Introduction: Given increasing adult use of amphetamine and methylphenidate and their high misuse potential, we examined suspected suicide attempts and other intentional misuse and medical outcomes and their associations with co-used other substances among amphetamine and methylphenidate exposure cases age 50+.Methods: Using the 2015-2021 U.S. National Poison Data System (N=7,701 amphetamine and/or methylphenidate cases), we fit two generalized linear models for a Poisson distribution with log link function, with suspected suicide attempt versus intentional misuse and major medical effect/death versus other outcomes as the dependent variables. Results: Of all amphetamine/methylphenidate exposure cases, suspected suicide attempts and intentional misuse were 28.4% and 13.2%, respectively. Benzodiazepine use was associated with a higher likelihood but any illicit drug use was associated with a lower likelihood of suspected suicide attempts compared to intentional misuse. Type of stimulant involved (amphetamine or methylphenidate) was not significant. Co-use of antidepressants (IRR=1.43, 95% CI=1.16-1.76), prescription opioids (IRR=1.48, 95% CI=1.21-1.81), drugs for cardiovascular disease (IRR=1.51 95% CI=1.20-1.90), antipsychotics (IRR=1.26, 95% CI=1.02-1.55), or illicit drugs (IRR=2.40, 95% CI=1.82-3.15) was associated with a higher likelihood of major effect/death.Conclusions: Suspected suicide attempts or intentional misuse accounted for more than 40% of amphetamine or methylphenidate exposure cases age 50+. The higher likelihood of major effect/death in cases involving antidepressants, antipsychotics, and cardiovascular disease drugs also suggests confounding effects of comorbid mental and physical health problems. Careful monitoring of those who were prescribed amphetamine or methylphenidate and use other substances are needed.

Background: The incidences of COVID-19 related suicide among adolescents and youths have been reported across the world. There is no cumulative study focusing on nature, patterns, and causative factors that lead to the present investigation. Methods: A purposive sampling of google news between 15 February to 6 July was performed. After excluding duplicate reports, the final list comprised a total of 37-suicide cases across 11 countries. Results: More male suicides were reported (21-cases, i.e., 56.76%), and the mean age of the total victims was 16.6±2.7 years (out of a total of 29-cases). About two-thirds of the suicides were from three countries named India (11-cases), United Kingdom (8-cases), and the USA (6-cases). Out of 23-student victims, 14 were school-going students. Hanging was the most common suicide method accounting in 51.4% of cases. The most common suicide causalities were related to mental sufferings such as depression, loneliness, psychological distress, etc., whereas either online schooling or overwhelming academic distress was placed as the second most risk factors followed by TikTok addiction-related psychological distress, and tested with COVID-19. Conclusion: The finding of the temporal distribution of suicides concerning lockdowns may help in exploring and evolving public measures to prevent/decrease pandemic-related suicides in young people.

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.

This article will examine the ambivalence in the views of Jewish authorities towards suicide. There are Jewish rulings which forbid the taking of one's own life, including requested euthanasia. There are seemingly contrary rulings which tolerate and sometimes admire suicide, particularly under conditions of religious persecution. The article will attempt an overview of suicide rates in Jewish communities, indicating variations in different circumstances. The question of whether religiosity affects suicide will be raised and examined. These variations—and of course other factors—may offer some clues to the precursors of suicide, and the processes which may be involved. The causal and risk factors in self-harm among Jews will also be examined. The article then turns to post-suicide events, behaviours and attitudes in Jewish communities.

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.

Suicide is a major public health concern in South Korea, and self-poisoning by pesticides is one of the common methods of suicide. Pesticide ban policies have been successful for suicide prevention; however, no studies have shown their effect according to occupational groups. The present study analyzed suicide and suicide by pesticide rates among South Korean workers age 15-64 in 2003-2017, their associations with occupational groups, and the impact of three major economic indices on these factors. Workers in the agriculture, forestry, and fishery industries have relative risks of 5.62 (95% CI: 5.54-5.69) for suicide overall and 25.49 (95% CI: 24.46-26.57) for suicide by pesticide. The real gross domestic product (RGDP) has a positive association with suicide overall only in the last five-year period investigated in this study, and the unemployment rate consistently has a positive association. The economic status and policy for suicide prevention affect suicide and suicide by pesticide rates differently among occupational groups and different time periods. Policy addressing suicidal risk for different occupational groups should be of concern in South Korea.

