-
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 -
Epidemiology and Psychiatric Sciences Apr 2018Suicide rates are increased among unemployed individuals and mental illness stigma can contribute to both unemployment and suicidality. Persons with mental illness...
AIMS
Suicide rates are increased among unemployed individuals and mental illness stigma can contribute to both unemployment and suicidality. Persons with mental illness perceive negative attitudes among the general public and experience discrimination in their everyday life (=public stigma components) potentially leading to self-stigma and anticipated discrimination (=individual stigma components). Previous research found evidence for an association between aspects of mental illness stigma and suicidality, but has not yet clarified the underlying pathways explaining how different stigma components interact and contribute to suicidal ideation.
METHOD
Public and individual stigma components and their association with suicidal ideation were examined among 227 unemployed persons with mental illness. A path model linking public stigma components (experienced discrimination, perceived stigma) with suicidal ideation, mediated by individual stigma components (anticipated discrimination, self-stigma), was examined using structural equation modelling within Mplus.
RESULTS
Our sample was equally split in terms of gender, on average 43 years old and about half reported no suicidal ideation during the past 30 days. In bivariate analyses all stigma components were significantly associated with suicidal ideation. In the path model and controlling for symptoms, the association between experienced discrimination and suicidal ideation was fully mediated by anticipated discrimination and self-stigma. Perceived stigma's contribution to suicidal ideation was fully mediated by anticipated discrimination, but not by self-stigma.
CONCLUSIONS
In general, programmes addressing multiple stigma components seem to be most effective in improving suicide prevention. Besides interventions targeting negative attitudes and discriminating behaviours of the general public, programmes to support persons with mental illness in coping with perceived and experienced stigma could improve suicide prevention. Future studies should test the short- and long-term effects of such interventions on suicidality and further investigate the role of stigma coping (e.g. secrecy) and emotional consequences (e.g. hopelessness and loneliness) for the association between stigma components and suicidality.
Topics: Adolescent; Adult; Discrimination, Psychological; Female; Humans; Male; Mental Disorders; Middle Aged; Perception; Self Concept; Social Stigma; Suicidal Ideation; Suicide; Young Adult
PubMed: 27919303
DOI: 10.1017/S2045796016000949 -
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 -
Epidemiology and Psychiatric Sciences Sep 2022Lithium has long been believed to reduce the risk of suicide and suicidal behaviour in people with mood disorders. Previous meta-analyses appeared to support this... (Meta-Analysis)
Meta-Analysis
AIMS
Lithium has long been believed to reduce the risk of suicide and suicidal behaviour in people with mood disorders. Previous meta-analyses appeared to support this belief, but excluded relevant data due to the difficulty of conducting meta-analysis of rare events. The current study is an updated systematic review and meta-analysis that includes all eligible data, and evaluates suicide, non-fatal suicidal behaviour (including suicidal ideation) and suicide attempts.
METHODS
We searched PubMed, PsycINFO and Embase and some trial registers. We included all randomised trials comparing lithium and placebo or treatment as usual in mood disorders published after 2000, to ensure suicide was reliably reported. Trial quality was assessed using the Cochrane Risk of Bias tool. Pooled data were analysed using Fisher's Exact test. In addition, meta-analysis was conducted using various methods, prioritizing the Exact method. All trials were included in the analysis of suicide initially, regardless of whether they reported on suicide or not. We conducted a sensitivity analysis with trials that specifically reported on suicides and one that included trials published before 2000. Pre-specified subgroup analyses were performed involving suicide prevention trials, trials excluding people already taking lithium, trials involving people with bipolar disorder exclusively and those involving people with mixed affective diagnoses. Non-fatal suicidal behaviour and suicide attempts were analysed using the same methods, but only trials that reported these outcomes were included. PROSPERO registration: CRD42021265809.
RESULTS
Twelve eligible studies involving 2578 participants were included. The pooled suicide rate was 0.2% for people randomised to lithium and 0.4% with placebo or treatment as usual, which was not a statistically significant difference; odds ratio (OR) = 0.41 (95% confidence interval 0.03-2.49), = 0.45. Meta-analysis using the Exact method produced an OR of 0.42 (95% confidence interval 0.01-4.5). The result was not substantially different when restricted to 11 trials that explicitly reported suicides and remained statistically non-significant when including 15 trials published before 2000 (mostly in the 1970s). There were no significant differences in any subgroup analysis. There was no difference in rates of all non-fatal suicidal behaviour in seven trials that reported this outcome, or in five trials that reported suicide attempts specifically. Meta-analyses using other methods also revealed no statistically significant differences.
CONCLUSIONS
Evidence from randomised trials is inconclusive and does not support the idea that lithium prevents suicide or suicidal behaviour.
Topics: Bipolar Disorder; Humans; Lithium; Mood Disorders; Randomized Controlled Trials as Topic; Suicidal Ideation; Suicide, Attempted
PubMed: 36111461
DOI: 10.1017/S204579602200049X -
Current Opinion in Psychology Feb 2023Understanding the factors that protect against suicidal ideation and behaviour may strengthen our ability to identify and support those at risk of death by suicide,... (Review)
Review
Understanding the factors that protect against suicidal ideation and behaviour may strengthen our ability to identify and support those at risk of death by suicide, above and beyond that which is possible by focusing solely on risk factors. A factor that may confer protection against the development of suicidal ideation and behaviour is hope, a future orientated construct that features within recent theories of suicide. Here, we provide an overview of the literature examining the role of hope in moderating and mediating the relationship between suicide risk factors and suicide ideation and behaviour. Evidence suggests that hope may be important in buffering against suicide ideation and behaviour across different population. Limitations and recommendation for future research are also discussed.
