Effect of hopelessness on the links between psychiatric symptoms and suicidality in a vulnerable population at risk of suicide

Clinical predictors of suicidal ideation, suicide attempts and suicide death in depressive disorder: a systematic review and meta-analysis

Patients with depressive disorders are especially prone to suicide risk. Among the clinical predictors of suicidality, those specifically related to depressive disorders have not been accurately detailed. Our aim was to conduct a systematic review and meta-analysis of studies reporting longitudinal predictors of suicidal ideation, suicide attempts and suicide death within depression, including diagnostic subtypes, symptoms, clinical course, and assessment scales. A systematic search of the literature between 2001 and 2022 identified 4422 references, among which 19 studies providing 45 different predictors of suicidality met the inclusion criteria. Random effects meta-analyses were performed for 22 predictors, three for suicidal ideation, eleven for suicide attempts and eight for suicide death. Heterogeneity and publication bias were inspected through I2 tests and Egger's tests respectively. Meta-analysis results showed that severity of hopelessness predicted suicidal ideation and suicide attempts. History of suicide attempts, suicidal ideation, severe depression, and psychotic symptoms predicted subsequent suicide attempts and suicide death. Time to full remission and sleep disturbances were also found as relevant predictors of future suicide behaviours. This review specifies which predictors of suicidality within the clinical features of depression will help clinicians and policy makers to better prevent suicide risk in patients with depressive disorders. Further longitudinal studies are needed to reliably assess the predictive ability of our results and to analyse other possible clinical predictors to prevent suicidality, especially with regard to suicidal ideation.

The relationships between anxiety and suicidal ideation and between depression and suicidal ideation among Chinese college students: A network analysis

Background

Suicide is a worldwide public health problem. Evidence from previous studies has confirmed the relationship among anxiety, depression and suicidal ideation. However, the complex psychopathological pathways between anxiety and suicidal ideation and between depression and suicidal ideation require further study.

Methods

A total of 505 college students from Shanghai during COVID-19 pandemic were investigated in an online study. Anxiety, depression and suicidal ideation of the participants were investigated. R software was used to construct the anxiety-suicidal ideation and depression-suicidal ideation networks and to evaluate the bridge expected influences.

Results

The anxiety-suicidal ideation network had 28 cross-community edges, the strongest one was A7 "Afraid something will happen"-S7 "Unable to solve personal problem"; A5 "Restlessness" and S3 "Hopelessness and suicide thoughts" had the highest bridge expected influences. The depression-suicidal ideation network had 36 cross-community edges, and the strongest one was D9 "Thoughts of death"-S5 "Unable to accomplish something important"; D9 "Thoughts of death" and S3 "Hopelessness and suicide thoughts" had the highest bridge expected influences.

Conclusion

Intricate psychopathological pathways exist between anxiety and suicidal ideation and between depression and suicidal ideation. "Restlessness", "Thoughts of death" and "Hopelessness and suicide thoughts" are considered targets for suicidal ideation interventions. The present study enriches the theory of symptoms and mental disorders and provides a reliable reference for the intervention practice of suicidal ideation.

How to Cope with Perfectionism? Perfectionism as a Risk Factor for Suicidality and the Role of Cognitive Coping in Adolescents

Suicide among adolescents is a significant health concern. Gaining more knowledge about markers that contribute to or protect against suicide is crucial. Perfectionism is found to be a personality trait that is strongly predictive for suicidality; it can be divided into personal standards perfectionism (PS) and concerns about mistakes and doubts perfectionism (CMD). This study investigated the association between PS, CMD, and suicidality in a sample of 273 Dutch secondary school students aged between 12 and 15 years old (M = 13.54, SD = 0.58, 55.8% males). We also examined whether adaptive, or maladaptive cognitive coping strategies influenced these associations. We hypothesized that students high in PS or CMD would experience an increased suicidality. Moreover, we expected that adaptive coping strategies would act as buffer between the association of perfectionism and suicidality, and that maladaptive coping strategies would strengthen this association. For analyses, we used a regression model with latent variables. The results showed that higher scores in perfectionism (PS and CMD) were related to an increase in suicidality. High levels of maladaptive coping in combination with high levels of perfectionism were associated with an increase in suicidality. Although adaptive coping was related to a decrease in suicidality, adaptive coping in interaction with PS and with CMD was not a predictor of suicidality. The results are relevant for prevention, and intervention programs. This paper makes recommendations for clinical practice and further research in order to prevent suicidality in adolescents.

