Objective
We report on the prevalence of suicidal thoughts and behaviors in Spanish university students and their risk and protective factors (distal/proximal; individual/environmental).
Methods
...First‐year university students completed an online survey including Self‐Injurious Thoughts and Behaviors Interview (SITBI) items, the screening version of the Columbia‐Suicide Severity Rating Scale (C‐SSRS) along with adversities and positive relationships during childhood/adolescence, recent stressful experiences, and lifetime mental disorders. Nested logistic regression models were estimated and areas under the curve (AUC) compared.
Results
A total of 2,118 students completed the survey (mean age = 18.8 SD = 1.4 years; 55.4% female). Twelve‐month prevalence of suicide ideation (SI) was 9.9%, plans, 5.6%, and attempts, 0.6%. Risk factors of 12‐month SI were as follows: parental psychopathology (OR = 1.7, 95% CI 1.2–2.5); sexual assault (OR = 5.6, 95% CI 1.4–22.1); lifetime mood disorder (OR = 5.2, 95% CI 3.5–7.7); and lifetime anxiety disorder (OR = 1.7, 95% CI: 1.1–2.5). Childhood positive relationships protected from SI were as follows: peers/others (OR = 0.6, 95% CI 0.4–0.9 for the second highest tertile) and family (OR = 0.4, 95% CI 0.3–0.7 for the highest tertile). AUC of the final model was 0.82 (SE = 0.015).
Conclusion
Our results indicate a high prevalence of SI among Spanish university students and identify protective and risk factors from a comprehensive conceptual model.
Aim
To assess gender differences in the association between risk/protective factors and suicidal thoughts and behaviors (STB); and whether there is any gender‐interaction with those factors and STB; ...among Spanish university students.
Methods
Data from baseline online survey of UNIVERSAL project, a multicenter, observational study of first‐year Spanish university students (18–24 years). We assessed STB; lifetime and 12‐month negative life‐events and family adversities; mental disorders; personal and community factors. Gender‐specific regression models and gender‐interactions were also analyzed.
Results
We included 2,105 students, 55.4% women. Twelve‐month prevalence of suicidal ideation (SI) was 10%, plans 5.7%, attempts 0.6%. Statistically significant gender‐interactions were found for lifetime anxiety disorder, hopelessness, violence between parents, chronic health conditions and family support. Lifetime mood disorder was a common risk factor of SI for both genders (Females: OR= 5.5; 95%CI 3.3–9.3; Males: OR= 4.4; 95%CI 2.0–9.7). For females, exposure to violence between parents (OR= 3.5; 95%CI 1.7–7.2), anxiety disorder (OR= 2.7; 95%CI 1.6–4.6), and alcohol/substance disorder (OR= 2.1; 95%CI 1.1–4.3); and for males, physical childhood maltreatment (OR= 3.6; 95%CI 1.4–9.2), deceased parents (OR= 4.6; 95%CI 1.2–17.7), and hopelessness (OR= 7.7; 95%CI 2.8–21.2), increased SI risk. Family support (OR= 0.5; 95%CI 0.2–0.9) and peers/others support (OR= 0.4; 95%CI 0.2–0.8) were associated to a lower SI risk only among females.
Conclusions
Only mood disorder was a common risk factor of SI for both genders, whereas important gender‐differences were observed regarding the other factors assessed. The protective effect from family and peers/others support was observed only among females. Further research assessing underlying mechanisms and pathways of gender‐differences is needed.
•This is the first systematic review and meta-analysis based on longitudinal studies analysing mental disorders and psychiatric comorbidity on suicidal behaviour among young people.•Mental disorders ...increase the risk for suicide attempts in young people.•In particular affective disorders predicted suicide attempts in young people.•Mental disorders and comorbidity are strong predictors of suicide behavior.
Suicide is the second leading cause of death for young people. Objective: To assess mental disorders as risk factors for suicidal behaviour among adolescents and young adults including population-based longitudinal studies.
We conducted a systematic literature review. Bibliographic searches undertaken in five international databases and grey literature sources until January 2017 yielded a total of 26,883 potential papers. 1701 full-text articles were assessed for eligibility of which 1677 were excluded because they did not meet our eligibility criteria. Separate meta-analyses were conducted for each outcome (suicide death and suicide attempts). Odds ratio (OR) and 95% confidence intervals (95%CI) and beta coefficients and standard errors were calculated.