Introduction: Around a million people are reported to die by suicide every year, and due to the stigma associated with the nature of the death, this figure is usually assumed to be an underestimate. Suicide may be prevented if prompt intervention is taken to mitigate risk. Machine learning and artificial intelligence-based modelling, such as natural language processing (NLP) and other text analytics approaches, has the potential to become a major technique for the detection, diagnosis, and treatment of people who are suffering from mental health issues. The primary aims of this research are to determine whether NLP techniques have been utilised in the field of suicide prevention, and if so, were they effective? What were their limitations? Methods: PubMed, EMBASE, MEDLINE, PsycInfo, and Global Health databases were searched for studies that reported use of NLP for suicide ideation or self-harm. Thematic analysis was used to synthesise and analyse the included studies. Findings were reported using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement, and the Mixed Methods Appraisal Tool (MMAT) was used in assessing paper quality. Result: The preliminary search of five databases generated 387 results. Removal of duplicates resulted in 158 potentially suitable studies. Twenty papers were finally included in this review. Discussion: Studies show that combining structured and unstructured data in NLP data modelling yielded more accurate results than utilizing either alone. Also, to reduce suicides, people with mental problems must be continuously and passively monitored. Further, NLP and other machine learning/artificial intelligence technologies can be used to address health inequities and electronic health records provide valuable data for creating suicide risk tools. Finally, Online, social media, and smartphone applications can be leverage in detecting people with suicide ideation. Conclusion: The use of artificial intelligence and machine learning opens new avenues for considerably guiding risk prediction and advancing suicide prevention frameworks. The review's analysis of the included research revealed that the use of NLP may result in low-cost and effective alternatives to existing resource-intensive methods of suicide prevention. To summarise, there is substantial evidence that NLP is useful in identifying people who have suicide ideation.

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.

Objective: Our goal is to develop an online questionnaire to survey the prevalence of suicidal behavior. Methods: We developed a questionnaire with 51 variables and proceeded with validations. Validations were performed using face validity, content validity, and construct validity. Reliability was performed by test-rest. Results: The face validity was 1.0 and the content validity was 0.91. The exploratory factor analysis got KMO = 0.86 and extracted one principal factor. The confirmatory factor analysis demonstrates RMSEA= 0.000 and CFI=1.000. The test-retest had an intraclass correlated coefficient of 0.98. Conclusion: The adequate development questionnaire was validated, and we have an instrument to survey suicide behaviors in the pandemic time.

Background: Facebook represents a new dimension for global information sharing. Suicidal behaviours and attempts are growingly reported on Facebook. This scoping review explores the various aspects of suicidal behaviours associated with Facebook, discussing the challenges and preventive measures. Methods: PubMed, Google Scholar, and Scopus were searched for related articles published in English up to October 2021, using different combinations of "Facebook" and "suicide". A group of consultant psychiatrists screened the records and read the full-text articles to extract relevant data. Results: Facebook impacts suicidal behaviours in different aspects. Announcing suicides through sharing notes or personal information, which can be helpful in prediction of suicide, and harmful since negatively affects audience. Live-streaming videos of suicide is another aspect, which questions the ability of Facebook to monitor shared contents that can negatively affect the audience. Helping bereaved families to share feelings and seek support online, commemorating the lost person by sharing their photos is another positive impact. Moreover, it can provide real-world details of everyday user behaviours, which are helpful to predict suicide risk, primarily through novel machine-learning techniques, and provide early warning and valuable help to prevent it. It can also provide a timeline of the user's activities and state of mind before suicide. Conclusions: Social media can detect suicidal tendencies, provide support for those seeking help, comfort family and friends with their grief, and provide insights via timelining the users' activities leading to their suicide. The lack of quantitative studies on evaluating preventative efforts on Facebook was one of the limitations. The creators' commitment and the users' social responsibility will be required to create a mentally healthy Facebook environment.

Although suicide is a major public health issue worldwide, we understand little of the onset and development of suicidal behavior. Suicidal behavior is argued to be the end result of the complex interaction between psychological, social and biological factors. Epidemiological studies resulted in a range of risk factors for suicidal behavior, but we do not yet understand how their interaction increases the risk for suicidal behavior. A new approach called network analysis can help us better understand this process as it allows to visualize and quantify complex association between many different symptoms or risk factors. A network analysis of data contain information on suicidal patients can help us understand how risk factors interact and how their interaction is related to suicidal thoughts and behaviour. A network perspective has been successfully applied to the field of depression and psychosis, but not yet to the field of suicidology. In this theoretical article, I will introduce the concept of network analysis to the field of suicide prevention, and offer directions for future applications and studies.

Ketamine, a racemic mixture of esketamine (S-ketamine) and arketamine (R-ketamine), has re-ceived particular attention for its rapid antidepressant and antisuicidal effects. NMDA receptor inhibition has been indicated as one of the main mechanisms of action of the racemic mixture, but other pharmacological targets have also been proposed. This study aimed at exploring the possible multiple targets of ketamine enantiomers related to their antidepressant and antisuicidal effects. To this end, targets were predicted in SwissTargetPrediction software for each ketamine enan-tiomer. The targets related to depression and suicide were collected by GeneCards database. The intersections of targets were analyzed by Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG). Network pharmacology analysis was performed in GeneMania and Cy-toscape softwares. Molecular docking was used to predict the main targets of the network. The results indicated that esketamine and arketamine share some biological targets, particularly NMDA receptor and phosphodiesterases 3A, 7A and 5A, but have specific molecular targets. While esketamine is predicted to interact with the GABAergic system, arketamine may interact with macrophage migration inhibitory factor (MIF). Both ketamine enantiomers activate neuroplas-ticity-related signaling pathways and show addiction potential. Our results identified novel poorly explored molecular targets that may be related to the beneficial effects of esketamine and arketamine against depression and suicide.

