Suicidal Ideation
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PLoS ONE ◽  
2021 ◽  
Vol 16 (12) ◽  
pp. e0260620
Tyler L. Malone ◽  
Zhou Zhao ◽  
Tzu-Ying Liu ◽  
Peter X. K. Song ◽  
Srijan Sen ◽  

The purpose of this study was to identify individual and residency program factors associated with increased suicide risk, as measured by suicidal ideation. We utilized a prospective, longitudinal cohort study design to assess the prevalence and predictors of suicidal ideation in 6,691 (2012–2014 cohorts, training data set) and 4,904 (2015 cohort, test data set) first-year training physicians (interns) at hospital systems across the United States. We assessed suicidal ideation two months before internship and then quarterly through intern year. The prevalence of reported suicidal ideation in the study population increased from 3.0% at baseline to a mean of 6.9% during internship. 16.4% of interns reported suicidal ideation at least once during their internship. In the training dataset, a series of baseline demographic (male gender) and psychological factors (high neuroticism, depressive symptoms and suicidal ideation) were associated with increased risk of suicidal ideation during internship. Further, prior quarter psychiatric symptoms (depressive symptoms and suicidal ideation) and concurrent work-related factors (increase in self-reported work hours and medical errors) were associated with increased risk of suicidal ideation. A model derived from the training dataset had a predicted area under the Receiver Operating Characteristic curve (AUC) of 0.83 in the test dataset. The suicidal ideation risk predictors analyzed in this study can help programs and interns identify those at risk for suicidal ideation before the onset of training. Further, increases in self-reported work hours and environments associated with increased medical errors are potentially modifiable factors for residency programs to target to reduce suicide risk.

PLoS ONE ◽  
2021 ◽  
Vol 16 (12) ◽  
pp. e0260359
Patricia Capdevila-Gaudens ◽  
J. Miguel García-Abajo ◽  
Diego Flores-Funes ◽  
Mila García-Barbero ◽  
Joaquín García-Estañ

Medical Education studies suggest that medical students experience mental distress in a proportion higher than in the rest of the population In the present study, we aimed to conduct a nationwide analysis of the prevalence of mental health problems among medical students. The study was carried out in 2020 in all 43 medical schools in Spain, and analyzes the prevalence of depression, anxiety, empathy and burnout among medical students (n = 5216). To measure these variables we used the Beck Depression Inventory Test for assessing depression, the Maslach Burnout Inventory Survey for Students was used for burnout, the State-Trait Anxiety Inventory (STAI) was used to assess anxiety state and trait and the Jefferson Empathy Scale 12 to obtain empathy scores. In relation to depression, the data indicate an overall prevalence of 41%, with 23.4% of participants having moderate to severe levels, and 10% experiencing suicidal ideation. Burnout prevalence was 37%, significantly higher among 6th year than among 1st year students. Anxiety levels were consistent with those reported previously among medical students (25%), and were higher than in the general population for both trait and state anxiety. The prevalence of trait anxiety was higher among women. Empathy scores were at the top end of the scale, with the highest-scoring group (>130) containing a greater percentage of women. Similarly to those published previously for other countries, these results provide a clear picture of the mental disorders affecting Spanish medical students. Medicine is an extremely demanding degree and it is important that universities and medical schools view this study as an opportunity to ensure conditions that help minimize mental health problems among their students. Some of the factors underlying these problems can be prevented by, among other things, creating an environment in which mental health is openly discussed and guidance is provided. Other factors need to be treated medically, and medical schools and universities should therefore provide support to students in need through the medical services available within their institutions.

2021 ◽  
Vol 23 (1) ◽  
Vasiliki Efstathiou ◽  
Maria-Ioanna Stefanou ◽  
Nikolaos Siafakas ◽  
Michael Makris ◽  
Georgios Tsivgoulis ◽  

Priyo Purnomo As’hab ◽  
Budi Anna Keliat ◽  
Ice Yulia Wardani

Background: The Worldwide resistance prevalence of the first-line TB drug, rifampicin (RR-TB), in 2017 was 7.4 per 100,000 population, and 82% of them experienced multidrug-resistant tuberculosis (MDR-TB). Indonesia is the top 20 country with an MDR-TB burden, and its prevalence is 8.8 per 100,000 population. MDR-TB requires a long-time treatment and has accompanying side effects: biological and psychosocial effects. However, efforts to overcome the psychosocial impacts have not been conducted. This study aims to determine the effect of acceptance and commitment therapy (ACT) on anxiety, depression, suicidal ideation, and treatment adherence in MDR-TB patients.Design and methods: This research employed a quasi-experimental design with a pre-test three post-tests using total sampling. The pre-test was conducted before the standard nursing intervention, post-test 1 was after the standard nursing intervention, post-test 2 was after ACT session 1, and post-test 3 was after ACT session 2. Data were collected by the Hamilton Rating Scale for Anxiety (HAM-A), Beck Hopelessness Scale (BHS), a Scale for Suicide Ideation (SSI), and Morisky Medication Adherence Scale (MMAS).Results: The standard nursing action and ACT reduce anxiety (p = 0.002), reduced depression (p = 0.0001), reduced suicidal ideation (p = 0.008), and increased treatment adherence (p = 0.0001).Conclusions: The standard nursing action and ACT reduce anxiety, depression, and suicidal ideation. They increase treatment adherence recommended for use in MDR-TB patients.

