scholarly journals Adolescent suicide and suicidal behavior: a review

2021 ◽  
Vol 3 (Number 2) ◽  
pp. 38-42
Author(s):  
Mohammad Nurunnabi ◽  
Monowar Ahmad Tarafdar ◽  
Afroza Begum ◽  
Sultana Jahan ◽  
A F M Rezaul Islam

Suicide among adolescent has emerged as a major public health issue in many low and middle-income (LAMI) countries. Suicidal behavior including ideation and attempt are the most important predictors of completed suicide and offer critical points for intervention. This article reviews recent population and national data based studies of adolescent suicide and suicide attempters for analyzing risk factors for adolescent suicide and suicidal behavior. According to WHO estimates, 800,000 suicide deaths occurred worldwide in 2016 and it is the third leading cause of death for 15-19 year olds. The suicide rate in Bangladesh was 5.9 per 100,000 population in 2016 (4.7 for males and 7.0 for females). Approximately, 90 percent of suicide cases meet criteria for a psychiatric disorder, particularly major depression, substance abuse and prior suicide attempts are strongly related to adolescent suicides. The relationship between psychiatric disorders and adolescent suicide is now well established. Factors related to family adversity, social alienation and precipitating problems also contribute to the risk of suicide. The main target of effective prevention of adolescent suicides is to reduce suicide risk factors. Recognition and effective management and control of psychiatric disorders, e.g. depression, are essential in preventing adolescent suicides. Research on the treatment of diagnosed depressive disorders and of those with suicidal behavior is reviewed.

2019 ◽  
Vol 4 (2) ◽  

In most of the countries suicide is one of the ten leading causes of death and for young people it is the second most common cause. But in children suicide is rare and associated with severe personal and social problems. A useful definition of suicidal behavior in children developed by Pfeiffer is “Any self-destructive behavior that has intent to seriously damage oneself or cause death (1986)”. The thought of a child dying by suicide challenges the ideals we hold about how our children grow and develop at their own home and society. It also raises considerations about children’s understandings of death and their capacity to have the intent to suicide. The relationship between psychiatric disorders and adolescent suicide is now well established. Mood disorders, substance abuse, conduct disorder and prior suicide attempts are strongly related with youth and child suicides. Factors related to family adversity, style of parenting and child rearing, recent socio-cultural transition and other precipitating problems also contribute to the risk of suicide. The main target of effective prevention of child and youth suicide is to reduce suicide risk factors. Recognition and effective treatment of psychiatric disorders, e.g. depression, conduct disorder, oppositional defiant disorders are essential in preventing child and adolescent suicides. In the treatment of youth depression, psychosocial treatments have proved to be useful and efficacious. Here we have described about the case of a 08 year old boy, presenting with restlessness, impulsiveness, multiple threats and one episode of attempted suicide following refusal to watch TV by parents.


Crisis ◽  
2004 ◽  
Vol 25 (2) ◽  
pp. 74-77 ◽  
Author(s):  
Andrej Marušič ◽  
Saška Roškar ◽  
Roderick H. Hughes

Summary: The number of adolescents who attempt or complete suicide is increasing. Risk factors range from mental disorders, to problems at school, family problems, or difficulties in establishing relationships. A further important, and too often underestimated, risk factor for adolescent suicide is the presence of suicidal behavior in the adolescent's family. We investigated 184 high school adolescents in a region in Slovenia with a high suicide rate (30/100,000/year). They were questioned by means of an anonymous questionnaire about the presence of suicidal behavior in their relatives and about the presence of suicidal thoughts, plans, and acts in themselves. The results revealed that 13% of the adolescents studied had a relative who had attempted suicide and a further 9% of the adolescents had lost a relative due to suicide. About half of all females and almost a third of males had had suicidal thoughts (differences between sexes were statistically significant: χ2 = 6.13; p < .01). Attempted suicide among relatives was positively correlated with the presence of suicidal plans among adolescents (Φ = 0.15; p < .05). This correlation proved to be even stronger and statistically more significant in men when we split the sample by gender. All variables (suicidal thoughts, suicidal plans, and suicide attempts) in the adolescent males positively correlated with attempted suicide among their relatives (Φ = 0.28, p < .01; Φ = 0.26, p < .05; Φ = 0.34, p < .01; respectively). Our results speak in favor of a higher risk of suicidal behavior among adolescents with suicidal behavior in their families.


