Dr Amir Mohammadamini The effect of exercise on suicidal behaviors: A systematic review and meta-analysis of randomized controlled trials

Association between suicidal ideation and oxidative balance score (OBS): National Health and Nutrition Examination Survey (NHANES) 2005-2018

BACKGROUND

The oxidative balance score (OBS) serves as an indicator of systemic oxidative stress status, where a higher OBS indicates significant exposure to antioxidants through dietary and lifestyle choices. Studies exploring the relationship between OBS and suicidal ideation are limited. Therefore, this study aimed to examine the association between OBS and suicidal ideation.

METHODS

This cross-sectional study selected 28,598 individuals aged ≥20 years from the 2005-2018 National Health and Nutrition Examination Survey dataset. The OBS was determined using 16 dietary components and 4 lifestyle components. Item 9 of the Patient Health Questionnaire-9 was used to evaluate suicidal ideation. The association between suicidal ideation and OBS, dietary OBS, and lifestyle OBS was examined using weighted logistic regression and restricted cubic spline. The subgroup analyses and interaction tests were further conducted to assess the robustness of these associations across different populations.

RESULTS

The prevalence of suicidal ideation was 3.35 %. OBS, dietary OBS, and lifestyle OBS were substantially and inversely linked with suicidal ideation in Models 1, 2, and 3 (p < 0.05). The odds ratio for the highest quartile (Q4) of these variables and suicidal ideation in Model 3 was 0.44 [95 % confidence interval (CI): 0.30-0.65], 0.54 (95 % CI: 0.37-0.78), and 0.50 (95 % CI, 0.34-0.74), respectively, compared with the lowest quartile (Q1). The subgroup analyses revealed consistent connections between the three oxidative stress indices and suicidal ideation. The lifestyle OBS was negatively correlated with suicidal ideation, especially in women (p for interaction < 0.05).

CONCLUSIONS

The dietary and lifestyle OBSs may influence suicidal ideation by modulating oxidative balance. An antioxidant diet and lifestyle are crucial in mitigating suicidal ideation. These findings suggest a potential sex-specific suicide ideation risk, which significantly correlates with suicidal ideation in women but not in men.

Network analysis of depressive and anxiety symptoms with well-being in students during the COVID-19 pandemic: a repeated cross-sectional study

The university student population is particularly vulnerable to depression, which was identified during the COVID-19 pandemic. Understanding how depressive symptoms are interrelated with mental and physical health in students is essential. The aim of this study was to reveal the network of depressive and anxiety symptoms with respect to well-being (life satisfaction, physical health, physical activity, and perceived stress) during a difficult situation-the COVID-19 pandemic-at two measurement points of different pandemic severities. A repeated cross-sectional study was conducted in June 2020 (T1) (lower pandemic severity) and March 2021 (T2) (higher pandemic severity) among 592 and 1230 Czech university students, respectively. The measurements used were the PHQ-9, GAD-7, PSS-10, SWLS, self-rated physical health (SRH), and sociodemographic survey. The network analysis approach was utilized. For the significance of differences, the χ2 test, Student's t test, and ANOVA were performed. The results revealed that scale-level depression, stress, and worse SRH increased over time, whereas life satisfaction decreased. Scale-level anxiety and physical activity were stable over time. PHQ2 Sad mood was the most central and influential node at T1 and T2. PHQ9 Suicidal Ideation was closely related to other variables at T1, whereas PHQ1 Anhedonia was closely related to other variables at T2. The most influential risk factors were the PHQ-2 score and the GAD-2 score, which are associated with uncontrollable worrying, whereas life satisfaction, physical health, and physical activity were the most protective factors. It is crucial to recognize and decrease the PHQ2 score and increase life satisfaction to improve the mental health of university students.

Participation, barriers, facilitators and bullying experiences of trans people in sport and fitness: findings from a national community survey of trans people in Australia

OBJECTIVES

This study aimed to assess participation rates of transgender and gender diverse (trans) people in sport/fitness activities, compare mental health outcomes for trans people participating in sport/fitness with those who do not and explore internal/external barriers and bullying experiences faced by trans people in sport/fitness contexts.

METHODS

A cross-sectional online survey open to trans people aged ≥16 years living in Australia was conducted between February and April 2023 and it assessed rates of sport/fitness participation, barriers to participation and bullying experiences through multiple-choice questions. Mental health measures comprised the Kessler Psychological Distress Scale (K10) and self-reported history of self-harm and suicidality. Covariate-adjusted binary logistic regression models tested associations between interpersonal factors, sport/fitness variables and mental health outcomes.