2021 ◽  
Vol 2021 ◽  
pp. 1-3
Maggie Driscoll ◽  
Jason Gu

COVID-19 infection is linked to increased risk of neuropsychiatric symptoms such as psychosis and suicidal ideation/behavior. After further review of the literature, there is not a large body of data on anxiety following COVID-19 infection. Most literature found is related to fear/anxiety of contracting and dying from COVID-19. We illustrate a case of a 27-year-old male with no previous psychiatric treatment history or symptomology, who developed severe anxiety with intrusive thoughts of self-harm via firearm after COVID-19 infection. Given the severe nature of the anxiety and intrusive thoughts, the patient feared for his safety and sought acute inpatient admission. The patient was effectively treated with group therapy and psychotropic medications and was able to be discharged in a timely manner with outpatient psychiatric follow-up. Much is still unknown of COVID-19. With this case report, we discuss a potential relationship between anxiety and COVID-19 infection.

2021 ◽  
Vol 12 ◽  
Jiann Lin Loo ◽  
Nurul Ain Mohamad Kamal ◽  
Jo Aan Goon ◽  
Hanafi Ahmad Damanhuri ◽  
Jaclyn Ai Chin Tan ◽  

Background: Oxidative stress markers are found to be linked with depression and suicide attempts in bipolar disorder (BD), although the role of DNA damage as a marker of suicidal ideation and attempt has yet to be determined. We aim to investigate the association between DNA damage and suicidal behaviour, i.e., suicidal ideation and suicide attempt, among suicidal ideators in BD patients while accounting for clinical and psychosocial risk factors.Methods: A cross-sectional study was conducted in the Universiti Kebangsaan Malaysia Medical Centre on 62 consecutive BD patients diagnosed using the M.I.N.I. Neuropsychiatric Interview and 26 healthy control participants. Socio-demographic and clinical assessments were performed using the Columbia Suicide Severity Rating Scale (C-SSRS) for lifetime suicidal ideation and attempt, Quick Inventory of Depressive Symptomatology (QIDS) for depression severity, Clinical Global Impression for Bipolar Disorder (CGI-BD) for illness severity [both mania (CGI-Mania) and major depressive episode (CGI-MDE)], Social Readjustment Rating Scale (SRRS) for change in life events, and Barratt Impulsiveness Scale (BIS) for behavioural impulsivity. The degree of DNA damage in peripheral blood samples was determined using a standard protocol of comet assay.Results: Multivariable logistic regression revealed higher scores of CGI-MDE as the sole significant factor for lifetime suicidal ideation (OR = 1.937, 95% CI = 1.799–2.076). Although initial bivariate analysis showed a significant association between DNA damage, malondialdehyde (MDA), catalase (CAT), and suicidal behaviour, the findings were not seen in multivariable logistic regression. Bivariate subgroup analysis showed that moderate and severe DNA damage (p = 0.032 and p = 0.047, respectively) was significantly associated with lifetime suicide attempts among lifetime suicidal ideators. The study is the first to look at the connexion between DNA damage and suicidal risk in bipolar patients. It is limited by the small sample size and lack of information on illicit substance use.Conclusions: More severe DNA damage was significantly associated with lifetime suicide attempts among lifetime suicidal ideators in BD. However, the severity of depression was found to be independently associated with lifetime suicidal ideation per se rather than DNA damage in BD. Larger prospective studies are required to ascertain the potential of DNA damage as a biomarker for the transition from suicidal ideation to a suicide attempt.

2021 ◽  
pp. 107780122110309
Yifeng Du ◽  
Olivia D. Chang ◽  
Mingqi Li ◽  
Misu Kwon

The present study tested a prediction model involving affectivity and dispositional optimism as predictors of suicide risk (i.e., depressive symptoms and suicidal ideation) in young adult Chinese females with and without prior interpersonal violence (IPV) victimization (294 nonvictimized and 94 victimized females). Results of hierarchical regression analyses indicated that negative affectivity was a significant predictor of both depressive symptoms and suicidal ideation for Chinese females, regardless of IPV victimization. Beyond affectivity, dispositional optimism was found to further add to the prediction model of depressive symptoms in both groups, but only for suicidal ideation in the IPV victimized group.

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