Comportamento Suicidário nos Internos de Psiquiatria em Portugal: Comparação com a Realidade Europeia

Introduction: The aim of this paper was to assess the prevalence of suicide ideation and attempts in Portuguese psychiatry trainees (adult and child and adolescence), and compare the data with the general population and other European countries. Material and Methods: A structured and anonymous questionnaire was sent by email to 159 portuguese trainees of adult psychiatry and child and adolescence psychiatry with questions about personal history of suicidal ideation and suicide attempts, as well as family history of suicide attempts and completed suicides. This is part of the BoSS Study (Burnout Syndrome Study) performed in 21 countries worldwide. Data was analysed in SPSS v.19. Results: From the inquired population, 62 trainees (40,3%) partially responded, and 46 (29%) were complete responders - these entered the final analysis. There was a ratio of 2:1 (female:male) and a mean age of 29 years. The suicidal ideation was present in passive form in 44% and in active form in 33%; also, 4.3% of respondents had previous suicide attempts. In first degree relatives, 22% had attempted suicide and 13% completed suicide. Discussion: The results are worriying and may be associated with some factors to which this population is exposed. Conclusion: It is necessary further research to better understand this phenomenon, its causes and potential modifiers.

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Suicidal behavior among Portuguese psychiatry trainees: Comparison with the European situation

European Psychiatry ◽

10.1016/j.eurpsy.2017.01.057 ◽

2017 ◽

Vol 41 (S1) ◽

pp. S63-S63

Author(s):

J. Gama Marques

Keyword(s):

Suicidal Ideation ◽

Suicide Ideation ◽

Suicide Attempts ◽

Active Form ◽

Adult Child ◽

Final Analysis ◽

Burnout Syndrome ◽

Adult Psychiatry ◽

History Of ◽

Competing Interest

IntroductionThe aim of this paper was to assess the prevalence of suicide ideation and attempts in Portuguese psychiatry trainees (adult, child and adolescence), and compare the data with the general population and other European countries.Material and MethodsA structured and anonymous questionnaire was sent by email to 159 Portuguese trainees of adult psychiatry, child and adolescence psychiatry with questions about personal history of suicidal ideation and suicide attempts, as well as family history of suicide attempts and completed suicides. This is part of the BoSS Study (Burnout Syndrome Study) performed in 21 countries worldwide. Data was analyzed in SPSS v.19.ResultsFrom the inquired population, 62 trainees (40.3%) partially responded, and 46 (29%) were complete responders - these entered the final analysis. There was a ratio of 2:1 (female: male) and a mean age of 29 years. The suicidal ideation was present in passive form in 44% and in active form in 33%; also, 4.3% of respondents had previous suicide attempts. In first-degree relatives, 22% had attempted suicide and 13% completed suicide.DiscussionThe results are worrying and may be associated with some factors to which this population is exposed.ConclusionIt is necessary further research to better understand this phenomenon, its causes and potential modifiers.Disclosure of interestThe author has not supplied his declaration of competing interest.

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Suicidal ideation and suicide attempts in bipolar disorder type I: an update for the clinician

Brazilian Journal of Psychiatry ◽

10.1590/s1516-44462009005000003 ◽

2009 ◽

Vol 31 (3) ◽

pp. 271-280 ◽

Cited By ~ 54

Author(s):

Lena Nabuco de Abreu ◽

Beny Lafer ◽

Enrique Baca-Garcia ◽

Maria A. Oquendo

Keyword(s):

