Risk Factors Associated With Various Severities of Suicidal and Non-Suicidal Self-Harm Among Israel Defense Forces Soldiers—A Nested Case–Control Study

ABSTRACT Objective Severe suicide attempt is a major risk factor for completed suicide. The aim of the present study was to focus on suicide behavior and timing to gain better understanding of these populations. Method The nested case–control retrospective study based on medical records of 246,866 soldiers, who demonstrated suicide attempts of varying severity, including death by suicide were compared with soldiers who did not demonstrate such behavior. Results Risk for death by suicide was associated with males, military seniority of less than 12 months. High frequency of visits with mental health care professionals was associated with being severe suicide attempters (SAs). Moderate suicide attempts were associated with being a male, visiting a primary care physician frequently, and belonging to one of the two latest immigrant groups in Israel (Ethiopians and former Soviet Union). Mild suicide attempts were associated with having a psychiatric diagnosis on the enlistment day, visiting a mental health care professional at high or average frequency, visiting a primary care physician at high or average frequency, being a male, and being born in the former Soviet Union. While the proportion of males demonstrating suicidal behavior was higher than the females’, severe SAs were higher among females. There was a clear tendency of female suicide attempters at all levels to act toward the end of their military service. Conclusions Although half of the SAs were females, their characteristics may be similar to those of the male SAs, contrary to the sex differences in suicide behavior among civilians.

Association and Genetic Expression between Genes Involved in HPA Axis and Suicide Behavior: A Systematic Review

Background: Suicide behavior (SB) has been highly associated with the response to stress and the hypothalamic–pituitary–adrenal (HPA) axis. The aim of this study was to summarize the results obtained in genetic studies that analyzed the HPA axis—stress pathway and SB through a systematic review. Methods: We performed an online search in PubMed, EBSCO, Web of Science, Scopus, and PsycoInfo databases up to May 2021. We followed the PRISMA guidelines for systematic reviews. We included case-control and expression studies that provided data on mRNA expression and single-nucleotide polymorphisms of genes associated with SB. Results: A total of 21,926 individuals participated across 41 studies (not repeats); 34 studies provided data on single-nucleotide polymorphisms in 21,284 participants and 11 studies reported data on mRNA expression in 1034 participants. Ten genes were identified: FKBP5, CRH, CRHBP, CRHR1, CRHR2, NR3C1, NR3C2, SKA2, MC2R, and POMC. Conclusions: Our findings suggest that key stress pathway genes are significantly associated with SB and show potential as biomarkers for SB.

Association of Thyroid Function with Suicidal Behavior: A Systematic Review and Meta-Analysis

Thyroid disease is a very common condition that influences the entire human body, including cognitive function and mental health. As a result, thyroid disease has been associated with multiple neuropsychiatric conditions. However, the relationship between thyroid dysfunction and suicide is still controversial. We conducted a systematic review and meta-analysis to describe the association of thyroid function with suicidal behavior in adults. We searched four data bases (MEDLINE, EMBASE, PsycINFO, and Scopus) from their inception to 20 July 2018. Studies that reported mean values and standard deviation (SD) of thyroid hormone levels [Thyroid-stimulating hormone (TSH), free thyroxine (FT4), free triiodothyronine (FT3), total thyroxine (TT4), and total triiodothyronine (TT3)] in patients with suicidal behavior compared with controls were included in this meta-analysis. The abstracts and papers retrieved with our search strategies were reviewed independently and in duplicate by four reviewers for assessment of inclusion criteria and data extraction, as well as for evaluation of risk of bias. Random-effects models were used in this meta-analysis to establish the mean difference on thyroid function tests between groups. Overall, 2278 articles were identified, and 13 studies met the inclusion criteria. These studies involved 2807 participants, including 826 participants identified with suicidal behavior. We found that patients with suicide behavior had lower levels of FT3 (−0.20 pg/mL; p = 0.02) and TT4 (−0.23 µg/dL; p = 0.045) compared to controls. We found no differences in either TSH, FT4, or TT3 levels among groups. With our search strategy, we did not identify studies with a comparison of overt/subclinical thyroid disease prevalence between patients with and without suicide behavior. The studies included in this meta-analysis had a low-to-moderate risk of bias. In the available literature, the evidence regarding the association of thyroid disorders and suicidal behavior is limited. We found that patients with suicidal behavior have significantly lower mean FT3 and TT4 levels when compared to patients without suicidal behavior. The clinical implications and pathophysiologic mechanisms of these differences remain unknown and further research is needed.

Suicide and Suicide risk factors: A Literature Review

Suicide can be defined as intentional self-inflicted death. It is a serious cause of mortality worldwide. Suicide is considered as a psychiatric emergency and the awareness of the seriousness of suicide in our society should not be overlooked. It is estimated that approximately 1.5% of all deaths worldwide are by suicide in the year 2020. The suicide mortality rate in 2015 was 12% in 100,000, which means about one death every 20 s. Rates of completed suicides are generally higher among men than among women, ranging from 1.5 times as much in the developing world to 3.5 times in the developed world. Suicide is generally most common among those over the age of 70; however, in certain countries, those aged between 15 and 30 are at the highest risk. Suicidal behavior is the second leading cause of death in adolescents in the world. Suicide behavior in adolescents can be prevented by recognizing risk factors and protective factors originating from themselves and the surrounding environment. This study aimed to identify risk factors and protective factors for adolescents who demonstrate suicidal behavior. Prevention programs that target young people, females, and low socioeconomic groups, and aimed to reduce harmful alcohol use can help prevent suicidal behaviours.

Oxidant- Antioxidant Status in Suicide Behavior in Kurdish Ethnicity

Introduction: Oxidative stress plays critical role in aging and pathogenesis of neurodegenerative and neuropsychiatric disorders. However, its role in suicidal behavior is not clarified yet. Consequently, we aimed to evaluate the oxidant-antioxidant status in the serum of suicide attempters in Ilam city. Methods: 50 suicide attempters and 40 control subjects (volunteers) aged 18-35 years were studied in the current experiment. In order to consider the oxidant-antioxidant status, serum levels of malondialdehyde (MDA), nitric oxide (NO), superoxide dismutase (SOD) and the total antioxidant capacity (TAC) were measured. Results: Serum levels of SOD enzyme and TAC were significantly lower in suicide attempters group compared to the controls. Furthermore, serum NO level was significantly higher in the suicide attempters in compare with the controls. Interestingly, the serum level of MDA was significantly lower in the suicide attempters compared to the controls. Conclusion: Presence of oxidative stress without MDA elevation, which has been detected in suicide attempters can be considered as a biochemical hallmark in suicide behavior.