Search Results (609)

Background/Objectives: Juvenile idiopathic arthritis (JIA) and inflammatory bowel disease (IBD) are chronic autoimmune conditions that impact the physical and psychological well-being of pediatric patients. While previous studies have shown a high prevalence of mental health challenges among youth with chronic conditions, the prevalence of mental health issues in Canadian pediatric patients with JIA and IBD remains unclear. We aimed to estimate the prevalence of documented mental health disorders and related medication use of youth with JIA or IBD at a tertiary care centre. Methods: We conducted a retrospective chart review of youths aged 12–17 diagnosed with JIA or IBD at McMaster Children’s Hospital (MCH) to understand the prevalence of generalized anxiety disorder (GAD), separation anxiety disorder, social anxiety disorder (SAD), obsessive–compulsive disorders (OCD), eating disorders, major depressive disorder (MDD), adolescent adjustment disorder, suicide attempt/suicide ideation, self-harm behaviour, substance use disorder, and attention deficit disorders (ADD). Results: We reviewed 429 patient charts, including 303 patients with IBD and 126 with JIA. Our findings identified 90 IBD patients and 20 JIA patients who had one or more documented mental health conditions. Proportionately, there was a higher prevalence of mental health conditions among IBD patients (30%) compared to JIA patients (16%). The most frequently observed conditions in both IBD and JIA patients were GAD (63%, 50%), ADD (33%, 35%), and MDD (29%, 15%). Conclusions: These findings highlight the critical need for early mental health screening and integrated care approaches that address both medical and psychosocial needs in adolescents with chronic illnesses. Future research should incorporate prospective study designs, include diverse geographic and demographic populations, and explore targeted interventions to improve mental and physical health outcomes in this vulnerable group. Full article

Understanding the effectiveness of suicide prevention measures for high-risk locations can often be challenging as many rely, at least to some degree, on psychological processes (e.g., engaging with help-seeking behaviours). Establishing how these measures may influence decision-making during a suicide attempt could be helpful for understanding how and when they may be most effective at preventing deaths. In the present work, we consider how suicide prevention measures may influence “goal pursuit” as it unfolds. Drawing on findings from across the suicide prevention literature, we apply the descriptive framework outlined in GOAL Architecture to consider how different measures may shape perceptions of “distance”, “time”, and “rate of progress” and, in turn, could influence levels of motivational drive associated with specific acts (e.g., “accessing means for suicide”). This is discussed in relation to real-time decisions around accessing means for suicide, avoiding intervention by a third party, and engaging in help-seeking behaviours. As well as the psychological processes that could encourage or prevent an individual from disengaging from a suicide attempt, we also consider potential risks and the influence of person-level factors. Full article

(1) Background: Suicide is a worldwide leading cause of death among people with mental disorders. Psychoeducation is an integral component of mental health care that may offer patients valuable tools to understand their conditions, develop coping strategies, and engage more effectively in the treatment process. In the present scoping review, we aimed to summarize the evidence on the implementation of psychoeducational interventions in inpatient settings after suicide attempts. (2) Methods: In August 2024, we searched the Web of Knowledge (all databases), PsycINFO, and CINAHL databases following the PRISMA-ScR guidelines. We included original articles evaluating the effects of psychoeducational interventions for patients hospitalized in psychiatric settings after a suicide attempt. We provided a narrative synthesis of the study characteristics and the main findings of the included studies. (3) Results: We included five papers reporting the results of six studies, of which two were randomized controlled trials. Participants were diagnosed with diverse mental disorders, and interventions were generally short in the hospitalization phase, with follow-ups in the short or long term. Outcomes were focused on suicidal ideation, depressive symptoms, and general functioning, along with feasibility and acceptability of the intervention. Psychoeducational interventions were generally well accepted, but more evidence is needed to determine their efficacy. (4) Conclusions: Psychoeducational intervention in an inpatient psychiatric setting may be important for the prevention of future suicide attempts. Nevertheless, research on the topic is still scarce. Methodologically sound randomized controlled trials evaluating the long-term efficacy of psychoeducational interventions on suicide prevention are needed. Future research should also investigate the utility of psychoeducation in non-psychiatric inpatient settings. Full article

