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International Journal of Environmental... Mar 2021To understand why attachment difficulties predispose individuals to suicidal thinking (suicide ideation) and behaviour, a leading cause of death, we need to explore the...
BACKGROUND
To understand why attachment difficulties predispose individuals to suicidal thinking (suicide ideation) and behaviour, a leading cause of death, we need to explore the role of pertinent psychological mechanisms. Attachment processes are closely linked to the development of mentalisation capabilities, or reflective functioning; the ability to understand and interpret self and other behaviour as an expression of mental states. Interventions designed to improve mentalisation have been associated with a reduction in suicidal behaviour, yet reflective functioning has not been directly investigated in relation to suicidal ideation and behaviour.
AIM
We aim to further verify the link between adult attachment security and suicidal ideation and examine whether deficits in reflective functioning mediate this relationship.
METHODS
Sixty-seven participants who experienced suicidal ideation within the past 12 months completed self-report measures of adult attachment, current suicidal ideation, reflective functioning, depressive symptomology and hopelessness. Partial correlations, mediation analyses and group comparisons were conducted to explore relationships between these factors.
RESULTS
Findings did not support a mediational role for reflective functioning in the relationship between attachment security and suicidal ideation. A direct relationship was established between attachment avoidance and suicidal ideation, after controlling for age, gender and depressive symptoms. However, participants with a history of attempted suicide were higher in anxious attachment compared to participants with no such history.
CONCLUSIONS
This study shows that the attachment dimensions of attachment anxiety and avoidance may play differential roles in increasing risk for suicidal attempts versus ideation. This has important implications for tailoring interventions. Those aimed at reducing suicide attempts should focus on reducing attachment anxiety by helping people develop skills in emotional regulation. Interventions aimed at reducing suicidal ideation should focus on reducing attachment avoidance by helping people develop closer relationships with significant others. However, longitudinal and experimental designs are required to verify causality.
Topics: Adult; Anxiety; Anxiety Disorders; Humans; Risk Factors; Suicidal Ideation; Suicide, Attempted; Thinking
PubMed: 33802833
DOI: 10.3390/ijerph18063090 -
British Journal of Clinical Pharmacology Sep 2022The urgent need for appropriate treatment for suicide, the tenth leading cause of death, has led to numerous studies. This study aims to systematically identify and... (Review)
Review
The urgent need for appropriate treatment for suicide, the tenth leading cause of death, has led to numerous studies. This study aims to systematically identify and appraise systematic reviews with or without meta-analyses investigating ketamine in suicidal ideation and behaviours. Scopus, ISI, Embase, PubMed, CINAHL, PsycINFO, Cochrane Library, Google Scholar and two registries were searched without any restrictions for systematic reviews investigating the efficacy of ketamine on suicidal ideation and behaviours. The primary outcome was the final inference of ketamine effectiveness. A formal narrative synthesis was conducted, and the AMSTAR-2 tool was used to evaluate the quality of the studies. Of 27 studies that addressed ketamine for suicidal ideation, only four reported mixed or negative results, and out of nine reviews, esketamine was significantly beneficial only in five. A transient rise in pulse rate and blood pressure, dissociation, confusion, blurred vision, nausea and vertigo were the most common adverse effects; however, most were mild. More than two-thirds of the included studies qualified as of low or critically low quality. Preliminary evidence for the short-term efficacy of ketamine in suicidality was noted by the majority of reviews; however, long-term effects remained unknown. Due to the low quality of many studies and the limitations of core studies, further research is required.
Topics: Humans; Ketamine; Registries; Suicidal Ideation; Systematic Reviews as Topic; Suicide Prevention
PubMed: 35451097
DOI: 10.1111/bcp.15360 -
Psychiatry Research Nov 2022Current suicidal ideation and suicide attempts among psychiatric patients during the COVID-19 pandemic were studied through systematic review and meta-analysis. We... (Meta-Analysis)
Meta-Analysis Review
Current suicidal ideation and suicide attempts among psychiatric patients during the COVID-19 pandemic were studied through systematic review and meta-analysis. We searched the following electronic databases using the relevant search terms: Medline, Embase, PubMed and Web of Science, with the search time as of January 31,2022. Forest plots were obtained using Stata statistical software and a random-effects model was used to conduct a meta-analysis of the prevalence of suicidal ideation. We found 21 eligible studies, 11 of which provided suitable data for meta-analysis. 10 studies explored current suicidal ideation and reported a pooled prevalence of 20.4% (95%CI 14.0-26.8). Six studies examined suicide attempts, with a pooled prevalence of 11.4% (95%CI 6.2-16.6). The prevalence of suicidal ideation and suicide attempts varied by the study method used and by the study sites. This work highlights the need for real-time monitoring of suicidal ideation and suicide in psychiatric patients during the covid-19 pandemic r to inform clinical practice and help identify research questions for future epidemiological studies.
