Search Results (113)

Background: In recent years, the sociopolitical landscape in the United States has shifted due to an increase in state-level legislation regarding LGBTQ+ rights, a trend that has been particularly pronounced in the Commonwealth of Kentucky. While the mental health impacts of enacted laws are increasingly documented, a critical gap remains in understanding the psychological toll of the legislative debates themselves—the prolonged periods of public discourse surrounding the restriction of rights. Methods: Utilizing data from the 2025 Queer Kentucky Survey (N = 817), this exploratory study examined the association between LGBTQ+ community belongingness and acute suicidality attributed specifically to anti-LGBTQ+ legislative debates. Data were derived from a non-probability snowball sample. Binary logistic regression models that adjusted for age, race, gender identity, education, and income were utilized. Results: Prevalence of debate-attributed suicidality was alarmingly high: 59.7% of the sample attributed increased suicidal thoughts, and 44.1% attributed a suicide attempt, specifically to the legislative debates. LGBTQ+ belongingness was a robust protective correlate, associated with significantly lower odds of both suicidal thoughts (OR = 0.61, p < 0.001) and attempts (OR = 0.41, p < 0.001). Analyses further revealed divergent risk for suicidality across demographic characteristics. Conclusions: Findings are consistent with the interpretation that legislative debates may function as distinct structural stressors associated with suicidal thoughts and suicide attempts. While community belongingness may offer a critical buffer, the elevated risks among Transgender and Black, Indigenous, and People of Color (BIPOC) populations highlight the need for intersectional, structural interventions beyond individual resilience. Full article

Background and objectives: Suicide attempts and self-harm are critical issues in adolescence, often leading to serious and irreversible consequences. These behaviours frequently co-occur and share common biopsychosocial risk factors. Identifying these factors enables a more comprehensive assessment of suicide and self-harm risk, helping specialists recognize high-risk individuals and implement effective preventive measures. This study aimed to examine the association between suicide attempts, self-harm and psychosocial factors among hospitalized adolescents. Materials and methods: A retrospective data analysis was performed using the database of the University Department of Children and Adolescents of the Republican Vilnius Psychiatric Hospital. The study covered patients’ records from December 2022 to February 2025. Information on gender, age, suicide attempts, self-harm, adverse events (bullying, psychological abuse, physical violence within the family, and sexual abuse) and unhealthy habits (smoking, harmful alcohol consumption, and psychoactive substance use), was selected and analyzed in this study. A Chi-square test was used to assess the difference between groups. Results were considered statistically significant when p < 0.05. Results: The study included 599 hospitalized adolescents (26.9% boys; mean age 15.1 ± 1.4 years), of whom 70.8% reported at least one episode of self-harm and 37.8% at least one suicide attempt. Rates of self-harm and suicide attempts were significantly higher in girls than in boys (self-harm: 81.3% vs. 42.2%, $\varphi =0.381$, $p<0.001$; suicide attempts: 45.5% vs. 16.5%, $\varphi =0.304$, $p<0.001$), and adolescents with self-harm had a significantly higher prevalence of suicide attempts than those without self-harm (46.7% vs. 15.8%, $\varphi =0.308$, $p<0.001$). Adverse childhood experiences and unhealthy behaviours were significantly more frequent in adolescents with self-harm and suicide attempts, although effect sizes were small to moderate ($\varphi$ range 0.086–0.230, all $p<0.05$). In multivariable models, female gender ($\beta =0.355$, $p<0.001$) and smoking ($\beta =0.330$, $p<0.001$) were the strongest predictors of self-harm, whereas alcohol use ($\beta =0.337$, $p<0.001$) and self-harm ($\beta =0.232$, $p<0.001$). Conclusions: Exposure to adverse childhood experiences and engagement in unhealthy habits were associated with higher rates of both self-harm and suicide attempts. A comprehensive assessment and early detection of self-harm behaviours and adverse psychosocial circumstances are crucial elements of effective suicide prevention strategies and prompt intervention among high-risk adolescents. Full article

This essay offers a comparative reading of Antonio Di Benedetto’s Los suicidas and Leila Guerriero’s Los suicidas del fin del mundo through the lens of the “suicidal archive.” Drawing on literary criticism, trauma studies, and biopolitical theory, it explores how both works transform suicide into a problem of representation, where writing functions as an aesthetic mediation against the chaos of reality. In dialogue with the ideas of Mbembe, De Martelaere, and Caruth, I argue that Di Benedetto and Guerriero move beyond the rational frameworks of scientific or journalistic discourse to probe the ethical and affective dimensions of suicidal acts. While Di Benedetto’s text renders repetition as a metaphysical and introspective structure, Guerriero’s transforms it into a collective, polyphonic archive of trauma. In both cases, literature emerges as a symbolic space of containment that, rather than closing off meaning, keeps the wound open. Ultimately, the essay concludes that the suicidal archive does not seek to explain or domesticate death but to inhabit its enigma—affirming writing as an act of resistance against silence and disappearance. Full article

