Recurrent suicidal ideation in young adults

Prediction of suicidal ideation among Chinese college students based on radial basis function neural network

Background

Suicide is one of the leading causes of death for college students. The predictors of suicidal ideation among college students are inconsistent and few studies have systematically investigated psychological symptoms of college students to predict suicide. Therefore, this study aims to develop a suicidal ideation prediction model and explore important predictors of suicidal ideation among college students in China.

Methods

We recruited 1,500 college students of Sichuan University and followed up for 4 years. Demographic information, behavioral and psychological information of the participants were collected using computer-based questionnaires. The Radial Basis Function Neural Network (RBFNN) method was used to develop three suicidal ideation risk prediction models and to identify important predictive factors for suicidal ideation among college students.

Results

The incidence of suicidal ideation among college students in the last 12 months ranged from 3.00 to 4.07%. The prediction accuracies of all the three models were over 91.7%. The area under curve scores were up to 0.96. Previous suicidal ideation and poor subjective sleep quality were the most robust predictors. Poor self-rated mental health has also been identified to be an important predictor. Paranoid symptom, internet addiction, poor self-rated physical health, poor self-rated overall health, emotional abuse, low average annual household income per person and heavy study pressure were potential predictors for suicidal ideation.

Conclusions

The study suggested that the RBFNN method was accurate in predicting suicidal ideation. And students who have ever had previous suicidal ideation and poor sleep quality should be paid consistent attention to.

The changes of suicidal ideation status among young people in Hong Kong during COVID-19: A longitudinal survey

BACKGROUND

Pandemics affect the physical and mental well-being of all potentially at-risk young people globally. This longitudinal study examines changes of suicidal ideation status among adolescents during COVID-19.

METHOD

A follow-up after nine-months of a school-based survey among 1,491 secondary school students was conducted during COVID-19. Psychological well-being, psychological factors, family support, and COVID-19-related experiences were examined.

RESULTS

The prevalence of suicidal ideation were 24% and 21% among the participants before and during COVID-19, respectively. In particular, 897 (65.0%) remained non-suicidal, 193 (14.0%) recovered from being suicidal, 148 (10.7%) newly reported being suicidal, and 143 (10.4%) remained suicidal. Respondents who remained suicidal were found to have significantly higher depression, anxiety, stress, loneliness, and social anxiety, fixed mind-set, lower meaning of life and self-control; and lower parental support and supervision than the other three groups. Participants with suicidal ideation reported more negative perceptions about COVID-19 than non-suicidal participants. Multinomial logistic regression showed that anxiety, trait anxiety and life satisfactory in baseline were associated with suicidal ideation at follow-up.

LIMITATION

This study was limited by the small number of protective variables being included in the baseline survey to examine the potential reasons for the recovery of suicidal ideation at follow-up.

CONCLUSION

Poor psychological well-being, lower level of family support, and negative impacts of the pandemic were consistently associated with students' presence of suicidal ideation during the pandemic. Further intervention studies are needed to examine effects of mental health consequences of COVID-19 on youth mental health and to promote positive youth well-being.

Suicide Ideation and Its Correlates Among University Undergraduates in South Western Nigeria

Suicide is one of the leading causes of death among young people aged 15 to 29 years of age. Ideation or suicidal thoughts , which precedes suicide is sometimes normalized and excused thereby missing avertable deaths within a given context. Understanding suicide ideation and the associated social correlates within contexts can provide cues on how to mitigate suicide. This paper examines the potential social factors that are shaping suicidal ideation among young people in two universities in Nigeria. Based on a mixed-method design, a survey was conducted among a proportionate sample of 500 young people (18-25years that are undergraduates). Four Focus Group Discussion sessions were also held among the same group and six semi-structured interviews with social workers at both universities. Quantitative evidence associated irregular financial support (OR = 0.60; p < 0.05) and broken intimate relationship (OR = 1.57; P < 0.05) with suicide ideation. Findings from the qualitative component also considered undergraduates that have academic challenges, engage in substance abuse, and have parents with marital problems to be prone to suicidal ideation. Suicidal ideation among these young people is embedded in their network of relationships, which can be mitigated when the quality of support systems is responsive and adequately accessed.

Coexistence of Substance Abuse among Emergency Department Patients Presenting with Suicidal Ideation

BACKGROUND

Patients who are suicidal commonly seek care in the emergency department (ED). Few studies have examined the coexistence between suicidal ideation, substance abuse, and psychiatric diagnosis.

OBJECTIVES

This study sought to determine how often suicidal ED patients have coexisting substance abuse and psychiatric diagnosis in addition to describing the characteristics of target population.

METHODS

In this retrospective cohort study, chart reviews were conducted of patients over 12 with suicidal ideation who presented to an academic ED from October 2016 to March 2017. Data abstracted included gender, age, insurance, prior psychiatric diagnoses, substances abused, presence of a suicide attempt, prior suicidality, number of ED visits in the prior year, and disposition. Both descriptive and inferential statistics were calculated.

RESULTS

There were 427 patient visits to the ED for suicidality during the study period, of which 54% were male, with a mean age of 34 years. Most patients (92%) had a psychiatric diagnosis, most commonly depression (67%). More than one psychiatric diagnosis was reported in 51% of patients, while 8% had no reported underlying psychiatric diagnosis. Substance abuse was reported in 58% of patients, including marijuana (42%) and opioids (41%). Polysubstance abuse was reported in 42%. Approximately half of the patients had three or more ED visits in the previous 12 months. Most patients were insured by Medicaid (51%), while 59% were admitted for inpatient treatment.

