Suicidal ideation, psychiatric disorder, and medical illness in a community epidemiological study

Protective behavioral strategies as a protective factor against suicidal ideation among college student drinkers

Objective: Research shows that alcohol use is linked to suicidal ideation (SI), while depression is strongly associated with SI. Protective behavioral strategies (PBS) are safe drinking strategies. PBS are broadly protective across alcohol-related problems; however, it is unclear if these effects extend to those at risk for SI. We hypothesized that alcohol use and depressive symptoms would be risk factors for SI, and that these factors would moderate the effects of PBS. PBS was hypothesized to be protective for individuals with elevated depressive symptoms and alcohol use. Participants: College student drinkers (n = 990; M age = 19.97, SD = 3.75) from a Southeastern University. Methods: Participants completed an online survey inquiring about demographics, depressive symptoms, SI, alcohol use, and PBS use. Results: Depressive symptoms were associated with an increased likelihood of SI; however, alcohol use was not. PBS were most protective for individuals with high levels of alcohol use and/or depressive symptoms. Conclusions: PBS may be protective for heavier drinkers who are at heightened risk for SI.

The Mediating Roles of Affect Lability and Experiential Avoidance Between Distress Tolerance and Suicidal Ideation Among College Students

Objective: Suicidal ideation (SI) is highly prevalent among college students. Research has shown that college students are also more likely to experience low distress tolerance, affect lability, and experiential avoidance, which have been linked to SI. There is a critical need to examine the mechanisms that increase the risk of SI among college students. It is hypothesized that distress tolerance will be a strong predictor of SI, and affect lability as well as experiential avoidance will mediate this relationship. Participants and Methods: Participants (n = 820) from a Southeastern University completed an online survey, inquiring about demographic information, affect lability, SI, experiential avoidance, and distress tolerance. Data were analyzed utilizing structural equation modeling. Results: Distress tolerance was not directly related to SI. However, affect lability and experiential avoidance were found to mediate this relationship. Conclusions: Affect lability and experiential avoidance may be important predictors of SI among college students.

Correlates for the severity of suicidal risk in participants with common mental disorders with comorbid chronic medical conditions in rural primary healthcare settings in India

Context

Suicide is on the rise in low- and middle-income countries (LMICs), including India. There are limited studies assessing factors linked to the severity of suicidal risk in patients with depression and comorbid chronic medical disorders in primary healthcare (PHC) settings.

Aim

This study examines factors linked to suicidal risk among participants in a cluster randomized controlled trial of collaborative care intervention (Healthier Options through Empowerment (HOPE Study)).

Settings and Design

The setting was at 49 PHC in the rural Ramanagara District of Karnataka State in southern India. Study eligibility criteria included being ≥30 years with at least mild depression or generalized anxiety disorder and at least one medical condition (cardiovascular disorder or type 2 diabetes mellitus).

Methods and Material

The severity of suicidal risk at baseline was assessed using the Mini International Neuropsychiatric Interview (MINI), and other measures included the severity of depression (Patient Health Questionnaire-9-items (PHQ-9)), the severity of anxiety (Generalized Anxiety Disorder Scale-7-items (GAD-7)), disability, social support, quality of life, number of comorbid chronic medical illnesses, and body mass index (BMI).

Statistical Analysis Used

Chi-square tests and independent-samples t-tests were used to compare the demographic and clinical characteristics of the no-low and mod-high suicidal risk groups. Logistic regression analysis was used to identify correlates associated with the mod-high suicidal risk group.

Results

Mod-high suicidal risk was significantly positively associated with the severity of depression and disability and significantly negatively associated with social support.

Conclusion

The severity of depression, higher disability scores, and lower social support were found to be independent correlates of mod-high suicidal risk. Screening, managing depression, and facilitating social support for patients with chronic medical illness in PHC settings may reduce suicidal risk.

Assessing Prevalence and Unique Risk Factors of Suicidal Ideation among First-Year University Students in China Using a Unique Multidimensional University Personality Inventor

BACKGROUND

University students with suicidal ideation are at high risk of suicide, which constitutes a significant social and public health problem in China. However, little is known about the prevalence and associated risk factors of suicidal ideation among first-year university students in China, especially during the COVID-19 pandemic.

OBJECTIVES

To investigate the prevalence of suicidal ideation and its factors in first-year Chinese university students from a vocational college in Zhejiang during the COVID-19 pandemic.

