Suicidal ideation and affect lability in single and multiple suicidal attempters with Major Depressive Disorder: An exploratory network analysis

INTRODUCTION

A better understanding of the specific contribution of risk factors to suicidal behavior could arise from analyzing suicidal ideation (SI) in clinical samples, and comparing single versus multiple suicide attempters through contemporary methods allowing complex and dynamical analyses of multiple and simultaneously interacting suicide risk factors.

METHOD

We explored associations among suicidal ideation (SI), affect lability and other suicide risk factors in 323 suicidal attempters diagnosed with major depressive disorder (MDD). We analyzed the network structure and centrality of the total sample, and compared single versus multiple attempters and subjects with low and high suicidal ideation.

RESULTS

SI was connected with anxiety (trait) and hopelessness. Central nodes for global and specific groups were affect lability (from anxiety to depression), anxiety as a trait, and harm avoidance. We observed some specific differences between clinical profiles of repeaters and non-repeaters and significant network density between high and low SI.

LIMITATIONS

Because our cross-sectional design, we cannot establish casual relationships among variables. We only examined associations at group level but not at single subject level.

CONCLUSIONS

Affect lability (mainly the shifts from anxiety to depression) and trait anxiety were central in each estimated network. These symptoms might be suitable targets for early detecting and treating suicidal patients.

Predictors of daily life suicidal ideation in adults recently discharged after a serious suicide attempt: A pilot study

The aims of the study are to examine the predictive role of fluctuations in daily life mood, social contexts, and behavior on subsequent suicidal ideation (SI); and to identify clinical and psychological factors associated with the general frequency of SI in a high-risk sample. The sample comprised 42 adults (73.8% female) hospitalized for a suicide attempt. Immediately following hospital discharge, they used Ecological Momentary Assessment for seven consecutive days, providing repeated measures of SI, environmental, contextual, and behavioral factors. Controlling for prior SI, a number of contextual variables were associated with subsequent SI. Being at home or at work were both associated with an increased probability of SI, while being in the home of close others, or in a festive or leisure environment decreased SI probability. Working, passive leisure and inactivity all increased the likelihood of SI. Being alone increased SI while being with close others significantly reduced this risk. Finally, no overall effect for stressful events was found but negative family events specifically were associated with increased likelihood of SI (γ = 0.448, t = 2.255, df = 29, p < 0.05). The findings provide preliminary results regarding proximal environmental and behavioral factors associated with the occurrence of suicidal ideation in a high-risk sample.

Risk-taking behaviors and subgrouping of suicide in Iran: A latent class analysis of national registries data

Suicide is one the most important public health problem which is rapidly growing concerns. The aim of this study was to subgroup suicide using LCA method. This cross-sectional study was conducted in Iran based on 66990 records registered in Ministry of Health in 2014. A case report questionnaire in the form of software was used for case registries. Latent class analysis was used to achieve the research objectives. Four latent classes were identified; (a) Non-lethal attempters without a history of psychiatric disorders, (b) Non-lethal attempters with a history of psychiatric disorders, (c) Lethal attempters without a history of psychiatric disorders, (d) Lethal attempters with a history of psychiatric disorders. The probability of completed/an achieved suicide is high in lethal attempter classes. Being male increases the risk of inclusion in lethal attempters' classes (OR = 4.93). Also, being single (OR = 1.16), having an age lower than 25 years (OR = 1.14) and being a rural citizen (OR = 2.36) associate with lethal attempters classes. The males tend to use more violent methods and have more completed suicide. Majority of the individuals are non-lethal attempters who need to be addressed by implementing preventive interventions and mental support provision.

The contribution of the socio-demographic characteristics on suicidal ideation among Israeli soldiers

Background

Suicidal ideation is a risk factor for suicide attempt. The aim of the present study is to compare suicidal ideation of different groups with different distress.

Methods

100 soldiers, aged 18–21, divided into four research cohorts: soldiers who had carried out a suicide attempt (n = 40); soldiers with a psychiatric diagnosis (n = 20); soldiers having high severity adjustment difficulties (n = 20); and a control group of soldiers, having neither a history of mental health diagnosis, nor adjustment difficulties (n = 20). All completed the suicide ideation scale.

Results

Half of the attempters had a psychiatric diagnosis (depression or anxiety) on the day of their enlistment and 37.5 % of them had a specified personality disturbance. The attempters were characterized by previously-attempted suicide (p < .01). The lowest mean values (M = 1.95, SD = .67) were among the attempter (F = 3.173, df = 3, p = .02) in motivation for military service. The variable expressing low motivation for military service was the sole predictor of suicide ideation (p = .032).

Conclusions

Early diagnosis facilitated better monitoring by military mental health officers.

