Comparison of the factors for suicidal ideation and suicide attempt: a comprehensive examination of stress, view of life, mental health, and alcohol use

Development and external validation of a logistic and a penalized logistic model using machine-learning techniques to predict suicide attempts: A multicenter prospective cohort study in Korea

Despite previous efforts to build statistical models for predicting the risk of suicidal behavior using machine-learning analysis, a high-accuracy model can lead to overfitting. Furthermore, internal validation cannot completely address this problem. In this study, we created models for predicting the occurrence of suicide attempts among Koreans at high risk of suicide, and we verified these models in an independent cohort. We performed logistic and penalized regression for suicide attempts within 6 months among suicidal ideators and attempters in The Korean Cohort for the Model Predicting a Suicide and Suicide-related Behavior (K-COMPASS). We then validated the models in a test cohort. Our findings indicated that several factors significantly predicted suicide attempts in the models, including young age, suicidal ideation, previous suicidal attempts, anxiety, alcohol abuse, stress, and impulsivity. The area under the curve and positive predictive values were 0.941 and 0.484 after variable selection and 0.751 and 0.084 in the test cohort. The corresponding values for the penalized regression model were 0.943 and 0.524 in the original training cohort and 0.794 and 0.115 in the test cohort. The prediction model constructed through a prospective cohort study of the suicide high-risk group showed satisfactory accuracy even in the test cohort. The accuracy with penalized regression was greater than that with the "classical" logistic model.

Association between Alcohol Use Disorder and Suicidal Ideation Using Propensity Score Matching in Chungcheongnam-do, South Korea

Objectives: This study aimed to analyze the association between alcohol use disorder (AUD) and suicidal ideation (SI) in the general Korean population. Methods: The 2022 Mental Health Awareness Survey was collected from the Chungcheongnam-do Mental Health Welfare Center (CHMHC). Before Propensity Score Matching (PSM), 823 participants were included in this study. After 1:4 PSM, the 255 participants were analyzed using the chi-square test and matched conditional logistic regression. Results: The AUD group had higher odds of experiencing SI than the non-AUD (adjusted odds ratio [AOR]: 2.40, 95% confidence intervals [CI]: 1.10-5.22). Stratified matched conditional logistic regression showed that, among the female, <40 years and single group, the AUD group was more likely to experience SI compared with the non-AUD, respectively (AOR:3.53, 95% CI: 1.20-10.44/AOR:3.45, 95% CI: 1.03-11.55/AOR:4.83, 95% CI: 1.18-19.69). However, among the male, ≥40 years and married group, we discovered no association between AUD and SI. Conclusions: Through this study, we found a strong association between the AUD group and SI. This association was particularly strong among female, <40 years, and single groups. This study elucidates the relationship between AUD and SI in the Chungnam region, which had not been previously identified in Korea, and it is expected to serve as foundational data for reducing the high suicide rate in this region. However, due to the limitation of being a cross-sectional study, future longitudinal research is required.

Mixed method examination of alcohol and suicidality among actively suicidal adults who engage in heavy episodic drinking

Suicide is a serious public health problem in the United States. Alcohol use has been substantially documented as a risk factors for suicide, yet it is unclear how alcohol is associated with suicidal ideation (SI) and behavior (SIB) at the event level. We examined the association between alcohol use and SI using a mixed methods approach that included daily assessments from 13 adults who engage in heavy episodic drinking with current SI and qualitative interviews among 12 of those adults. Participants were recruited on social media. Separate mixed effects logistic regression models indicated that individuals' alcohol use on a given day was associated with SI (OR = 1.37), and suicidal urges (OR = 1.41). Adjusting for repeated measures, the expected marginal mean for intensity of SI (EMM = 3.33) and urges (EMM = 2.94) were higher on days with reported drinking behavior than days without reported drinking (EMM = 2.68 and EMM = 2.62 respectively). Qualitative data indicated that the association between alcohol use and SIB is more complex than a single directionality. Instead, the association can be unidirectional, bidirectional, and/or dependent on factors including mental health and amount of alcohol consumed. Overall, these findings emphasize a need for integrated alcohol and SIB interventions while providing insight on possible daily, just-in-time adaptations.