METHODS

Using a cluster sampling technique, a university-wide survey was conducted of 686 first-year university students from Hangzhou in March 2020 using University Personality Inventory (UPI). UPI includes an assessment for suicidal ideation and possible risk factors. Suicidal ideation prevalence was calculated for males and females. Univariate analysis and multivariable logistic regression models were conducted, adjusting for age and sex. Analyses were carried out using the SPSS version 22.0 software.

RESULTS

The prevalence of 12-month suicidal ideation among first-year university students during March 2020 was 5.2%, and there was no significant difference between males and females (4.8% vs. 6.0%, x2 = 0.28, p = 0.597). Multivariable logistic regression analysis identified social avoidance (B = 0.78, OR = 2.17, p < 0.001) and emotional vulnerability (B = 0.71, OR = 2.02, p < 0.001) as positively associated with suicidal ideation.

CONCLUSIONS

Social avoidance and emotional vulnerabilities are unique factors associated with greater suicidal ideation among first-year university students during the COVID-19 pandemic. UPI serves as a validated tool to screen suicide risks among Chinese university students. Encouraging social engagement and improving emotional regulation skills are promising targets to reduce suicidal ideation among first-year university students.

Depression and suicidal ideation among dental students of Southern Saudi Arabia: A cross sectional study

PURPOSE

To assess depression and suicidal ideation among dental students at King Khalid University College of Dentistry, Abha, Saudi Arabia.

METHODS

A cross-sectional questionnaire-based study was carried out among dental students between January and March 2020. The Arabic version of the Patient Health Questionnaire (PHQ-9) was used to assess depression, while suicidal ideation was assessed using three questions related to suicidal behaviors drawn from the literature.

RESULTS

A total of 218 participants completed the questionnaires. More than 40% of the participants experienced depression while the prevalence of suicidal ideation was 48.2%; around a third of the sample had suicidal ideation, and half of which made a suicidal attempt in the preceding year (p < 0.05). There was a lack of association between depression severity and suicidal ideation.

CONCLUSION

A large proportion of dental students experienced depression and suicidal ideation. These findings invite in depth analysis of the causative and contributing factors for such high rates as well as ways for addressing them.

Emotional Demand and Mental Health in Korean Employees

Background: Emotional demand (ED) at work is related to mental health in the general workforce, not just emotional workers. We investigated the relationships between ED and mental health outcomes, including distress, depressive symptoms (DS), experience of depression (DE), and suicidal ideation (SI) on the entire general workforce using nationally representative data. Methods: 5787 full-time employees were analyzed using cross-sectional design with the fourth Korean National Health and Nutrition Examination Survey (K-NHANES IV). Work-related psychosocial factors and mental health status were measured through face-to-face interviews. Multi-stage and stratified survey designs were considered in the analysis, and the mental health effects of ED were analyzed using multivariable logistic analysis. The Cochran–Armitage trend test was conducted to investigate increases in the relationship between the severity of ED and mental health outcomes. Results: The subjects comprised 3089 men and 2698 women. ED was reported by 36.7% of men and 39.3% of women. The estimated prevalence of distress was 27.5% in men and 34.6% in women. Adjusted odds ratios (ORs) of ED for distress were 2.62 (95% confidence interval (CI) = 2.10–3.28) for men and 2.57 (95% CI = 1.92–3.45) for women. DS was significantly related to ED (men: OR = 1.72, 95% CI = 1.18–2.50; women: OR = 1.91, 95% CI = 1.33–2.74). ED was also significant psychosocial risk factor for DE (men: OR = 1.88, 95% CI = 1.07–3.29; women: OR = 1.77, 95% CI = 1.15–2.75) and SI (men: OR = 1.64, 95% CI = 1.11–2.41; women: OR = 2.31, 95% CI = 1.63–3.28). Conclusions: ED was a risk factor for distress, DS, DE, and SI in the general workforce. Legal and social safety networks should be constructed for workers whose emotions may be hidden at work, as well as workers in emotion-related fields.

Prevalence and factors associated with suicidal ideation amongst college students in the Nelson Mandela Bay Municipality, South Africa

Background

Suicidal behaviour amongst college students constitutes a significant social and public health problem globally. This study determined the prevalence and associated factors of suicidal ideation amongst students of higher education in the Nelson Mandela Bay Municipality (NMBM), South Africa.

Methods

In this institution-based cross-sectional study, a multistage cluster sampling of 826 participants, drawn from a college in NMBM, was conducted from January to March 2020. Data were collected with a standardised self-administered questionnaire. Multivariable logistic regression analysis was used to identify the factors associated with suicidal ideation.