24 studies were finally included involving 25,354 participants (12–26 years). The presence of any mental disorder was associated with higher risk of suicide death (OR = 10.83, 95%CI = 4.69–25.00) and suicide attempt (OR = 3.56; 95%CI 2.24–5.67). When considering suicidal attempt as the outcome, only affective disorders (OR = 1.54; 95%CI = 1.21–1.96) were significant. Finally, the results revealed that psychiatric comorbidity was a primary risk factor for suicide attempts.
Data were obtained from studies with heterogeneous diagnostic assessments of mental disorders. Nine case-control studies were included and some data were collected in students, not in general population.
Mental disorders and comorbidity are strong predictors of suicide behaviour in young people. Detection and management of the affective disorders as well as their psychiatric comorbidity could be a crucial strategy to prevent suicidality in this age group.
Self-injurious behaviours in children and young people with Autism Spectrum Disorder (ASD) imply risks to their physical integrity and affect their quality of life
and that of their families. In ...addition, they hinder their integration into the school and social environments, this being limited by the characteristics of
this type of disorder. Although there is little information about self-harm in this population, in general it has been seen that the greater the affectation
and the lower the cognitive level, the more prevalent self-injurious behaviours are. The aim of this study was to review the efficacy of cognitive-behavioral interventions for the reduction of self-injurious behaviors in children and youth with ASD. For it, we searched PsycINFO, Scopus and Google
Scholar. The review included studies in English or Spanish languages on cognitive-behavioral interventions to reduce self-injurious behaviors in
children and youth with ASD; with samples consisting of individuals with ASD between 1 and 30 years of age presenting self-injurious behaviors;
and conducted between 1970 and 2022. Of the 228 studies identified, only 7 met the inclusion criteria. The included studies included participants
between the ages of 3 and 26 years diagnosed with ASD and were published between 1974 and 2015, evidencing the efficacy of cognitive-behavioral interventions. Although these studies show positive post-intervention results, they are scarce in number. Further research is therefore needed
on the effectiveness of behavioural and cognitive interventions to reduce self-injurious behaviours in children and young people with ASD.
Las conductas autolesivas en niños y jóvenes con Trastorno del Espectro Autista (TEA) entrañan riesgos para su integridad física, afectan a su
calidad de vida, la de sus familias y dificultan su integración en el ámbito escolar y social, integración ya de por sí limitada por las características
propias de este tipo de trastornos. Aunque hay pocos estudios sobre autolesiones en esta población, en general se ha visto que, a mayor afectación
y menor nivel cognitivo, las conductas autolesivas son más frecuentes que en casos más leves. El objetivo de este trabajo fue revisar la eficacia
de las intervenciones de tipo cognitivo-conductual para la reducción de conductas autolesivas en niños y jóvenes con TEA. Para ello se realizaron
búsquedas en PsycINFO, Scopus y Google Scholar. La revisión incluyó estudios en lengua inglesa o española sobre intervenciones de tipo cognitivo-conductual para reducir conductas autolesivas en niños y jóvenes con TEA; con muestras formadas por personas TEA entre 1 y 30 años que
presentaban conductas autolesivas; y realizados entre 1970 y 2022. De los 228 estudios identificados, solo 7 cumplieron los criterios de inclusión.
Los estudios incluidos en la presente revisión incluyeron participantes entre los 3 y los 26 años diagnosticados con TEA y fueron publicados entre
1974 y 2015, evidenciando la eficacia de las intervenciones cognitivo-conductuales. Aunque dichos estudios muestran resultados positivos tras las
intervenciones, su número es escaso, por lo que es necesario seguir investigando sobre la eficacia de las intervenciones de carácter cognitivo-conductual para reducir conductas autolesivas en niños y jóvenes con TEA
To assess the accuracy of WMH-ICS online screening scales for evaluating four common mental disorders (Major Depressive EpisodeMDE, Mania/HypomaniaM/H, Panic DisorderPD, Generalized Anxiety ...DisorderGAD) and suicidal thoughts and behaviorsSTB used in the UNIVERSAL project.
Clinical diagnostic reappraisal was carried out on a subsample of the UNIVERSAL project, a longitudinal online survey of first year Spanish students (18-24 years old), part of the WHO World Mental Health-International College Student (WMH-ICS) initiative. Lifetime and 12-month prevalence of MDE, M/H, PD, GAD and STB were assessed with the Composite International Diagnostic Interview-Screening Scales CIDI-SC, the Self-Injurious Thoughts and Behaviors Interview SITBI and the Columbia-Suicide Severity Rating Scale C-SSRS. Trained clinical psychologists, blinded to responses in the initial survey, administered via telephone the Mini-International Neuropsychiatric Interview MINI. Measures of diagnostic accuracy and McNemar χ2 test were calculated. Sensitivity analyses were conducted to maximize diagnostic capacity.