Risk Factors ◽

Bipolar Disorder ◽

Suicidal Ideation ◽

Suicidal Behavior ◽

Suicide Ideation ◽

Suicide Attempts ◽

Clinical Samples ◽

Type I ◽

History Of ◽

Axis I

OBJECTIVE: This article reviews the evidence for the major risk factors associated with suicidal behavior in bipolar disorder. METHOD: Review of the literature studies on bipolar disorder, suicidal behavior and suicidal ideation. RESULTS: Bipolar disorder is strongly associated with suicide ideation and suicide attempts. In clinical samples between 14-59% of the patients have suicide ideation and 25-56% present at least one suicide attempt during lifetime. Approximately 15% to 19% of patients with bipolar disorder die from suicide. The causes of suicidal behavior are multiple and complex. Some strong predictors of suicidal behavior have emerged in the literature such as current mood state, severity of depression, anxiety, aggressiveness, hostility, hopelessness, comorbidity with others Axis I and Axis II disorders, lifetime history of mixed states, and history of physical or sexual abuse. CONCLUSION: Bipolar disorder is the psychiatric condition associated with highest lifetime risk for suicide attempts and suicide completion. Thus it is important to clinicians to understand the major risk factors for suicidal behavior in order to choose better strategies to deal with this complex behavior.

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Suicide Prevention Through Online Gatekeeping Using Search Advertising Techniques

Crisis ◽

10.1027/0227-5910/a000322 ◽

2015 ◽

Vol 36 (4) ◽

pp. 267-273 ◽

Cited By ~ 8

Author(s):

Hajime Sueki ◽

Jiro Ito

Keyword(s):

Suicidal Ideation ◽

Suicide Prevention ◽

Help Seeking ◽

Service Use ◽

Web Search ◽

Suicide Attempts ◽

Consultation Service ◽

Search Advertising ◽

Internet Users ◽

History Of

Abstract. Background: Nurturing gatekeepers is an effective suicide prevention strategy. Internet-based methods to screen those at high risk of suicide have been developed in recent years but have not been used for online gatekeeping. Aims: A preliminary study was conducted to examine the feasibility and effects of online gatekeeping. Method: Advertisements to promote e-mail psychological consultation service use among Internet users were placed on web pages identified by searches using suicide-related keywords. We replied to all emails received between July and December 2013 and analyzed their contents. Results: A total of 139 consultation service users were analyzed. The mean age was 23.8 years (SD = 9.7), and female users accounted for 80% of the sample. Suicidal ideation was present in 74.1%, and 12.2% had a history of suicide attempts. After consultation, positive changes in mood were observed in 10.8%, 16.5% showed intentions to seek help from new supporters, and 10.1% of all 139 users actually took help-seeking actions. Conclusion: Online gatekeeping to prevent suicide by placing advertisements on web search pages to promote consultation service use among Internet users with suicidal ideation may be feasible.

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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.

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Attachment Organization in Suicide Prevention Research

Crisis ◽

10.1027/0227-5910/a000231 ◽

2014 ◽

Vol 35 (1) ◽

pp. 60-66 ◽

Cited By ~ 10

Author(s):

Amanda Venta ◽

Carla Sharp

Keyword(s):

Risk Factors ◽

Suicidal Ideation ◽

Suicide Attempt ◽

Interpersonal Relationships ◽

Suicide Ideation ◽

Suicide Attempts ◽

Critical Role ◽

Self Report ◽

Future Research ◽

Self Harm

Background: Identifying risk factors for suicide-related thoughts and behaviors (SRTB) is essential among adolescents in whom SRTB remain a leading cause of death. Although many risk factors have already been identified, influential theories now suggest that the domain of interpersonal relationships may play a critical role in the emergence of SRTB. Because attachment has long been seen as the foundation of interpersonal functioning, we suggest that attachment insecurity warrants attention as a risk factor for SRTB. Aims: This study sought to explore relations between attachment organization and suicidal ideation, suicide attempts, and self-harm in an inpatient adolescent sample, controlling for demographic and psychopathological covariates. Method: We recruited 194 adolescents from an inpatient unit and assigned them to one of four attachment groups (secure, preoccupied, dismissing, or disorganized attachment). Interview and self-report measures were used to create four variables reflecting the presence or absence of suicidal ideation in the last year, single lifetime suicide attempt, multiple lifetime suicide attempts, and lifetime self-harm. Results: Chi-square and regression analyses did not reveal significant relations between attachment organization and SRTB, although findings did confirm previously established relations between psychopathology and SRTB, such that internalizing disorder was associated with increased self-harm, suicide ideation, and suicide attempt and externalizing disorder was associated with increased self-harm. Conclusion: The severity of this sample and methodological differences from previous studies may explain the nonsignificant findings. Nonsignificant findings may indicate that the relation between attachment organization and SRTB is moderated by other factors that should be explored in future research.