Results

Participants’ ages ranged from 18 to 24 years, with a mean age of 20.49 years (standard deviation, 1.88 years). The lifetime prevalence of suicidal ideation and plans in the preceding 12 months were 24.5% and 9.6%, respectively. The odds of suicidal ideation were higher in students who experienced bullying (adjusted odds ratio [AOR], 1.89; 95% confidence interval [CI], 1.35–2.65), mental illness (AOR, 1.89; 95% CI, 1.35–2.65), a history of sexual assault (AOR, 2.50; 95% CI, 1.20–5.21) and experience of sexual assault by or to a close family member (AOR, 1.69; 95% CI, 1.01–2.82). Underlying chronic illness was associated with a twofold risk for suicidal ideation in both sexes.

Conclusion

About a quarter of the students sampled at the college had experienced suicidal ideation and some had had suicidal plans in the preceding 12 months. Screening for the identified risk factors amongst the student population coupled with prompt interventions would mitigate the risk of suicide in the study population.

Prevalence and correlates of suicidality in Andalusia (Spain): Results of the epidemiological study PISMA-ep

BACKGROUND

Suicidality is an important public health problem. Hence, the aims of this study are to report prevalence rates and correlates of suicidality in Andalusia (Southern Spain).

METHODS

This is a cross-sectional household survey conducted on a representative sample of adults living in Andalusia. 4507 subjects were interviewed using the Mini International Neuropsychiatric Interview (MINI) to assess suicidality and standardized instruments were employed to evaluate associated variables. A multivariate logistic regression analysis was used to explore independent associations with suicidality.

RESULTS

Current prevalence of suicidality was 6.4%, 4.4% showed death wish, 1.4% had ideas of self-harm, 2.4% had suicidal thoughts, 1.1% had a suicidal plan, 0.6% had attempted suicide during the month prior to the interview, and, lastly, 2.6% reported to have had any sort of suicide attempt during his/her previous life. Independent factors associated with suicidality were being female, older age, not having a stable couple, lower levels of social support, having had physical childhood abuse experience, having experienced an increasing number of stressful life events, higher neuroticism scores, having a family history of mental disorder and nicotine or drugs dependence.

LIMITATIONS

The instrument employed to measure suicidality is a screening tool rather than a more in-depth diagnostic measure. We have not included all potential correlates of suicidality. This is a cross-sectional study which cannot establish causal relationships between exposures and outcomes.

CONCLUSIONS

This is the first epidemiological study in Andalusia on suicidality offering important results of clinical interest for suicide prevention.

Fatigue and Suicidal Ideation in People With Multiple Sclerosis: The Role of Social Support

Fatigue and poor sleep quality are among the most common patient-reported problems associated with multiple sclerosis (MS). Social support, on the other hand, is often found to be positively associated with quality of life in patients with neurological diseases. Studies also show that suicidal ideation (SI) levels in MS are elevated compared to the general population. Thus, the aim of this study is to assess the associations between fatigue, social support, and SI in patients with MS. Out of 184 MS patients asked to participate in this cross-sectional study, 156 agreed (RR 69.8%; 75% female; mean age: 39.95 ± 9.97 years). Patients filled-in the Multidimensional Fatigue Inventory-20, the Pittsburgh Sleep Quality Index, the Multidimensional Scale of Perceived Social Support and the subscale of the General Health Questionnaire-28 focused on assessing SI. Models were controlled for age, gender, disease duration, functional disability, and sleep quality. Data were analyzed using multiple linear regressions. SI was positively associated with lower sleep quality and four types of fatigue: general, mental, reduced activity, and reduced motivation (p < 0.05). Physical fatigue was not significantly associated with SI. Social support was negatively associated with SI in all models. The final models under study explained from 24.3 to 29.7% of the total variance in SI. SI yielded associations with both sleep quality and fatigue, with the exception of physical fatigue. Information provided by physicians on sleep management, and a psychosocial intervention focused on people who provide support for patients with MS (family, friends, and significant others) may reduce levels of SI.

Suicidal ideation in patients with obstructive sleep apnoea and its relationship with disease severity, sleep-related problems and social support

We aimed to assess the prevalence of suicidal ideation and to examine the relationships between obstructive sleep apnoea severity, sleep-related problems, social support and suicidal ideation in obstructive sleep apnoea patients. We included 149 patients (68% male; mean age, 48.99 ± 9.57 years) with diagnosed obstructive sleep apnoea (Apnoea–Hypopnoea Index ⩾5) based on full-night polysomnography. The prevalence of suicidal ideation among obstructive sleep apnoea patients was 20.1 per cent. Structural equation modelling showed that suicidal ideation in obstructive sleep apnoea was strongly related to poor sleep quality and high fatigue levels. No relationship between social support and suicidal ideation in obstructive sleep apnoea patients was found.

