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Journal of Public Health Management and...Suicide and suicidal behavior among youth and young adults are a major public health crisis, exacerbated by the COVID-19 pandemic and demonstrated by increases in...
Suicide and suicidal behavior among youth and young adults are a major public health crisis, exacerbated by the COVID-19 pandemic and demonstrated by increases in suicidal ideation and attempts among youth. Supports are needed to identify youth at risk and intervene in safe and effective ways. To address this need, the American Academy of Pediatrics and the American Foundation for Suicide Prevention, in collaboration with experts from the National Institute of Mental Health, developed the Blueprint for Youth Suicide Prevention ( Blueprint ) to translate research into strategies that are feasible, pragmatic, and actionable across all contexts in which youth live, learn, work, and play. In this piece, we describe the process of developing and disseminating the Blueprint. Through a summit and focus meetings, cross-sectoral partners convened to discuss the context of suicide risk among youth; explore the landscape of science, practice, and policy; build partnerships; and identify strategies for clinics, communities, and schools-all with a focus on health disparities and equity. These meetings resulted in 5 major takeaways: (1) suicide is often preventable; (2) health equity is critical to suicide prevention; (3) individual and systems changes are needed; (4) resilience should be a key focus; and (5) cross-sectoral partnerships are critical. These meetings and takeaways then informed the content of the Blueprint , which discusses the epidemiology of youth and young adult suicide and suicide risk, including health disparities; the importance of a public health framework; risk factors, protective factors, and warning signs; strategies for clinical settings, strategies for community and school settings; and policy priorities. Following the process description, lessons learned are also discussed, followed by a call to action for the public health community and all who serve and support youth. Finally, key steps to establishing and sustaining partnerships and implications for policy and practice are discussed.
Topics: Young Adult; Humans; Adolescent; Child; Suicide Prevention; Pandemics; Suicide; Suicidal Ideation; Risk Factors
PubMed: 37131276
DOI: 10.1097/PHH.0000000000001764 -
Psychiatry Research Nov 2023Assessing and managing suicide behaviors is highly relevant to individuals with schizophrenia spectrum disorders. Our study aims to assess the association between... (Meta-Analysis)
Meta-Analysis Review
Assessing and managing suicide behaviors is highly relevant to individuals with schizophrenia spectrum disorders. Our study aims to assess the association between adverse childhood experiences and suicidal behaviors in individuals with schizophrenia spectrum disorders. We included observational studies comparing the probability of suicide behaviors in adults with schizophrenia spectrum disorders exposed and unexposed to adverse childhood experiences. Odds ratio estimates were obtained by pooling data using a random-effects pairwise meta-analysis. Standardized criteria were used to assess the strength of the association of the pooled estimate. We found 21 eligible studies reporting outcomes for 6257 individuals from 11 countries. The primary outcome revealed an association between any suicidal behavior and adverse childhood experiences, which resulted "highly suggestive" according to validated Umbrella Criteria. Similarly, a positive association was confirmed for suicidal ideation and suicide attempt and for any subtype of adverse childhood experience. This meta-analysis showed that exposure to adverse childhood experiences strongly increases the probability of suicide behaviors in people with schizophrenia spectrum disorders.
Topics: Adult; Humans; Suicidal Ideation; Schizophrenia; Adverse Childhood Experiences; Suicide, Attempted; Probability
PubMed: 37769371
DOI: 10.1016/j.psychres.2023.115488 -
Psychological Medicine Sep 2023While suicide rates have recently declined for White individuals, rates among Black and Hispanic individuals have increased. Yet, little is known about racial/ethnic...
BACKGROUND
While suicide rates have recently declined for White individuals, rates among Black and Hispanic individuals have increased. Yet, little is known about racial/ethnic differences in precursors to suicide, including suicidal ideation (SI) and suicide attempts (SA).
METHODS
Data from 2009-2020 National Survey of Drug Use and Health (NSDUH) consisted of non-institutionalized US civilians aged ⩾18 ( = 426 008). We compared proportions of White, Black, and Hispanics among adults reporting no past-year suicidal thoughts/behavior, SI, and SA. Multivariable-adjusted analyses were used to evaluate the independence of observed racial/ethnic differences in past-year SI, SA, and mental health service use.
