Suicidal Behavior in Swiss Students: An 18-Month Follow-up Survey

Suicidal behavior and its relationship with other mental disturbances was assessed in an epidemiological study of 1937 Swiss adolescents aged 14 to 19 years. During the most recent 12 months, 27.5% of the females and 16.1%of the males reported suicidal ideation, while 3.3% of the girls and 1.0% of the boys reported suicidal ideation. Suicidality was significantly correlated with physical and mental impairment, alcohol and drug abuse. Of the total epidemiological sample, 475 students (24.5%) were reassessed 12 and 18 months later. Of this follow-up sample, 37 females (12.4%) and 10 males (5.6%) described suicidal ideation as a continuing problem. They revealed significantly more psychiatric symptoms than nonpersistent ideators. Three girls (1.0%) and one boy (0.6%) reported suicide attempts during the follow-up period of 18 months. Only one out of six of the ideators of both sexes received psychiatric treatment. The findings indicate that transient suicidal ideation is common in adolescents. Persistent suicidal behavior appears to be a sign of severe social and psychological disturbances and is associated with serious physical and mental impairment. There is a high risk of completed suicide for youths who demonstrate persistent suicidal ideation, and far more substantial prevention efforts should be designed and implemented to address the circumstances of these youths.

Download Full-text

Outcome of Suicidal Ideation and Behavior in a Young, Help-Seeking Population over a 2-Year Period

Crisis ◽

10.1027/0227-5910.28.1.4 ◽

2007 ◽

Vol 28 (1) ◽

pp. 4-10 ◽

Cited By ~ 10

Author(s):

E.M. Cosgrave ◽

J. Robinson ◽

K.A. Godfrey ◽

H.P. Yuen ◽

E.J. Killackey ◽

...

Keyword(s):

Suicidal Ideation ◽

Suicidal Behavior ◽

Help Seeking ◽

Psychiatric Service ◽

Completed Suicide ◽

Axis I ◽

The Stability ◽

And Behavior ◽

Levels Of Functioning

Abstract. Suicidal behavior is associated with negative outcomes, including completed suicide. This study examined the prevalence of suicidal behavior in a sample of referrals to a youth psychiatric service and investigated the stability of suicidality over 2 years. Of the 140 people (mean age 17.8) who were referred to a youth psychiatric service, 82 who were accepted for treatment (RA group) and 58 who were not accepted (RNA group) were assessed; 57% reported considering suicide and 39% reported attempting suicide in the 12 months prior to referral. Participants who reported suicidal ideation were significantly more likely than nonsuicidal participants to have multiple Axis I diagnoses and lower levels of functioning. At the 2-year follow-up there was a significant reduction in suicidality in the RA group, but not in the RNA group. In conclusion, suicidality is prevalent among young people referred to psychiatric services. Even brief contact with services results in a reduction in suicidality over 2 years.

Download Full-text

The role of serotonin in adolescent suicide: theoretical, methodological, and clinical concerns

International Journal of Adolescent Medicine and Health ◽

10.1515/ijamh-2015-5003 ◽

2015 ◽

Vol 27 (2) ◽

pp. 129-133 ◽

Cited By ~ 7

Author(s):

María Dolores Picouto ◽

Francisco Villar ◽

María Dolores Braquehais

Keyword(s):

Suicidal Ideation ◽

Suicidal Behavior ◽

Adolescent Suicide ◽

Suicide Attempts ◽

Life Stage ◽

Biological Marker ◽

Future Research ◽

Completed Suicide ◽

Increased Risk

Abstract Introduction: Adolescent suicide is a complex phenomenon that has similarities and differences with adult suicidal behavior. Serotonergic (5-HT) dysfunction has extensively been studied in adults and has been postulated as a biological marker for suicide. Methods: We conducted a comprehensive review of the studies available in MEDLINE from January 1998 until January 2014 on the role of “serotonin” both in adults’ and adolescents’ “completed suicide”, “suicide attempts”, and “suicidal ideation”. Results: Studies on 5-HT conducted in adults and replicated in adolescents have yielded inconsistent results. Although some genes related to the serotonergic system have been associated with an increased risk of suicide, attempts to reproduce those findings have been unsuccessful and a common genetic variant associated to suicidal behavior has yet to be identified. Discussion: Studies on the neurobiology of adolescent suicide should consider the biological specificities of this life stage and of gender differences during this period. Future research designs should also try to integrate findings in the psychological and biological domains. Prospective studies may help understand the process that leads from suicidal ideation to suicide attempts or completed suicides in this population.