Suicidal Behaviour Among Adolescents and Young Adults with Self-Reported Chronic Illness

OBJECTIVE

The aims of this study were to estimate the: (1) 12-mo prevalence of suicidal thoughts, plans, and attempts in a population sample of adolescents and young adults with and without chronic illness; (2) associations among chronic illness and suicidal thoughts and behaviour (STB); and, (3) moderating roles of mood and substance use disorder on this association.

METHOD

Individuals were aged 15 to 30 y ( n = 5,248) from the Canadian Community Health Survey-Mental Health. Twelve-month STB and psychiatric disorder were measured using the World Health Organization Composite International Diagnostic Interview 3.0. Multinomial logistic regression examined associations between chronic illness and STB, adjusting for relevant sociodemographic and health characteristics. Product term interactions among chronic illness, mood, and substance use disorders were included in the regression models to examine potential moderating effects.

RESULTS

Prevalence of suicidal thoughts, plans, and attempts was higher in individuals with chronic illness ( P < 0.01 for all). After adjustment, chronic illness increased the odds for suicidal thoughts [OR = 1.28 (1.01 to 1.64)], plans [OR = 2.34 (1.22 to 4.39)], and attempts [OR = 4.63 (1.52 to 14.34)]. In the presence v. absence of a mood disorder, the odds for suicidal thoughts were higher among individuals with chronic illness [OR = 1.89 (1.06 to 5.28)].

CONCLUSIONS

Suicidal thoughts and behaviours are common among adolescents and young adults with chronic illness, particularly among those with comorbid mood disorders. Health professionals should routinely ask about STB during assessments of their adolescent and young adult patients.

Gender differences and psychological factors associated with suicidal ideation among youth in Malaysia

Suicide is a global phenomenon that has been showing an upward trend in recent years. It is the second leading cause of death among youth. Studies on suicidal ideation warrant greater attention, as it leads to suicide attempts and other health risk behaviors. Thus, the objective of this study was to compare gender differences in suicidal ideation and determine the predictors of suicidal ideation among youth. This cross-sectional study was carried out among 232 youths aged between 15 and 25 years from selected urban areas in Malaysia. The results showed that suicidal ideation was higher among male participants compared with female participants. Age was the predictor of suicidal ideation for males, while depression and loss of motivation, as components of hopelessness, were the predictors of suicidal ideation among females. Hence, it is important that professionals conduct early identification tests for suicidality among young people. This will facilitate the early detection of depression and hopelessness, which is important, in order to prevent suicidal behaviors or other problems before these occur.

Intra-personal and extra-personal predictors of suicide attempts of South Korean adolescents

The purpose of this study was to explore significant variables predicting adolescent suicidal attempts. Socio-environmental variables such as gender, school record, school grade, school adaptation, and family intimacy together with intra-individual variables including depression, anxiety, delinquency, stress, and self-esteem were considered as candidates. Data from 1481 adolescents were collected from Korea National Youth Policy Institute. For statistical analyses, hierarchical logistic regression analysis was performed. Results of hierarchical logistic regression analysis showed that gender, school grade, depression, delinquent, stress, and family intimacy were significant predictors of suicidal attempts of adolescents. Among those, the most powerful predictor was depression, and the second was delinquency. Classification accuracy by the model of our study was 87.6%. Implications and limitations of present study and suggestions for future study were discussed.

Is cognitive impairment associated with suicidality? A population-based study

Suicide is one of the main causes of mortality in young people and in individuals with depression. The impact of impaired cognitive function on suicidal ideation is largely unknown. The aim of this study was to examine how cognitive functioning may influence suicidal thoughts, both in the general population and in a subgroup of individuals with depression. A total of 4583 participants (aged 18 years and older) were interviewed in a cross-sectional study of a representative sample of the non-institutionalized Spanish population. Cognitive functioning was evaluated using five cognitive tests. Participants were also asked to provide information about mental health symptoms and conditions through an adaptation of the Composite International Diagnostic Interview (CIDI 3.0). Logistic regression analysis was performed overall and by age group. Lifetime prevalence of suicidal ideation was 3.7%, whereas prevalence of suicidal ideation in the previous 12 months was 0.9%. Depression was the strongest risk factor for suicidal ideation. Compared with people without suicidal ideation, people with suicidal ideas performed significantly worse on cognitive functioning after adjusting for age, years of education, gender, and the presence of depression. In the age-subgroup analyses, only the youngest group (18-49 years) showed a significant association between cognitive functioning and suicidal ideation. Worse cognitive functioning was also associated with more frequent suicidal ideas in those individuals with depression even when depression severity was taken into account. In conclusion, both cognitive functioning and diagnosis of depression are associated with higher risk of suicide in the Spanish general population, especially in young individuals.