Patterns of Comorbidity of Suicide Attempters: An Update

Between 10 and 20 million people attempt suicide every year worldwide, and suicide attempts represent a major economic burden. Suicide attempters suffer from high rates of comorbidity, and comorbidity is the rule in suicide re-attempters. Comorbidity complicates treatment and prognosis and causes a more protracted course. In the present narrative review, we included these patterns of comorbidity: intra-Axis I disorders, intra-Axis II disorders, Axis I with Axis II disorders, and psychiatric with physical illnesses. We also briefly reviewed the patterns of comorbidity in suicide re-attempters. We concluded that comorbidity at different levels appears to be the rule in suicide attempters, particularly in those who re-attempt. However, several issues deserve further research regarding the patterns of comorbidity in suicide attempters.

Family process and content: comparing families of suicide attempters, human immunodeficiency virus positive patients and general population in southern iran, 2012

Background:

Family is considered as the smallest social unit, which is the basis of forming a society and one of the effective factors for individual behaviors. When family pattern is useful, the family will be productive and otherwise it becomes nonproductive.

Aim:

This study aimed to investigate family process and content among families of suicide attempters, human immunodeficiency virus (HIV) positive patients, and general population in Shiraz, Southern Iran.

Subjects and Methods:

This was a causal-comparative study. Our study population included three groups of single men, including suicide attempters, HIV positive patients and general population in Southern Iran. Our sample size was 180 male individuals including 60 suicide attempters referring to one of hospitals in Shiraz, 60 HIV positive patients referring to Behavioral Health Consultation Center, and 60 individuals from the general population who were selected using simple sampling method and were being investigated by Samani's family process and family content questionnaires. Data were being analyzed by ANCOVA and MANCOVA.

Results:

The two clinical groups had a poorer situation than the general population (P < 0.001) in some dimensions of family process including decision-making and coping (P < 0.001), mutual respect, and communication (P = 0.02) when compared with the general population. HIV positive patients had significantly lower scores than suicide attempters in some dimensions of family content including financial resources, social position (P < 0.001), and place of residence (P = 0.04). The two clinical groups had a poor situation in most of the dimensions when compared with the general population (P < 0.001).

Conclusions:

The results of this study indicate the importance of education in the field of communication, decision-making and coping skills.

Difference in suicide methods used between suicide attempters and suicide completers

Background

In light of the increased suicide rate in Korea, it has become important for researchers to examine the various factors associated with it. The purpose of this study is to compare and analyze the difference between suicide attempters and completers in terms of the suicide methods used and the lethality of these methods. In addition, we investigated certain demographic factors that are associated with the choice of suicide method by evaluating their lethality.

Finding

The most frequently used methods of suicide were different in the two groups of attempters and completers. Drug poisoning was the most frequent method in suicide attempters, whereas hanging was the most common method among suicide completers. Drug poisoning, stabbing, and other chemical poisoning were evaluated as relatively non-lethal compared to other suicide methods. While about 70.0% of the suicide attempters used relatively non-lethal methods, almost all suicide completers used lethal methods, based on our classification of the lethality of the method. In terms of gender, males used more lethal methods of suicide.

Conclusions

Suicide completers’ choice of suicide methods are different from those of suicide attempters and tend to be more lethal. Interventions to restrict access to more lethal suicidal methods could be a useful strategy to reduce the suicide rates in South Korea.

Suicidal process, suicidal communication and psychosocial situation of young suicide attempters in a rural Vietnamese community

The study aimed to explore the suicidal process, suicidal communication and psychosocial situation of young suicide attempters in a rural community in Hanoi, Vietnam. Semi-structured interviews were conducted, in a community setting, with 19 suicide attempters aged 15-24 who had been consecutively hospitalized in an intensive care unit. In 12 of 19 cases, the first pressing, distinct and constant suicidal thoughts appeared less than one day before the suicide attempt in question. However, distress and mild, fleeting suicidal thoughts had been present up to six months before the suicide attempt in 16 cases. Five respondents had a suicide plan one to three days before attempting suicide. Altogether, 13 engaged in some form of suicidal communication before their attempt. This communication was, however, difficult for outsiders to interpret. Twelve of the respondents were victims of regular physical abuse and 16 had suffered psychological violence for at least one year before attempting suicide. Eighteen of the respondents used pesticides or raticides in their suicide attempts. None sought advice or consultation in the community despite long-standing psychosocial problems. The strategy of reducing the availability of suicide means (e.g., pesticides or raticides) in Asian countries should be complemented with a long-term suicide-preventive strategy that targets school dropouts and domestic violence, and promotes coping abilities and communication about psychological and social problems as well as recognition of signs of distress and suicidal communication.