Stress and suicide risk among adolescents: the role of problematic internet use, gaming disorder and emotional regulation

BACKGROUND

Previous studies have associated videogame playing and social media use with suicidal behaviors together with lower stress coping or poor emotion regulation strategies. Due to the inconclusive evidence regarding the factors associated with suicidal behavior, the present study aimed to overcome the limitations of previous research and explored the relationship between adolescent stress, problematic internet use (PIU), gaming disorder (GD), and emotional regulation (ER) in a cross-section design. It was hypothesized that stress would have a direct effect on suicide risk (SR) as well as being mediated by PIU, GD, and ER.

METHODS

The participants comprised 430 adolescents (58.4% male) aged between 16 and 19 years. They completed an online survey including the Mobile-Related Experiences Questionnaire, Internet Gaming Disorder Scale-Short Form, Meta-Mood Trait Repair Scale, and Spanish version of the Suicidal Behaviors Questionnaire.

RESULTS

A total of 34.2% of the adolescents (N = 147) were at risk for SR. Results also indicated that 30,7% had experienced suicidal ideation at some point in their life, 12.1% had at least one plan to die by suicide, and 5.1% had attempted suicide. Results of path analysis confirmed that stress appeared to be a risk factor for suicide, but that its effects were not mediated by PIU. However, ER and GD mediated the effect of stress on SR. The results suggest that stress is a main risk factor for suicide, especially among adolescents with poor emotional regulation or problematic gaming.

CONCLUSIONS

Considering the prevalence of suicide among adolescents, the results of the present study suggest that suicide prevention programs should include emotional regulation strategies, stress coping, and videogaming management skills in the early stages of high school. Providing these protective resources to adolescents will help them face the stressful and changing situations typical of adolescence and will help them to attain greater well-being and satisfaction with life.

Epidemiology of suicide and suicide attempts in Jahrom district, Southern Iran in light of COVID pandemic: A prospective observational study

Background and Aims

Suicide is a global public health issue. The covid-19 epidemic has led to disturbance in daily life and economic activity. It is assumed that increased stress and anxiety cause suicide. This study aimed to describe the causes and methods of committing suicide during the COVID pandemic.

Methods

This descriptive study was conducted on all outpatients, inpatients, and those who died during the period from March 21, 2021 to March 20, 2022 due to suicide attempts, referred to hospitals and clinics affiliated with Jahrom University of Medical Sciences or were identified by the social emergency and welfare organization.

Results

A total of 330 suicide attempters with an average age of 26.74 ± 0.64 years were studied. They were 220 women (66.67%), 159 single (48.18%), and 309 (73.64%) people who had diplomas and high school degrees. In general, the three main reasons for committing suicide were emotional issues and problems with 169 people (51.21%), family violence with 127 people (38.48%), and economic issues and problems with 90 people (27.27%). In terms of suicide manners, 283 people (85.76%) used medicine (or pharmaceuticals), 16 people (4.85%) used agricultural pesticides, and 11 people (3.33%) used rodenticides. Furthermore, 164 people (49.70%) suffered from depression, 94 people (28.49%) were children of divorce, 60 people (18.18%) were drug users, 151 people (45.76%) had a history of alcohol consumption, and 116 people (35.15%) had a history of committing suicide. A total of 6 cases of complete suicide (leading to death) have occurred.

Conclusion

The most important factors for suicide throughout the covid-19 epidemic were emotional issues, marital incompatibility, and economic issues. Medicine poisoning was the most important method of committing suicide. In times of crisis, a multisectoral public health approach is needed to prevent increased anxiety, stress, and subsequent suicide attempts.

The impact of the COVID-19 pandemic on suicides: A population study

This study examines the factors associated with the change in the number of suicides per month during the COVID-19 pandemic from 2019 to 2021. For economic indicators, employment and unemployment rates, Consumer Price Index, and Consumer Sentiment Index were used. As inverse indicators of social distancing, the numbers of overseas departures, domestic trips, and movie audience were used. The monthly numbers of inpatients and outpatients for depression were included to consider the effect of the prevalence of depression. Pearson's correlation coefficient analysis and a linear regression were conducted. There was a continued decrease in the number of suicides of 1.7% in 2021 from 2020 following the 4.4% decrease in the previous year. The employment rate was positively associated with the number of suicides for males, while the consumer price index was negatively associated with the number of suicides for females. While the inverse social distancing measures were positively correlated with the number of suicides, no significant association was observed in the regression analysis. Commonly shared thoughts that the pandemic would lead to an increase in suicides by its direct negative impact on mental health or indirect impact through the aggravation of economic conditions and social distancing need to be re-examined.

