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Clinical Psychology & Psychotherapy Sep 2022Research indicates that the emergency department is the primary setting for people to present with suicidal ideation. Attempting to provide interventions for this... (Review)
Review
BACKGROUND
Research indicates that the emergency department is the primary setting for people to present with suicidal ideation. Attempting to provide interventions for this population depends greatly on understanding their needs and life circumstances at the time of presentation to services, therefore enabling more appropriate treatment pathways and services to be provided.
AIM
This review aims to collate, evaluate and synthesize the empirical research focused on the population of people presenting to hospital settings with suicidal ideation.
METHOD
A systematic literature search was performed. Articles that met a specified set of inclusion criteria including participants being over 18, not being admitted to hospital and presenting to an emergency department setting underwent a quality assessment and data analysis. The quality assessment used was the EPHPP Quality Assessment Tool for Quantitative Studies (Thomas et al., 2004).
RESULTS
Twenty-seven articles were included in the review. Studies were quantitative and of reasonable methodological quality (Thomas et al., 2004). The literature was characterized by demographic information, mental health factors associated with the presentation to hospital and treatment pathways or outcomes reported. The reviewed research showed that people presenting to emergency departments with suicidal ideation were varying in age, gender, ethnic background and socio-economic status (SES). Large proportions of studies reported psychosocial factors alongside interpersonal struggles as the main presenting reason. The review highlights large variability across these factors. Mental health diagnosis was common, previous suicide attempt was a risk factor, and treatment pathways were unclear. The review identifies the outstanding gaps and weaknesses in this literature as well as areas in need of future research.
CONCLUSIONS
In conclusion, the review highlights the prevalence of people reporting interpersonal factors as the reason for suicidal ideation and not mental health disorders or diagnosis. Despite this, no mention of trauma or life stories was made in any study assessing this population. Despite a large variation across studies making synthesis difficult, data proves clinically relevant and informative for future practice and guidance on areas needing further research.
Topics: Humans; Suicidal Ideation; Suicide, Attempted; Risk Factors; Mental Disorders; Hospitals
PubMed: 35716391
DOI: 10.1002/cpp.2761 -
RMD Open Jul 2023To conduct a systematic review of the literature on the association between fibromyalgia and mortality and to pool the results in a meta-analysis. (Meta-Analysis)
Meta-Analysis
OBJECTIVE
To conduct a systematic review of the literature on the association between fibromyalgia and mortality and to pool the results in a meta-analysis.
METHODS
The authors searched the PubMed, Scopus, and Web of Science databases using the key words 'fibromyalgia' and 'mortality' to identify studies that addressed an association between fibromyalgia and mortality. Original papers that assessed associations between fibromyalgia and mortality (all or specific causes) and provided an effect measure (hazard ratio (HR), standardised mortality ratio (SMR), odds ratio (OR)) quantifying the relationship between fibromyalgia and mortality were included in the systematic review. Of 557 papers that were initially identified using the search words, 8 papers were considered eligible for the systematic review and meta-analysis. We used a Newcastle-Ottawa scale to assess the risk of bias in the studies.
RESULTS
The total fibromyalgia group included 188 751 patients. An increased HR was found for all-cause mortality (HR 1.27, 95% CI 1.04 to 1.51), but not for the subgroup diagnosed by the 1990 criteria. There was a borderline increased SMR for accidents (SMR 1.95, 95% CI 0.97 to 3.92), an increased risk for mortality from infections (SMR 1.66, 95% CI 1.15 to 2.38), and suicide (SMR 3.37, 95% CI 1.52 to 7.50), and a decreased mortality rate for cancer (SMR 0.82, 95% CI 0.69 to 0.97). The studies showed significant heterogeneity.
CONCLUSIONS
These potential associations indicate that fibromyalgia should be taken seriously, with a special focus on screening for suicidal ideation, accident prevention, and the prevention and treatment of infections.
Topics: Humans; Databases, Factual; Fibromyalgia; Odds Ratio
PubMed: 37429737
DOI: 10.1136/rmdopen-2023-003005 -
Journal of Psychosomatic Research Jun 2022In psychiatric literature, few original studies exist on the topic of demoralization in suicide. In this review, we aim to identify original studies on suicidal ideation... (Review)
Review
OBJECTIVE
In psychiatric literature, few original studies exist on the topic of demoralization in suicide. In this review, we aim to identify original studies on suicidal ideation (SI)/suicidal behavior (SB) and demoralization in populations of community-dwellers and patients with somatic or psychiatric disorders.