A total of 287 students were included in the clinical reappraisal study. For 12-month and lifetime mood disorders, sensitivity/specificity were 67%/88.6% and 65%/73.3%, respectively. For 12-month and lifetime anxiety disorders, these were 76.8%/86.5% and 59.6%/71.1%, and for 12-month and lifetime STB, 75.9%/94.8% and 87.2%/86.3%. For 12-month and lifetime mood disorders, anxiety disorders and STB, positive predictive values were in the range of 18.1-55.1% and negative predictive values 90.2-99.0%; likelihood ratios positive were in the range of 2.1-14.6 and likelihood ratios negative 0.1-0.6. All outcomes showed adequate areas under the curve AUCs (AUC>0.7), except M/H and PD (AUC = 0.6). Post hoc analyses to select optimal diagnostic thresholds led to improved concordance for all diagnoses (AUCs>0.8).
The WMS-ICS survey showed reasonable concordance with the MINI telephone interviews performed by mental health professionals, when utilizing optimized cut-off scores. The current study provides initial evidence that the WMS-ICS survey might be useful for screening purposes.
Suicide is the second leading cause of death in adolescents and young adults aged 15 to 29 years. Specifically, the presence of internalizing and externalizing symptomatology is related to increased ...risk for suicide at these ages. Few studies have analyzed the relations between these symptoms and their role as mediators in predicting suicide behavior. This study aimed to examine the relation between internalizing and externalizing symptomatology and suicide behaviors through a longitudinal study. The sample consisted of 238 adolescents aged 12 to 18 years. The data were analyzed via the PROCESS Statistical Package. The main results showed that previous depression symptoms had a significant indirect effect, through previous suicide behaviors and current depression symptoms, on current suicide behaviors, accounting for 61% of the total variance explained. Additionally, being a girl increased this risk. Therefore, the implementation of early identification and intervention programs to address youth symptoms of depression and suicidal behaviors could significantly reduce the risk for future suicidal behaviors in adolescence.
Objective
To assess internalizing and externalizing symptoms as risk factors for suicidal behaviour and suicide among adolescents and young adults.
Method
We conducted a systematic review of articles ...published until January 2017. We identified 26 883 potential papers; 1701 full‐text articles were assessed for eligibility, of which 1479 were excluded because of methodological reasons. Diverse meta‐analyses were performed for each group of symptoms. Odds ratios (ORs) and 95% confidence intervals (95% CI) or beta coefficients for categorical variables, and effect size (ES) were calculated for continuous variables.
Results
Finally, 41 studies were included, involving participants aged 12–26 years for a systematic review, and 24 articles were included for meta‐analysis. The meta‐analysis showed that youths with any internalizing (ES = 0.93) or externalizing symptoms (ES = 0.76 and OR = 2.59) were more likely to attempt suicide in future. This effect was also seen in depression symptoms (OR = 6.58 and ES = 1.00), legal problems (OR = 3.36), and anxiety (ES = 0.65).
Conclusion
Reported internalizing and externalizing symptoms are predictors of suicide behaviour in young people; therefore, the detection and management of these symptoms in young populations could be a crucial strategy for preventing suicidality in this group.
Abstract Background Adolescents with previous self-injurious thoughts and behaviors (SITB) have over 2-fold risk of dying by suicide, higher than older ages. This meta-analysis aims to disentangle ...the association of each SITB with subsequent suicidal behavior in adolescence/young adulthood, the contribution of each SITB, and the proportion of suicide deaths with no previous suicide attempt. Methods We searched 6 databases until June 2015. Inclusion criteria: 1. Assessment of any previous SITB a) suicidal thoughts and behaviors (ideation; threat/gesture; plan; attempt); b) non-suicidal thoughts and behaviors (thoughts; threat/gesture; self-injury); c) self-harm as a risk factor of suicide attempt or suicide death; 2. Case-control or cohort studies; 3. Subjects aged 12-26y. Random effect models, metaregression analyses including mental health and environmental variables, and population attributable risks (PAR)s were estimated. Results From 23,682 potentially eligible articles, 29 were included in the meta-analysis (1,122,054 individuals). While 68% of all youth suicide deaths had no previous suicide attempt, suicide death was very strongly associated with any previous SITB (OR= 22.53, 95%CI: 18.40–27.58). Suicide attempts were also associated with a history of previous SITB (OR= 3.48, 95%CI: 2.71–4.43). There were no moderating effects for mental health and environmental features. The PAR of previous SITB to suicide attempts is 26%. Limitations There is considerable heterogeneity between the available studies. Due to limitations in the original studies, an over-estimation of the proportion dying at their first attempt cannot be ruled out, since they might have missed unrecognized previous suicide attempts. Conclusions Although more than two thirds of suicide deaths in adolescence/young adulthood have occurred with no previous suicidal behavior, previous SITBs have a much higher risk of dying by suicide than previously reported in this age group.