RESULTS

Of 664 respondents (median age 32 years), around one-third (32.8%) regularly participated in sport/fitness. Common internal barriers to participation included anxiety about others' reactions (63.9%), body dissatisfaction/dysphoria (56.5%) and fears about feeling accepted/affirmed by others (54.7%). Respondents commonly reported experiencing inadequate bathroom/changing facilities (44.4%), exclusionary rules and regulations surrounding gender (36.7%), and invasive or uncomfortable policies or procedures (23.3%). Over one-third (34.4%) of trans people had experienced gender-based bullying or exclusion. Regular sport/fitness participation was associated with significantly lower K10 scores (mean difference=-4.4, 95% CI-5.8, -2.9, p<0.001) and a 40% reduction in odds of recent thoughts of self-harm and suicide (aOR 0.6, 95% CI 0.5, 0.9, p=0.01; aOR 0.6, 95%CI 0.4, 0.9, p=0.02).

CONCLUSION

Trans people face significant barriers to sport/fitness despite experiencing significant mental health and personal benefits from participation. Affirming and including trans people in sport and fitness should be a key priority for sport and fitness federations, organisations and policy-makers.

Pediatric suicide: Review of a preventable tragedy

Concepts of suicide are explored in this issue with a focus on suicide in children and adolescents. The epidemiology of pediatric suicide in the United States is reviewed; also, risk and protective factors, as well as prevention strategies, are discussed. Suicide in the pediatric athlete and the potential protective effect of exercise are examined. In addition, this analysis addresses the beneficial role of psychological management as well as current research on pharmacologic treatment and brain stimulation procedures as part of comprehensive pediatric suicide prevention. Though death by suicide in pediatric persons has been and remains a tragic phenomenon, there is much that clinicians, other healthcare professionals, and society itself can accomplish in the prevention of pediatric suicide as well as the management of suicidality in our children and adolescents.

Constructing prediction models and analyzing factors in suicidal ideation using machine learning, focusing on the older population

Suicide among the older population is a significant public health concern in South Korea. As the older individuals have long considered suicide before committing suicide trials, it is important to analyze the suicidal ideation that precedes the suicide attempt for intervention. In this study, six machine learning algorithms were employed to construct a predictive model for suicidal thinking and identify key variables. A traditional logistic regression analysis was supplementarily conducted to test the robustness of the results of machine learning. All analyses were conducted using a hierarchical approach to compare the model fit of each model in both machine learning and logistic regression. Three models were established for analysis. In Model 1, socioeconomic, residential, and health behavioral factors were incorporated. Model 2 expanded upon Model 1 by integrating physical health status, and Model 3 further incorporated mental health conditions. The results indicated that the gradient boosting algorithm outperformed the other machine learning techniques. Furthermore, the household income quintile was the most important feature in Model 1, followed by subjective health status, oral health, and exercise ability in Model 2, and anxiety and depression in Model 3. These results correspond to those of the hierarchical logistic regression. Notably, economic and residential vulnerabilities are significant factors in the mental health of the older population with higher instances of suicidal thoughts. This hierarchical approach could reveal the potential target population for suicide interventions.

Can sports participation be a protective factor against suicide-related outcomes in adolescents: a systematic review

Background

Suicide-related outcomes among adolescents have become a serious public health problem worldwide. Emerging evidence suggests that sports participation may interact with suicide-related outcomes. The objective of this systematic review is to systematically review and summarize the association between sports participation and suicide-related outcomes among adolescents.

Design

A systematic review according to PRISMA Statement (International Platform of Registered Systematic Review and Meta-Analysis Protocols registration: INPLASY202330072) https://inplasy.com/inplasy-2023-3-0072/.

Methods

The literature search was conducted in three electronic databases: Web of Science, PubMed, and EBSCOhost.

Results

A total of 16 studies (12 cross-sectional studies, 4 prospective studies) met the inclusion criteria were evaluated. Strong consistent evidence was found for the negative association between suicidal ideation, suicide attempts, and sports participation among adolescents. There was insufficient evidence to support consistency in the association between sports participation and suicide plans, and no evidence regarding gender differences between sports participation and these suicide-related outcomes. Furthermore, there was heterogeneity in the measures of sports participation and suicide-related outcomes across the included studies.

Conclusion

Evidence suggests that more sports participations are associated with lower suicidal ideation and suicide attempts in adolescents. However, the directionality of the observed associations should be examined based on more high-quality longitudinal studies in the future.

How to optimize the systematic review process using AI tools

Systematic reviews are a cornerstone for synthesizing the available evidence on a given topic. They simultaneously allow for gaps in the literature to be identified and provide direction for future research. However, due to the ever-increasing volume and complexity of the available literature, traditional methods for conducting systematic reviews are less efficient and more time-consuming. Numerous artificial intelligence (AI) tools are being released with the potential to optimize efficiency in academic writing and assist with various stages of the systematic review process including developing and refining search strategies, screening titles and abstracts for inclusion or exclusion criteria, extracting essential data from studies and summarizing findings. Therefore, in this article we provide an overview of the currently available tools and how they can be incorporated into the systematic review process to improve efficiency and quality of research synthesis. We emphasize that authors must report all AI tools that have been used at each stage to ensure replicability as part of reporting in methods.