Author(s):  
Leo Sher

Abstract Adolescent suicide research has mostly focused on demographic risk factors. Such studies focus on who is at risk, but do not explain why certain adolescents are at risk for suicide. Studies of the neurobiology of adolescent suicide could clarify why some youths are more suicidal than others and help to find biological markers of suicidal behavior in teenagers. Over the past decade the role of brain-derived neurotrophic factor (BDNF) in the pathophysiology of suicidal behavior has attracted significant attention of scientists. BDNF is involved in the pathophysiology of many psychiatric disorders associated with suicidal behavior including depression, post-traumatic stress disorder, schizophrenia, and obsessive-compulsive disorder. BDNF dysregulation could be associated with increased suicidality independently of psychiatric diagnoses. BDNF plays an important role in the regulation and growth of neurons during childhood and adolescence. Prominent among the brain regions undergoing developmental change during adolescence are stressor-sensitive areas. The serotonin dysfunction found in adolescent and adult suicidal behavior could be related to the low level of BDNF, which impedes the normal development of serotonin neurons during brain development. BDNF dysfunction could play a more significant role in the pathophysiology of psychiatric disorders and suicidal behavior in adolescents than in adults. Treatment-induced enhancement in the BDNF function could reduce suicidal behavior secondary to the improvement in psychiatric pathology or independently of improvement in psychiatric disorders. It is interesting to hypothesize that BDNF could be a biological marker of suicidal behavior in adolescents or in certain adolescent populations.


2021 ◽  
pp. 44-56
Author(s):  
Sergey Zinovievich Savin ◽  
Evgeniya Valerievna Solodkaya

In the pathogenesis of depressive disorders and the consequent suicidal behavior, an important role belongs to the neurochemical processes and structures of the central nervous system. An analytical study of Russian and foreign literature was carried out to obtain information about the relationship between neurochemical factors in the development of depressive disorders and to elucidate the causes and risk factors of suicidal behavior due to depression and an unhealthy habit common among young people, i.e. tobacco smoking. A systematic search of scientific publications on the neurobiological aspects of the research into the causes and risk factors of depressive spectrum disorders was carried out. The analysis of the results of relevant neurobiological studies in the field of etiology and formation of depressive disorders with suicidal behavior contributes to the development of effective means of prevention and treatment of depressive spectrum disorders.


SLEEP ◽  
2021 ◽  
Author(s):  
Zach Simmons ◽  
Gary Burlingame ◽  
Juergen Korbanka ◽  
Kevin Eastman ◽  
Douglas Thomas ◽  
...  

Abstract Study Objectives Insomnia is a risk factor for suicidal behavior including attempts and death by suicide. We investigated whether insomnia symptom severity was associated with suicidality and death by suicide in patients with psychiatric disorders. Methods The sample included 180 deceased patients with psychiatric disorders seen at Weber Human Services between 2008 and 2018 who completed the Outpatient Questionnaire-45.2 (OQ) prior to death. Insomnia symptom severity was assessed using item 41 from the OQ. Manner of death was determined by death records and autopsy reports. History of suicidality was determined through electronic medical records. Cases were grouped into 4 lifetime categories: non-suicidal (n=30), suicidal ideation (n=36), suicide attempt (n=95), and death by suicide (n=19). Demographic, medical, and psychiatric features of each group were compared using linear regression. Logistic regression was used to determine whether insomnia symptom severity was associated with lifetime suicidality severity grouping, adjusting for psychiatric disorders commonly linked to suicidality. Results Lifetime suicidality was associated with sleep problems, fatigue, headaches, and psychiatric disorders (i.e., depressive, personality, and trauma-related disorders). Referenced to the non-suicidal group, greater insomnia symptom severity was significantly associated with suicide attempts and death by suicide, with odds ratios (OR) of OR=2.67, p=0.011, and OR=5.53, p=0.002, respectively, even after adjusting important psychiatric diagnoses. Conclusions Results suggest that insomnia symptom severity endorsed during a clinical visit is associated with heightened suicidality, especially suicidal behavior. The presence of insomnia symptoms in patients with psychiatric disorders may indicate risk for suicide and is a target for suicide prevention.


