Worldwide prevalence of suicidal ideation and suicide plan among people with schizophrenia: a meta-analysis and systematic review of epidemiological surveys

Schizophrenia is a severe psychiatric disorder with high premature mortality rates. This is a meta-analysis and systematic review of the prevalence of suicidal ideation (SI) and suicide plan (SP) among people with schizophrenia. PubMed, Web of Science, Embase, and PsycINFO were systematically searched from their respective inception to October 10, 2020. Data on prevalence of SI and/or SP were synthesized using the random effects model. Twenty-six studies covering 5079 people with schizophrenia were included for meta-analysis. The lifetime and point prevalence of SI were 34.5% (95% CI: 28.2−40.9%), and 29.9% (95% CI: 24.2−35.6%), respectively. The lifetime prevalence of SP was 44.3% and the point prevalence of SP ranged between 6.4 and 13%. Subgroup and meta-regression analyses revealed that source of patients, survey countries, and sample size were significantly associated with the point prevalence of SI, while male proportion and quality assessment scores were significantly associated with the lifetime and point prevalence of SI. Survey time and mean age were significantly associated with lifetime prevalence of SI. Both SI and SP are common in people living with schizophrenia, especially in males and inpatients. Routine screening and effective interventions for SI and SP should be implemented in this population.

Mood and Suicidality among Cyberbullied Adolescents: A Cross-Sectional Study from Youth Risk Behavior Survey

Background: There is limited literature available showing the mental health burden among adolescents following cyberbullying. Objective: The aim was to evaluate the association between low mood and suicidality among cyberbullied adolescents. Method: A cross-sectional analysis of the data was performed among adolescents from the National Youth Risk Behavior Surveillance System. Responses from adolescents related to cyberbullying and suicidality were evaluated. Chi-square and mix-effect multivariable logistic regression analysis was performed to determine the association of cyberbullying with sadness/hopelessness and suicide consideration, plan, and attempts. Results: Of a total of 8274 adolescents, 14.8% of adolescents faced cyberbullying past year. There was a higher prevalence of cyberbullying in youths aged 15, 16, and 17 years (25%, 26%, 23%, respectively), which included more females than males (68% vs. 32%; p < 0.0001). Caucasians (53%) had the highest number of responses to being cyberbullied compared to Hispanics (24%) or African Americans (11%; p < 0.0001). There was an increased prevalence of cyberbullied youths, feelings of sadness/hopelessness (59.6% vs. 25.8%), higher numbers considering suicide (40.4% vs. 13.2%), suicide plan (33.2% vs. 10.8%), and multiple suicidal attempts in comparison to non-cyberbullied (p < 0.0001). On regression analysis, cyberbullied adolescents had a 155% higher chance of feeling sad and hopeless [aOR = 2.55; 95%CI = 2.39–2.72] and considered suicide [aOR = 1.52 (1.39–1.66)] and suicide plan [aOR = 1.24 (1.13–1.36)]. Conclusion: In our Study, cyberbullying was associated with negative mental health outcomes. Further research is warranted to examine the impact of cyberbullying among adolescents and guiding the policies to mitigate the consequences.

Prevalence of Suicidality in Major Depressive Disorder: A Systematic Review and Meta-Analysis of Comparative Studies

Background: Suicidality is common in major depressive disorder (MDD), but there has been no systematic review published about all aspects of suicidality. This meta-analysis and systematic review compared the prevalence of the whole range of suicidality comprising suicidal ideation (SI), suicide plan (SP), suicide attempt (SA), and completed suicide (CS), between patients with MDD and non-MDD controls.Methods: Major international (PubMed, PsycINFO, Web of Science, EMBASE) and Chinese (Chinese Nation Knowledge Infrastructure and WANFANG) databases were systematically and independently searched from their inception until January 12, 2021.Results: Fifteen studies covering 85,768 patients (12,668 in the MDD group and 73,100 in the non-MDD group) were included in the analyses. Compared to non-MDD controls, the odds ratios (ORs) for lifetime, past month, past year, and 2-week prevalence of SI in MDD were 2.88 [95% confidence interval (CI) = 0.30–27.22, p = 0.36], 49.88 (95% CI = 2–8.63, p &lt; 0.001), 13.97 (95% CI = 12.67–15.41, p &lt; 0.001), and 24.81 (95% CI = 15.70–39.22, p &lt; 0.001), respectively. Compared to non-MDD controls, the OR for lifetime SP in MDD was 9.51 (95% CI = 7.62–11.88, p &lt; 0.001). Compared to non-MDD controls, the ORs of lifetime and past-year prevalence of SA were 3.45 (95% CI = 1.58–7.52, p = 0.002), and 7.34 (95% CI = 2.14–25.16, p = 0.002), respectively, in MDD patients. No difference in the prevalence of CS between MDD and controls was found (OR = 0.69, 95% CI = 0.23–2.02, p = 0.50).Conclusions: MDD patients are at a higher risk of suicidality, compared to non-MDD controls. Routine screening for a range of suicidality should be included in the management of MDD, followed by timely treatment for suicidal patients.Systematic Review Registration: Identifier [INPLASY202120078].

