechanisms of suicidal intrusions, this approach appears to be a promising new treatment to prevent suicidal behavior as it potentially targets one of the linking pins between suicidal ideation and suicidal actions.

(1) Aims: To analyse the relationship between demographic and clinical characteristics and particular kinds of suicidal behaviour and its relationship with a nurse-led suicide prevention program. (2) Methods: A 5-year cross-sectional study design. Study performed in the region of Osona (Catalonia) during 2013-2017. Suicidal behaviour was classified as suicidal ideation, interrupted self-directed violence, suicide attempt and completed suicide. (3) Results: The sample included 753 patients ─ of whom 53 died by suicide─ and encompassed 931 suicidal behaviour episodes. Men represented 38.4% of the sample but 81.1% of deaths by suicide. Mental disorders were associated with suicidal behaviour in 75.4% of the sample. 66.4% of the individuals were engaged in the nurse-led Suicidal Behaviour Case Management Program, of which 0.8% (n=4) died by suicide. (4) Conclusion: The main risk factors were female sex for suicidal behaviour, and male sex and older age for suicide. Mental disorders, widowhood and retirement were also associated with suicide. A high proportion of patients was engaged to the nurse-led suicide prevention program with a low proportion of suicides.

Detecting suicidal ideation in adults with major depression is crucial for timely intervention and prevention of self-harm. As suicide is influenced by various biological, socio-cultural and psychological factors, traditional screening methods have accuracy and efficiency limitations. In certain cultures, societal stigma and marginalization can compel individuals with depression to conceal their suffering. Such individuals often turn to online social media platforms and share their experiences with peers under the protection of anonymity. Our research explored the potential of machine learning detection of suicidal ideation among Romanian adults with major depression that contributed to a web-based depression support forum. A trained algorithm (C4.5 decision tree) analyzed 125 posts fed to on a free access online support forum over 5 years (2014 – 2018) and classified them based on suicidal ideation content. 32 texts (25%) were identified as having a high probability of suicidal ideation content. 65% of the authors were male, with a mean age of 36.7±10.3 years and an average duration of illness of 3.4±1.4 years. Texts indicating positive suicidal ideation were generally shorter and elicited more general responses but fewer professional responses compared to those without suicidal ideation content. The study's main limitations include the relatively small number of classified texts, the absence of prospective information and the lack of qualitative evaluation of the excerpts' content. As socio-demographic and linguistic actuarial results were comparable to data reported by real life studies, we may consider basic text mining techniques as a screening tool that is able to detect suicidal ideation in texts written in unstructured Romanian language.

Eating disorder (ED) symptoms often co-occur with nonsuicidal self-injury (NSSI). This comorbidity is consistent with evidence that trait negative urgency increases risk for both of these phenomena. We previously found that impaired late-stage negative emotional response inhibition (i.e., negative emotional action termination or NEAT) might represent a neurocognitive mechanism for heightened negative urgency among people with NSSI history. The current study evaluated whether relations between negative urgency and ED symptoms similarly reflect deficits in this neurocognitive process. One hundred and five community adults completed an assessment of ED symptoms, negative urgency, and an emotional response inhibition task. Results indicated that, contrary to predictions, negative urgency and NEAT contributed independent variance to the prediction of ED symptoms, while controlling for demographic covariates and NSSI history. Worse NEAT was also uniquely associated with restrictive eating, after accounting for negative urgency. Our findings suggest that difficulty inhibiting ongoing motor responses triggered by negative emotional reactions (i.e., NEAT) may be a shared neurocognitive characteristic of ED symptoms and NSSI. However, negative urgency and NEAT dysfunction capture separate variance in the prediction of ED-related cognitions and behaviors, distinct from the pattern of results we previously observed in NSSI.