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Medicina (Kaunas, Lithuania) May 2019Borderline personality disorder (BPD) is associated with suicidal behaviors and self-harm. Up to 10% of BPD patients will die by suicide. However, no research data... (Review)
Review
Borderline personality disorder (BPD) is associated with suicidal behaviors and self-harm. Up to 10% of BPD patients will die by suicide. However, no research data support the effectiveness of suicide prevention in this disorder, and hospitalization has not been shown to be useful. The most evidence-based treatment methods for BPD are specifically designed psychotherapies.
Topics: Borderline Personality Disorder; Hospitalization; Humans; Suicidal Ideation; Suicide
PubMed: 31142033
DOI: 10.3390/medicina55060223 -
Psychiatry Research Dec 2021We aimed to do a systematic review and meta-analysis of studies describing suicidal ideation, suicide attempts and suicide and associated risk factors during COVID-19... (Meta-Analysis)
Meta-Analysis Review
We aimed to do a systematic review and meta-analysis of studies describing suicidal ideation, suicide attempts and suicide and associated risk factors during COVID-19 pandemic. We searched following electronic databases using relevant search terms: Medline, Embase, PsycInfo and CINAHL and systematically reviewed the evidence following PRISMA guidelines. The meta-analysis of prevalence of suicidal ideation was done using random effect model. The search returned 972 records, we examined 106 in full text and included 38 studies describing 120,076 participants. Nineteen studies described suicide or attempted self-harm, mostly in case reports. Out of 19 studies describing suicidal ideations, 12 provided appropriate data for meta-analysis. The pooled prevalence of suicidal ideation in these studies was 12.1% (CI 9.3-15.2). Main risk factors for suicidal ideations were: low social support, high physical and mental exhaustion and poorer self-reported physical health in frontline medical workers, sleep disturbances, quarantine and exhaustion, loneliness, and mental health difficulties. We provide first meta-analytic estimate of suicidal ideation based on large sample from different countries and populations. The rate of suicidal ideations during COVID pandemic is higher than that reported in studies on general population prior to pandemic and may result in higher suicide rates in future.
Topics: COVID-19; Humans; Pandemics; SARS-CoV-2; Suicidal Ideation; Suicide, Attempted
PubMed: 34670162
DOI: 10.1016/j.psychres.2021.114228 -
Current Psychiatry Reports Jul 2021We review recent evidence on suicide among older adults, examine risk factors contributing to vulnerability to late-life suicide, and summarize possible interventions. (Review)
Review
PURPOSE OF REVIEW
We review recent evidence on suicide among older adults, examine risk factors contributing to vulnerability to late-life suicide, and summarize possible interventions.
RECENT FINDINGS
We found a steadily increasing rate of late-life suicide in the USA in the past decade. Evidence supporting the integration of depression care managers into primary care for risk reduction is among the strongest to date. Pharmacologic and neuromodulation studies should be considered in geriatric depression complicated by suicidality. Broad societal campaigns about suicide education, as well as active outreach to psychiatric patients after discharge or a suicidal crisis, prevent suicidal behavior. Growing research supports an integrative multidisciplinary approach. Suicide is a complex and multifaceted behavior with numerous casual points for intervention. Access to deadly means, presence of depression, disease, disability, and social disconnection are factors that increase vulnerability. Quality geriatric care, regular screening in primary and emergency care settings, and a multidisciplinary approach are necessary to mitigate risk factors. The COVID-19 pandemic amplifies need for a more aggressive approach.
Topics: Aged; COVID-19; Humans; Pandemics; Risk Factors; SARS-CoV-2; Suicidal Ideation; Suicide Prevention
PubMed: 34273004
DOI: 10.1007/s11920-021-01268-2 -
European Psychiatry : the Journal of... Oct 2022Suicide is a major public health problem and a cause of premature mortality. With a view to prevention, a great deal of research has been devoted to the determinants of... (Review)
Review
BACKGROUND
Suicide is a major public health problem and a cause of premature mortality. With a view to prevention, a great deal of research has been devoted to the determinants of suicide, focusing mostly on individual risk factors, particularly depression. In addition to causes intrinsic to the individual, the social environment has also been widely studied, particularly social isolation. This paper examines the social dimension of suicide etiology through a review of the literature on the relationship between suicide and social isolation.