METHODS
We employed a systematic approach that followed PRISMA guidelines, searching through four major electronic databases (PubMed/MEDLINE, Scopus, Science Direct, and PsychINFO) for relevant titles/abstracts published from January 1980-June 2021. We included original studies that explicitly mentioned the investigation of a potential association between SI/SB and demoralization.
RESULTS
A total of 18 studies met our inclusion criteria. Their synthesis revealed that demoralization can be associated with SI/SB in a wide range of populations (community dwellers, patients with somatic or psychiatric disorders) and lead to significantly higher suicide risk (odds ratios of >6 were encountered in community dwellers experiencing financial hardship or isolation). Moreover, demoralization alone (about half the patients who were demoralized did not meet the criteria for an affective disorder nor were they clinically depressed) or together with depression has been identified as a major risk factor for SI/SB. Regarding the crucial issue of progression from SI to SA, in the context of the "ideation-to-action" frame, some authors found that the interaction of demoralization and over-arousal could be a useful predictor for this progression, while others found that depression alone was sufficient to differentiate attempters from non-attempters or the interaction with shutdown (helplessness and low positive emotions).
CONCLUSION
These results emphasize the possibility to identify demoralization as an independent risk factor for suicide. In patients with psychiatric disorders, the association between demoralization and SI/SB may be transnosographic. Overall, from the clinical implications perspective, our findings highlight that: i. Assessment of demoralization may contribute to a more comprehensive suicide risk detection. This appears particularly relevant in Emergency Departments (EDs) where heterogeneous population typologies are usually admitted and a clinical diagnosis of depression is often difficult to be defined. ii. Additionally, since meaninglessness is considered one of the demoralization subcomponents, meaning-centered psychotherapeutic approaches prove to be indicated and they can be initiated already at the EDs upon first contact with the patient. Further studies are necessary to confirm these findings.
Topics: Demoralization; Humans; Mood Disorders; Risk Factors; Suicidal Ideation; Suicide
PubMed: 35334350
DOI: 10.1016/j.jpsychores.2022.110788 -
Neuro-oncology Advances 2023Subsequent to a diagnosis of a brain tumor, psychological distress has been associated with negative effects on mental health as well as suicidality. The magnitude of... (Review)
Review
BACKGROUND
Subsequent to a diagnosis of a brain tumor, psychological distress has been associated with negative effects on mental health as well as suicidality. The magnitude of such impact has been understudied in the literature. We conducted a systematic review to examine the impact of a brain tumor on suicidality (both ideation and attempts).
METHODS
In accordance with the PRISMA guidelines, we searched for relevant peer-reviewed journal articles on PubMed, Scopus, and Web of Science databases from inception to October 20, 2022. Studies investigating suicide ideation and/or attempt among patients with brain tumors were included.
RESULTS
Our search yielded 1,998 articles which were screened for eligibility. Seven studies consisting of 204,260 patients were included in the final review. Four studies comprising 203,906 patients (99.8%) reported elevated suicidal ideation and suicide attempt incidence compared with the general population. Prevalence of ideation and attempts ranged from 6.0% to 21.5% and 0.03% to 3.33%, respectively. Anxiety, depression, pain severity, physical impairment, glioblastoma diagnosis, male sex, and older age emerged as the primary risk factors associated with increased risk of suicidal ideation and attempts.
CONCLUSION
Suicidal ideation and attempts are increased in patients and survivors of brain tumors compared to the general population. Early identification of patients exhibiting these behaviors is crucial for providing timely psychiatric support in neuro-oncological settings to mitigate potential harm. Future research is required to understand pharmacological, neurobiological, and psychiatric mechanisms that predispose brain tumor patients to suicidality.
PubMed: 37313501
DOI: 10.1093/noajnl/vdad058 -
Archives of Suicide Research : Official... 2022The exploration of inter- and intra-individual variability in suicidal ideation (SI) is vital to suicide research. However, this research relies on the identification...
BACKGROUND
The exploration of inter- and intra-individual variability in suicidal ideation (SI) is vital to suicide research. However, this research relies on the identification and measurement of standardized SI characteristics.
OBJECTIVE
This review aimed to identify characteristics of SI examined in research, describe how these characteristics are measured, and assess how they are aligned with those included in the Columbia Suicide Severity Rating Scale (C-SSRS).
METHODS
Four databases were systematically searched, and relevant data was extracted. The C-SSRS provided a framework for comparing SI names, measures and operational definitions.
RESULTS
After comparing operational definitions of identified characteristics, five core domains emerged: (1) severity, (2) temporality, (3) variability, (4) controllability, and (5) deterrents/reasons for ideating. Except for variability, all SI characteristics in the literature were congruent with those measured in the C-SSRS.