Predictive Model of Suicide Risk in Young People: The Mediating Role of Alcohol Consumption

Suicidal behavior is one of the public health problems that cause most deaths in young people and has been associated with emotional and affective problems, so predictive models are required to account for the relationship between depression, anxiety, hopelessness, and alcohol consumption to propose actions for its prevention. The Plutchik Suicide Risk Scale, the CAGE Questionnaire, the Hopelessness Scale, the Depression Inventory and the Beck Anxiety Scale were applied. A total of 1.379 young people (M = 20.45; SD = 3.23) from the cities of Manizales (n = 739; 53.6%) and Medellín (n = 640; 46.5%) in Colombia were evaluated. The variables of anxiety, hopelessness and depression explained 51% (R² = 0.509; 95% CI = 0.467-0.552; p = 0.001) of the variation in suicidal risk. Likewise, alcohol consumption is a mediating variable between depression and anxiety in the prediction of suicidal risk, whose total, direct and indirect effects are statistically significant. The findings support the role of alcohol consumption as a mediating variable between anxiety, depression, hopelessness and suicidal risk in young people, given the difficulties it causes in information processing, regulation of emotions and therefore in having an adequate coping with the demands of the environment. This justifies the importance of directing suicide prevention actions through strategies for the reduction of alcohol consumption and the management of emotions in young people. HIGHLIGHTSAlcohol modulates the effect of depression and anxiety on suicide riskThis is a study on the risk of suicide in young people in ColombiaThe findings have implications for timely clinical interventions.

Incidence and risk factors for suicidal ideation in a sample of Chinese patients with mixed cancer types

PURPOSE

Suicidal ideation (SI) is often overlooked as a risk factor for people with cancer. Because it is often a precursor for suicidal behavior, it is critical to identify and address SI in a timely manner. This study investigated SI incidence and risk factors in a cohort of Chinese patients with mixed cancer types.

METHODS

Data from this cross-sectional study were collected from 588 patients receiving medical therapy for tumors at Nanfang Hospital and the Integrated Hospital of Traditional Chinese Medicine at Southern Medical University. SI was measured using the Self-rating Idea of Suicide Scale (SIOSS). Anxiety and depression were assessed using the Hospital Anxiety and Depression Scale (HADS). The Chinese version of the Demoralization Scale II (DS-II-C) was used to assess demoralization. Univariate and correlation analyses were used to identify correlative factors of SI and multiple stepwise linear regression analysis was used to characterize potential risk factors.

RESULTS

SI was reported in 24.7% of participants and the SIOSS score was 14.00 (13.00, 15.00) in the SI group. Multiple linear regression results showed that demoralization, medical financial burden, cancer type, living condition, caretaker, working state, residence, gender, and marital status explained 32.1% of the SI in this cohort (F = 28.705, P < 0.001).

CONCLUSION

Approximately one-quarter of cancer patients in this study reported SI influenced by both external and internal factors. Characterizing these factors can be informative for prevention and treatment efforts.

Longitudinal Effects of Stressful Life Events on Problematic Smartphone Use and the Mediating Roles of Mental Health Problems in Chinese Undergraduate Students

Background and Aims: This three-wave longitudinal study investigated the effects of stressful life events on problematic smartphone use and the mediating roles of mental health problems (i.e., depressive symptoms, poor sleep quality, and suicidal ideation) in Chinese undergraduate students. Methods: A total of 197 undergraduate students completed the three-wave surveys. Their severity of stressful life events, mental health problems, and problematic smartphone use were assessed. Results: Regression analyses revealed that stressful life events at T1 was significantly associated with problematic smartphone use at T3. Mediation analyses showed that mental health problems (i.e., depressive symptoms, poor sleep quality, and suicidal ideation) at T2 fully mediated the association between stressful life events at T1 and problematic smartphone use at T3 (B = 0.042, 0.034, and 0.022, respectively). Conclusions: The present study revealed that stressful life events and mental health problems (i.e., depressive symptoms, poor sleep quality, and suicidal ideation) are predictors of problematic smartphone use in Chinese college students.