Topics: Humans; Suicidal Ideation; Risk Factors
PubMed: 36446315
DOI: 10.1016/j.copsyc.2022.101491 -
Psychiatria Danubina Sep 2017There is evidence in the literature that adverse early attachment experiences and subsequent attachment insecurities during adulthood would lead to pessimism, low... (Review)
Review
BACKGROUND
There is evidence in the literature that adverse early attachment experiences and subsequent attachment insecurities during adulthood would lead to pessimism, low self-esteem, hopelessness and, ultimately, to suicide risk.
SUBJECTS AND METHODS
This paper aims to review finding on the link between attachment style and suicidality. We searched the literature using the database of the U.S. National Center for Biotechnology Information (NCBI)-MedLine/Pubmed system from January 1992 until December 2016. We started with 1992 because, as far as we know, there are no published studies exploring the relationship between suicide and insecure attachment before that year. We considered reports published on the relationship between attachment style and suicidality. We applied several combinations of the following search terms: attachment, adult attachment style and suicidality, suicide, suicidal ideation, suicidal behavior or suicidal thoughts, and suicide attempts. We selected only English language studies.
RESULTS
Research suggests that insecure attachment style, mostly anxious, and unresolved traumas are associated with an increased suicide risk. Few studies prospectively examined clinical course, comorbid psychiatric disorders, familial suicidality or other psychosocial factors.
CONCLUSIONS
Further research is needed to highlight the nature of the link between attachment and suicidality. The presence of suicidal ideation and attempts might be a consequence of an underlying interaction between the emergence of psychiatrics symptoms, and the long-lasting presence of inadequate patterns of attachment. Within this context, Separation Anxiety Disorder, categorized in the DSM-5 as a condition not confined to childhood but as an anxiety disorder that may occur through the entire lifespan, might be the a key for the comprehension of this link. From a neurobiological point of view, the role of oxytocin remains unclear.
Topics: Adult; Anxiety Disorders; Female; Hope; Humans; Male; Mental Disorders; Object Attachment; Pessimism; Risk Factors; Self Concept; Suicidal Ideation; Suicide; Suicide, Attempted; Suicide Prevention
PubMed: 28949306
DOI: 10.24869/psyd.2017.250 -
International Journal of Environmental... Feb 2023Synthesizing evidence to examine changes in suicide-related outcomes before and during the pandemic can inform suicide management during the COVID-19 crisis. We searched... (Meta-Analysis)
Meta-Analysis Review
Synthesizing evidence to examine changes in suicide-related outcomes before and during the pandemic can inform suicide management during the COVID-19 crisis. We searched 13 databases as of December 2022 for studies reporting both the pre- and peri-pandemic prevalence of suicidal ideation, suicide attempts, or rate of death by suicide. A random-effects model was used to pool the ratio of peri- and pre-pandemic prevalence of suicidal ideation and attempt (Prevalence Ratio-PR) and rate of death by suicide (Rate Ratio; RR). We identified 51, 55, and 25 samples for suicidal ideation, attempt, and death by suicide. The prevalence of suicidal ideation increased significantly among non-clinical (PR = 1.142; 95% CI: 1.018-1.282; = 0.024; = 28) and clinical (PR = 1.134; 95% CI: 1.048-1.227; = 0.002; = 23) samples, and pooled estimates differed by population and study design. Suicide attempts were more prevalent during the pandemic among non-clinical (PR = 1.14; 95% CI: 1.053-1.233; = 0.001; = 30) and clinical (PR = 1.32; 95% CI: 1.17-1.489; = 0.000; = 25) participants. The pooled RR for death by suicide was 0.923 (95% CI: 0.84-1.01; = 0.092; = 25), indicating a nonsignificant downward trend. An upward trend of suicidal ideation and suicide attempts was observed during the COVID-19 pandemic, despite suicide rate remaining stable. Our findings suggest that timely prevention and intervention programs are highly needed for non-clinical adult population and clinical patients. Monitoring the real-time and long-run suicide risk as the pandemic evolves is warranted.
Topics: Adult; Humans; Pandemics; COVID-19; Suicide, Attempted; Suicidal Ideation; Prevalence
PubMed: 36834037
DOI: 10.3390/ijerph20043346 -
Current Psychiatry Reports Jun 2011Suicide in late life is an enormous public health problem that will likely increase in severity as adults of the baby boom generation age. Data from psychological... (Review)
Review
Suicide in late life is an enormous public health problem that will likely increase in severity as adults of the baby boom generation age. Data from psychological autopsy studies supplemented with recent studies of suicidal ideation and attempts point to a consistent set of risk factors for the spectrum of suicidal behaviors in late life (suicide ideation, attempts, and deaths). Clinicians should be vigilant for psychiatric illness (especially depression), physical illness, pain, functional impairment, and social disconnectedness. Recent advances in late-life suicide prevention have in common collaborative, multifaceted intervention designs. We suggest that one mechanism shared by all preventive interventions shown to reduce the incidence of late-life suicide is the promotion of connectedness. For the clinician working with older adults, our recommendation is to not only consider risk factors, such as depression, and implement appropriate treatments but to enhance social connectedness as well.
Topics: Aged; Depression; Depressive Disorder; Humans; Social Support; Suicidal Ideation; Suicide; Suicide Prevention
PubMed: 21369952
DOI: 10.1007/s11920-011-0193-3 -
Tidsskrift For Den Norske Laegeforening... Nov 2017
Topics: Chronic Disease; Humans; Suicidal Ideation; Suicide
PubMed: 29135170
DOI: 10.4045/tidsskr.17.0630