Suicide is a major public health concern worldwide, and identifying the spatial patterns associated with its occurrence is essential for designing effective preventive strategies. This study aimed to identify and characterize suicide locations in two provinces of Castilla-La Mancha, Spain, using a descriptive and retrospective analysis of 421 cases recorded by the Institutes of Legal Medicine and Forensic Sciences of Toledo and Albacete between 2020 and 2024. Locations were classified as critical or non-critical based on recurrence and public accessibility, and logistic regression was used to explore predictors of suicide in public settings. Results showed that 82% of cases involved men, yielding a 5:1 male-to-female ratio that exceeds the national average; the mean age was 56.6 years, and hanging was the most frequent method (56.1%). Most suicides occurred in private environments, and only one location met the criteria for a critical site. These findings indicate that spatial clustering plays a minimal role in the regional suicide burden and that prevention efforts should prioritize means restriction and early detection in private settings, along with broader measures for dispersed public cases rather than hotspot-focused interventions. The study underscores the importance of systematically incorporating spatial information into forensic records to improve regional suicide surveillance and inform more targeted, context-sensitive prevention policies. Full article

Introduction: Paternal filicide is a rare and complex form of intrafamilial homicide, frequently associated with underlying psychopathology, interpersonal conflict, and psychosocial stressors. While maternal filicide has been more extensively studied, cases involving fathers—especially those employing multiple homicidal methods—remain significantly underrepresented in the forensic literature. This paper presents an unusual case of paternal filicide involving combined lethal methods, contextualized through a narrative review of comparable cases. Methods: A comprehensive forensic-pathological and psychiatric investigation was conducted following the homicide of an 8-year-old boy, killed by his father through a combination of asphyxiation and stabbing. A narrative literature review was performed using PubMed, Scopus, and Google Scholar, focusing on case reports and case series concerning paternal filicide. Particular attention was paid to homicidal methods, motivational dynamics, psychiatric comorbidities, and post-crime behavior. Results: The child’s body was found concealed in a building, in a bed storage drawer, with packing tape tightly wrapped around the mouth and nose and a kitchen knife embedded in the neck. No defensive wounds were observed, suggesting a sudden and unopposed assault, likely facilitated by the victim’s trust in the perpetrator. Autopsy findings revealed signs of asphyxiation and three stab wounds to the chin, neck, and thorax, involving vital structures such as the thyroid cartilage and heart. The father was found in a state of acute alcohol intoxication and subsequently convicted of intentional homicide. The motive appeared to be revenge-related, stemming from a highly conflictual marital separation. The literature review confirmed the predominance of retaliatory motives, frequent substance use, and post-crime suicidal behavior. However, the use of combined homicidal methods and the concealment of the body were found to be exceedingly rare. Conclusions: This case, combined with the literature review, highlights the need for deeper scientific exploration of paternal filicide. Comprehensive forensic and psychiatric assessments are essential to identify recurring situational patterns, motivational profiles, sociocultural contexts, and psychiatric vulnerabilities. These findings are critical not only for post-crime evaluations but also for the development of interdisciplinary prevention strategies targeting early warning signs and high-risk family dynamics. Full article

Suicide remains one of the leading causes of death worldwide, yet psychiatry continues to assess risk primarily through suicidal ideation. This narrow focus overlooks a critical factor: sleep. A growing body of evidence demonstrates that insomnia, nightmares, and circadian disruption are consistent and potentially modifiable correlates of suicidal behavior across various diagnoses and age groups, supported primarily by longitudinal and prospective studies. Despite this, structured sleep assessment is seldom integrated into routine psychiatric care, predominantly due to cultural inertia and inadequate training. This perspective necessitates a shift: sleep assessment should be regarded alongside mood and cognition in every evaluation of suicide risk. Brief questionnaires and targeted interventions are readily accessible and feasible for implementation, thereby presenting concrete opportunities for prevention. By incorporating sleep evaluation into standard practice and future predictive models, psychiatry can advance toward more precise, actionable, and timely suicide prevention. To continue neglecting sleep is to overlook one of the most accessible and effective means of saving lives. Full article