METHODS
Medline searches via PubMed and PsycINFO were conducted. The keywords were "suicid*" AND "isolation."
RESULTS
Of the 2,684 articles initially retrieved, 46 were included in the review.
CONCLUSIONS
Supported by proven theoretical foundations, mainly those developed by E. Durkheim and T. Joiner, a large majority of the articles included endorse the idea of a causal relationship between social isolation and suicide, and conversely, a protective effect of social support against suicide. Moreover, the association between suicide and social isolation is subject to variations related to age, gender, psychopathology, and specific circumstances. The social etiology of suicide has implications for intervention and future research.
Topics: Humans; Risk Factors; Social Isolation; Social Support; Suicidal Ideation; Suicide Prevention
PubMed: 36216777
DOI: 10.1192/j.eurpsy.2022.2320 -
Medicina 2020Autism is a neurodevelopmental disorder characterized by a qualitative alteration in social interaction and communication, associated with restricted interests and... (Review)
Review
Autism is a neurodevelopmental disorder characterized by a qualitative alteration in social interaction and communication, associated with restricted interests and stereotyped behaviors. People with autism are four times more likely to develop depression, than the general population, it is even considered as the most common mental health condition in people with autism spectrum disorders (ASD). One of the challenges is to recognize the manifestations related to depression in people with ASD, in whom, in general, it is expressed differently in relation to those with typical development. Depression in people with autism can manifest itself with restlessness and insomnia and not with feelings of sadness, so it is essential to be attentive and not justify all behavioral problems to autism. Young adults with ASD have higher baseline levels of almost all the depression characteristics listed in the DSM-5, which can lead to overdiagnosis or underreporting of depression. On the other hand, adults with autism have an increased risk of experiencing suicidal thoughts, planning suicide, carrying it out and even dying from suicide. Many of them have a history of depression, harassment and loneliness. It is essential the early detection of depression, develop appropriate tools for diagnosis in autism as well as generate awareness of the risk of ideation or suicide, a problem that only in recent years has been addressed with greater depth. In this paper I analyze depression in autism, the risk of suicidal ideation and suicide, prioritizing clinical aspects, their evaluation and risk factors.
Topics: Autism Spectrum Disorder; Depressive Disorder; Female; Humans; Male; Risk Factors; Suicidal Ideation; Suicide
PubMed: 32150706
DOI: No ID Found -
Journal of Affective Disorders Oct 2023Academic pressure is a potential contributor to adolescent mental health problems, but international evidence on this association has never been synthesised. (Review)
Review
BACKGROUND
Academic pressure is a potential contributor to adolescent mental health problems, but international evidence on this association has never been synthesised.
METHODS
We conducted the first systematic review of the association between academic pressure and adolescent depression, anxiety, self-harm, suicidality, suicide attempts and suicide. We searched MEDLINE, PsycINFO, ERIC and Web of Science (core collection) up to November 24, 2022, for studies of school-going children or adolescents, which measured academic pressure or timing within the school year as the exposure and depression, anxiety, self-harm, or suicidal ideation, attempts or suicide as outcomes. Risk of bias was assessed using the Mixed Methods Appraisal Tool. We used narrative synthesis to summarise the evidence. The review was prospectively registered with PROSPERO (CRD42021232702).
RESULTS
We included 52 studies. Most studies assessed mixed anxiety and depressive symptoms (n = 20) or depressive symptoms (n = 19). Forty-eight studies found evidence of a positive association between academic pressure or timing within the school year and at least one mental health outcome.
LIMITATIONS
Most studies were cross-sectional (n = 39), adjusted for a narrow range of confounders or had other limitations which limited the strength of causal inferences.