Background/Objectives: Long-acting injectable antipsychotics (LAIs) represent a significant advancement in the treatment of schizophrenia (SCZ), particularly for improving adherence and long-term outcomes. This study aimed to assess the clinical outcomes of patients receiving atypical LAIs compared to those on various oral antipsychotics over a one-year follow-up in a naturalistic setting. Methods: Sixty patients with SCZ were subdivided in two groups, those receiving LAIs (n = 25) and those receiving oral antipsychotics (n = 35). The groups were comparable for age, gender, educational attainment, employment status, marital status, smoking habits, and baseline SCZ severity, with no differences in baseline chlorpromazine equivalent dosages. Results: Over the follow-up period, patients in the LAI group discontinued treatment less frequently (χ² = 4.72, p = 0.030), showed fewer suicide attempts (χ² = 5.63, p = 0.018), fewer hospitalizations (χ² = 4.95, p = 0.026), and fewer relapses (χ² = 6.61, p = 0.010). Significant differences also emerged on the Drug Attitude Inventory (DAI-10) scores (F = 8.76, p = 0.005) and Body Mass Index (BMI) values (F = 8.32, p = 0.007), with the LAI group showing more favorable outcomes. Conclusions: LAIs, compared to oral antipsychotics, may promote treatment adherence, as shown by decreased hospitalization; furthermore, their use is related with better outcomes, like fewer relapses and less suicide attempts in individuals with SCZ in real-world settings. Full article

Suicidality, encompassing suicidal ideation, attempts, and completed suicide, continues to be a significant public health concern globally. Traditional research has emphasized genetic, neurobiological, and psychosocial factors; however, recent findings suggest that gut microbiota may play a crucial role in influencing suicidal behavior. The gut microbiota impacts neuroinflammation, neurotransmitter metabolism, and the hypothalamic–pituitary–adrenal (HPA) axis, all of which are associated with psychiatric disorders linked to suicidality. This review gathers current evidence on the gut–brain axis, investigating the role of microbiota in suicidality through mechanisms such as immune system modulation, serotonin regulation, and the stress response. We also consider the potential of microbiota-targeted interventions, such as probiotics and dietary changes, as innovative therapeutic strategies. Despite the accumulating evidence, research in this field remains limited, emphasizing the urgent need for further investigation to clarify the causal relationship between gut microbiota and suicidality. Full article

Background: Suicidal behavior presents a significant dilemma in the context of Alzheimer’s disease. Numerous ethical discussions have emerged regarding euthanasia for patients suffering from neurodegenerative conditions, and research indicates an elevated incidence of suicide in the early stages of dementia. However, there remains a gap in knowledge concerning the historical prevalence of suicidal ideations or attempts among individuals diagnosed with Alzheimer’s disease. This study aims to investigate the historical patterns of suicidal behavior and the associated factors across the lifespan in patients with Alzheimer’s disease. Methods: This study is an excerpt from a case–control research study, where the sample size was calculated at 150 participants, with 75 in the case group and 75 in the control group. Here, the descriptive statistics for the first third of the sample, 50 participants, are discussed. Results: Among the participants in the case group, 12.5% reported having suicidal ideation throughout life, compared to 24% in the control group (OR for suicidal ideation = 0.432 [0.095–1.966]). Additionally, among the participants in the case group, 4% reported having attempted suicide at some point in their life, compared to 8% in the control group (OR for suicide attempts = 0.479 [0.41–5.652]). People with Alzheimer’s disease tended to have a worse quality of life but less suicidality. Conclusions: It appears that suicidal behavior is inversely related to the risk of developing suicidal intentions. The odds ratio data demonstrate the need for a larger sample size to determine whether there is a difference in the history of suicide throughout the lives of people with Alzheimer’s disease and among the general population. Full article