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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.

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Examining Time Perspective Orientation in Suicide Ideation and Suicide Attempts

Journal of Social and Clinical Psychology ◽

10.1521/jscp.2019.38.7.627 ◽

2019 ◽

Vol 38 (8) ◽

pp. 627-646

Author(s):

Arezoo Shahnaz ◽

Boaz Y. Saffer ◽

E. David Klonsky

Keyword(s):

Psychological Functioning ◽

Suicide Risk ◽

Time Perspective ◽

Suicide Ideation ◽

Suicide Attempts ◽

Time Perspectives ◽

The Past ◽

History Of ◽

Negative Orientation ◽

Two Measures

Introduction: Time perspective orientation (TPO) refers to the way an individual psychologically and behaviorally connects to temporal concepts of past, present, and future. Previous studies have hypothesized that certain types of time perspectives, such as a negative orientation towards the past, predict negative psychological functioning and outcomes, including suicide risk. The current study examines whether differences in TPOs are linked to suicidal thoughts or suicidal acts using two measures of time perspective. Methods: We recruited a large online U.S.-based sample comprised of three groups: participants with (a) a history of suicide attempts (attempters; n = 107), (b) a history of suicide ideation but no history of attempts (ideators; n = 164), and (c) no history of ideation or attempts (nonsuicidal; n = 194). Results: A Positive Past (d = 0.71) and Negative Past (d = 0.89) orientation yielded large differences between individuals with a history of suicide ideation and nonsuicidal participants, where Positive Past was elevated among nonsuicidal participants and Negative Past among ideators. These differences were not accounted for by depression or anxiety. However, TPO differences between individuals with a history of suicide ideation and individuals with a history of attempts ranged from negligible to small (d range = 0.03—0.33). Discussion: The findings suggest that time perspective may be robustly associated with the development of suicide ideation, but only minimally related to suicide attempts among ideators.

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Interoceptive deficits, non-suicidal self-injury, and suicide risk: a multi-sample study of indirect effects

Psychological Medicine ◽

10.1017/s0033291718003872 ◽

2019 ◽

Vol 49 (16) ◽

pp. 2789-2800 ◽

Cited By ~ 1

Author(s):

Christopher R. Hagan ◽

Megan L. Rogers ◽

Amy M. Brausch ◽

Jennifer J. Muehlenkamp ◽

Thomas E. Joiner

Keyword(s):

Suicidal Ideation ◽

Suicidal Behavior ◽

Indirect Effect ◽

Indirect Effects ◽

Suicide Ideation ◽

Suicide Attempts ◽

Pain Tolerance ◽

Self Report ◽

Self Injury ◽

Two Samples

AbstractBackgroundInteroceptive deficits (ID) have been associated with non-suicidal self-injury (NSSI) and suicidal behavior in multiple studies. Many of these studies are limited in scope, and have not fully examined possible mechanisms explaining how ID affect suicidal behavior.MethodsThis study assesses how self-reported ID relate to suicide ideation and attempts in six distinct and geographically diverse samples of adults (n = 2706) and one sample of adolescents (n = 436). Participants responded to a variety of self-report questionnaires and interviews.ResultsContrary to our hypothesis, self-reported ID were only associated with suicidal ideation in two samples, one of which was the adolescent sample. Largely consistent with our predictions, self-reported ID exhibited an indirect effect on suicide attempts through versatility of NSSI in four of the five adult samples tested. Finally, the indirect effects of self-reported ID on suicide attempts through NSSI versatility did not act indirectly through behaviorally assessed pain tolerance.ConclusionsWe found that, in adults, self-reported ID are not associated with suicidal ideation, but are connected with a history of suicide attempts, through an indirect effect via NSSI. Our findings also indicate that the mechanism of action leading from self-reported ID to suicidal behavior may differ between adolescents and adults, and relate to suicidal behavior independent of pain tolerance. Clinical implications and future directions are discussed.