Association between First Sexual Intercourse and Sexual Violence Victimization, Symptoms of Depression, and Suicidal Behaviors among Adolescents in the United States: Findings from 2017 and 2019 National Youth Risk Behavior Survey

The objective of this study was to investigate the association between first sexual intercourse and sexual violence victimization, symptoms of depression, and suicidal ideation among sexually active adolescents in the United States. Data for this study came from the U.S. 2017 and 2019 iterations of the National Youth Risk Behavior Survey. An analytic sample of 6252 adolescents aged 14–18 years old (49.5% female) who reported ever having sexual intercourse was analyzed using Poisson regression. The outcome variables investigated in this study were sexual violence victimization, symptoms of depression, suicidal ideation, a suicide plan, and suicide attempts, and the main explanatory variables were age at first sexual intercourse and forced sexual intercourse. We also analyzed differences by gender and race. Of the 6252 adolescents who reported ever having sexual intercourse, 7.1% had their first sexual intercourse before age 13, and 14.8% experienced forced sexual intercourse. About 16% of adolescents experienced sexual violence during the past year, 42.6% reported symptoms of depression, 23.9% experienced suicidal ideation, 19.3% made a suicide plan, and 11.1% attempted suicide during the past year. In the regression analysis, early sexual intercourse was significantly and positively associated with suicidal ideation (relative risk (RR) = 1.15, 95% Confidence Interval (CI) = 1.02–1.30), suicide plan (RR = 1.18, 95% CI = 1.00–1.38), and suicide attempts (RR = 1.36, 95% CI = 1.15–1.61). Controlling for the effects of covariates, history of forced sexual intercourse was positively associated with the five outcomes examined with the relative risk ranging between 1.59 and 6.01. Findings of this study suggest that history of early or forced sexual intercourse is associated with poor mental health outcomes among adolescents and underscores the importance of developing interventions that offer psychological support in reducing the adverse impact of early sexual intercourse and forced sexual intercourse on adolescent health.

Neuroaxial anesthesia caused paraplegia: a case report

Patients who undergo; anesthesia, neuraxial analgesia, or some type of neuraxial blockage are exposed to multiple complications. 33-year-old male patient, suffers a femur fracture with a long oblique trace causing pain and functional limitation for movements. Surgical resolution is determined using neuraxial block at L2-L3 level, and intravenous sedation. During his postoperative follow-up, a decrease in strength was confirmed in the lower limbs with 0/5 on the Daniels scale, 100% sensitivity without sphincter control, steroids were prescribed along with magnetic resonance imaging and a neurosurgical evaluation was requested. The MRI shows bulging of the fibrous annulus that obliterates the epidural fat and makes contact with the thecal sac in the L5-S1 intervertebral disc level. The neurosurgery service prescribes rehabilitation sessions at home, electrostimulation and neuropathic medications. Patient was discharged with rehabilitation sessions at home and medical treatment. In his last consultation, an evaluation from the psychiatry department was requested for ideas of disability, hopelessness, fantasies of death without a suicide plan related to limitations and loss of functionality. Patient does not return to external follow-up, cannot be located.

Cigarette Smoking and Suicidal Behaviors in Colombian High-School Students

The study aimed to quantify the association between last-month cigarette smoking and lifetime suicide behaviors in high-school students at Santa Marta, Colombia. A cross-sectional study was designed in which high-school students participated. They were asked about last-month cigarette smoking and lifetime suicide behaviors (suicide ideation, plan, and attempt). Crude odds ratios (ORs) were calculated and adjusted for confounding variables. A total of 1,462 students participated and they were between 13 and 17 ( M = 14.4, SD = 0.8) years, and 60.3% girls. The last-month prevalence of cigarette smoking was 11.6%, lifetime suicide ideation 10.2%, plan 18.5%, and attempted 15.4%. Cigarette smoking was associated with suicide ideation (OR = 1.67, 95% confidence interval [CI] = [1.17, 2.41]), suicide plan (OR = 1.97, 95% CI = [1.33, 2.93]), and suicide attempt (OR = 2.79, 95% CI = [1.87, 4.17]), after adjusting for gender, family function, and depressive symptoms. In conclusion, cigarette smoking is related to suicide behaviors in high-school students at Santa Marta, Colombia.

Suicidal Mental Imagery: Investigating a Novel Marker of Suicide Risk

Rates of suicidal ideation and behavior are high and increasing in emerging adulthood. Research focused on suicidal ideation as a predictor of suicidal behavior has nearly exclusively conceptualized suicidal ideation as verbal thoughts about suicide. Emerging research suggests, however, that mentally imagining suicide may be even more impairing than verbal thoughts about suicide. Thirty-nine emerging adults with a lifetime history of suicidal cognitions completed self-report assessments of characteristics of their suicidal cognitions, histories of suicide plans and behavior, and the degree to which their suicidal cognitions took the form of mental imagery or verbal thought. Suicidal mental imagery predicted more intense and longer duration of suicidal cognitions, a higher likelihood of having made a suicide plan, and a higher likelihood of having made a suicide attempt over and above suicidal verbal thoughts. Thus, suicidal mental imagery could provide a novel target for suicide assessment and intervention for emerging adults.