Childhood maltreatment and suicide attempts in prisoners: a systematic meta-analytic review

In the past decade, the links between core types of childhood maltreatment and suicidal acts have become an increasingly important area of investigation. However, no meta-analytic review has examined this relationship in prisoners. We undertook the first systematic meta-analytic review examining the link between childhood maltreatment and suicide attempts in prisoners to redress this important gap. We searched Medline, PsychINFO, Embase, Web of Science and CINAHL from inception until August 2019. Meta-analyses using random effect models were applied, and heterogeneity was quantified using the I2 statistic. Publication bias and risk of bias across studies were assessed. We identified 24 studies comprising 16 586 prisoners. The rates of different types of childhood maltreatment ranged between 29% and 68% [95% confidence interval (CI) 18-81%]. The rate of suicide attempts in prisoners was 23% (95% CI 18-27%). Main results demonstrated that sexual abuse [odds ratio (OR) 2.68, 95% CI 1.86-3.86], physical abuse (OR 2.16, 95% CI 1.60-2.91), emotional abuse (OR 2.70, 95% CI 1.92-3.79), emotional neglect (OR 2.29, 95% CI 1.69-3.10), physical neglect (OR 1.57, 95% CI 1.27-1.94) and combined abuse (OR 3.09, 95% CI 2.14-4.45) were strongly associated with suicide attempts in prisoners. There was an indication of publication bias. Duval and Tweedie's trim-and-fill method was applied, which increased the odds for suicide attempts. Given the high rates of prison suicide deaths and suicide attempts, our findings suggest an urgent need for targeted suicide prevention priorities for prisoners, with a particular focus on ameliorating the effects of childhood traumatic experiences on suicidal prisoners.

Risk for suicide nursing diagnosis and its related risk factors, in psychiatric settings: A descriptive study

AIM

To assess the frequency of risk for suicide nursing diagnosis and its related risk factors, in the nursing care provided in psychiatric settings.

DESIGN

This is a descriptive study.

METHODS

The samples were the documented nursing reports. These reports were evaluated and analysed in terms of using the NANDA-I risk for suicide nursing diagnosis and the risk factors related to this diagnosis.

RESULTS

From the 1,440 reports that were reviewed, 10 nursing diagnoses and 478 risk factors, were identified. Based on the results of this study, risk for suicide is used at a very low level in psychiatric settings, while, considerable number of suicide's risk factors are still existing in these settings.

The Role of Hopelessness in the Health of Low-Class Rural Chinese Residents

It is well known that health inequality has been happening between rural and urban Chinese populations, however, the health differences among rural Chinese residents remain unclear. This study aims to assess the physical and mental health of rural Chinese residents in different social classes, and then to examine the mediating role of hopelessness between social class and health-related quality of life (HRQOL). A stratified multi-stage sampling was used to recruit 2003 rural residents responding to the 12-item Short Form Health Survey (SF-12). The results showed that lower-class rural Chinese residents reported lower physical and mental health as well as a higher level of hopelessness. Furthermore, hopelessness could fully mediate the association between social class and physical and mental health. These findings will generate significant implications for identifying those at particular risk for lower quality of life and designing social work intervention programs in rural China's context.