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M32. THE NATURE OF THE RELATIONSHIP OF SUICIDALITY WITH SCHIZOTYPY AND PSYCHOSIS EXPERIENCE

Schizophrenia Bulletin ◽

10.1093/schbul/sbaa030.344 ◽

2020 ◽

Vol 46 (Supplement_1) ◽

pp. S146-S146

Author(s):

Richard Linscott ◽

Ellen Wright ◽

Theresa Parker ◽

Kirstie O’Hare

Keyword(s):

Suicidal Ideation ◽

Suicide Attempts ◽

Population Sample ◽

Interpersonal Theory ◽

Magical Thinking ◽

Interpersonal Theory Of Suicide ◽

Magical Ideation ◽

Causal Connections ◽

History Of ◽

Using Data

Abstract Background Meehl portrayed pervasive, chronic suicidality as a key sign of schizotypy. Consistent with this view, positive schizotypy predicts concurrent and future suicidality, is particularly predictive of greater lethality, and is a more potent predictor of suicidality than other psychopathology. Whereas the most prominent explanation for this relationship is that it is spurious, several possible causal connections have not been tested. Also, most existing evidence relates to positive schizotypy and psychosis experience. We describe three studies of the schizotypy – suicidality link. Methods In the first, we tested whether, as Meehl argued, schizotypy is associated with suicide dread. A general population sample (n = 350) of young adults (18 to 24 years) reported on schizotypy and suicidality, including efforts to avert suicide attempts. In univariate analyses, positive, negative, and disorganized components of schizotypy each significantly predicted persistent or frequent suicidal ideation in the past month (ORs from 2.10 to 3.71), history of attempts with intent to die (1.59 to 2.15), fear or dread of the possibility of making an attempt (1.58 to 1.63), and worry about acting on an unwanted impulse to attempt suicide (2.48 to 2.62). In fully-adjusted analyses (controlling for depression, anxiety, stress, and all schizotypy components), positive schizotypy predicted reporting of greater worry about impulsive suicidal behaviour (OR = 1.71, p = .009, 95% CI 1.15 to 2.56). In the second, we tested whether the schizotypy – suicidality link can be understood using contemporary suicide theory. In a random sample of high school pupils (n = 177), schizotypy components predicted classification as an active suicidal ideator (R2 = 0.76, 95% CI 0.56 to 0.95). These effects were accounted by the influences of magical thinking, unusual perceptual experiences, and suspiciousness being mediated in part by perceived burdensomeness, as per the interpersonal theory of suicide. However, direct effects were also observed from social anxiety and magical ideation components of schizotypy. In the third, we modelled latent growth mixtures of suicidality using data from five waves of the Dunedin Multidisciplinary Health and Development Study. We test how growth in suicidality (from 18 to 38 years) is related to psychosis experience (age 11 years) and schizotypy (age 13 and 15 years). Schizotypy predicted membership of a growth class characterised by chronically death- and suicidal-ideation that, in turn, predicted attempt behaviour. Results See above. Discussion The complexity of the observed links of schizotypy and psychosis experience with suicidality do not lend themselves to being discounted as spurious or due to common underlying causal factors. Research addressing possible causal connections is warranted, as are efforts to identify whether reduction of suicidality may result from interventions targeting features of subclinical psychosis.

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