Topics: Humans; Suicide, Attempted; Suicidal Ideation; COVID-19; Pandemics; Prevalence
PubMed: 36113254
DOI: 10.1016/j.psychres.2022.114837 -
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 -
Scandinavian Journal of Work,... Nov 2022Working in high-stress and male-dominated occupations is associated with an elevated risk of suicide. The current study sought to conduct the first systematic literature... (Meta-Analysis)
Meta-Analysis
OBJECTIVES
Working in high-stress and male-dominated occupations is associated with an elevated risk of suicide. The current study sought to conduct the first systematic literature review and meta-analysis aimed at determining suicide risk across the diverse, high pressure and male-dominated transport industry (commercial aviation, merchant seafaring, transit/driving) as compared to the general/employed population.
METHODS
Searches of PubMed/Medline, Scopus and PsycINFO databases were conducted without date restriction until March 2021. Studies were included if they were written in English, were peer reviewed, and presented primary observational research data. Studies referring exclusively to suicidal ideation, suicide attempts, self-harm, and/or accidents were excluded.
RESULTS
Following deletion of duplicates and non-English titles, a total of 4201 titles/abstracts were screened and 92 full-texts were read against inclusion/exclusion criteria. The final included sample consisted of 23 articles (16 used for meta-analysis). Results from the meta-analysis indicated that transport workers had a significantly elevated risk for suicide as compared to the general/employed population. Results were consistent across sensitivity analyses, and there was some variation across subgroup analyses.
CONCLUSIONS
Overall, we found transport workers had a significantly higher risk for suicide than the general/employed population, and this appeared to be driven by the association for those working in merchant seafaring/maritime occupations. The findings are discussed in relation to an identified need for the development, implementation, and evaluation of tailored workplace suicide prevention strategies for transport industry workers.
Topics: Male; Humans; Suicide, Attempted; Suicidal Ideation; Suicide
PubMed: 36153776
DOI: 10.5271/sjweh.4059 -
The International Journal of... Mar 2022Suicide is a global health crisis. However, no objective biomarkers of suicide risk currently exist, and self-reported data can be unreliable, which limits prediction,... (Review)
Review
BACKGROUND
Suicide is a global health crisis. However, no objective biomarkers of suicide risk currently exist, and self-reported data can be unreliable, which limits prediction, diagnostic, and treatment efforts. Reliable biomarkers that can differentiate between diagnostic subgroups, predict worsening symptoms, or suggest novel therapeutic targets would be extremely valuable for patients, researchers, and clinicians.
METHODS
MEDLINE was searched for reports published between 2016 and 2021 using search terms (suicid*) AND (biomarker*) OR (indicat*). Reports that compared biomarkers between suicidal ideation, suicide attempt, death from suicide, or any suicide subgroup against other neuropsychiatric disorders were included. Studies exclusively comparing suicidal behavior or death from suicide with healthy controls were not included to ensure that biomarkers were specific to suicide and not other psychopathology.
RESULTS
This review summarizes the last 5 years of research into suicide-associated biomarkers and provides a comprehensive guide for promising and novel biomarkers that encompass varying presentations of suicidal ideation, suicide attempt, and death by suicide. The serotonergic system, inflammation, hypothalamic-pituitary-adrenal axis, lipids, and endocannabinoids emerged as the most promising diagnostic, predictive, and therapeutic indicators.
CONCLUSIONS
The utility of diagnostic and predictive biomarkers is evident, particularly for suicide prevention. While larger-scale studies and further in-depth research are required, the last 5 years of research has uncovered essential biomarkers that could ultimately improve predictive strategies, aid diagnostics, and help develop future therapeutic targets.
Topics: Biomarkers; Humans; Hypothalamo-Hypophyseal System; Pituitary-Adrenal System; Risk Factors; Suicidal Ideation; Suicide, Attempted
PubMed: 34865007
DOI: 10.1093/ijnp/pyab083 -
Journal of Affective Disorders Oct 2023The affective, cognitive, and behavioral aspects of impulsivity involved in suicide-related outcomes can be investigated through the UPPS model, which conceptualizes... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
The affective, cognitive, and behavioral aspects of impulsivity involved in suicide-related outcomes can be investigated through the UPPS model, which conceptualizes these facets in multidimensional terms related to negative and positive urgency, lack of premeditation and perseverance, and sensation seeking. This systematic review and meta-analysis provided a comprehensive understanding of the role of all facets of impulsivity in the development of suicidal ideation and behaviors.
METHODS
We conducted a systematic search on six databases (PsycINFO, PsycARTICLES, PubMed, MEDLINE, Scopus, and Web of Science) until May 5,2023. Overall, 49 studies met the criteria for systematic review, of which 37 were included in a meta-analysis of data from 17.898 individuals. Additional moderation analyses included age, gender, sample status, country of study conduct, assessment instruments, type of suicide-related outcome, study quality, and research design.
RESULTS
We found significant relationships between aspects of impulsivity and suicide-related outcomes. Specially, affective facets related to impulsivity showed a stronger association with suicidal ideations and attempts than cognitive and behavioral dimensions, recommending the main involvement of emotional aspects-positive and negative-in suicide-related dimensions.
LIMITATIONS
The limited number of studies may have negatively impacted the power of moderation analyses. In addition, for most dimensions of impulsivity, the limited number of longitudinal studies did not allow to test the moderating role of research design.