The relation of childhood trauma to suicide ideation in patients suffering from obsessive-compulsive disorder with lifetime suicide attempts

The aim of this study was to evaluate the relations of childhood trauma (CT) and obsessive-compulsive (OC) symptom dimensions to suicide ideation in patients with obsessive-compulsive disorder (OCD). Seventy OCD outpatients with lifetime suicide attempts and 60 controls were included. Participants completed the Scale for Suicide Ideation (SSI), the Childhood Trauma Questionnaire-Short Form (CTQ-SF), the Yale-Brown Obsessive Compulsive Scale (Y-BOCS), the Dimensional Obsessive-Compulsive Scale (DOCS) and the Depression Anxiety Stress Scales (DASS-21). Among OCD patients, 97.1% had current suicide ideation. OCD patients revealed higher scores on CT, suicide ideation, depression and anxiety than controls. The CT history of sexual abuse (SA) and OC symptom dimension of unacceptable thoughts explained suicide ideation. It was concluded that SA and unacceptable thoughts may contribute to high suicidality and have important implications for the assessment and treatment of suicide risk in OCD patients with lifetime suicide attempts.

A short-term longitudinal examination of the relations between depression, anhedonia, and self-injurious thoughts and behaviors in adults with a history of self-injury

BACKGROUND

Limited research has addressed the role of anhedonia in predicting suicidality and/or nonsuicidal self-injury (NSSI) in adults, despite evidence suggesting that loss of interest or pleasure may increase vulnerability for self-inflicted harm, even beyond other depressive symptoms.

METHODS

In the current study, we explored the role of symptoms of depression and recent changes in anhedonia in predicting suicidality, NSSI ideation, and perceptions of NSSI helpfulness among individuals with a history of NSSI or suicide attempts (N=187).

RESULTS

We found that changes in anhedonia partially mediated the effect of depression on suicidality, and fully mediated the effect of depression on perceptions of NSSI helpfulness. Anhedonia did not predict NSSI ideation above and beyond depression symptoms, and did not significantly predict NSSI frequency when accounting for suicidality. Compared to individuals with a history of NSSI only or suicide attempt only, people with a history of both NSSI and suicide attempt evidenced greater risk and symptomatology.

CONCLUSIONS

Results confirm the relation between anhedonia and suicidality evidenced in past research, but suggest a complex relationship between anhedonia, depression, and facets of non-suicidal self-injury.

Association between FKBP5 and CRHR1 genes with suicidal behavior: A systematic review

Suicide is one of the leading causes of death around the world with approximately one million suicides per year. An increasing number of neurobiological studies implicate HPA system dysfunction in suicide behavior, stimulating genetic research to focus on genes related to this system. This systematic review was focused on searching a correlation between FKBP5 and CRHR1 genes with suicidal behavior. Therefore, an electronic search strategy, using PubMed, EBSCO and Cochrane Library databases, was conducted from the inception of the studies into the databases to July 2016. The inclusion criteria were: use of at least one analysis investigating the relation between either the genetic variants in FKBP5 and/or CRHR1 genes with suicidal behavior. 2) use of a case-control design; 3) investigation about suicidal behavior in the form of suicide completion or history of at least one suicide attempt, as defined by each individual study; 4) inclusion of samples comprising control subjects; and 6) inclusion of reports written only in English language. The PRISMA guidelines were followed and the search strategy ensured that all possible studies were identified to compile the review. Using the keyword combinations, the search strategy provided 3334 articles, of which only 15 case-control studies were included in this systematic review. The included studies comprised 2526 subjects with suicidal behavior. A quantitative synthesis of results from the included studies was not undertaken due to marked methodological heterogeneity. This review showed a significant genetic association in most studies in FKBP5 and CRHR1 genes with a high rate of attempted suicide, pointing out that the expression of these genes and its polymorphisms could be a key predictor of suicide risk. In conclusion, this systematic review supports an association between suicidal behavior and genetic variants in FKBP5 and CRHR1 genes.