Background/Objectives: Healthcare workers (HCWs) experienced marked psychological distress during and after the COVID-19 pandemic, including high levels of burnout, depression, and suicidal ideation. Italy, one of the first Western countries to be severely affected, recorded high mortality, even among healthcare staff. Emerging evidence suggests that suicidal ideation may also occur in the absence of major depressive episodes, possibly linked to subthreshold mood dysregulation and circadian rhythm disturbances, described within the construct of Dysregulation of rhythms and hyper-energy Syndrome (DYMERS). This study examined the prevalence of suicidal ideation and/or death-related thoughts among Italian HCWs, with particular attention to clinically relevant signs emerging in the absence of a full depressive episode. Methods: A cross-sectional analysis was conducted on 97 HCWs at the University Hospital of Cagliari, Italy, compared with a pre-pandemic community sample from the same region. Depressive symptoms and suicidal ideation or death-related thoughts were assessed with the Patient Health Questionnaire-9 (PHQ-9), considering their presence both in individuals with and without a depressive episode. Daily activation and energy were measured using item 10 of the 12-Item Short Form Health Survey (SF-12), while circadian rhythm dysregulation was evaluated with the Biological Rhythms Interview of Assessment in Neuropsychiatry (BRIAN). Results: HCWs showed a significantly higher prevalence of suicidal or death-related thoughts than the community sample (14.4% vs. 5.7%, p = 0.001; OR = 2.81, 95% CI 1.4–4.4). Notably, 8.2% of HCWs without probable depression reported such thoughts; given the very small number of events (n = 4), this estimate is exploratory, and inferential statistics should be interpreted with caution. Based on descriptive data, these individuals appeared to show higher perceived activation (SF-12, item 10) and rhythm dysregulation (BRIAN). This observation is exploratory and consistent with the DYMERS heuristic framework. Conclusions: Subthreshold symptoms and DYMERS may represent critical risk factors in suicide prevention strategies for HCWs. Full article

Background: Stress is a critical determinant of mental health, yet conventional monitoring approaches often rely on subjective self-reports or physiological signals that lack real-time responsiveness. Recent advances in large language models (LLMs) offer opportunities for speech-driven, adaptive stress detection, but existing systems are limited to retrospective text analysis, monolingual settings, or detection-only outputs. Methods: We developed a real-time, speech-driven stress detection framework that integrates audio recording, speech-to-text conversion, and linguistic analysis using transformer-based LLMs. The system provides multimodal outputs, delivering recommendations in both text and synthesized speech. Nine LLM variants were evaluated on five benchmark datasets under zero-shot and few-shot learning conditions. Performance was assessed using accuracy, precision, recall, F1-score, and misclassification trends (false-negatives and false-positives). Real-time feasibility was analyzed through latency modeling, and user-centered validation was conducted across cross-domains. Results: Few-shot fine-tuning improved model performance across all datasets, with Large Language Model Meta AI (LLaMA) and Robustly Optimized BERT Pretraining Approach (RoBERTa) achieving the highest F1-scores and reduced false-negatives, particularly for suicide risk detection. Latency analysis revealed a trade-off between responsiveness and accuracy, with delays ranging from ~2 s for smaller models to ~7.6 s for LLaMA-7B on 30 s audio inputs. Multilingual input support and multimodal output enhanced inclusivity. User feedback confirmed strong usability, accessibility, and adoption potential in real-world settings. Conclusions: This study demonstrates that real-time, LLM-powered stress detection is both technically robust and practically feasible. By combining speech-based input, multimodal feedback, and user-centered validation, the framework advances beyond traditional detection only models toward scalable, inclusive, and deployment-ready digital mental health solutions. Full article