CONCLUSIONS
This study supports the role of impulsivity in suicidal ideation and behavior, identifying the affective component of impulsivity as the most involved, providing a significant contribution from a clinical and diagnostic point of view.
Topics: Humans; Suicide; Impulsive Behavior; Suicidal Ideation; Longitudinal Studies
PubMed: 37459976
DOI: 10.1016/j.jad.2023.07.086 -
PloS One 2022Refugees, and other forcibly displaced people, face mental distress and may be disproportionately affected by risk factors for suicide. Little is known about suicidal...
BACKGROUND
Refugees, and other forcibly displaced people, face mental distress and may be disproportionately affected by risk factors for suicide. Little is known about suicidal behaviour in these highly mobile populations because collecting timely, relevant, and reliable data is challenging.
METHODS AND FINDINGS
A systematic review was performed to identify studies of any design reporting on suicide, suicide attempts, or suicidal ideation among populations of displaced people. A sensitive electronic database search was performed in August 2020, and all retrieved studies were screened for relevance by two authors. Studies were categorised by the population being evaluated: refugees granted asylum, refugees living in temporary camps, asylum seekers, or internally displaced people. We distinguished between whether the sampling procedure in the studies was likely to be representative, or the sample examined a specific non-representative subgroup of displaced people (such as those already diagnosed with mental illness). Data on the rates of suicide or the prevalence of suicide attempts or suicidal ideation were extracted by one reviewer and verified by a second reviewer from each study and converted to common metrics. After screening 4347 articles, 87 reports of 77 unique studies were included. Of these, 53 were studies in representative samples, and 24 were based on samples of specific target populations. Most studies were conducted in high-income countries, and the most studied population subgroup was refugees granted asylum. There was substantial heterogeneity across data sources and measurement instruments utilised. Sample sizes of displaced people ranged from 33 to 196,941 in studies using general samples. Suicide rates varied considerably, from 4 to 290 per 100,000 person-years across studies. Only 8 studies were identified that compared suicide rates with the host population. The prevalence of suicide attempts ranged from 0.14% to 15.1% across all studies and varied according to the prevalence period evaluated. Suicidal ideation prevalence varied from 0.17% to 70.6% across studies. Among refugees granted asylum, there was evidence of a lower risk of suicide compared with the host population in 4 of 5 studies. In contrast, in asylum seekers there was evidence of a higher suicide risk in 2 of 3 studies, and of a higher risk of suicidal ideation among refugees living in camps in 2 of 3 studies compared to host populations.
CONCLUSION
While multiple studies overall have been published in the literature on this topic, the evidence base is still sparse for refugees in camps, asylum seekers, and internally displaced people. Less than half of the included studies reported on suicide or suicide attempt outcomes, with most reporting on suicidal ideation. International research networks could usefully define criteria, definitions, and study designs to help standardise and facilitate more research in this important area.
REGISTRATION
PROSPERO CRD42019137242.
Topics: Humans; Mental Disorders; Prevalence; Refugees; Suicidal Ideation; Suicide, Attempted
PubMed: 35271568
DOI: 10.1371/journal.pone.0263797 -
Tijdschrift Voor Psychiatrie 2022
Topics: Adolescent; Humans; Suicidal Ideation; Suicide; Suicide, Attempted
PubMed: 35506970
DOI: No ID Found -
Clinical Psychology Review Apr 2022Suicidality in autistic youth is a major public health issue. This study aimed to determine global prevalence of, and risk/protective factors for suicidality in autistic... (Meta-Analysis)
Meta-Analysis Review
Suicidality in autistic youth is a major public health issue. This study aimed to determine global prevalence of, and risk/protective factors for suicidality in autistic youth via systematic review and meta-analysis. We systematically searched Embase, PubMed, PsycINFO, Web of Science, and the Cochrane library for studies from inception to November 22nd, 2021. We selected empirical studies reporting on suicide outcomes (i.e., ideation, behaviors, attempts and deaths) in autistic youth (≤25 years). Random effects models were used to estimate the pooled prevalence of suicide outcomes with 95% confidence interval (CI). Heterogeneity was investigated with potential moderators using meta-regression analyses. The final selection included 47 papers, 29 of which were included in meta-analyses and 37 were narratively synthesized (sociodemographic, psychiatric, psychological, other factors, and interventions). The pooled prevalence of suicidal ideation was 25.2% (95% CI 18.2-33.8; i.e., one in four), suicide attempts 8.3% (3.6-18.2), and suicide deaths 0.2% (0.05-0.52). Estimates in self-reports were higher than in parent-reports. Age was a significant but inconsistent moderator on suicide outcomes, but substantial heterogeneity remained. Adverse childhood experiences were strong risk factors for suicidality, while resilience was protective. Participatory suicide risk-assessment, early intervention, and resilience promotion should be primary clinical/research goals.
Topics: Adolescent; Autistic Disorder; Humans; Prevalence; Suicidal Ideation; Suicide; Suicide, Attempted
PubMed: 35290800
DOI: 10.1016/j.cpr.2022.102144