CONCLUSIONS
We found evidence that academic pressure is a potential candidate for public health interventions which could prevent adolescent mental health problems. Large population-based cohort studies are needed to investigate whether academic pressure is a causal risk factor that should be targeted in school- and policy-based interventions.
FUNDING
UCL Health of the Public; Wellcome Institutional Strategic Support Fund.
Topics: Child; Humans; Adolescent; Mental Health; Anxiety; Suicide, Attempted; Suicidal Ideation; Schools
PubMed: 37437728
DOI: 10.1016/j.jad.2023.07.028 -
Medicina (Kaunas, Lithuania) Jan 2021: Suicide in adolescents represents a major public health concern. To date, a growing number of suicide preventive strategies based on the use of new technologies are... (Review)
Review
: Suicide in adolescents represents a major public health concern. To date, a growing number of suicide preventive strategies based on the use of new technologies are emerging. We aimed to provide an overview of the present literature on the use of new technologies in adolescent suicide prevention. : An electronic search was run using the following keywords: Technology OR Technologies OR APP OR Application OR mobile application) AND (Adolescent OR youth OR puberty) AND (Suicid* OR Self-harm OR self-destruction). Inclusion criteria were: English language, published in a peer-reviewed journal, suicide prevention with the use of new technologies among adolescents. : Our search strategy yielded a total of 12 studies on the use of telemedicine, 7 on mobile applications, and 3 on language detection. We also found heterogeneity regarding the study design: 3 are randomized controlled trials (RCT), 13 are open-label single group trials, 2 are randomized studies, and 1 is a cross-sectional study. Telemedicine was the most adopted tool, especially web-based approaches. Mobile applications mostly focused on screening of depressive symptoms and suicidal ideation, and for clinical monitoring through the use of text messages. Although telepsychiatry and mobile applications can provide a fast and safe tool, supporting and preceding a face-to-face clinical assessment, only a few studies demonstrated efficacy in preventing suicide among adolescents through the use of these interventions. Some studies suggested algorithms able to recognize people at risk of suicide from the exploration of the language on social media posts. : New technologies were found to be well accepted and tolerated supports for suicide prevention in adolescents. However, to date, few data support the use of such interventions in clinical practice and preventive strategies. Further studies are needed to test their efficacy in suicide prevention among adolescents and young adults.
Topics: Adolescent; Humans; Mobile Applications; Randomized Controlled Trials as Topic; Suicidal Ideation; Telemedicine; Young Adult; Suicide Prevention
PubMed: 33530342
DOI: 10.3390/medicina57020109 -
BMC Psychiatry Aug 2021Emotional dysregulation seems to be a core feature of Borderline Personality Disorders (BPD). In addition, recent research in the adolescent population has shown that...
BACKGROUND
Emotional dysregulation seems to be a core feature of Borderline Personality Disorders (BPD). In addition, recent research in the adolescent population has shown that suicidal behaviours have been associated with maladaptive strategies of emotion regulation.
METHODS
This study examined the relative contributions of emotional dysregulation to suicide attempt history in a clinical sample of borderline adolescents. Data were analyzed from 85 participants of the Collaborative European Research Network on Borderline Personality Disorder. Participants completed measures of BPD traits and symptoms, suicide behaviours, emotional dysregulation, attachment styles and lifetime depressive disorders.
RESULTS
In an SEM model, lifetime depressive disorders and insecure attachment styles have a significant direct effect on lifetime suicide attempt, but only lifetime depressive disorders have an indirect effect through emotion dysregulation. The results suggest that emotional dysregulation has a mediating role in suicide attempts among BPD adolescents.
CONCLUSIONS
These findings call for the development of interventions targeting the role of emotion dysregulation in effectively predicting and preventing suicidality in borderline adolescents.
Topics: Adolescent; Borderline Personality Disorder; Emotions; Humans; Suicidal Ideation; Suicide, Attempted
PubMed: 34372810
DOI: 10.1186/s12888-021-03377-x -
Canadian Family Physician Medecin de... Oct 2019
Topics: Family Practice; Internship and Residency; Suicidal Ideation; Suicide
PubMed: 31604726
DOI: No ID Found -
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