Globally 703 000 people commit suicide (4th leading cause of mortality among 15-29 year-olds, 1.4% of all deaths globally) every year, which have a negative effect on families, colleagues, and societies. India accounts for 36.6 percent of global suicide in women and 24.3 percent among men, while having only 17.8 percent of the global population, also remarkable fact is that the suicide ratio for female is 14.7 per 100,000 compared to 21.2 per 100,000 of male which is 2.1 times the global average in female, while 1.4 times higher for men. COVID-19 (coronavirus disease-2019) pandemic has certainly affected the physical, mental, economical and social well being of global population directly or indirectly in different ways. Deteriorating physical, mental, economical and social health of an individual could increase the suicidal tendency, leading to accidents and suicide. This study tried to find out the COVID-19 pandemic situation impact on accidental death as well as suicide rates in India. The study period is from 1st January 1967 to 31st December 2021, to assess the effect of the COVID-19 pandemic situation on suicide and accidental death rates. This study revealed that the suicide deaths percentage among males increased significantly in comparison to females in COVID-19 era and actual count and incidence also increased. This study revealed that the mean accidental death and suicide both increased during COVID period of study as compared to pre-pandemic whole period from 1967 by 25.47 % and 30.61% respectively. Alternatively we can say that the accidental death and suicides increased significantly in India, which is largely preventable.

Background: Currently, completed suicide, suicide ideation, suicide behavior, and suicide attempts are major public health problems worldwide. Major Depressive Disorder (MDD) is one of the most common mental disorders associated with an increased risk of suicide. Since the relationship between suicide and cholesterol levels is still controversial, in this study, we explore the association between SNPs rs754203 and rs4900442 of CYP46A1 with suicide risk in Mexican patients with major depressive disorder. Methods: We evaluated 188 unrelated suicide completers and compared them to 144 non-suicidal individuals (controls) and 126 MDD patients. Genotypes were analyzed using the Real Time-polymerase chain reaction method and two allele-specific probes to detect specific SNP targets. A chi-square test was used to identify a possible risk genotype or allele type for suicide. Results: Statistical analysis showed significant differences between completed suicide and controls in their allelic and genotypic frequencies in rs754203 SNP. The genotype G/G of CYP46A1 rs754203 was significantly associated with suicide. Also, the G allele was associated with an increased risk of suicide (OR= 1.370, 95% CI= 1.002-1.873). No differences in either genotype distribution or allele frequencies of CYP46A1 rs4900442 were observed. Conclusions: The results of the current study report the first association between G allele carriers (A/G + G/G) of rs754203 and increased risk for suicide, especially in males.

Every year around 800 000 people commit suicide, this represents one death every 40 seconds. In the search for possible biological biomarkers associated with suicide and/or psychiatric disorders, serum cholesterol levels have been extensively explored. Several studies have indicated that cholesterol and associated proteins, especially apolipoproteins (Apos), may play an important role in the diagnosis, prognosis, and susceptibility of suicide. Here, we describe the current knowledge and findings in the relationship between apolipoproteins and suicide.

Background: General Practitioners (GP) have an important role in the prevention of suicidal behavior. The purpose of this study was to explore their views and experiences of identifying and assessing suicidal ideation. Methods: Ten GPs were recruited through convenience sampling, based on accessibility, interest and willingness to participate. In-depth interviews were carried out and results transcribed ver-batim. Aspects of experiences with suicidal patients emerged through the thematic analyses process. Results: The GPs described the varied clinical picture when patients presented in their office. How they identified depressive symptoms apart from originally somatic complaints, formed a trusting relationship and addressed suicide ideation. They described customized interventions as well as obstacles and factors that facilitated communication: time, own personal traits, pa-tient’s disclosure and organizational barriers. Conclusions: The levels of the suicidal process among patients in general practice vary greatly. GPs adjust their appraisals to profundity understand and intervene in order to prevent a crisis to escalate into subsequent suicidal behavior.

(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.

Most police Mental Health Act (Section 136) detentions in England and Wales relate to suicide prevention. Despite attempts to reduce detention rates, numbers have risen almost continually. Although Section 136 has been subject to much academic and public policy scrutiny, the topic of individuals being detained on multiple occasions remains under-researched and thus poorly understood. A mixed methods study combined six in-depth interviews with people who had experienced numerous suicidal crises and police intervention, with detailed police and mental health records. A national police survey provided wider context. Consultants with lived experience of complex mental health problems jointly analysed interviews. Repeated detention is a nationally recognised issue. In South East England it almost exclusively relates to suicide or self-harm and accounts for a third of all detentions. Females are detained with the highest frequencies. The qualitative accounts revealed complex histories of unresolved trauma that had catastrophically damaged interviewee’s relational foundations, rendering them disenfranchised from services and consigned to relying on police intervention in repeated suicidal crises. A model is proposed that offers a way to conceptualise the phenomenon of repeated detention, highlighting that long-term solutions to sustain change are imperative, as reactive-only responses can perpetuate crisis cycles.

