scholarly journals A Systematic Review of Neuromodulation Treatment Effects on Suicidality

2021 ◽  
Vol 15 ◽  
Author(s):  
Mehmet Utku Kucuker ◽  
Ammar G. Almorsy ◽  
Ayse Irem Sonmez ◽  
Anna N. Ligezka ◽  
Deniz Doruk Camsari ◽  
...  

Introduction: Neuromodulation is an important group of therapeutic modalities for neuropsychiatric disorders. Prior studies have focused on efficacy and adverse events associated with neuromodulation. Less is known regarding the influence of neuromodulation treatments on suicidality. This systematic review sought to examine the effects of various neuromodulation techniques on suicidality.Methods: A systematic review of the literature from 1940 to 2020 following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline was conducted. Any reported suicide-related outcome, including suicidal ideation, suicide intent, suicide attempt, completed suicide in reports were considered as a putative measure of treatment effect on suicidality.Results: The review identified 129 relevant studies. An exploratory analysis of a randomized controlled trial comparing the effects of sertraline and transcranial direct-current stimulation (tDCS) for treating depression reported a decrease in suicidal ideation favoring tDCS vs. placebo and tDCS combined with sertraline vs. placebo. Several studies reported an association between repetitive transcranial magnetic stimulation and improvements in suicidal ideation. In 12 of the studies, suicidality was the primary outcome, ten of which showed a significant improvement in suicidal ideation. Electroconvulsive therapy (ECT) and magnetic seizure therapy was also shown to be associated with lower suicidal ideation and completed suicide rates. There were 11 studies which suicidality was the primary outcome and seven of these showed an improvement in suicidal ideation or suicide intent and fewer suicide attempts or completed suicides in patients treated with ECT. There was limited literature focused on the potential protective effect of vagal nerve stimulation with respect to suicidal ideation. Data were mixed regarding the potential effects of deep brain stimulation on suicidality.Conclusions: Future prospective studies of neuromodulation that focus on the primary outcome of suicidality are urgently needed.Systematic Review Registration:https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=125599, identifier: CRD42019125599.

2013 ◽  
Vol 14 (1) ◽  
pp. 92-112 ◽  
Author(s):  
Nazanin H. Bahraini ◽  
Grahame K. Simpson ◽  
Lisa A. Brenner ◽  
Adam S. Hoffberg ◽  
Alexandra L. Schneider

Traumatic brain injury (TBI) is prevalent among many populations and existing data suggest that those with TBI are at increased risk for death by suicide. This systematic review serves as an update to a previous review, with the aim of evaluating the current state of evidence regarding prevalence and risk of suicide deaths, post-TBI suicidal ideation and suicide attempts, and treatments to reduce suicide-related outcomes among TBI survivors. Review procedures followed the PRISMA statement guidelines. In all, 1014 abstracts and 83 full-text articles were reviewed to identify 16 studies meeting inclusion criteria. Risk of bias for individual studies ranged from low to high, and very few studies were designed to examine a priori hypotheses related to suicide outcomes of interest. Overall, findings from this systematic review supported an increased risk of suicide among TBI survivors compared to those with no history of TBI. Evidence pertaining to suicidal thoughts and attempts was less clear, mainly due to heterogeneity of methodological quality across studies. One small randomised controlled trial was identified that targeted suicide prevention in TBI survivors. Further research is needed to identify the prevalence of post-TBI ideation and attempts, and to establish evidence-based suicide prevention practices among TBI survivors.


Crisis ◽  
2010 ◽  
Vol 31 (1) ◽  
pp. 30-35 ◽  
Author(s):  
Sudath Samaraweera ◽  
Athula Sumathipala ◽  
Sisira Siribaddana ◽  
S. Sivayogan ◽  
Dinesh Bhugra

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.


2021 ◽  
Vol 34 (2) ◽  
pp. e100247
Author(s):  
Matt Pelton ◽  
Matt Ciarletta ◽  
Holly Wisnousky ◽  
Nicholas Lazzara ◽  
Monica Manglani ◽  
...  