Download Full-text

National Differences in Intelligence and Population Rates of Suicidal Ideation, Suicide Plans, and Attempted Suicide

Perceptual and Motor Skills ◽

10.2466/pms.105.2.355-361 ◽

2007 ◽

Vol 105 (2) ◽

pp. 355-361 ◽

Cited By ~ 6

Author(s):

Martin Voracek

Keyword(s):

Suicidal Ideation ◽

Suicidal Behavior ◽

Attempted Suicide ◽

Suicide Attempts ◽

Close Correspondence ◽

Completed Suicide ◽

National Differences ◽

Epidemiological Surveys ◽

Ecological Correlation ◽

Cross National

Population rates of suicidal ideation, suicide plans or attempted suicide from three independent multinational epidemiological surveys (the WHO/EURO and WHO SUPRE-MISS studies and a third one) were not significantly associated with national IQ figures. This result conflicts with previous evidence from cross-national studies (by Lester and by Voracek) of a positive ecological correlation between level of national intelligence and rates of completed suicide. Across nations, the indicators for the prevalence of suicidal behavior also lacked close correspondence with suicide rates, which may be due to the higher unreliability of assessing covert suicidal behavior (suicide ideas, thoughts, plans, and, to a lesser extent, also suicide attempts) as compared to suicidal behavior that is indisputably overt (completed suicide). Several alternative explanations for the current nil findings are also discussed.

Download Full-text

Emergency Department Admission and Mortality Rate for Suicidal Behavior

Crisis ◽

10.1027/0227-5910/a000282 ◽

2014 ◽

Vol 35 (6) ◽

pp. 406-414 ◽

Cited By ~ 10

Author(s):

Raimondo Maria Pavarin ◽

Angelo Fioritti ◽

Francesca Fontana ◽

Silvia Marani ◽

Alessandra Paparelli ◽

...

Keyword(s):

Emergency Department ◽

Metropolitan Area ◽

Suicidal Behavior ◽

Mortality Risk ◽

Illicit Drugs ◽

Attempted Suicide ◽

Cox Model ◽

Emergency Department Admission ◽

Completed Suicide

Background: The international literature reports that for every completed suicide there are between 8 and 22 visits to an Emergency Department (ED) for attempted suicide/suicidal behavior. Aims: To describe the characteristics of admission to emergency departments (EDs) for suicide-related presenting complaints in the metropolitan area of Bologna; to estimate the risk for all-cause mortality and for suicide; to identify the profiles of subjects most at risk. Method: Follow-up of patients admitted to the EDs of the metropolitan area of Bologna between January 2004 and December 2010 for attempted suicide. A Cox model was used to evaluate the association between sociodemographic variables and the general mortality risk. Results: We identified 505 cases of attempted suicide, which were more frequent for female subjects, over the weekend, and at night (8:00 p.m./8:00 a.m.). The most used suicide methods were psychotropic drugs, sharp or blunt objects, and jumping from high places. In this cohort, 3.6% of subjects completed suicide (4.5% of males vs. 2.9% of females), 2.3% within 1 year of the start of follow-up. The most common causes of death were drug use and hanging. In the multivariate analysis, those who used illicit drugs 24 hr prior to admission to the ED (hazard ratio [HR] = 3.46, 95% CI = 1.23–9.73) and patients who refused the treatment (HR = 6.74, 95% CI = 1.86–24.40) showed an increased mortality risk for suicide. Conclusion: Deliberate self-harm patients presenting to the ED who refuse treatment represent a specific target group for setting up dedicated prevention schemes.