Objectives
To assess the association between gender and suicide attempt/death and identify gender-specific risk/protective factors in adolescents/young adults.
Methods
Systematic review (5 databases ...until January 2017). Population-based longitudinal studies considering non-clinical populations, aged 12–26 years, assessing associations between gender and suicide attempts/death, or evaluating their gender risk/protective factors, were included. Random effect meta-analyses were performed.
Results
Sixty-seven studies were included. Females presented higher risk of suicide attempt (OR 1.96, 95% CI 1.54–2.50), and males for suicide death (HR 2.50, 95% CI 1.8–3.6). Common risk factors of suicidal behaviors for both genders are previous mental or substance abuse disorder and exposure to interpersonal violence. Female-specific risk factors for suicide attempts are eating disorder, posttraumatic stress disorder, bipolar disorder, being victim of dating violence, depressive symptoms, interpersonal problems and previous abortion. Male-specific risk factors for suicide attempt are disruptive behavior/conduct problems, hopelessness, parental separation/divorce, friend’s suicidal behavior, and access to means. Male-specific risk factors for suicide death are drug abuse, externalizing disorders, and access to means. For females, no risk factors for suicide death were studied.
Conclusions
More evidence about female-specific risk/protective factors of suicide death, for adolescent/young adults, is needed.
Background: Suicide is the second leading cause of death in young people aged 15-29 in Spain. It is imperative to detect cases with suicidal risk for early intervention. The purpose of the study was ...to examine the self-reported presence of suicide spectrum indicators using a trichotomous rating scale: no, yes, prefer not to say. This last alternative was intended to safeguard the sensitive nature of the phenomenon and explore its clinical character. Method: 5,528 adolescents made up the definitive sample (12-18 years; M + ó - SD = 14.20 + ó - 1.53; 50.74% female). Results: Prevalence reached 15.38% for ideation, 9.32% for planning, and 3.65% for previous suicide attempts. Girls' rates were twice those of men. Suicidality showed a tendency to increase with age. Adolescents with the presence of suicidal indicators (yes) and omission of response (prefer not to say) both had lower levels of socioemotional strength and subjective well-being, and higher levels of psychopathology than the group with the absence of markers (no). Conclusions: Prefer not to say is a response category that increases the sensitivity of the self-report, allowing more accurate identification of cases with a high suicidal risk that would go unnoticed by the traditional dichotomous system (no-yes). Keywords: Suicide spectrum Adolescents Self-report Prefer not to say Sensitivity Antecedentes: En España, el suicidio constituye la segunda causa de muerte en jóvenes de 15 a 29 años. Es imperativa la detección de casos con riesgo suicida para una intervención temprana. El objetivo del estudio fue examinar la presencia autoinformada de indicadores del espectro suicida en adolescentes mediante una escala de respuesta tricotómica: no, sí, no deseo contestar. Incluir esta última alternativa pretendía salvaguardar la naturaleza sensible del fenómeno y explorar su carácter clínico. Método: 5,528 adolescentes conformaron la muestra definitiva (12-18 años; M + ó - DT = 14,20 + ó - 1,53; 50,74% mujeres). Resultados: Las prevalencias alcanzaron el 15.38% en ideación, 9,32% en planificación y 3,65% en tentativas suicidas previas. Las mujeres duplicaron las cifras de los hombres. La suicidalidad mostró una tendencia a incrementar con la edad. Adolescentes con presencia de indicadores suicidas (sí) y omisión de respuesta (no deseo contestar) obtuvieron, de forma equivalente, niveles inferiores en fortaleza socioemocional y bienestar subjetivo, y superiores en psicopatologia, frente al grupo con ausencia de marcadores (no). Conclusiones: No deseo contestar constituye una categoría de respuesta que incrementa la sensibilidad del autoinforme, permitiendo una identificación más precisa de casos con alto riesgo suicida que pasarían desapercibidos mediante el sistema dicotómico tradicional (no-sí). Palabras clave: Espectro suicida Adolescentes Autoinforme No deseo contestar Sensibilidad
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