Factors associated with suicidal ideation and attempts in Spain for different age groups. Prevalence before and after the onset of the economic crisis

BACKGROUND

Little is known about whether the prevalence of suicidal ideation and attempts has changed in the wake of the economic crisis. The aim of this study was to estimate current prevalence of suicidal ideation and attempts in the general population in Spain, to compare it with the prevalence found before the economic crisis, and to analyse the factors associated with suicidality in different age groups.

METHODS

A total of 4583 non-institutionalised adults were interviewed in a cross-sectional household survey of a nationally representative sample in Spain. Several modules of an adapted version of the Composite International Diagnostic Interview were administered to the participants, and logistic regression models were employed in each age group.

RESULTS

Lifetime prevalence of suicidal ideation and attempts in Spain were respectively, 3.67% and 1.46%. Mental disorders presented the highest significant effects on lifetime suicidal ideation. Marital status, heavy alcohol consumption, and occupational status were associated with lifetime suicidal ideation in people aged 18-49, whereas loneliness was associated with the 50-64 group, and financial problems with the 65+ group. A younger age, poor health status and the presence of depression were all associated with lifetime suicide attempts.

LIMITATIONS

The cross-sectional design of the study represents a methodological limitation.

CONCLUSIONS

The current prevalence of suicidal ideation and attempts in Spain is similar to the one found ten years ago, before the recent economic crisis. The factors associated with suicidality vary among age groups. Suicide prevention programmes should focus on early detection and prevention for depression and anxiety disorders.

Racial differences in suicidal ideation among school going adolescents

BACKGROUND

Young adults are at increased risk for suicidal behavior and there is growing concern about racial differences in suicidal ideation, especially in the younger population.

AIM

The aim of this study is to assess suicidal ideation in school going tribal and nontribal adolescents and to study its relationships with psychological well-being, depression, and anxiety.

MATERIALS AND METHODS

A total of 259 students of Classes X, XI, and XII of three Schools of Ranchi, who fulfilled inclusion and exclusion criteria, were screened for suicidal ideation by Suicidal Ideation Questionnaire (SIQ) and psychological well-being by General Health Questionnaire-12 (GHQ-12). The level of anxiety and depression was assessed by Hospital Anxiety Depression Scale (HADS).

RESULTS

Overall 33.2% of the adolescents had suicidal ideation out of which 34.2% were tribal-students and 32.8% nontribal-students with no significant intergroup difference. Psychological discomfort (GHQ-12 Score ≥3) was noticed in 59.1% of adolescents, but no racial difference was found. However, the mean HADS depression score was significantly higher in tribal adolescents, more so in tribal boys than nontribal adolescents or boys, respectively. There was a significant positive correlation of SIQ total score in all the adolescents with GHQ-12 total score, HADS total score, HADS anxiety score, and HADS depression score.

CONCLUSION

There were no racial differences in suicidal ideation and psychological discomfort among tribal and nontribal adolescents. Tribal adolescents, and more specifically tribal boys, had more depression than their nontribal counterparts. Suicidal ideation was positively correlated with psychological discomfort, anxiety, and depression.

Urban-rural influences on suicidality: gaps in the existing literature and recommendations for future research

Suicide is a major public health issue of particular concern among rural populations, which experience a consistently higher suicide rate than urban areas. Although extensive research efforts have been directed towards understanding suicidality and related factors, there is a continued lack of clinically useful factors to target preventive measures, particularly among some regional and demographic groups. This suggests limitations in the conceptualisation of this important construct. A review of the literature was undertaken, using a snowballing and saturation approach. Literature was considered relevant if it addressed the research question 'what are the current limitations in research on urban/rural influences on suicidality?' Findings were used to develop a set of guidelines to inform future research. A number of gaps in existing research relevant to limitations in rural suicide research were identified: inconsistencies in terminology; a focus on high-end suicidal behaviours; a disproportionate focus on urban populations; a dominance of cross-sectional research; and a high use of clinical samples. These limitations are discussed in terms of their implications for rural suicidality, and are used to support the development of recommendations for future research, with a focus on encouraging consistency and standardisation. A number of limitations can be identified in existing research on suicide. Targeting these specific areas can be an important step in addressing the current gaps in knowledge relating to rural suicide prevention.