Download Full-text

Prevalence of Suicidal Ideation in Sri Lanka

Crisis ◽

10.1027/0227-5910/a000010 ◽

2010 ◽

Vol 31 (1) ◽

pp. 30-35 ◽

Cited By ~ 3

Author(s):

Sudath Samaraweera ◽

Athula Sumathipala ◽

Sisira Siribaddana ◽

S. Sivayogan ◽

Dinesh Bhugra

Keyword(s):

Suicidal Ideation ◽

Sri Lanka ◽

General Population ◽

Suicide Attempts ◽

National Average ◽

The West ◽

Suicide Methods ◽

Suicide Rates ◽

Completed Suicide ◽

The World

Background: Suicidal ideation can often lead to suicide attempts and completed suicide. Studies have shown that Sri Lanka has one of the highest rates of suicide in the world but so far no studies have looked at prevalence of suicidal ideation in a general population in Sri Lanka. Aims: We wanted to determine the prevalence of suicidal ideation by randomly selecting six Divisional Secretariats (Dss) out of 17 in one district. This district is known to have higher than national average rates of suicide. Methods: 808 participants were interviewed using Sinhala versions of GHQ-30 and Beck’s Scale for Suicidal Ideation. Of these, 387 (48%) were males, and 421 (52%) were female. Results: On Beck’s Scale for Suicidal Ideation, 29 individuals (4%) had active suicidal ideation and 23 (3%) had passive suicidal ideation. The active suicidal ideators were young, physically ill and had higher levels of helplessness and hopelessness. Conclusions: The prevalence of suicidal ideation in Sri Lanka is lower than reported from the West and yet suicide rates are higher. Further work must explore cultural and religious factors.

Download Full-text

Serotonergic Genes and Suicidality

Crisis ◽

10.1027//0227-5910.22.2.54 ◽

2001 ◽

Vol 22 (2) ◽

pp. 54-60 ◽

Cited By ~ 42

Author(s):

Lisheng Du ◽

Gabor Faludi ◽

Miklos Palkovits ◽

David Bakish ◽

Pavel D. Hrdina

Keyword(s):

Suicidal Ideation ◽

Suicidal Behavior ◽

Tryptophan Hydroxylase ◽

Association Studies ◽

Receptor Gene ◽

Brain Regions ◽

Depressive Illness ◽

Control Group ◽

Serotonergic Activity ◽

Completed Suicide

Summary: Several lines of evidence indicate that abnormalities in the functioning of the central serotonergic system are involved in the pathogenesis of depressive illness and suicidal behavior. Studies have shown that the number of brain and platelet serotonin transporter binding sites are reduced in patients with depression and in suicide victims, and that the density of 5-HT2A receptors is increased in brain regions of depressed in suicide victims and in platelets of depressed suicidal patients. Genes that code for proteins, such as tryptophan hydroxylase, 5-HT transporter, and 5-HT2A receptor, involved in regulating serotonergic neurotransmission, have thus been major candidate genes for association studies of suicide and suicidal behavior. Recent studies by our group and by others have shown that genetic variations in the serotonin-system-related genes might be associated with suicidal ideation and completed suicide. We have shown that the 102 C allele in 5-HT2A receptor gene was significantly associated with suicidal ideation (χ2 = 8.5, p < .005) in depressed patients. Patients with a 102 C/C genotype had a significantly higher mean HAMD item #3 score (indication of suicidal ideation) than T/C or T/T genotype patients. Our results suggest that the 102T/C polymorphism in 5-HT2A receptor gene is primarily associated with suicidal ideation in patients with major depression and not with depression itself. We also found that the 5-HT transporter gene S/L polymorphism was significantly associated with completed suicide. The frequency of the L/L genotype in depressed suicide victims was almost double of that found in control group (48.6% vs. 26.2%). The odds ratio for the L allele was 2.1 (95% CI 1.2-3.7). The association between polymorphism in serotonergic genes and suicidality supports the hypothesis that genetic factors can modulate suicide risk by influencing serotonergic activity.

Download Full-text

Prevalence and correlates of suicidal ideation and suicide attempts in preadolescent children: A US population-based study

Translational Psychiatry ◽

10.1038/s41398-021-01593-3 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Hannah R. Lawrence ◽

Taylor A. Burke ◽

Ana E. Sheehan ◽

Brianna Pastro ◽

Rachel Y. Levin ◽

...