RESULTS
In the entire sample, 20 791 (4.9%) reported past-year SI only and 3661 (0.9%) reported a SA. Compared to White individuals, Black and Hispanic individuals were significantly less likely to report past-year SI [OR 0.73 (95% CI 0.69-0.77); OR 0.75 (95% CI 0.71-0.79), respectively], but more likely to report a past-year SA [OR 1.45 (95% CI 1.28-1.64); OR 1.19 (95% CI 1.04-1.37), respectively] even after multivariable adjustment. Black and Hispanic individuals were significantly less likely to use mental health services, but the lack of significant interactions between race/ethnicity and SI/SA in association with service use suggests differences in service use do not account for differences in SI or SA.
CONCLUSIONS
Black and Hispanic individuals are significantly less likely than White individuals to report SI but more likely to report SAs, suggesting differences in suicidal behavior across race/ethnicity that may be impacted by socio-culturally acceptable expressions of distress and structural racism in the healthcare system.
Topics: Adult; Aged; Humans; Ethnicity; Hispanic or Latino; Mental Health Services; Suicidal Ideation; Suicide, Attempted; Racial Groups; Patient Acceptance of Health Care; White; Black or African American
PubMed: 36106374
DOI: 10.1017/S003329172200280X -
Frontiers in Public Health 2023Individuals with Internet addiction (IA) are at significant risk of suicide-related behaviors. This study aimed to investigate the relationships among IA, psychotic-like...
BACKGROUND
Individuals with Internet addiction (IA) are at significant risk of suicide-related behaviors. This study aimed to investigate the relationships among IA, psychotic-like experiences (PLEs), and suicidal ideation (SI) among college students.
METHODS
A total of 5,366 college students (34.4% male, mean age 20.02 years) were assessed using the self-compiled sociodemographic questionnaires, Revised Chinese Internet Addiction Scale (CIAS-R), 15-item Positive subscale of the Community Assessment of Psychic Experiences (CAPE-P15), Self-rating Idea of Suicide Scale (SIOSS), and 2-item Patient Health Questionnaire (PHQ-2).
RESULTS
The prevalence of IA and SI were 9.3 and 12.1% among Chinese college students, respectively. There were direct effects of IA and PLEs on SI. The total effect of IA on SI was 0.18 ( < 0.001). PLEs mediated the relationship between IA and SI (Indirect effect = 0.07).
CONCLUSION
IA had both direct and indirect effects on SI. These findings enable us to elucidate the mechanism of how IA influences individual SI, which can provide vital information for developing and implementing targeted interventions and strategies to alleviate SI among Chinese college students.
Topics: Humans; Male; Young Adult; Adult; Female; Suicidal Ideation; Internet Addiction Disorder; Mental Disorders; Surveys and Questionnaires; Students
PubMed: 37841710
DOI: 10.3389/fpubh.2023.1276496 -
BMC Psychiatry Aug 2023Generally, pandemics such as COVID-19 take an enormous toll on people's lives. As the pandemic now turns to an endemic state, growing attention has been paid to the...
BACKGROUND
Generally, pandemics such as COVID-19 take an enormous toll on people's lives. As the pandemic now turns to an endemic state, growing attention has been paid to the multiple adverse mental health and behavioral issues, such as suicidal ideation and substance use. However, the interplay of suicidality and substance misuse during the pandemic has been limited. We aimed to investigate the prevalence of co-occurrence of suicide ideation, alcohol and cannabis misuse, and the factors that are associated with these co-occurrences in the province of Saskatchewan during the COVID-19 pandemic.
METHODS
We performed a multivariable trivariate probit regression on a sample of 666 Saskatchewan adolescents and adults (16 years or older), drawn from the cycle 10 data collection (March 2022) of the Mental Health Commission of Canada, and Canadian Centre on Substance Use and Addiction (MHCC-CCSA) dataset.
RESULTS
The prevalence of suicidal ideation was higher among respondents who reported both problematic cannabis and alcohol use (25.8%) than single users of alcohol (23.2%) and cannabis (18.7%). Younger respondents (16-34 years) and those who reported recent changes in other substance use were independent factors that were associated with the common experience of suicide ideation, problematic cannabis, and alcohol use. Having a diagnosis of mental health disorders either before or during the pandemic, and the perceived inability to bounce back after the pandemic (low resilience) are strong correlates of suicidal ideation. Those who lived alone, between 35 and 55 years of age were more likely to report problematic alcohol use. Those who reported changes in alternative activities, who reported pandemic stress, and declared a LGBTQIA2S + identity had higher probability of problematic cannabis use.
CONCLUSIONS
As the pandemic persists, improving access to suicide and substance use interventions for the vulnerable groups identified in this study may be impactful.