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.

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.

The fight against suicide is highly challenging as it may be one of the most complex and at the same time most threatening among all psychiatric phenomena. In spite of its huge impact, and despite advances in neurobiology research, understanding and predicting suicide remains a major challenge for both researchers and clinicians. To be able to identify those patients who are likely to engage in suicidal behaviors and identify suicide risk in a reliable and timely manner, we need more specific, novel biological and genetic markers/indicators to develop better screening and diagnostic methods, and in the next step to utilize these molecules as intervention targets. One such potential novel approach is offered by our increasing understanding of the involvement of neuroinflammation based on multiple observations of increased proinflammatory states underlying various psychiatric disorders including suicidal behavior. The present paper overviews our existing understanding of the association between suicide and inflammation including peripheral and central biomarkers, genetic and genomic markers, and our current knowledge of intervention in suicide risk using treatments influencing inflammation, also overviewing the next steps to be taken and obstacles to be overcome before we can utilize cytokines in the treatment of suicidal behavior.

Due to the continuing high suicide rates among young men, there is a need to understand help-seeking behaviour and engagement with tailored suicide prevention interventions. The aim of this study was to compare help-seeking among younger and older men who attended a therapeutic centre for men in a suicidal crisis. In this case series study, data were collected from 546 men who were referred into a community-based therapeutic service in North West England. Of the 546 men, 337 (52%) received therapy; 161 (48%) were aged between 18 and 30 years (mean age 24 years, SD=3.4). Analyses included baseline differences, symptom trajectories for the CORE-34 Clinical Outcome Measure (CORE-OM) and engagement with the therapy. For the CORE-OM there was a clinically significant reduction in mean scores between assessment and discharge (p<0.001) for both younger and older men. At initial assessment, younger men were less affected by entrapment (46% v 62%; p=.02), defeat (33% v 52%; p=.01), not engaging in new goals (38% v 47%; p=.02), and positive attitudes towards suicide (14% v 18%; p=.001) than older men. At discharge assessment, older men were significantly more likely to have an absence of positive future thinking (15% v 8%; p=0.03), have less social support (45% v 33%; p=.02) and feelings of entrapment (17% v 14%; p=.02) than younger men. Future research needs to assess the long-term effects of help-seeking using a brief psychological intervention for young men in order to understand whether the effects of the therapy are sustainable over a period of time following discharge from the service.

Due to the continuing high suicide rates among young men, there is a need to understand help-seeking behaviour and engagement with tailored suicide prevention interventions. The aim of this study was to explore help-seeking behaviour and engagement for young men aged 18 to 30 years who attended a therapeutic centre for men in a suicidal crisis. In this prospective cohort study, data were collected from 546 men who were referred into a community-based therapeutic service in North West England. Of the 546 men, 337 (52%) received therapy; 161 (48%) were aged between 18 and 30 years (mean age 24 years, SD=3.4). One third (n=54; 34%) of the men were seen within 48 hours of their referral. Analyses included baseline differences, symptom trajectories for the CORE-34 Clinical Outcome Measure (CORE-OM) and engagement with the therapy. For the CORE 34 there was a clinically significant reduction in mean scores between assessment and discharge (p<0.001), with all outcomes demonstrating a large effect size. Future research needs to assess the long-term effects of help-seeking using a brief psychological intervention for young men in order to understand whether the effects of the therapy are sustainable over a period of time following discharge from the service.

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.

Background: Suicide is a major health problem. The aim of this study was a comparative study of the causes and methods of completed suicide referred to legal Medicine Organization in Bushehr Province during the years 2006- 2015. Methods: This consideration has been done as a retrospective cross-sectional study; the data were collected by the check list. After coordination to the medico legal 343 cases of completed suicide lead to death over a ten year period from 2006 to 2015 were extracted and the data were analyses by SPSS software. Results: The rate of completed suicide was 2.43 and 1.12 suicides per 100,000 people in male and female, respectively. The mean age were 29.25 and 27.61 years in male and female, respectively p>0.05. A higher completed suicide rate was found among single people. The most common ways of a suicide among people who live in Bushehr were hanging out 184(53.6%), self-Immolation 83(24.2%) and firearms 37(10.8%). Motive of suicide was psychological disorders, Physical disease, Conflict with family and substance abuse. 43(12.5%) people smoking and 22(6.4%) people were both smoking and opioid. During the ten year period of studied, throughout the all years that frequency of hanging out has been higher than others. Conclusion: Due to the high incidence of completed suicide in young people and unmarried individuals also hanging out in male and self-burning in females are prevalent. So determination of preventive measures appears to be necessary. Social factors such as psychological disorders and family conflicts have a noticeable role from .Bushehr people.