Social support and suicide in Japanese men and women - the Japan Public Health Center (JPHC)-based prospective study

Although the important role of social support in mental health is acknowledged, no prospective study has yet examined the relation of social support to suicide. Here, we investigated the association between social support and suicide in a cohort of Japanese men and women. A total of 26,672 men and 29,865 women aged 40-69 years enrolled in the Japan Public Health Center-based prospective study in 1993-1994 completed a self-administered questionnaire which included four items of social support, and were followed for death through December 2005. Hazard ratios (HRs) and 95% confidence intervals (95% CI) of suicidal death by social support index were estimated using a Cox proportional hazards regression model. A total of 180 suicidal deaths were recorded during an average of 12 years' follow-up. Men and women with the highest level of social support had a significantly decreased risk of suicide, with HRs (95% CI) for the highest versus lowest social support group of 0.56 (0.33-0.94) and 0.38 (0.16-0.89) in men and women, respectively. Esteem support and having four or more friends were associated with a lower risk of suicide in women [0.32 (0.13-0.77)] and in both sexes [men: 0.56 (0.36-0.88); women: 0.65 (0.32-1.30)], respectively, whereas confident support was not. These findings suggest that social support may be important for suicide prevention. Avoiding social isolation may decrease the incidence of suicide in men and women, and esteem support can provide additional benefit for women.

Type-D personality and depersonalization are associated with suicidal ideation in the German general population aged 35-74: results from the Gutenberg Heart Study

BACKGROUND

Suicidal ideation (SID) is a major risk factor for suicide attempts. Mental disorders are among the strongest correlates of suicide, with depression and anxiety disorders playing a major role. The present study aims to investigate the contribution of under researched factors contributing to SID such as depersonalization, Type-D personality and cardiovascular risk factors.

METHODS

Factors associated with SID were investigated in a sample of N=5000 participants (aged 35-74 years) of the community-based survey "Gutenberg Heart Study". The factors were assessed by self-report instruments, computer-assisted interviews and medical examination.

RESULTS

7.5% of the sample reported SID over the last 2 weeks. In the univariate analysis SID was significantly associated with female sex, living without a partner, low socioeconomic status, diagnosis of coronary heart disease, family history of myocardial infarction, smoking and mental distress. In the full adjusted model significant associations remained with age (in years) OR 1.02 (95%CI 1.01-1.04, p=0.002), self-reported depression OR 3.21 (95%CI 2.23-4.62, p<0.0001), panic disorder OR 1.56 (95%CI 1.03-2.36, p=0.036), depersonalization OR 2.45 (95%CI 1.78-3.38, p<0.0001), Type-D personality OR 1.98 (95%CI 1.49-2.63, p<0.0001) and impairment by mental distress OR 2.15 (95%CI 1.74-2.67, p<0.0001).

LIMITATIONS

Main limitations are the reliance on self-report measures of SID and of mental distress.

CONCLUSIONS

For the first time it has been shown that in the general population depersonalization and Type-D personality are uniquely associated with SID. These associations need further elucidation.

Suicide ideation among college students: a multivariate analysis

The goal of this study was to develop a multi-dimensional model that might explain suicide ideation among college students. Face-to-face interviews were conducted with 1,249 first-year college students. An estimated 6%(wt) of first-year students at this university had current suicide ideation. Depressive symptoms, low social support, affective dysregulation, and father-child conflict were each independently associated with suicide ideation. Only 40%(wt) of individuals with suicide ideation were classified as depressed according to standard criteria. In the group who reported low levels of depressive symptoms, low social support and affective dysregulation were important predictors of suicide ideation. Alcohol use disorder was also independently associated with suicide ideation, while parental conflict was not. Results highlight potential targets for early intervention among college students.

