Family processes are a risk factor for suicide but few studies target this domain. We evaluated the effectiveness of a family intervention, the Resourceful Adolescent Parent Program (RAP-P) in ...reducing adolescent suicidal behavior and associated psychiatric symptoms.
A preliminary randomized controlled trial compared RAP-P plus Routine Care (RC) to RC only, in an outpatient psychiatric clinic for N = 48 suicidal adolescents and their parents. Key outcome measures of adolescent suicidality, psychiatric disability, and family functioning were completed at pre-treatment, 3-month, and 6-month follow-up.
RAP-P was associated with high recruitment and retention, greater improvement in family functioning, and greater reductions in adolescents' suicidal behavior and psychiatric disability, compared to RC alone. Benefits were maintained at follow-up with a strong overall effect size. Changes in adolescent's suicidality were largely mediated by changes in family functioning.
The study provides preliminary evidence for the use of family-focused treatments for adolescent suicidal behavior in outpatient settings. Clinical trial registration information-Family intervention for adolescents with suicidal behaviour: A randomized controlled trial and mediation analysis; http://anzctr.org/; ACTRN12613000668707.
Pregnancy loss is arguably a traumatic and stressful life event that potentially impacts the emotional and behavioral health of those who experience it, especially adolescents. Research assessing ...this relationship has primarily focused on adult women populations.
Using data from National Longitudinal Study of Adolescent to Adult Health, a cross-sectional research design was employed to investigate whether pregnancy loss outcomes are associated with depressive mood and suicidal behavior (i.e., suicidal thoughts and suicide attempt) among adolescent girls (N = 6, 913). We also investigated the mediating effect of depressive mood. Initially, an all-encompassing pregnancy loss variable was used, which included abortions and miscarriages. Acknowledging the differences between these pregnancy loss outcomes, we created separate measures for each.
Using the all-encompassing pregnancy loss variable, findings from logistic regression analyses showed that pregnancy loss is positively and significantly associated with depressive mood and suicidal behaviors. Depressive mood mediated the relationship between pregnancy loss and suicidal behaviors. Miscarriage was positively and significantly associated with suicidal thoughts as well as attempting suicide. Depressive mood mediated the relationship between miscarriage and suicidal thoughts, while only partially mediating the relationship between miscarriage and suicide attempt. No significant effects were observed for abortion on outcomes of interest.
Cross-sectional analyses were performed limiting our ability to make casual inferences.
Pregnancy loss is associated with depressive mood and suicidal behavior, especially among adolescent girls who experience a miscarriage. Adolescent pregnancy and pregnancy loss should remain a focus of scholars and health professionals.
•Pregnancy loss is associated with depressive mood and suicidal behavior.•Miscarriage is associated with depressive mood and suicidal behavior.•Depressive mood plays an important role among girls who experience pregnancy loss.•Abortion was not associated with negative emotional or suicidal outcomes.
Full text
Available for:
GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
IntroductionSuicide behaviour is a complex and multifactor concept that includes different risk factors. According with literature a dimensional concept of illness could help to understand this ...complexity and clarify clinical aspects of suicide risk.ObjectivesThe aim of this study is to identify different profiles of symptoms in a sample of suicide attempters and the relationship between this profiles and suicide behaviour in terms of outcome: presence and intensity of suicidal ideation, presence and number of attempts and severity of the medical damage in the current attempt.Methods634 patients were recruited at the psychiatry emergency of eight public general hospitals in Spain between November 2020 until February 2022 in the SURVIVE protocol. The patients were assessed in 15 days using a battery of clinical tools that includes Brief Symptom Inventory, a sociodemographic interview, Mini Clinical Interview and C-SSRS, ACSS and BIS-11 scales. Latent profile analysis was applied to obtain profile symptoms. Logistic and multivariant regression was used to obtain data about outcome.ResultsThree clinical profiles of psychiatric symptoms were described in suicide attempters (p < 0.01): high symptoms (HS) (45.02%), moderate symptoms (MS) (42.5 %) and low symptoms (LS) (12.48%). Significant differences were found between classes in four symptom domains (Figure 1): anxiety, obsessive-compulsive, sensitivity, and somatization (p < 0.01). Participants of the HS class showed