Topics: Adult; Adolescent; Humans; Suicidal Ideation; Pandemics; Cannabis; Prevalence; Saskatchewan; COVID-19; Substance-Related Disorders; Risk Factors
PubMed: 37553652
DOI: 10.1186/s12888-023-05051-w -
BMC Public Health Oct 2023As the HIV epidemic among MSM in China continues, Chinese men who have sex with men (MSM) face various mental health difficulties, including suicide ideation,...
BACKGROUND
As the HIV epidemic among MSM in China continues, Chinese men who have sex with men (MSM) face various mental health difficulties, including suicide ideation, depression, and stigma. The current study aims to assess the mechanisms between HIV-related stigma, depression, and suicidal ideation among MSM in China.
METHODS
This national cross-sectional study was completed on the geosocial networking application (GSN) app, Blued, from December 2020 to March 2021. We used the HIV Stigma Scale and the Center for Epidemiologic Studies Depression Scale (CES-D) to measure HIV stigma and depression, respectively. Suicidal ideation was measured by the suicidal ideation-related item. Descriptive analyses, logistic regression, and structural equation modeling (SEM) were used for data analysis.
RESULTS
A total of 244 HIV-positive MSM were included in the analysis. The mediation model revealed that the direct pathway of perceived HIV-related stigma on suicidal ideation was significant (standardized pathway coefficient = 0.07), and the indirect pathway of perceived HIV-related stigma on suicidal ideation via depression was also significant (standardized pathway coefficient = 0.04). There was a partial mediating effect of depression in the association between perceived HIV-related stigma and suicidal ideation.
CONCLUSIONS
Our study found that both perceived HIV-related stigma and depression were associated with suicidal ideation among HIV-positive MSM in China, and that depression could serve as a mediator between HIV-related stigma and suicidal ideation. Targeted interventions regarding HIV-related stigma and depression should be taken into account to reduce suicidal ideation among HIV-positive MSM in China.
Topics: Male; Humans; Suicidal Ideation; Homosexuality, Male; Depression; HIV Infections; Cross-Sectional Studies; Sexual and Gender Minorities; China; Social Stigma
PubMed: 37891525
DOI: 10.1186/s12889-023-17047-y -
Journal of Affective Disorders Nov 2023Identifying and managing major depressive disorder (MDD) patients with suicidal ideation or behavior (MDSI) is critical for reducing the disease burden. This scoping... (Review)
Review
Major depressive disorder with suicidal ideation or behavior in Chinese population: A scoping review of current evidence on disease assessment, burden, treatment and risk factors.
BACKGROUND
Identifying and managing major depressive disorder (MDD) patients with suicidal ideation or behavior (MDSI) is critical for reducing the disease burden. This scoping review aims to map the existing evidence related to MDSI in the Chinese population.
METHOD
A scoping review was conducted to summarize the published evidence regarding epidemiology or disease burden, evaluation, diagnosis, management, and prognosis of MDSI. The search strategy imposed restriction on English or Chinese publications between 1 January 2011 and 28 February 2022.
RESULTS
Of the 14,005 identified records, 133 met the eligibility criteria and were included for analysis. The included studies were characterized as high heterogeneity in evaluation of suicidal ideation or behavior. Compared with MDD patients without suicidal ideation or behavior, MDSI patients were more likely to suffer from psychological and somatic symptoms, social function impairment, and lower quality of life. Younger age, female gender, longer disease course, and comorbid psychological or physical symptoms were consistently found to be risk factors of suicidal ideation or behavior. Relevant research gaps remain regarding comprehensive evaluation of standard clinical diagnosis, disease burden, social-cultural risk factors, and effectiveness of interventions targeting MDSI. Studies with large sample size, representative population are warranted to provide high-quality evidence.
CONCLUSIONS
MDD patients with suicidal ideation or behavior should be prioritized in treatment and resource allocation. Heterogeneity exists in the definition and evaluation of MDSI in different studies. To better inform clinical practice, it is imperative to establish a unified standard for evaluation and diagnosis of suicidal ideation or behavior among MDD population.
Topics: Humans; Depressive Disorder, Major; East Asian People; Quality of Life; Risk Factors; Suicidal Ideation
PubMed: 37619652
DOI: 10.1016/j.jad.2023.08.106 -
Neuroscience and Biobehavioral Reviews Mar 2024A growing body of research has demonstrated the potential role for physical activity as an intervention across mental and other medical disorders. However, the... (Review)
Review
A growing body of research has demonstrated the potential role for physical activity as an intervention across mental and other medical disorders. However, the association between physical activity and suicidal ideation, attempts, and deaths has not been systematically appraised in clinical samples. We conducted a PRISMA 2020-compliant systematic review searching MEDLINE, EMBASE, and PsycINFO for observational studies investigating the influence of physical activity on suicidal behavior up to December 6, 2023. Of 116 eligible full-text studies, seven (n = 141691) were included. Depression was the most frequently studied mental condition (43%, k = 3), followed by chronic pain as the most common other medical condition (29%, k = 2). Two case-control studies examined suicide attempts and found an association between physical activity and a reduced frequency of such attempts. However, in studies examining suicidal ideation (k = 3) or suicide deaths (k = 2), no consistent associations with physical activity were observed. Overall, our systematic review found that physical activity may be linked to a lower frequency of suicide attempts in non-prospective studies involving individuals with mental disorders.