One-year efficacy of a lifestyle behavioural intervention on physical and mental health in people with severe mental disorders: results from a randomized controlled trial

This multicentric randomized controlled trial (RCT), carried out in six Italian University mental health sites, aims to test the efficacy of a six-month psychosocial intervention (LYFESTYLE) on Body Mass Index (BMI), body weight, waist circumference, fasting glucose, triglycerides, cholesterol, Framingham and HOmeostasis Model Assessment of insulin resistance (HOMA-IR) indexes in patients with schizophrenia, bipolar disorder, and major depression. Moreover, the efficacy of the intervention has also been tested on several other physical and mental health domains. Patients were randomly allocated to receive the six-month experimental intervention (LIFESTYLE) or a behavioural control intervention. All enrolled patients were assessed at baseline and after one year. We recruited 401 patients (206 in the experimental and 195 in the control group) with a diagnosis of schizophrenia or other psychotic disorder (29.9%), bipolar disorder (43.3%), or major depression (26.9%). At one year, patients receiving the experimental intervention reported an improvement in body mass index, body weight, waist circumference, HOMA-IR index, anxiety and depressive symptoms and in quality of life. Our findings confirm the efficacy of the LIFESTYLE intervention in improving physical and mental health-related outcomes in patients with severe mental illnesses after one year.

Lifestyle modification for mental health and well-being

Background

Unhealthy life-style leads to mental ill-health and poor quality of life and is the major determinant of a wide range of lifestyle disorders. The aim was to 1) review the work relating to life style modification for promoting mental health and 2) Present recommendations on life-style modification for mental health and wellbeing.

Material and Methods

The work on life style changes for promotion of mental health was retrieved from the scientific literature and critically reviewed.

Conclusions

Recommendations on 'Life-style modification for mental health and wellbeing' are presented. 20 specific components of healthy life style included are: Routine, time management, prayer, basic activities, reading newspaper, study/work, exercise, recreation/ relaxation/ talent promotion, education, cognitive activities, social networking, guidelines for behavior, peer group, social group, marriage/family, life skills, physical health, health education, mobile use, and digital media. The lifestyle modification package is comprehensive and geared to promote mental health and well-being.

Physical activity, suicidal ideation, suicide attempt and death among individuals with mental or other medical disorders: A systematic review of observational studies

A growing body of research has demonstrated the potential role for physical activity as an intervention across mental and other medical disorders. However, the association between physical activity and suicidal ideation, attempts, and deaths has not been systematically appraised in clinical samples. We conducted a PRISMA 2020-compliant systematic review searching MEDLINE, EMBASE, and PsycINFO for observational studies investigating the influence of physical activity on suicidal behavior up to December 6, 2023. Of 116 eligible full-text studies, seven (n = 141691) were included. Depression was the most frequently studied mental condition (43%, k = 3), followed by chronic pain as the most common other medical condition (29%, k = 2). Two case-control studies examined suicide attempts and found an association between physical activity and a reduced frequency of such attempts. However, in studies examining suicidal ideation (k = 3) or suicide deaths (k = 2), no consistent associations with physical activity were observed. Overall, our systematic review found that physical activity may be linked to a lower frequency of suicide attempts in non-prospective studies involving individuals with mental disorders.

Influence of pulmonary rehabilitation on symptoms of anxiety and depression in interstitial lung disease: A systematic review of randomized controlled trials

BACKGROUND

Interstitial lung diseases (ILDs) cause fibrosis of lung parenchyma, leading to impaired quality of life, dyspnea, and functional decline. Individuals with ILD experience a high prevalence of anxiety and depression. Recent research has demonstrated pulmonary rehabilitation (PR) alleviates symptoms of anxiety and depression in those with COPD.

RESEARCH QUESTION

What is the influence of PR on symptoms of anxiety and depression in individuals with ILD?

STUDY DESIGN

We conducted a PRISMA-2020-compliant systematic review of randomized controlled trials (RCTs) investigating PR's effect on anxiety and depression in patients with ILD. We searched MEDLINE, EMBASE, Cochrane, and PsycINFO from inception until April 3, 2023. A narrative synthesis was conducted where a quantitative approach was not feasible.

RESULTS

Five RCTs (n = 281) were included. Idiopathic pulmonary fibrosis (IPF) was the most common type of ILD (k = 3). One study reported clinically-significant improvements in symptoms of anxiety among patients with IPF, and two studies for symptoms of depression among patients with sarcoidosis. Dropout rates were similar between intervention and control groups. All studies were at a high risk of bias.

INTERPRETATION

Pulmonary rehabilitation is not detrimental to anxiety or depression for patients with ILD, and may improve symptoms of anxiety in IPF and depression in sarcoidosis. However, no conclusion can be drawn from available evidence, which is limited by heterogeneous populations/interventions, sample sizes and unexpectedly low prevalences of clinically-significant anxiety or depression. Further adequately powered RCTs that focus on anxiety and depressive symptoms as primary outcomes are needed.