Background: Aluminum phosphide (AlP), also known as “rice tablet,” is widely used as an effective pesticide. However, AlP poisoning is a common cause of mortality in many countries, such as Iran. Unfortunately, there is no specific antidote for AlP toxicity to date. AlP releases phosphine gas when it is exposed to moisture and acid. Phosphine is a robust mitochondrial toxin that could significantly inhibit cellular energy metabolism. AlP poisoning is an emergency condition that needs instant and effective intervention. Dihydroxyacetone (DHA) is a simple saccharide used for several pharmacological as well as cosmetic purposes. Previously, we found that DHA could significantly prevent mitochondrial impairment induced by toxic agents such as cyanide and phosphine in various in vitro and in vivo experimental models.Methods: Hospitalized patients (n = 111) were evaluated for eligibility criteria. Among these patients, n = 35 cases were excluded due to incomplete data (n = 11) and suspicion of poisoning rather than AlP (n = 24). Meanwhile, n = 76 cases with confirmed AlP poisoning were included in the study. AlP-poisoned patients who did not receive DHA (n =18) were used as the control group.Patients (n = 58) received at least one dose of DHA (500 ml of 5% DHA solution w/v, i.v.) in addition to routine treatment of AlP poisoning. Arterial blood gas (ABG), blood pH, bicarbonate levels, and other vital signs and biochemical measurements were monitored. Moreover, the mortality rate and time of hospitalization were evaluated in both DHA-treated (n = 58) and AlP-poisoned patients without DHA administration (n = 18). Several biomarkers were assessed before (upon hospitalization) and after DHA treatment. The routine tests for AlP-poisoned patients in this study were the measurement of electrolytes (K+ and Na+), WBC, RBC, hemoglobin, INR, carbonate (HCO3), blood pH, PaCO2, and PaO2 and SGPT, SGOT, BUN, Cr. Results: Upon patients' admission, significant decreases in blood pH (acidosis), blood PaO₂, and HCO₃ levels were the hallmarks of AlP poisoning. It was found that DHA significantly alleviated biomarkers of AlP poisoning and tremendously enhanced patients’ survival rate compared to patients treated based on hospital routine AlP poisoning protocols (no DHA). No significant adverse effects were evident in DHA-treated patients in the current study.Interpretation: These data suggest that parenteral DHA is a novel and effective antidote against AlP poisoning.Trial registration: IR.SUMS.REC.1394.102

Since its initial outbreak in late 2019, the COVID-19 pandemic has profoundly affected the global community. In addition to the negative health consequences of contracting COVID-19, the implementation of strict quarantine and lockdown measures has also disrupted social networks and devastated the global economy. As a result, there is rising concern that the pandemic has taken a toll on the mental health of the general population. To better understand its impact, an increasing number of studies examined the effects of the pandemic on mental health and psychosocial implications of enforced quarantine and lockdown. In this article, we aim to review and summarize the findings from a variety of studies that have explored the psychosociological effects of the pandemic and its impact on the mental well-being of the general population. We will also examine how various demographic groups, such as the elderly and youth, can be more susceptible or resilient to the pandemic’s mental health effects. We hope to provide a broader understanding of the underlying causes of mental health issues triggered by the pandemic and provide recommendations that may be employed to address mental health issues in the population over the long-term.

Relatively little research attention has been paid to sex issues in late life suicidal behaviour. The aim was to compare clinical characteristics of women and men aged 70+ who were hospitalized after a suicide attempt. We hypothesized higher depression and anxiety scores in women, and we expected to find that men would more often attribute the attempt to health problems and compromised autonomy. Participants (56 women and 47 men, mean age 80) were interviewed by a psychologist. In addition to psychiatric and somatic health assessments, participants responded to an open-ended question concerning attributions of the attempt. There were no sex differences in depression and anxiety, but women were more likely to report that they found their situation hopeless (67.9% vs. 43.8%, p = 0.02). At least one serious physical disability was noted in 60.7% of the women and 53.2% of the men (p = 0.55). Proportions attributing their attempt to somatic illness did not differ (women, 14.5% vs. men 17.4%, p = 0.79), and similar proportions attributed the attempt to reduced autonomy (women, 21.8% vs. men, 26.1 %, p = 0.64). The unexpected lack of sex differences might be influenced by cultural context in which sex norms play a part.