Suicidal Ideation

Background. Suicidal ideation is an important risk factor for suicide attempts and completions, and early identification of the likely presence of self-harm cognitions would benefit clients and clinicians alike. This study examined the clinical utility of the Kessler K10 psychological distress score as an indicator of suicidal ideation. Methods. Suicidal ideation was assessed on the basis of four relevant questions contained in the General Health Questionnaire (GHQ-28), and these were subsequently analyzed against the K10 scores. The data were collected using a monthly risk-factor surveillance system where each month a representative random sample of South Australians over the age of 16 years is interviewed. The cumulative data covered the period 2002 to 2007 (n = 12,884). Results. Psychological distress and suicidal ideation were reported by 9.9% and 5.1% of the participants, respectively. Univariate analysis demonstrated a positive linear relationship between the K10 score and suicidal ideation. Participants scoring in the very high range of the K10 were more likely to report suicidal ideation and this was experienced with greater frequency than by those who were less distressed. A logistic regression analysis revealed that even those in the moderate category were four times more likely to experience suicidal ideation than those in the low category, and those in the high and very high categories were 21 and 77 times more likely, respectively. Separate models based on sex and using odds-ratios based on very high vs. low K10 scores showed that males were 104 times more likely to report suicidal ideation compared to a 63 times higher rate for females. Both sexes had a 52% probability of experiencing suicidal ideation if they fell into the very high distress group. Conclusions. The K10 score is a clinically useful indicator of the presence of suicidal ideation.

Sex- and age-related increase in prevalence rates of death wishes and suicidal ideation in the community: results from the KORA-F3 Augsburg Study with 3,154 men and women, 35 to 84 years of age

Among risk factors for suicide, suicidal ideation (SID) is of paramount importance. This study sought to determine sex- and age-related SID point prevalence rates in the general population. A population-based survey of 3154 subjects, 35 to 84 years, conducted in 2004/05 in southern Germany, identified 170 subjects (5.4%; 95% CI 4.6-6.2) suffering from SID within the last 14 days. Age-adjusted short-term period prevalence in women (6.0%, 95% CI 4.9.-7.2) was higher than in men (4.0%, 95% CI 3.1-5.1). Among 10-year age groups, sex-related differences were only significant in middle-aged subjects (55-64 years). Prevalence increased significantly with age, leading to a prevalence of >10% in the oldest age group (75-84 years). The population-based approach demonstrates a substantial proportion of subjects suffering from SID, particularly in older age groups.

The impact of two universal randomized first- and second-grade classroom interventions on young adult suicide ideation and attempts

OBJECTIVE

This paper reports the impact of two first- and second-grade classroom based universal preventive interventions on the risk of Suicide Ideation (SI) and Suicide Attempts (SA) by young adulthood. The Good Behavior Game (GBG) was directed at socializing children for the student role and reducing aggressive, disruptive behavior. Mastery Learning (ML) was aimed at improving academic achievement. Both were implemented by the teacher.

METHODS

The design was epidemiologically based, with randomization at the school and classroom levels and balancing of children across classrooms. The trial involved a cohort of first-grade children in 19 schools and 41 classrooms with intervention at first and second grades. A replication was implemented with the next cohort of first grade children with the same teachers but with little mentoring or monitoring.

RESULTS

In the first cohort, there was consistent and robust GBG-associated reduction of risk for suicide ideation by age 19-21 years compared to youths in standard setting (control) classrooms regardless of any type of covariate adjustment. A GBG-associated reduced risk for suicide attempt was found, though in some covariate-adjusted models the effect was not statistically robust. No statistically significant impact on these outcomes was found for ML. The impact of the GBG on suicide ideation and attempts was greatly reduced in the replication trial involving the second cohort.

CONCLUSIONS

A universal preventive intervention directed at socializing children and classroom behavior management to reduce aggressive, disruptive behavior may delay or prevent onset of suicide ideation and attempts. The GBG must be implemented with precision and continuing support of teachers.

The prevalence of suicidal ideation in the general population: results from the Outcome of Depression International Network (ODIN) study

BACKGROUND

Suicidal ideation is believed to be part of a constellation of suicidal behaviours that culminates in suicide. There is little information on the cross-national prevalence of all suicidal ideation or of serious suicidal ideation in spite of its likely public health importance.

METHODS

A two-stage screening approach of over 12,000 adults from the general population were evaluated by face to face interview to identify those meeting ICD-10 criteria for depressive disorders at eight sites in five European countries. This study is a cross-sectional analysis of item 9 (suicidal ideation) of the Beck depression inventory from the total screened sample.

RESULTS

The standardised period prevalence for all suicidal ideation varied from 1.1 to 19.8% while for serious suicidal ideation there was much less variation. Examining the inter-relationships between all suicide ideation, serious suicide ideation, depressive disorders and suicide failed to support a seamless transition from suicide ideation through depression and serious ideation to suicide.

CONCLUSIONS

Strategies to prevent suicide should be tailored to take account of site specific differences in its aetiology and understanding the path from suicidal ideation through depression to suicide is crucial to this.