Background: The mental health of physicians has become a pressing global concern. High rates of depression, anxiety, and burnout are reported in the literature, with each condition linked to reduced job satisfaction, increased medical errors, and ultimately suicidal ideation (SI). Although research on physicians’ mental health is emerging in Saudi Arabia, data on suicidality remain scarce. Objective: This study aims to determine the prevalence of SI and its determinants among physicians in Saudi Arabia. Methods: A cross-sectional study was conducted with 423 physicians across all medical specialties of all ranks, who were recruited using a convenience sampling technique. The study tool comprised three main sections. The first section included questions regarding sociodemographic factors, lifestyle, and work-related factors. The second section included items on suicidality and the Patient Health Questionnaire-9 to screen for depressive symptoms. The third section included the Brief Resilient Coping Scale (BRCS) to measure the coping mechanisms of the participants. Results: SI was disclosed by 9.7% of the respondents, with 0.5% reporting previous suicide attempts. Suicidal ideation was independently associated with low income (OR = 3.94, 95% CI 1.32–11.76, p = 0.014) and higher depression scores (OR = 1.09 per point, 95% CI 1.02–1.16, p = 0.008). Moreover, knowing a colleague with suicidal behavior (i.e., knowing a colleague who had contemplated suicide or had attempted suicide/died by suicide) was significantly associated with SI among our participants (p < 0.001 and p < 0.006, respectively). Higher scores on the BRCS, specifically with respect to growing from adversity and actively replacing losses, were linked to lower odds of SI (p < 0.001 and p < 0.045, respectively). Conclusions: Physicians in Saudi Arabia experience an alarming level of SI that is associated with low income and depression. The results of this study underscore the importance of additional research to evaluate the effectiveness of intervention programs designed to enhance mental health support for physicians, encourage adaptive coping mechanisms, foster peer support networks, and combat stigma associated with mental illnesses. Full article

Suicide in children is a major global health crisis, with profound impacts on families, friends, and society. Understanding ways to ameliorate the rate of suicide attempt (SA) is critical given that it is a key factor in predicting future suicide risk. SA is the deliberate act of causing physical injury to oneself with the intent of death. The incidence of SA may be influenced by physical activity (PA). PA includes bodily movement via skeletal muscles that results in energy expenditure and physical fitness. While there is evidence to suggest that PA improves dysregulation of the parasympathetic nervous system which underpins the physiology of suicidal behaviour, evaluating the impact of PA on SA in children is required. Objectives: This systematic review aims to determine the relationship between PA and SA in children to inform alternative preventative and interventional strategies. Methods: This systematic review was registered with PROSPERO: CRD42023389415. Eight electronic databases were systematically searched. References were transferred to Covidence software for title and abstract screening and full text review were performed based on eligibility criteria: (1) children aged 6–18 years old; (2) participated in PA (individual, group exercise, or team sports); and (3) examined SA as a dependent variable. The JBI Checklist was used to measure the quality and level of bias of included studies. Results: Of the 2322 studies identified, 21 were included in the final analysis of the review. Twenty studies were cross-sectional in design, and one implemented a prospective study design. Thirteen studies (61.9%) yielded statistically significant results, indicating that increased PA, particularly team sport, may be associated with reduced odds of SA. There was some evidence to suggest that certain intensities and frequencies of PA may be beneficial to some and detrimental to other subgroups. Conclusions: The results suggest that PA may reduce the risk of suicide attempts. Although PA may be associated with reduced SA in children, future research is required, which (1) uses standardised outcome variables; (2) adopts longitudinal and experimental study designs; (3) explores qualitative research to determine distinctive factors that influence participation in PA not captured by quantitative research; and (4) examines different target populations such as children with a broad range of mental health issues. Full article

Despite initial concerns about the severe negative impact of COVID-19 on individuals with a history of mental health problems and suicide attempts, its effects remain unclear. This study examined the pandemic’s impact on individuals with and without lived experience of suicide attempts. An online nationwide sample of 1351 adults from the United States completed questionnaires from 26 May to 25 June 2021. A history of suicide attempt(s) (n = 159; 12%) was associated with significantly higher odds of utilizing mental health services, hospitalization for psychiatric reasons, and contacting hotlines. This history predicted worse outcomes in functioning, optimism, despair, and impairment. Notably, 57.6% of these individuals believed surviving a suicide attempt made them more resilient, while 21.9% expressed uncertainty about its impact on their resilience. In sum, participants with a history of suicide attempt(s) reported more depressive symptoms, worse daily functioning, more despair, less optimism, and greater service utilization during the pandemic, yet many also cited increased resilience due to their suicide history. Full article