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

Objectives: The aim of our study was to evaluate patients after suicide attempts treated at the Department of Trauma Surgery for Children before and after the outbreak of the Covid-19 pandemic. Material and methods: Retrospective review of the medical database at equal time intervals of 24 months to identify patients treated before and after the COVID-19 was done. Thorough analysis including injury mechanism, medical procedures, history of previous mental disorders or suicidal behavior was performed. Furthermore, results were compared with the Polish police suicide statistics. Results: Based on our retrospective review we found 4 patients treated in our department before the pandemic and 10 patients treated after COVID-19 outbreak. The group before SARS-Cov-2 era consisted of three girls and one boy with a mean age of 14.97 (12.7-17.6). The group treated in the pandemic crisis consisted of 8 boys and 2 girls, the mean age was 15.49 (10.8-17.2). In the pre-COVID-19 group, 2 out of 4 patients had received psychiatric treatment before, but none had attempted suicide before. In the COVID-19 group, 6 out of 10 patients had previously received psychiatric treatment, moreover 3 of them attempted suicide before. Based on our analysis, the number of individuals who displayed suicidal attempts has raised. Between 2018 and 2021 the largest number of suicides concerned the 13-18 y.o. group, both for the Silesian Voivodeship (H=9.374; p=0.0092) and for the whole country (H= 10.203; p=0.0061). Conclusions: 1. Results of our study indicate that the pandemic may have caused a wide range of negative mental health consequences for young individuals; 2. During the SARS-Cov-2 era, we observed an alarming 2.5-fold increase in the number of patients treated after suicide attempts at the children's orthopedic trauma department; 3. Suicide attempts in children are often related with high energy trauma.

Background and objectives: Suicide is a topical issue in Lithuania and all around the world. It is the second most common cause of death among young people. There is a lack of research studies on the psychosocial aspects of adolescent suicide in Lithuania. This study aimed to evaluate demographics, life circumstances, and health conditions as factors related to suicide attempt in adolescents. Materials and Methods: A retrospective study was performed at the Children’s Hospital (Vilnius University Santara Clinics). Medical documentation of adolescents treated in this hospital after suicide attempts from January 2011 to April 2018 were analyzed. Results: There were 117 cases of hospitalization due to suicide attempts during this period, and 102 cases were included in the study. There were 83.8% female and 16.2% male patients with an average age of 15.02 ± 1.9 years (p = 0.405); 40.6% of patients lived in divorced families, 17.7% lived in orphanages, 4.2% lived in foster care, 36.4% suffered from parental alcoholism, and 17.2% experienced suicide in their close surroundings. They had comorbidities (girls 72.5%, boys 68.8%), mostly depression (31.3%), were suffering from bullying (54.1%) or violence (26.0%), and 85.4% showed signs of other types of self-harm (girls more often (p < 0.001)). Most of them chose to cut for suicide attempts (86.0% girls, 56.2% boys). In 52.8% of cases, the attempt was spontaneous and 34% relapsed. Thirty-four events occurred in March (18.9%) (p = 0.688). Conclusions: Our study revealed the possible circumstances related to adolescent suicide attempt. Female gender was more common overall and males were more likely to carry out more potentially lethal methods. Other common associated factors were a lack of prosperity in family life, experience of bullying, violence, comorbidities, and the early spring period. Signs of any self-harm could be an indicator of later suicide attempt.

Background: There is a lack of literature specifically examining the workplace bullying of apprentices and trainees in traditional, male-dominated sectors such as the Australian building and construction industry. Using social identity theory (SIT), the aim of this study was to gather the attitudes, thoughts, and feelings of construction industry leaders to better understand how social identification (i.e., group membership) impacts bullying on targets and perpetrators, and the willingness to report bullying for targets and bystanders. Method: One-on-one, semi-structured interviews using a purposive sample of eight leaders from construction and blue-collar industries. Qualitative data were analysed using reflexive thematic analysis. Results: Four overarching themes were identified: difficulties for apprentices transitioning into industry, the need for continued improvement to industry culture, reluctance to report bullying, and rethinking apprenticeships to empower. Each theme provides insight into the psychosocial phenomenon of the bullying of trade apprentices and suggests that an apprentices’ level of social identification with work groups shapes how bullying is identified, interpreted, and prevented. Conclusion: Findings from this study will be important for tailoring evidence-based interventions, human resource policies and initiatives for education and awareness training. Themes also highlight systemic inadequacies impacting apprentices’ mental health and skill development, with implications for the future sustainability of apprenticeship training agreements.

Suicidal behaviour is a public health problem whose magnitude is both substantial and increasing. Since many individuals seek medical treatment following a suicide attempt, strategies aimed at reducing further attempts in this population are a valid and feasible secondary prevention approach. An evaluation of the available evidence suggests that existing treatment approaches have limited efficacy in this setting, highlighting the need for innovative approaches to suicide prevention. Existing research on the neurobiology of social pain has highlighted the importance of this phenomenon as a risk factor for suicide, and has also yielded several attractive targets for pharmacological preventive strategies. In this paper, the available evidence related to these targets is synthesized and critically evaluated. The way in which social pain is related to the “anti-suicidal” properties of recently approved treatments, such as ketamine and psilocybin, is also examined. Such strategies may be effective for the short-term reduction of suicidal ideation and behaviour in individuals who have made a suicide attempt suicide prevention, particularly in cases where social pain is identified as a contributory factor. These pharmacological approaches may be effective regardless of the presence or absence of a specific psychiatric diagnosis.