Background/Objectives: Suicide is a critical public health issue that leads to premature mortality among young people and requires substantial public health interventions. Demonstrating the importance of developing effective suicide prevention programs through health indicators can be valuable. This study aims to examine the change in suicide rates and Years of Life Lost (YLL) in Türkiye over the 2013–2023 period—a country that displays characteristics of both developed and developing nations—and to reveal the productivity losses using the human capital approach. Methods: The data for this descriptive study were obtained from the Turkish Statistical Institute between 2012 and 2023. YLL was computed by determining the difference between the age at which an individual died by suicide and their expected age of death for both males and females. Years of Potential Life Lost (YPLL) was estimated using the same method as YLL for individuals aged 15–64 (working age). The time trend of suicide and YLL rates was calculated using Annual Percentage Change and the Average Annual Percent Change values, based on a Poisson-based Generalized Linear Model and the Joinpoint regression method. Using the human capital approach, the economic cost of the labor force lost due to suicide was estimated. Results: The YLL per death was 33.57 years for males, 47.73 years for females, and 37.06 years overall. The age group with the highest YLL percentage is 20–24 among males (23.55%) and 15–19 among females (33.06%). An increase of 7.8% was observed among males from 2018 to 2021. The mean changes in the overall time trend were found to be significant in male suicides. Among females, there was a 5.3% decrease until 2017, followed by a 4.5% increase from 2017 onwards. Combined, male and female suicide rates have significantly increased since 2017. The financial loss associated with suicide over a 12-year period totaled USD 10,775,943,197 with an annual loss of USD 897,995,266. The premature mortality cost per death was estimated at USD 278,400.84 for men and USD 186,625.16 for women, while the premature mortality cost per YLL was USD 8292.23 for men and USD 3910.36 for women. Conclusions: Changes in the temporal trend of suicide may be associated with societal events. The study reveals that premature deaths due to suicide in Türkiye are a multidimensional public health problem that significantly affects not only individuals but also the overall productivity and economic structure of society. Full article

(1) Background: With the continuous expansion of graduate education, the mental health of postgraduates has become a growing concern for both academia and society. Understanding how family and institutional resources influence psychological outcomes is critical for developing effective support strategies; (2) Methods: A cross-sectional survey was conducted among 3998 postgraduate students across China, including 3393 master’s students (51.78% female, M = 24.21, SD = 1.521) and 605 doctoral students (37.19% female, M = 27.77, SD = 2.841). Multi-group structural equation modeling was employed to examine how family functioning and supervisor–postgraduate relationships influenced mental health, research self-efficacy, and suicidal tendencies; (3) Results: The findings showed that although most structural relationships were consistent across groups, two critical pathways were nonsignificant at the doctoral stage, providing evidence of partial structural invariance; (4) Conclusions: The study suggests that while family and school support generally play a protective role, their influence varies across educational stages. Tailoring psychological interventions to the distinct needs of master’s and doctoral students is essential, offering both theoretical insights into the dual role of contextual resources and practical guidance for targeted mental health support in graduate education. Full article

Background: The deployment of large language models (LLMs) in mental health therapy presents a compelling yet deeply fraught opportunity to address widespread disparities in access to psychological care. Recent empirical evidence reveals that these AI systems exhibit substantial shortcomings when confronted with complex clinical contexts. Methods: This paper synthesizes key findings from a critical analysis of LLMs operating in therapeutic roles and argues for the urgent establishment of comprehensive risk management frameworks, policy interventions, and ethical protocols governing their use. Results: LLMs tested in simulated therapeutic settings frequently exhibited stigmatizing attitudes toward mental health conditions and responded inappropriately to acute clinical symptoms such as suicidal ideation, psychosis, and delusions. Real-world evaluations reinforce these concerns. Some studies found that therapy and companion bots endorsed unsafe or harmful suggestions in adolescent crisis vignettes, while others reported inadequate chatbot responses to self-harm and sexual assault queries, prompting concern from clinicians, disappointment from patients, and calls for stronger oversight from policymakers. These failures contravene fundamental principles of safe clinical practice, including non-maleficence, therapeutic alliance, and evidence-based care. Moreover, LLMs lack the emotional intelligence, contextual grounding, and ethical accountability that underpin the professional responsibilities of human therapists. Their propensity for sycophantic or non-directive responses, driven by alignment objectives rather than clinical efficacy, further undermines their therapeutic utility. Conclusions: This analysis highlights barriers to the replacement of human therapists with autonomous AI systems. It also calls attention to the regulatory vacuum surrounding LLM-based wellness and therapy applications, many of which are widely accessible and unvetted. Recommendations include professional standards, transparency in training and deployment, robust privacy protections, and clinician oversight. The findings underscore the need to redefine AI as supportive, not substitutive. Full article

The exponential growth of human interactions on social media via the internet has revolutionized global communication, but it has also emerged as a critical factor in mental health linked to suicidal ideation and mental disorders. This systematic review and meta-analysis aimed to synthesize evidence on the most prevalent disorders in adolescents and young adults associated with social media use based on previous research, highlighting risk factors and key findings. Publications from 2020 to 2024 in highly relevant databases were reviewed following the PRISMA declaration guidelines. The meta-analysis (conducted in R software) of the included documents (24 studies, 68 effects) verified a significant and positive association between exposure to risk factors in social networks and various disorders in adolescents and young adults (aggregate correlation r = 0.2173, 95% CI [0.1826, 0.2520], p ≤ 0.0001), although with high heterogeneity (I² = 99.66%). Prevention strategies were indicated by revealing data from contexts in which 40% of adolescents who died by suicide had developed online identities focused on suicidal thoughts. Full article