This study uses a nationally representative longitudinal dataset in the US to examine the long-term association of volunteering for environmental, recycling, and conservation groups with a person’s (a) willingness to continue to volunteer later in life and (b) several measures of their mental and physical well-being including perceived social status, optimism, psychological stress, suicidal thoughts and attempts, depressive symptoms and general self-reported physical health. By using Add Health data, we match responses to an environmental volunteerism question in Wave III (2002) with subjective well-being responses in Wave V (2016–2018) to examine the long-term association between these variables. After excluding missing responses, the analysis sample consists of 9800 individuals. After using linear survey regression analyses and several techniques based on propensity scores (stratification, weighting, matching) two key results emerged: first, being involved in environmental groups and organizations early in life showed a significant positive association with more hours spent on volunteering or community service work later in life; and second, people who volunteer in early adulthood are more optimistic, more sociable, have a higher perceived social status, display less stress and depressive symptoms. Full article

Bipolar disorder (BD) may present with neurocognitive dysfunction due to inflammatory alterations through different biological pathways. However, findings are not consistent regarding the patterns of neurocognitive dysfunction and elevation of inflammatory biomarkers during the different mood phases. Therefore, we aimed to determine associations between inflammatory biomarkers, neurocognitive functioning, and clinical outcomes in patients with BD in euthymia. We conducted a cross-sectional study including 109 adults. Serum levels of interleukin-6 (IL-6), high-sensitivity C-reactive protein (hs-CRP), neurocognitive parameters (ACER), number of suicide attempts (SA), and hospitalizations (NH) were measured. We found negative and moderate correlations between IL-6 and ACER total score, language, visuospatial abilities, and orientation/attention. There was a positive and moderate correlation between IL-6 and NH. IL-6 significantly predicted ACER total score, language, memory, orientation/attention, visuospatial abilities, and NH. Overall, IL-6 had an inverse association with neurocognition and clinical variables, whereas hs-CRP did not play a role. Here we demonstrate that IL-6 predicts neurocognitive functioning in adults with BD. BD may be a biological model for studying the relationship between inflammation and neurocognition in severe psychiatric disorders. Prospective studies at different mood phases of the disease must be conducted. Full article

Background and Objectives: Suicidality in adults with Attention-Deficit/Hyperactivity Disorder (ADHD) is an emerging clinical concern, yet its mechanisms and risk factors are not fully understood. Specifically, little is known about the characteristics of suicide attempts (SAs), including the use of violent/nonviolent methods. This study aimed to investigate the prevalence and methods of SA in adults with ADHD and to identify associated sociodemographic and clinical factors. Materials and Methods: The sample included 211 adult outpatients with ADHD. Patients were grouped based on the presence/absence of a lifetime SA. Among attempters, those who used a violent method (e.g., hanging, shooting, or jumping from a height) were compared with those who used a nonviolent method (e.g., poisoning). Statistical analyses included χ² tests, Kruskal–Wallis tests, and logistic regression. Results: In total, 9.9% (n = 21; 95% CI: 4.5–10.4) of participants reported a lifetime SA, with 23.8% (n = 5; 95% CI: 4.8–41.9) using violent methods. SA was significantly associated with comorbid personality disorders (p = 0.006, OR: 6.613, 95% CI: 0.537–5.812) and a higher number of hospitalizations (p = 0.008, OR: 1.980, 95% CI: 0.296–2.675). Nonviolent methods were linked to low self-esteem (p = 0.008). No significant associations with ADHD features or other psychiatric comorbidities emerged. Conclusions: Adults with ADHD are at risk for SA, showing patterns similar to other psychiatric populations. Unlike suicidal ideation, which has been directly linked to ADHD in previous studies, the transition to an SA appeared to be associated with comorbid personality disorders. Full article