Fatores associados à ideação suicida na comunidade: um estudo de caso-controle

Este estudo tem como objetivo identificar variáveis associadas à ideação suicida ao longo dos últimos 12 meses, na cidade de Campinas, São Paulo, Brasil. Através de um estudo de caso-controle investigou-se fatores associados a ideação suicida mediante análise de variáveis independentes relacionadas ao indivíduo, à família e à saúde. Foram entrevistados 29 casos de ideação e 166 controles. Os casos foram identificados através de um inquérito de prevalência e os controles, selecionados aleatoriamente da mesma base populacional, entre os que não relataram pensamento suicida nos últimos 12 meses. Modelos de análise de regressão foram propostos para controlar a ação dos fatores de confusão ou modificadores de efeito. Nos resultados obtidos, as variáveis demográficas não estiveram associadas à ideação. Na análise final permaneceram com significância estatística as variáveis falta de energia e humor deprimido, derivadas do SRQ-20, dificuldades emocionais relatadas, vizinhança não solidária e menor freqüência à igreja. Ideação suicida mostrou-se consistentemente associada a fatores relacionados a sintomas depressivos, principalmente falta de energia e humor deprimido.

Self-reported gambling-related suicidality among gambling helpline callers

Problem gamblers often attribute suicidal ideation or attempts to their gambling. Logistic regression analyses were applied to data from problem gamblers (N = 986) calling a helpline. Problem gamblers reporting gambling-related suicidality (n = 252; 25.6%) were more likely than those denying it (n = 734; 74.4%) to acknowledge family, financial, legal, and mental and substance-related problems. Of problem gamblers acknowledging gambling-related suicidality, those reporting gambling-related suicide attempts (n = 53; 21.5%) were more likely than those denying them (n = 193; 78.5%) to acknowledge gambling-related illegal behaviors, mental health and substance abuse treatment, and family histories of alcohol problems, and were less likely to report prior gambling treatment. The findings suggest that increased gambling severity is associated with gambling-related suicidality.

Hopelessness and suicidal ideation among adolescents in two cultures

BACKGROUND

This study examines the cross-sectional and longitudinal associations among cognitive variables, depressive symptoms and suicidal ideation in Hong Kong Chinese and Caucasian American adolescents.

METHODS

Community adolescents (n = 2,044) ages 14-18 years from Hong Kong and the United States provided information regarding their suicidal ideation, depressive symptoms, and cognitions (self-efficacy, cognitive errors and hopelessness), at two surveys, six months apart.

RESULTS

Self-efficacy was a weak unique predictor of suicidal ideation in both cultures. Hopelessness was the strongest of cognitive variables in concurrent associations with suicidal ideation in bivariate and multivariate models, in both cultures, and in both boys and girls. Hopelessness continued to offer unique prediction when depressive symptoms were controlled, both concurrently and prospectively.

CONCLUSIONS

Our results support hopelessness theories of suicidal ideation and behavior in Hong Kong, and extend the cognitive theory of suicidality to a modernized Asian culture.

Do Patients Volunteer Their Life Weariness and Suicidal Ideations? A Sri Lankan Study

Summary: Objectives: Sri Lanka has a high suicide rate. The importance of suicidal ideations and their relationship to the common mental disorders (CMD) have not been adequately explored. This study examined whether patients harboring suicidal thoughts or life weariness would volunteer them. It also examined the relationship between life weariness, suicidal ideations, and the probability of underlying CMD. Method: A case control study was nested within a cross-sectional survey of attendees to the outpatients department in a general hospital. The index group consisted of patients presenting with multiple complaints and repeated visits, the control group was 100 patients randomly selected from a total of 5,767 between 16 and 65 years of age, not fulfilling criteria for the index group. Presence of underlying CMD was assessed by the General Health Questionnaire 30 (GHQ-30). The two groups were compared for symptoms volunteered, response to questions from GHQ-30 on suicidal ideations, and hopelessness. Results: Somatic symptoms were the most common in both groups. Eighty-one patients (81%) in the index group and 34 patients (34%) in the control group had probable CMD. No patient in either group volunteered suicidal ideation as a symptom. However, 59% of index patients and 26% of controls admitted life weariness, and 51/59 index patients and 15/26 controls who had life weariness also had underlying CMD as defined by GHQ scores. Conclusion: Patients who have suicidal thoughts do not volunteer them unless directly asked. There is a strong relationship between suicidal ideation and the probability of underlying CMD.