A meta-analysis showed a significant association between activated immune-inflammatory and nitro-oxidative (IO&NS) pathways and suicide attempts (SA). There are no data whether suicidal ideation (SI) is accompanied by activated IO&NS pathways and whether there are differences between SA and SI. The current study searched PubMed, Google Scholar, and Web of Science, for articles published from inception until May 10, 2021, and systematically reviewed and meta-analyzed the association between recent SA/SI (< 3 months) and IO&NS biomarkers. We included studies which compared psychiatric patients with and without SA and SI and controls (either healthy controls or patients without SA or SI) and used meta-analysis (random-effect model with restricted maximum-likelihood) to delineate effect sizes with 95% confidence intervals (CI). Our search included 59 studies comprising 4.034 SA/SI cases and 12.377 controls. Patients with SA/SI showed activated IO&NS pathways (SMD: 0.299; CI: 0.200; 0.397) when compared to controls. The immune profiles were more strongly associated with SA than with SI, particularly when compared to healthy controls, as evidenced by activated IO&NS pathways (SMD: 0.796; CI: 0.503; 1.089), an immune-inflammatory response (SMD: 1.409; CI: 0.637; 1.462), inflammation (SMD: 1.200; CI: 0.584; 1.816), and neurotoxicity (SMD: 0.904; CI: 0.431; 1.378). The effects sizes of the IO&NS, immune-inflammatory response and inflammatory profile were significantly greater in SA than in SI. In conclusion: increased neurotoxicity due to inflammation and nitro-oxidative stress and lowered neuroprotection may explain at least in part why psychiatric patients show increased SA and SI. The IO&NS pathways are more pronounced in recent SA than in SI.

Background: Suicide attempts (SA) frequently occur in patients with mood disorders and schizophrenia, which are both accompanied by activated immune-inflammatory and nitro-oxidative (IO&NS) pathways. Methods: We searched PubMed, Google Scholar, and Web of Science, for articles published from inception until February 1, 2021. We included studies that compared blood biomarkers in psychiatric patients with (SA+) and without SA (SA-) and heathy controls and we combined different IO&NS biomarkers into immune, inflammatory, and neurotoxic profiles and used meta-analysis (random-effect model with restricted maximum-likelihood) to delineate effect sizes with 95% confidence interval (CI).Findings: Our search included 51 studies comprising 4.945 SA+ patients and 24.148 controls. We stratified the control group into healthy controls and SA- patients. SA+ patients showed significantly (p<0.001) increased immune activation (SMD: 1.044; CI: 0.599-1.489), inflammation (SMD: 1.109; CI: 0.505, 1.714), neurotoxicity (SMD: 0.879; CI: 0.465, 1.293), and lowered neuroprotection (SMD: 0.648; CI: 0.354, 0.941) as compared with healthy controls. When compared with SA- patients, those with SA+ showed significant (p<0.001) immune activation (SMD: 0.290; CI: 0.183, 0.397), inflammation (SMD: 0.311; CI: 0.191, 0.432), and neurotoxicity (SMD: 0.315; CI: 0.198, 0.432), and lowered neuroprotection (SMD: 0.341; CI: 0.167, 0.515). Patients with current, but not lifetime, SA showed significant (p<0.001) levels of inflammation and neurotoxicity as compared with controls. Conclusions: Patients with immune activation are at a higher risk of SA which may be explained by increased neurotoxicity due to inflammation and nitro-oxidative stress. This meta-analysis discovered new biomarkers of SA and therapeutic targets to treat individuals with SA.

Not a lot is known about either death or the dying process. Politicians and many in the medical profession in the UK tend to shy away from interfering with it by not allowing euthanasia as an end of life option for the patient. This is the first paper in a series of two, comparing the situation in human medicine and veterinary medicine, in which euthanasia is well practiced for relieving suffering at the end of an animal’s life. This first part takes the form of a literature review including best practice around end of life care, its deficiencies and the need for assisted dying. Veterinary surgeons are well trained in the ethics of euthanasia and put it to good use in the best interest of their animal patients. In countries which have legalized physician assisted suicide for the terminally ill reporting indicates that it works well, without increases in involuntary euthanasia and most importantly without intimidation of the vulnerable. However, there is still an ever increasing tendency to overuse sedation and opioids at the end of life, which merits further investigation. With advances in medical science able to significantly prolong the dying process, patient autonomy demands a review of the law in the UK.

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.

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.