Background: It is common for patients with eating disorders (ED) to report traumatic experiences early in their lifetime. The objective of this study was to explore the presence and types of traumatic events and the comorbidity with Post-Traumatic Stress Disorder (PTSD) in a sample of adolescents with severe ED. Method: A total of 118 adolescents treated at our Eating Disorders Day Care Hospital (EDDCH) were systematically evaluated for depressive symptoms, disordered eating, early traumatic experiences, and presence of PTSD. Likewise, various clinical variables were collected including comorbidities, age upon ED diagnosis, number of hospital admissions, presence of non-suicidal self-injury, and suicide attempts. Results: Seventy-seven (65.3%) of adolescents of the total sample reported exposure to four or more traumatic events (bullying, psychological abuse, and sexual abuse being the most common). Fifty-seven of them (48.3% of the total sample) scored significantly high in PTSD assessment. Patients with ED and comorbid PTSD (PTSD+) presented higher disordered eating (p < 0.001) and depressive symptoms (p < 0.001) and also a higher prevalence of both non-suicidal self-injury (p = 0.031) and suicide attempts (p = 0.004). The depressive symptoms, measured with the CDI, emerged as an independent predictor of belonging to the PTSD+ group, explaining 22.9% of the variance. Conclusions: It is imperative to systematically screen adolescents with severe ED for traumatic events and PTSD, especially in patients presenting with more depressive symptoms and suicidal or non-suicidal self-injury behaviours, since this subset of patients could be at a higher risk of PTSD. Offering specific psychotherapeutic care targeting PTSD and/or posttraumatic symptoms in addition to the ED standard of care could arguably improve the prognosis of the ED in comorbid patients. Full article

A growing knowledge base highlights the importance of accounting for a variety of social and structural determinants of health (SDOH) when understanding mental and behavioral health among adolescents and young adults. The objective of the current study is to examine patterns of self-reported SDOH deficits and characterize participant health indicators and social identity across classes. Data is from a cross-sectional national study of young people who were recruited through study advertisements on social media and surveyed online. Data were collected between June 2022 and October 2023. Eligibility included (1) ages 13–22 years, (2) living in the United States, and (3) proficient in English. Health indicators included suicide attempts, suicidal ideation, drug overdose, perceived likelihood of living to age 35, non-suicidal self-injury, recent alcohol use, and depression. Five classes of SDOH deficits were identified: (1) Economic Instability, (2) Low Overall SDOH Deficits, (3) High Social SDOH Deficits (adversity and discrimination), (4) High Economic SDOH Deficits, and (5) High Overall SDOH Deficits. Differences across class by health indicators and marginalized identity were found, with high proportions of gender minority and sexual minority youth in both the High Overall SDOH Deficit group and the High Social SDOH Deficit classes. Black youth were more likely to be part of the High Economic SDOH Deficits class. The findings encourage a public health approach that recognizes that improving the health of today’s young people must be connected to policies that reduce poverty, improve neighborhoods, and increase access to basic goods, services, and healthcare. Full article

This paper explores suicidality and suicide research from an autoethnographic analysis framed through grief concepts. Self-identifying as a Muslim in the United States, the author explains how lived experiences being racialized through Islamophobia, identifying as a genderfluid non-binary woman, being socially biracial, holding a postpartum bipolar diagnosis, and being connected to a diaspora, are critical elements to develop a deeper sociocultural understanding of suicide. Grief concepts that are used to analyze these themes include disenfranchised grief, ambiguous loss, anticipatory grief, and secondary loss. While these grief concepts are understood as part of the author’s embodied lived experience as an individual, there is also a collective grief that is explored through the author’s bilingual experience with Arabic as it relates to the topics of suicide and genocide occurring in the Arabic-speaking diaspora located in Gaza, Palestine. A conceptual framework is offered to make sense of the author’s lived experience by both incorporating and challenging existing academic perspectives on suicide and research. The emic, or insider, perspective is contextualized such that it may hold implications beyond the individual author, such as for U.S. Muslims and other hard-to-reach populations. A positionality statement demonstrates the author’s reflexivity of being an insider ‘participant’–researcher in conducting transformative research approaches with the U.S. Muslim community. Further directions are shared for scholars with lived experience who may seek to utilize comparable individual or collaborative autoethnographic approaches with such majority-world communities. Full article