Keyword(s):

Suicidal Ideation ◽

Sexual Minority ◽

Family Income ◽

Suicide Attempts ◽

Psychiatric Treatment ◽

The United States ◽

Minority Youth ◽

Sexual Minority Youth ◽

Treatment Utilization ◽

Preadolescent Children

AbstractThe present study evaluated sociodemographic and diagnostic predictors of suicidal ideation and attempts in a nationally representative sample of preadolescent youth enrolled in the Adolescent Brain Cognitive Development Study. Rates and predictors of psychiatric treatment utilization among suicidal youth also were examined. Eleven thousand eight hundred and seventy-five 9- and 10-year-old children residing in the United States were assessed. Children and their parents/guardians provided reports of children’s lifetime history of suicidal ideation, suicide attempts, and psychiatric disorders. Parents also reported on sociodemographic characteristics and mental health service utilization. Multivariate logistic regression analyses were employed to evaluate sociodemographic and diagnostic correlates of suicidal ideation, suicide attempts among youth with suicidal ideation, and treatment utilization among youth with suicidal ideation and suicide attempts. Lifetime prevalence rates were 14.33% for suicidal ideation and 1.26% for suicide attempts. Youth who identified as male, a sexual minority, or multiracial had greater odds of suicidal ideation, and sexual minority youth and youth with a low family income had greater odds of suicide attempts. Comorbid psychopathology was associated with higher odds of both suicidal ideation and suicide attempts. In youth, 34.59% who have suicidal ideation and 54.82% who had attempted suicide received psychiatric treatment. Treatment utilization among suicidal youth was lower among those who identified as female, Black, and Hispanic. Suicidal ideation and attempts among preadolescent children are concerningly high and targeted assessment and preventative efforts are needed, especially for males, racial, ethnic, and sexual minority youth, and those youth experiencing comorbidity.

Download Full-text

A probe in the connection between inflammation, cognition and suicide

Journal of Psychopharmacology ◽

10.1177/0269881118764022 ◽

2018 ◽

Vol 32 (4) ◽

pp. 482-488 ◽

Cited By ~ 11

Author(s):

Ricardo Cáceda ◽

W Sue T Griffin ◽

Pedro L Delgado

Keyword(s):

Suicidal Ideation ◽

Suicidal Behavior ◽

Linear Models ◽

Suicide Attempts ◽

Limited Data ◽

Physical Pain ◽

Reactive Protein ◽

Depressed Patients ◽

Downstream Effects ◽

Suicidal Patients

Background: Increased inflammation is linked to suicide risk. However, it is unclear whether increased inflammation drives suicidal crises or is a trait associated with lifetime suicidal behavior. Limited data exist on the sources of increased inflammation observed in suicidal patients and on its downstream effects. Aims: To examine factors associated with inflammation and with suicidal ideation severity in acutely suicidal depressed patients. Methods: Fifty-two adult depressed patients of both sexes hospitalized for severe suicidal ideation were characterized for suicidality, depression, anxiety, medical comorbidity, psychological and physical pain, impulsivity, verbal fluency, C-reactive protein (CRP) and interleukin (IL) 6. Two generalized linear models were performed with either CRP or suicidal ideation severity as dependent variables. Results: CRP levels were positively associated with age, body mass index (BMI), IL6, current physical pain and number of lifetime suicide attempts. Suicidal ideation severity was not significantly correlated with either CRP or IL6. Suicidal ideation severity was positively associated with female sex, presence of an anxiety disorder, current physical pain, number of lifetime suicide attempts and with delay discounting for medium and large losses. Conclusions: Increased inflammation is not associated with acute suicidal risk, but seems to represent a trait associated with lifetime suicidal behavior.

Download Full-text

Suicidality and Aggressive Behavior in Body Dysmorphic Disorder

10.1093/med/9780190254131.003.0013 ◽

2017 ◽

Author(s):

Katharine A. Phillips

Keyword(s):

Suicidal Ideation ◽

Physical Aggression ◽

Body Dysmorphic Disorder ◽

Suicide Attempts ◽

Violent Behavior ◽

Clinical Samples ◽

Obsessive Compulsive ◽

Compulsive Disorder ◽

Completed Suicide ◽

Increased Risk

This chapter reviews suicidality and aggressive/violent behavior in body dysmorphic disorder (BDD) and presents clinical cases, which reflect the extreme suffering that BDD often causes. Suicidal ideation and suicide attempts are common in BDD. This has been found in both clinical and epidemiologic samples and in adults as well as youth. More severe BDD symptoms are independently associated with an increased risk of suicidal ideation and suicide attempts. Suicidality appears more common in BDD than in obsessive-compulsive disorder and other clinical samples with which BDD has been directly compared. Although data are limited, the rate of completed suicide appears markedly elevated; indeed, individuals with BDD have many risk factors for completed suicide. Physical aggression and violence are less well studied but appear to commonly occur as a consequence of BDD. Surgeons, dermatologists, and other clinicians who provide cosmetic treatment may be at particular risk. Additional studies designed to investigate these topics are urgently needed.