BackgroundPeople living with HIV/AIDS (PLWHA) must contend with a significant burden of disease. However, current studies of this demographic have yielded wide variations in the incidence of suicidality (defined as suicidal ideation, suicide attempt and suicide deaths).AimsThis systematic review and meta-analysis aimed to assess the lifetime incidence and prevalence of suicidality in PLWHA.MethodsPublications were identified from PubMed (MEDLINE), SCOPUS, OVID (MEDLINE), Joanna Briggs Institute EBP and Cochrane Library databases (from inception to before 1 February 2020). The search strategy included a combination of Medical Subject Headings associated with suicide and HIV. Researchers independently screened records, extracted outcome measures and assessed study quality. Data were pooled using a random-effects model. Subgroup and meta-regression analyses were conducted to explore the associated risk factors and to identify the sources of heterogeneity. Main outcomes were lifetime incidence of suicide completion and lifetime incidence and prevalence of suicidal ideation and suicide attempt.ResultsA total of 185 199 PLWHA were identified from 40 studies (12 cohorts, 27 cross-sectional and 1 nested case-control). The overall incidence of suicide completion in PLWHA was 10.2/1000 persons (95%CI: 4.5 to 23.1), translating to 100-fold higher suicide deaths than the global general population rate of 0.11/1000 persons. The lifetime prevalence of suicide attempts was 158.3/1000 persons (95%CI: 106.9 to 228.2) and of suicidal ideation was 228.3/1000 persons (95%CI: 150.8 to 330.1). Meta-regression revealed that for every 10-percentage point increase in the proportion of people living with HIV with advanced disease (AIDS), the risk of suicide completion increased by 34 per 1000 persons. The quality of evidence by Grading of Recommendations, Assessment, Development and Evaluations for the suicide deaths was graded as ‘moderate’ quality.ConclusionsThe risk of suicide death is 100-fold higher in people living with HIV than in the general population. Lifetime incidence of suicidal ideation and attempts are substantially high. Suicide risk assessments should be a priority in PLWHA, especially for those with more advanced disease.


2019 ◽  
Vol 3 (1) ◽  
pp. 78
Author(s):  
Victor Meireles Campos ◽  
Ieda Aleluia

BACKGROUND: Suicidal ideation is one of the main symptoms indicative of suicide attempts and suicide. According to the WHO, about 800,000 cases of suicide were reported around the world in 2014, which translates to an index of 1 suicide every 40 seconds. Medical students constitute a population at risk for the development of suicidal ideation. Several life factors may influence the risk of suicidal ideation, those being personality traits, social factors and mental health. OBJECTIVE: Identify the indicators of suicidal ideation among medical students during their academic training. METHODS: This is a systematic review carried out in the electronic databases Pubmed and BVS. Articles that addressed the subject of suicidal ideation among medical students in Portuguese, English and Spanish from 2008 to 2018 were included. RESULTS: We found 263 articles, of which 12 articles met the inclusion and exclusion criteria. After the application of the STROBE statement, 6 articles were selected for the creation of this systematic review. The prevalence of suicidal ideation varied from 3.7% to 35.6% around the world and several factors were linked to the increase of suicidal ideation risk. CONCLUSION: A suicidal ideation is a frequent and multifactorial phenomenon that involves several realms of a medical student's life. The risk factors identified in this review were linked to the increased risk of suicidal ideation development.


Author(s):  
Katharine A. Phillips

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.


2015 ◽  
Vol 28 (5) ◽  
pp. 608
Author(s):  
João Gama Marques ◽  
Alice Roberto ◽  
Cátia Guerra ◽  
Mariana Pinto da Costa ◽  
Anja Podlesek ◽  
...  

<strong>Introduction:</strong> 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.<br /><strong>Material and Methods:</strong> 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.<br /><strong>Results:</strong> 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.<br /><strong>Discussion:</strong> The results are worriying and may be associated with some factors to which this population is exposed.<br /><strong>Conclusion:</strong> It is necessary further research to better understand this phenomenon, its causes and potential modifiers.


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