Is suicidality a mental disorder? Applying DSM-5 guidelines for new diagnoses

The efficacy of using psychotherapy treatments for obsessive-compulsive disorder on minimizing suicidal thoughts and behaviours: A scoping review

BACKGROUND

Suicidal thoughts and behaviours (STBs) are significant public health challenges that affect a variety of individuals and communities. Despite numerous efforts to discover and refine psychotherapy treatments to minimize STBs, the efficacy of STB treatments remains unclear.

OBJECTIVE

Conduct a scoping review to assess the efficacy of using psychotherapy treatments to minimize STBs among individuals with obsessive-compulsive disorder (OCD).

METHOD

A scoping review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews guidelines (PRISMA-ScR) to screen 163 studies published between 2010 and 2021.

RESULTS

A total of seven articles that fulfil the eligibility criteria reported that psychotherapy treatments for obsessive-compulsive disorder were found to be effective and applicable approaches to minimize the severity of the OCD symptoms and STBs, despite variance in studies' target samples, types of interventions, periods and indicators.

CONCLUSION

The current review has provided evidence showing the significant effects of psychotherapy treatments on various health-related aspects of life for individuals diagnosed with obsessive-compulsive disorder, and it is recommended to use them for enhancing treatment outcomes and minimizing STBs.

IMPLICATION FOR PRACTICE

This scoping review verifies the formalization and incorporation of psychotherapy treatments for OCD to minimize STBs into standard practice and highlights the importance of mental health professionals being part of the implementation of these treatments.

Distinguishing Prevention from Treatment in Suicide Prevention. Comment on Turner et al. The Paradox of Suicide Prevention. Int. J. Environ. Res. Public Health 2022, 19, 14983

In "The Paradox of Suicide Prevention", Turner and colleagues made an important contribution: they applied Rose's prevention paradox to suicide prevention efforts in healthcare systems. However, in doing so, they conflated prevention and treatment and did not distinguish suicide from suicidality. Their views may confuse efforts to design and implement clinical pathways for preventing suicide.

Genetic differences between suicide deaths and deaths of undetermined intent

INTRODUCTION

Few, if any, prior studies have considered whether undetermined intent (UDI) deaths and suicide deaths differ with respect to genetic liability for suicidal behavior or psychopathology.

METHODS

The authors used Swedish national registry data to identify suicide deaths (N = 31,835) and UDI deaths (N = 10,623); sociodemographic covariates; and registrations for psychopathology. Family genetic risk scores (FGRS) were derived for each form of psychopathology. The authors used LASSO models to assess genetic and phenotypic differences across outcomes.

RESULTS

In the multivariate LASSO regressions, higher FGRS for major depression, bipolar disorder, and suicide death were associated with lower odds of UDI relative to unambiguous suicide (OR = 0.91-0.95), while those for alcohol and drug use disorders, ADHD, and criminal behavior were associated with higher odds of UDI relative to unambiguous suicide (OR = 1.04-1.12). When the corresponding phenotypic registration status for these outcomes was included in a subsequent model, the associations were attenuated and of small magnitude, but many remained different from OR = 1.

CONCLUSIONS

Aggregate genetic differences between unambiguous suicide decedents and UDI deaths are small, particularly when accounting for psychiatric comorbidity, but in some cases, statistically significant. These findings suggest that different analytic treatment of UDI deaths may be warranted depending on the research question. Replication in other samples, and using molecular genetic data, is necessary.

Differentiating genuine from feigned suicidality in corrections: A necessary but perilous task

Feigning suicidality is common among patients in correctional settings, but there has been little discussion on the differences between genuine and feigned presentations of suicidality. Differentiating suicidality from feigned suicidality is among the riskiest diagnostic challenges. Still, some headway can be made if we compare features of genuine suicidality with those of feigned presentations. To this end, I first describe a typical profile of suicidality. Next, I contrast it with the features that correctional patients who feign suicidality display in California's prison health care system. I also outline the dangers involved in identifying feigned suicidality, and I offer some ways in which to understand feigned suicidality in corrections.