Download Full-text

S210. COMPARATIVE EFFECTIVENESS OF ANTIPSYCHOTICS FOR RISK OF ATTEMPTED OR COMPLETED SUICIDE AMONG PERSONS WITH SCHIZOPHRENIA

Schizophrenia Bulletin ◽

10.1093/schbul/sbaa031.276 ◽

2020 ◽

Vol 46 (Supplement_1) ◽

pp. S118-S119

Author(s):

Heidi Taipale ◽

Markku Lähteenvuo ◽

Antti Tanskanen ◽

Ellenor Mittendorfer-Rutz ◽

Jari Tiihonen

Keyword(s):

Drug Use ◽

Comparative Effectiveness ◽

Attempted Suicide ◽

Suicide Attempts ◽

Antipsychotic Therapy ◽

Completed Suicide ◽

Hazard Ratios ◽

Persons With Schizophrenia ◽

Swedish Cohort

Abstract Background Suicidal attempts and suicide are rather common phenomena in persons with schizophrenia whom are 6–14 times more likely to die due to suicide than the general population. Very little is known on effectiveness of antipsychotics in preventing suicide attempts and completed suicides among patients with schizophrenia. Whether all antipsychotics are effective in preventing attempted or completed suicides also remains unclear. The objective of our study was to investigate comparative effectiveness of antipsychotics for risk of attempted or completed suicide among all patients with schizophrenia in Finland and Sweden. Methods Two nationwide register-based cohort studies were conducted including all individuals with schizophrenia in Finland (N=61889) and Sweden (N=29823). The Finnish cohort included all persons treated for schizophrenia in inpatient care (1972–2014), with follow-up for drug use and outcomes during 1996–2017. The Swedish cohort included all persons with treatment contact due to schizophrenia in inpatient or specialized outpatient care, sickness absence, or disability pension (2006–2013), with follow-up for drug use and outcomes during 2006–2016. The main exposure included the ten most commonly used antipsychotic monotherapies, and also adjunctive pharmacotherapies (antidepressants, mood stabilizers, lithium, benzodiazepines and related drugs were investigated). The main outcome measure was attempted or completed suicide which was analyzed with within-individual models by comparing use and non-use periods in the same individual. Sensitivity analyses were conducted by between-individual models, with attempted suicide (hospitalization only) as an outcome, and by censoring first 30 days from each exposure. Results are reported as hazard ratios (HRs) with 95 % confidence intervals (95% CI). Results Compared with no use of antipsychotics, clozapine was the only antipsychotic therapy consistently associated with a decreased risk of suicidal outcomes. Hazard ratios (HRs) and 95% CI for attempted or completed suicide were 0.64 (95% CI 0.49–0.84) in the Finnish cohort, and 0.66 (0.43–0.99) in the Swedish cohort, and for attempted suicide 0.60 (0.46–0.79) in the Finnish cohort and 0.62 (0.40–0.95) in the Swedish cohort. No other antipsychotic was associated with a reduced risk of attempted and/or completed suicide than clozapine. Regarding adjunctive pharmacotherapies, benzodiazepines and Z-drugs were associated with an increased risk of suicide attempts or deaths (HRs for benzodiazepines 1.29–1.30 and 1.33–1.62 for Z-drugs, not reaching statistical significance in the Swedish cohort). Discussion The results from two large nationwide cohorts provide the first evidence on comparative real-world effectiveness of specific antipsychotics in the prevention of severe suicidal behavior. Clozapine was the only pharmacological treatment associated with a substantially decreased risk of attempted or completed suicide and should be considered as a first-line treatment for patients with suicidal ideation or behavior.

Download Full-text