Severe depression with psychotic symptoms and suicidal behaviors is a critical mental health condition requiring comprehensive care. While clinical interventions are necessary, less is known about the lived experiences of individuals who recover from such complex states. This study explores the lived experiences of recovery among individuals diagnosed with major depressive disorder with severe depression, psychotic symptoms, and suicidal ideation or suicide attempts, focusing on how they found meaning in their journey and maintained recovery over time. A phenomenological approach was employed. In-depth interviews were conducted with nine individuals who had experienced severe depression with psychotic symptoms and suicidal behaviors, received psychiatric treatment, and later achieved recovery. Data were analyzed using interpretive phenomenological analysis. Participants described recovery as a deeply personal and transformative journey. Three core themes emerged: (1) understanding and reframing internal experiences, (2) drawing strength from therapy, relationships, and self-care, and (3) gradually regaining agency, identity, and meaning in life. Recovery from severe depression with psychotic symptoms and suicidal behaviors is possible. Mental health nurses and professionals play a vital role in supporting this journey through person-centered, holistic, and empowering care approaches. Full article

Background/Objectives: Depression is common in young doctors. Religion/spirituality, vocation, and family might protect against it. The objective of this study was to evaluate mental health, spirituality, and flourishing (a multi-dimensional assessment of well-being) in new medical residents. We also evaluated the associations of baseline characteristics with flourishing. Methods: We conducted a cross-sectional survey in 743 new medical residents who responded to (1) a questionnaire addressing mental health, vocation, spirituality, family, and religion and (2) the “Secure Flourish Index”, which assesses happiness/life satisfaction, physical/mental health, meaning/purpose, character/virtue, social relationships, and financial/material stability. Results: The mean age was 25.7 ± 4.0, and 526 (70.8%) were females, 157 (21.1%) had felt depressed, and 22 (3.0%) had suicidal ideation. The mean values for assessments of vocation and family were very high (>9.2), while religion and spirituality had intermediate values (5.2–6.5). Participants with depression or suicidal ideation had lower assessments in all four of the aforementioned domains, although differences were only significant for depression–religion (p = 0.03). The average “Secure Flourish Index” was 8.2 ± 0.9. There were lower levels of flourishing in males and in those with depression or suicidal ideation, with p-values < 0.001. Flourishing had a correlation with vocation and family (with r-values of 0.3–0.4) and with spirituality and religion (with r-values of 0.25–0.27), with p-values ≤ 0.001. Conclusions: Resident well-being is critical for physicians and healthcare quality. Spirituality and religion may serve as a protective resource, enhancing flourishing. Our study shows that new medical residents seem to have high value assessments for vocation and family importance and intermediate values for religion and spirituality. The mean flourishing scores were high, but were lower in males and in those with depression. Flourishing seems to be correlated with vocation, family, spirituality, and religion, but these associations need to be confirmed with validated screening tools. Full article

Background: The widespread use of social media among children and adolescents has raised increasing concern about its potential impact on mental health. Given the unique neurodevelopmental vulnerabilities during adolescence, understanding how digital platforms influence psychiatric outcomes is critical. Objectives: This narrative review aims to synthesize current evidence on the relationship between social media exposure and key psychiatric symptoms in youth, including depression, anxiety, body image disturbances, suicidality, and emotional dysregulation. Methods: We conducted a comprehensive narrative review of the literature, drawing from longitudinal, cross-sectional, and neuroimaging studies published in peer-reviewed journals. Specific attention was given to moderators (e.g., age, gender, and personality traits) and mediators (e.g., sleep, emotion regulation, and family context) influencing the relationship between social media use and mental health outcomes. Results: Evidence indicates that certain patterns of social media use, especially passive or compulsive engagement, are associated with increased risk of depression, anxiety, body dissatisfaction, and suicidal ideation. Adolescent girls, younger users, and those with low self-esteem or poor emotional regulation are particularly vulnerable. Neuroimaging studies show that social media activates reward-related brain regions, which may reinforce problematic use. Family support and digital literacy appear to mitigate negative effects. Conclusions: Social media use is not uniformly harmful; its psychological impact depends on how, why, and by whom it is used. Multilevel prevention strategies, including media education, parental involvement, and responsible platform design, are essential to support healthy adolescent development in the digital age. Full article