Topics: Humans; Suicide, Attempted; Suicidal Ideation; Risk Factors; Mental Disorders; Exercise
PubMed: 38246231
DOI: 10.1016/j.neubiorev.2024.105547 -
BMC Psychiatry Aug 2023While negative parenting style has considered as a risk factor for suicide ideation, little attention has been given to the mechanisms between harsh parenting and...
BACKGROUND
While negative parenting style has considered as a risk factor for suicide ideation, little attention has been given to the mechanisms between harsh parenting and suicide ideation in the context of Chinese culture. This study explored the the potential mediating roles of self-esteem and the potential moderating roles of school social support in the relationship between harsh parenting and suicide ideation among Chinese adolescents.
METHODS
We conducted a cross-sectional study among 4189 Chinese adolescents who completed measures of harsh parenting, school social support, self-esteem, and suicide ideation. The moderated mediation model was used to test the roles of self-esteem and school social support on the association between harsh parenting and adolescent suicide ideation.
RESULTS
(1) There were significant positive correlations between harsh parenting and adolescents suicide ideation. (2) Self-esteem mediates the relationship between harsh parenting and suicide ideation in adolescents. (3) School social support moderates the indirect effect of harsh parenting on suicidal ideation.
CONCLUSIONS
Beyond the direct impact of harsh parenting, harsh parenting also indirectly contributes to adolescent suicide ideation via the mediator of adolescents' self-esteem. School social support moderates the relationship between harsh parenting and self-esteem as well as the relationship between self-esteem and suicide ideation. The findings suggest potential pathways for suicide prevention and intervention strategies and highlighted that buffering effect of school social support is limited as risk increasing.
Topics: Humans; Adolescent; Suicidal Ideation; Cross-Sectional Studies; East Asian People; Parenting; Social Support; Schools
PubMed: 37605138
DOI: 10.1186/s12888-023-05108-w -
Comprehensive Psychiatry Jul 2024This study aimed to explore the longitudinal associations of rumination with suicidal ideation and suicide attempts in individuals with major depressive disorder (MDD).
BACKGROUND
This study aimed to explore the longitudinal associations of rumination with suicidal ideation and suicide attempts in individuals with major depressive disorder (MDD).
METHODS
Participants were derived from the Depression Cohort in China study (DCC). Those who completed at least one follow-up visit during the 12 months were included in the analysis. Dimensions of rumination including brooding and reflection were each measured using five items of the Ruminative Responses Scale. Suicidal ideation was assessed using the Beck Scale for Suicide Ideation. Suicide attempts were also assessed and all were analyzed with generalized estimating equations.
RESULTS
Our final sample included 532 participants aged 18 to 59 years (mean [SD], 26.91 [6.94] years) consisting of 148 (27.8%) males and 384 (72.2%) females. After adjusting for temporal trend and potential confounders, individuals with higher levels of reflection were more likely to report suicidal ideation (AOR =1.11, 95% CI:1.01-1.22). However, no statistically significant association was found between brooding and suicidal ideation (AOR =1.06, 95% CI:0.96-1.17). Conversely, individuals with higher levels of brooding were more likely to report suicide attempts (AOR =1.13, 95% CI:1.02-1.24), while no statistically significant association was observed between reflection and suicide attempts (AOR =0.91, 95% CI:0.82-1.01).
CONCLUSION
Rumination reflects a disturbance in cognitive emotional processing and manifests in different dimensions. Our findings suggest that high levels of reflection and brooding may be associated with a higher likelihood of having suicidal ideation and suicide attempts, respectively. However, it should be interpreted with caution, given that effect sizes are small.
Topics: Humans; Depressive Disorder, Major; Suicidal Ideation; Female; Male; Suicide, Attempted; Adult; China; Rumination, Cognitive; Longitudinal Studies; Adolescent; Young Adult; Middle Aged
PubMed: 38513451
DOI: 10.1016/j.comppsych.2024.152472