higher values in relation with the BSI summary indexes, and more diagnoses, higher levels of suicidal ideation and suicidal related behaviour as well as higher acquired capability for suicide. Participants of the LS class were more likely to be women, older and unemployed and was related, according the analysis, with severe medical damage when compared with other groups (P< 0.01).Image:ConclusionsAccording with the predictive model the study suggests different symptom-frequency clusters related with suicide attempt outcomes. Suicide ideation presence and intensity is related with HS class and acquired capability of suicide. Suicide ideation intensity is also related with number of diagnosis and number of previous attempts. Suicide behaviours presence is associated with being student and number with HS profile. Both presence and number were related with number of diagnosis as well as number of previous attempts (the higher all these clinical factors, the more intense of ideation in the last month). Finally, the severity of medical damage was related with LS profile and unemployed/retired work status. The dimensional symptom profile could be useful to predict suicide attempt outcome. Further study is needed to clarify this relation.Disclosure of InterestNone Declared
Suicide accounts for over 58,000 deaths in Europe per annum, where suicide attempts are estimated to be 20 times higher. Males have been found to have a disproportionately lower rate of suicide ...attempts and an excessively higher rate of suicides compared to females. The gender difference in suicide intent is postulated to contribute towards this gender imbalance. The aim of this study is to explore gender differences in suicide intent in a cross-national study of suicide attempts. The secondary aims are to investigate the gender differences in suicide attempt across age and country.
Data on suicide attempts (acquired from the EU-funded OSPI-Europe project) was obtained from eight regions in Germany, Hungary, Ireland and Portugal. Suicide intent data was categorized into 'Non-habitual Deliberate Self-Harm' (DSH), 'Parasuicidal Pause' (SP), 'Parasuicidal Gesture' (SG), and 'Serious Suicide Attempt' (SSA), applying the Feuerlein scale. Gender differences in intent were explored for significance by using χ
-tests, odds ratios, and regression analyses.
Suicide intent data from 5212 participants was included in the analysis. A significant association between suicide intent and gender was found, where 'Serious Suicide Attempts' (SSA) were rated significantly more frequently in males than females (p < .001). There was a statistically significant gender difference in intent and age groups (p < .001) and between countries (p < .001). Furthermore, within the most utilised method, intentional drug overdose, 'Serious Suicide Attempt' (SSA) was rated significantly more often for males than females (p < .005).
Considering the differences in suicidal intent between males and females highlighted by the current study, gender targeted prevention and intervention strategies would be recommended.
Full text
Available for:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
BACKGROUND AND OBJECTIVES
Depression is common, and suicide rates are increasing. Adolescent depression screening might miss those with unidentified suicide risk. Our primary objective in this study ...was to compare the magnitude of positive screen results across different approaches.
METHODS
From June 2019 to October 2020, 803 mostly Medicaid-enrolled adolescents aged ≥12 years with no recent history of depression or self-harm were screened with the Patient Health Questionnaire-9 Modified for Adolescents (PHQ-9A) and the Ask Suicide-Screening Questions (ASQ) across 12 primary care practices. Two PHQ-9A screening strategies were evaluated: screening for any type of depression or other mental illness (positive on any item) or screening for major depressive disorder (MDD) (total score ≥10).
RESULTS
Overall, 56.4% of patients screened positive for any type of depression, 24.7% screened positive for MDD, and 21.1% screened positive for suicide risk. Regardless of PHQ-9A screening strategy, the ASQ identified additional subjects (eg, 2.2% additional cases compared with screening for any type of depression or other mental illness and 8.3% additional cases compared with screening positive for MDD). Of those with ≥6 month follow-up, 22.9% screened positive for any type of depression (n = 205), 35.6% screened positive for MDD (n = 90), and 42.7% with a positive ASQ result (n = 75) had a depression or self-harm diagnosis or an antidepressant prescription.
CONCLUSIONS
Suicide risk screening identifies cases not identified by depression screening. In this study, we underscore opportunities and challenges in primary care related to the high prevalence of depression and suicide risk. Research is needed regarding optimal screening strategies and to help clinicians manage the expected number of screening-identified adolescents.
PDF