2019 ◽  
Vol 8 (6) ◽  
pp. 834 ◽  
Author(s):  
Esmé Eggink ◽  
Eric P. Moll van Charante ◽  
Willem A. van Gool ◽  
Edo Richard

The global number of people living with dementia is expected to increase to 130 million in 2050. Based on extensive evidence from observational studies, it is estimated that about 30% of dementia cases may be attributable to potentially modifiable risk factors. This suggests that interventions targeting these factors could perhaps delay or prevent the onset of dementia. Since the vast majority of people with dementia live in low- and middle-income countries, such interventions should preferably be easy and affordable to implement across a wide range of health care systems. However, to date, results from dementia prevention trials do not provide convincing evidence that treatment of these risk factors reduces the risk of dementia. The current paper aims to give an overview of available evidence for the potential for dementia prevention. In particular, we discuss methodological issues that might complicate the development of effective prevention interventions and explore the opportunities and challenges for future dementia prevention research. Currently, several ongoing and planned trials are testing the effect of multi-domain interventions on dementia risk in high-risk populations. It is desirable that future dementia strategies also target the wider population, through interventions on the individual, community, and population level, in order to constrain the growing prevalence of dementia worldwide.


Author(s):  
Jane Pirkis ◽  
Angela Nicholas ◽  
David Gunnell

Abstract Much of our knowledge about the risk factors for suicide comes from case–control studies that either use a psychological autopsy approach or are nested within large register-based cohort studies. We would argue that case–control studies are appropriate in the context of a rare outcome like suicide, but there are issues with using this design. Some of these issues are common in psychological autopsy studies and relate to the selection of controls (e.g. selection bias caused by the use of controls who have died by other causes, rather than live controls) and the reliance on interviewing informants (e.g. recall bias caused by the loved ones of cases having thought about the events leading up to the suicide in considerable detail). Register-based studies can overcome some of these problems because they draw upon contain information that is routinely collected for administrative purposes and gathered in the same way for cases and controls. However, they face issues that mean that psychological autopsy studies will still sometimes be the study design of choice for investigating risk factors for suicide. Some countries, particularly low and middle income countries, don't have sophisticated population-based registers. Even where they do exist, there will be variable of interest that are not captured by them (e.g. acute stressful life events that may immediately precede a suicide death), or not captured in a comprehensive way (e.g. suicide attempts and mental illness that do not result in hospital admissions). Future studies of risk factors should be designed to progress knowledge in the field and overcome the problems with the existing studies, particularly those using a case–control design. The priority should be pinning down the risk factors that are amenable to modification or mitigation through interventions that can successfully be rolled out at scale.


Author(s):  
Kelly C. Cukrowicz ◽  
Erin K. Poindexter

Suicide is a significant concern for clinicians working with clients experiencing major depressive disorder (MDD). Previous research has indicated that MDD is the diagnosis more frequently associated with suicide, with approximately two-thirds of those who die by suicide suffering from depression at the time of death by suicide. This chapter reviews data regarding the prevalence of suicidal behavior among those with depressive disorders. It then reviews risk factors for suicide ideation, self-injury, and death by suicide. Finally, the chapter provides an empirical overview of treatment studies aimed at decreasing risk for suicide, as well as an overview of several recent treatment approaches showing promise in the reduction of suicidal behavior.


2008 ◽  
Vol 39 (5) ◽  
pp. 763-771 ◽  
Author(s):  
J. G. Fiedorowicz ◽  
A. C. Leon ◽  
M. B. Keller ◽  
D. A. Solomon ◽  
J. P. Rice ◽  
...  

BackgroundSuicide is a leading cause of death and has been strongly associated with affective disorders. The influence of affective disorder polarity on subsequent suicide attempts or completions and any differential effect of suicide risk factors by polarity were assessed in a prospective cohort.MethodParticipants with major affective disorders in the National Institute of Mental Health (NIMH) Collaborative Depression Study (CDS) were followed prospectively for up to 25 years. A total of 909 participants meeting prospective diagnostic criteria for major depressive and bipolar disorders were followed through 4204 mood cycles. Suicidal behavior was defined as suicide attempts or completions. Mixed-effects, grouped-time survival analysis assessed risk of suicidal behavior and differential effects of risk factors for suicidal behavior by polarity. In addition to polarity, the main effects of age, gender, hopelessness, married status, prior suicide attempts and active substance abuse were modeled, with mood cycle as the unit of analysis.ResultsAfter controlling for age of onset, there were no differences in prior suicide attempts by polarity although bipolar participants had more prior severe attempts. During follow-up, 40 cycles ended in suicide and 384 cycles contained at least one suicide attempt. Age, hopelessness and active substance abuse but not polarity predicted suicidal behavior. The effects of risk factors did not differ by polarity.ConclusionsBipolarity does not independently influence risk of suicidal behavior or alter the influence of well-established suicide risk factors within affective disorders. Suicide risk assessment strategies may continue to appraise these common risk factors without regard to mood polarity.


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