CONCLUSION

Substance abuse and psychiatric diagnosis were reported frequently among patients presenting to the ED with suicidal ideation, often involving more than one substance/diagnosis. Future studies should be aimed at evaluating the relationship between these conditions and determining how to better care for this population.

Tobacco smoking and other substance use disorders associated with recurrent suicide attempts in bipolar disorder

BACKGROUND

Suicide attempts (SA) are more frequent in bipolar disorder (BD) than in most other mental disorders. Prevention strategies would benefit from identifying the risk factors of SA recurrence in BD. Substance use disorders (SUD) (including tobacco-related) are strongly associated with both BD and SA, however, their specific role for the recurrence of SA in BD remains inadequately investigated. Thus, we tested if tobacco smoking - with or without other SUDs - was independently associated with recurrent SA in BD.

METHODS

916 patients from France and Norway with ascertained diagnoses of BD and reliable data about SA and SUD were classified as having no, single, or recurrent (≥2) SA. Five SUD groups were built according to the presence/absence/combination of tobacco, alcohol (AUD) and cannabis use disorders. Multinomial logistic regression was used to identify the correlates of SA recurrence.

RESULTS

338 (37%) individuals reported at least one SA, half of whom (173, 51%) reported recurrence. SUD comorbidity was: tobacco smoking only, 397 (43%), tobacco smoking with at least another SUD, 179 (20%). Regression analysis showed that tobacco smoking, both alone and comorbid with AUD, depressive polarity of BD onset and female gender were independently associated with recurrent SA.

LIMITATIONS

Lack of data regarding the relative courses of SA and SUD and cross-national differences in main variables.

CONCLUSION

Tobacco smoking with- or without additional SUD can be important risk factors of SA recurrence in BD, which is likely to inform both research and prevention strategies.

Suicide mortality among youth in southern Brazil: a spatiotemporal evaluation of socioeconomic vulnerability

Objective:

To conduct a geospatial analysis of suicide deaths among young people in the state of Paraná, southern Brazil, and evaluate their association with socioeconomic and spatial determinants.

Methods:

Data were obtained from the Mortality Information System and the Brazilian Institute of Geography and Statistics. Data on suicide mortality rates (SMR) were extracted for three age groups (15-19, 20-24, and 25-29 years) from two 5-year periods (1998-2002 and 2008-2012). Geospatial data were analyzed through exploratory spatial data analysis. We applied Bayesian networks algorithms to explore the network structure of the socioeconomic predictors of SMR.

Results:

We observed spatial dependency in SMR in both periods, revealing geospatial clusters of high SMR. Our results show that socioeconomic deprivation at the municipality level was an important determinant of suicide in the youth population in Paraná, and significantly influenced the formation of high-risk SMR clusters.

Conclusion:

While youth suicide is multifactorial, there are predictable geospatial and sociodemographic factors associated with high SMR among municipalities in Paraná. Suicide among youth aged 15-29 occurs in geographic clusters which are associated with socioeconomic deprivation. Rural settings with poor infrastructure and development also correlate with increased SMR clusters.

Nature and determinants of suicidal ideation among U.S. veterans: Results from the national health and resilience in veterans study

BACKGROUND

Suicidal thoughts and behaviors among U.S. military veterans are a major public health concern. To date, however, scarce data are available regarding the nature and correlates of suicidal ideation (SI) among U.S. veterans. This study evaluated the prevalence and correlates of suicidal ideation in a contemporary, nationally representative, 2-year prospective cohort study.

METHOD

Data were analysed from a total of 2157 U.S. veterans who participated in the National Health and Resilience Veterans Study (NHRVS; Wave 1 conducted in 2011; Wave 2 in 2013). Veterans completed measures assessing SI, sociodemographic characteristics, and potential risk and protective correlates.

RESULTS

The majority of veterans (86.3%) denied SI at either time point, 5.0% had SI onset (no SI at Wave 1, SI at Wave 2), 4.9% chronic SI (SI at Waves 1 and 2), and 3.8% had remitted SI (SI at Wave 1, no SI Wave 2). Greater Wave 1 psychiatric distress was associated with increased likelihood of chronic SI (relative risk ratio [RRR]=3.72), remitted SI (RRR=3.38), SI onset (RRR=1.48); greater Wave 1 physical health difficulties were additionally associated with chronic SI (RRR=1.64) and SI onset (RRR=1.47); and Wave 1 substance abuse history was associated with chronic SI (RRR 1.57). Greater protective psychosocial characteristics (e.g., resilience, gratitude) at Wave 1 were negatively related to SI onset (RRR=0.57); and greater social connectedness at Wave 1, specifically perceived social support and secure attachment style, was negatively associated with SI onset (RRR=0.75) and remitted SI (RRR=0.44), respectively.

LIMITATIONS

Suicidal ideation was assessed using a past two-week timeframe, and the limited duration of follow-up precludes conclusions regarding more dynamic changes in SI over time.

CONCLUSIONS

These results indicate that a significant minority (13.7%) of U.S. veterans has chronic, onset, or remitted SI. Prevention and treatment efforts designed to mitigate psychiatric and physical health difficulties, and bolster social connectedness and protective psychosocial characteristics may help mitigate risk for SI.