CONCLUSIONS
This review highlighted conceptual and methodologic inconsistencies in the study of SI, specifically the nomenclature, measurement and definitions of SI characteristics. Standardized approaches to the study of SI characteristics are needed. These approaches will enhance accurate and reliable measurement of SI, allow for findings to be synthesized across studies and propel the exploration of inter and intra-individual SI variability leading to more individualized and effective SI treatment.
Topics: Humans; Suicidal Ideation; Suicide
PubMed: 35040371
DOI: 10.1080/13811118.2021.2022551 -
Lancet Regional Health. Americas Jul 2022The suicide rate in Guyana has consistently ranked as one of the highest in the world. This systematic review synthesises and critically analyses the existing literature... (Review)
Review
BACKGROUND
The suicide rate in Guyana has consistently ranked as one of the highest in the world. This systematic review synthesises and critically analyses the existing literature on suicidal behaviours and ideation in Guyana.
METHODS
Systematic review with narrative synthesis was conducted following PRISMA guidelines. PubMed, PsychInfo, CINAHL and SCOPUS databases were searched until 31 March 2021. Articles which included the analysis of suicidal behaviour or suicidal ideation using data collected in Guyana were eligible for inclusion. Articles relating to the Jonestown mass murder-suicide event were excluded. This review was pre-registered with PROSPERO [CRD42021247669].
FINDINGS
The search resulted in 318 articles, of which 24 met eligibility for inclusion. The majority were quantitative (=18), relating to suicide mortality (=9), and suicide attempt and suicidal ideation (=9). Additionally, qualitative (=5) and mixed-method (=1) papers investigated the experiences of those bereaved by suicide, gatekeepers of suicidality, and adolescent students. Eleven studies were multinational, whilst 13 focused on Guyana. The quality of the publications varied.
INTERPRETATION
Despite high annual suicide rates in Guyana, published research is very limited. This review found preliminary evidence for key risk groups; males, female youth, and Indo-Guyanese ethnicity. Pesticide poisoning was identified as the most common method for suicide in Guyana. There is a need for local research investigating the context and narrative of suicide to inform culturally tailored prevention strategies. This study was limited to a narrative synthesis and may be impacted by publication bias.
FUNDING
This research was supported by an Australian Government Research Training Program Scholarship through Griffith University Australia.
REGISTRATION
Pre-registered in PROSPERO [CRD42021247669].
PubMed: 36778929
DOI: 10.1016/j.lana.2022.100253 -
BMC Psychiatry Dec 2023Electroretinogram (ERG) is one of the tools used to investigate the electrophysiological underpinnings of mental health illnesses and major clinical phenomena (e.g.,...
BACKGROUND
Electroretinogram (ERG) is one of the tools used to investigate the electrophysiological underpinnings of mental health illnesses and major clinical phenomena (e.g., suicide) to improve their diagnosis and care. While multiple studies have reported specific ERG changes among individuals with suicidal behaviors, we know of no review that has been done to characterize their findings to inform future research.
METHODS
This review included available literature concerning ERG and suicidal behaviors. The paper's first section briefly overviews the theoretical basis of ERG and neurotransmitters involved in suicidal behaviors. The second section describes the findings of a review of studies reporting ERG findings among individuals with suicidal behaviors.
RESULTS
Most reviewed studies reported normal amplitude and implicit time of the a-waves, but the latency in individuals with suicidal behaviors was lower than normal. Additionally, the b-waves amplitude was reduced, but the implicit time and latency were increased. The b-a amplitude ratio and oscillatory potential were decreased.
CONCLUSION
Despite identifying certain ERG correlates with suicidal behaviors in the existing studies, there is a need for adequately powered and methodologically robust studies to advance clinical translation.
Topics: Humans; Electroretinography; Suicidal Ideation; Suicide; Mental Disorders; Mental Health
PubMed: 38102572
DOI: 10.1186/s12888-023-05453-w -
Frontiers in Psychiatry 2023We aimed to evaluate the association between epilepsy and suicidality, including suicidal ideation, attempts and completed suicide. (Review)
Review
BACKGROUND
We aimed to evaluate the association between epilepsy and suicidality, including suicidal ideation, attempts and completed suicide.
METHODS
We systematically searched PubMed, Embase, Cochrane Online Library, and Clinicaltrials.gov from 1946 to June 21, 2021 and assessed the quality of the studies using the Newcastle-Ottawa Scale. We calculated the pooled OR and the crude rate for suicidal ideation, suicide attempts and completed suicide in patients with epilepsy (PWE).