Suicidal behaviour remains difficult to predict and prevent, even for experienced mental health care professionals. The known distal risk factors for suicidal behaviour are not sufficiently specific to fully understand the complex dynamic processes that precede a suicide attempt. Real-time mobile monitoring data can be used to analyse proximal risk mechanisms within the suicidal process. At the same time smartphone-based safety planning and self-monitoring may enhance a patient’s self-management skills thereby increasing their capacity to respond to a suicidal crisis and to become more aware of crisis symptoms. The current paper describes the theoretical and conceptual rationale for the CASPAR study which applies an innovative approach to the study of suicidal processes. It uses basic science approaches to inform the implementation of an innovative suicide prevention intervention. We aim to develop and implement mobile safety plan in conjunction with real-time monitoring in order to both directly implement suicide prevention interventions and to study the ongoing dynamics of individual suicidal behaviour by applying network analysis.

This is the second of a series of two papers comparing the end of life issues in human and veterinary medicine. We outline the main differences between human and animal patients such as patient communication, finance and ‘conflicts of interest’ between animal, owner and veterinarian. We discuss striking similarities between human and veterinary issues such as assessing quality of life and the primary role of the attending veterinarian or doctor being the welfare and care of the patient. This paper takes the form of an ethical argument in favour of allowing euthanasia in human medicine, by providing insights into end of life issues for humans from an independent veterinary perspective. Veterinary surgeons are well trained in the ethics of euthanasia and put it to good use in the best interest of their animal patients. Doctors in the UK are limited and unwilling to put forward a case for the option of euthanasia for those patients who face a slow and agonizing death. With advances in medical science being able to significantly prolong the dying process, autonomy for the patient demands a review of the law regarding patient choice in the UK.

Background: Over 900,000 cases of COVID-19 and 23,000 deaths have been reported till 13 July in India. Preserving the limited healthcare workforce is part of the strategy against the pandemic. Mortality and morbidity data have a role in customising this strategy. At this time, there is no published study on COVID-related mortality among doctors or other healthcare workers in India. Methods: A multi-pronged search was made for all reported deaths linked with COVID-19 among doctors in India. Details of COVID-linked deaths reported by mainstream media and by multiple professional social media sources were collected, screened, verified and analysed. Violent deaths occurring in the setting of pandemic-related work were separately listed. Deaths from other diseases were excluded. Results: Among 108 COVID-linked deaths among doctors, there were four pandemic-related violent deaths including three road accidents and a suicide. Of the 104 non-violent deaths, 55.5% were below 60 years of age, while 29.6% and 21% were below the age of 50 and 40 respectively. The average age at death was 56.3 (range 22 - 96). Over half of the deaths occurred among general practitioners, while surgical specialties accounted for 27% of the mortality. The geographic distribution of deaths of doctors correlated with the reported number of COVID-19 patients in each state. The total number of COVID-related healthcare worker deaths was 136, out of which eight (5.8%) were violent, and occurred in young individuals with an average age of 27.8 years. Conclusions: The majority of the 104 COVID-related non-violent deaths among doctors (55.5%) occurred below the age of 60. The average at death was 56.6 years. The states with highest number of COVID-19 cases had greater number of doctor deaths. Violent deaths among young healthcare workers in the setting of the pandemic requires special attention.

The literature on the causation of multiple sclerosis (MS), both genetic and environmental, extends over hundreds of years, with no firm conclusions on the exact role of autoimmunity and lifestyle. The epidemiology of MS was the basis for this review, but with a new, extensive examination of genes pertaining to each disorder, and disease of first, and second, degree relatives of those with MS. The author’s motivation was to discover some relationship between MS, and notable familial conditions, as the heredity of MS is concluded to be 30%, and the disorders had a chronic and/or idiopathic nature. This investigation hoped to further understand the randomness of MS- who acquires it, and what symptoms develop- after the author’s decades of observing several incidences of multiple members developing MS in a single family. Online databases for the human genome were used to link genes to MS, and symptoms, including excessive depression, fatigue and suicide rates, in coordination with linking genes for specific familial conditions including seizures, stroke, mental illness, bowel disorders, and thyroid conditions. Interesting associations were found, notably a cluster of Th2 cytokines, known to cure the animal model of MS, important receptors for neurotransmitters and hormones, a gene specific to Epstein Barr Virus, and potential genes for mitochondrial dysfunction. The results surprised the author, showing polygenic regions of chromosome 2 and 5, especially a cluster at loci 5q31-q33, may be dysregulated. The conclusion agrees with past hypotheses MS results not from a single gene, but from various genes, including those expressed in glial cells. The individual theories to the causation of MS, starting with Charcot may be explained by multiple pathways converging into a single disease outcome. In coordination with a sunlight factor, chromosome 2 appears to mediate the immune system, and inflammation, through ultraviolet radiation producing vitamin D3 in the skin, but additionally through peptides formed in the melanocyte stimulating and concentrating hormone class. The impact of stress in MS could be primary, given the loci of several stress-related and stress-modulated genes on these chromosomes, and calls for more appreciation of, and greater care for, the MS patients’ state of mind.