RESULTS
We screened 2,786 studies and included 88 articles with 1,178,401 PWE and 6,900,657 participants as controls. Search terms included epilepsy and suicide. The pooled rates of suicidal ideation, suicide attempts and completed suicide in PWE were 19.73% (95% CI: 17.00-22.62%), 5.96% (95% CI: 4.82-7.20%), and 0.24% (95% CI: 0.11-0.42%), respectively. Compared to the control group, PWE were at a significantly higher risk of total suicidality (pooled OR, 2.60; 95%: 2.13-3.18), including suicidal ideation (pooled OR, 2.70; 95% CI, 2.21-3.30), suicide attempts (pooled OR, 2.74; 95% CI, 2.08-3.61) and completed suicide (pooled OR, 2.36; 95% CI, 1.45-3.83). Subgroup analyses showed significant differences in the subgroups of the measurement of suicidality.
CONCLUSION
The rate of suicidal ideation, suicide attempts and completed suicide in PWE were about 19.73, 5.96, and 0.24%. And there was an increased risk of suicidality in PWE especially temporal lobe epilepsy and drug-resistant epilepsy. Clinicians need to be aware of this risk in PWE with early identification and prevention at the time of diagnosis.Protocol Registration: PROSPERO CRD42021278220.
PubMed: 37065883
DOI: 10.3389/fpsyt.2023.1097516 -
International Journal of Environmental... Jul 2022Young people experience high rates of suicidal ideation, self-harm, suicide attempt and death due to suicide. As a result of increasing globalisation, young people are... (Review)
Review
Young people experience high rates of suicidal ideation, self-harm, suicide attempt and death due to suicide. As a result of increasing globalisation, young people are increasingly mobile and can migrate from one country to another seeking educational and employment opportunities. With a growing number of young migrants, it is important to understand the prevalence of suicidal behaviour among this population group. We systematically searched Medline, Embase, and PsycINFO from inception until 31 March 2022. Eligible studies were those providing data on suicidal ideation, self-harm, suicide attempt, and death due to suicide. Seventeen studies were included in the review, some of which provided data on multiple outcomes of interest. Twelve studies provided data on suicidal ideation, five provided data on self-harm, eight provided data on suicide attempt, and one study had data on suicide death among young migrants. The quality of the included studies was varied and limited. The studies included in this review commonly reported that young migrants experience higher rates of self-harm and suicide attempt, but no major differences in suicidal ideation and suicide death compared to non-migrant young people. However, the limited number of studies focused on suicidal behaviour among young migrants highlights the need for further high-quality studies to capture accurate information. This will enable the development of policies and interventions that reduce the risk of suicidal behaviour among young migrants.
Topics: Adolescent; Humans; Mental Processes; Prevalence; Self-Injurious Behavior; Suicidal Ideation; Suicide, Attempted
PubMed: 35886183
DOI: 10.3390/ijerph19148329 -
Iranian Journal of Public Health Jun 2023We systematically reviewed (evaluated methodological quality) meta-analysis studies on the suicidal ideation of South Koreans using a measurement tool to assess... (Review)
Review
BACKGROUND
We systematically reviewed (evaluated methodological quality) meta-analysis studies on the suicidal ideation of South Koreans using a measurement tool to assess systematic reviews version 2 (AMSTAR-2) to present the ways for improving the quality of follow-up meta-analysis studies and suggest the direction of future studies.
METHODS
We analyzed 11 meta-analysis studies based on AMSTAR-2 criteria by collecting documents related to suicidal thoughts using seven electronic databases (DBPia, Scholar, KISS, KCI, RISS, KoreaEmbase, and National Assembly Electronic Library) from Jan 1, 2000 to Dec 3, 2022.
RESULTS
Among the 142 papers searched, we analyzed the final 11 selected studies. Not all analyzed meta-analysis studies conducted quality assessment and these studies omitted the list of excluded references and the adequacy of the literature search. Moreover, 54.5% of the analyzed studies (six out of eleven studies) did not present the effect of publication bias. Consequently, SOMETHING was critically low due to omissions in critical domains.
CONCLUSION
In all 11 studies analyzed, 2 or more of 7 critical domains were omitted, and the quality level was confirmed to be critically low. Therefore, future meta-analysis studies on suicidal ideation will have to include quality assessment and improve the quality of meta-analysis, such as testing bias effects.
PubMed: 37484152
DOI: 10.18502/ijph.v52i6.12951