Search Results (824)

Background/Objectives: Adolescent psychiatric inpatient units play a critical role in the management of severe psychiatric disorders and suicide risk. However, limited evidence exists regarding the clinical and familial factors that simultaneously influence suicidal ideation and treatment outcomes in hospitalized adolescents. This study aimed to identify demographic, diagnostic, and clinical predictors of suicidal ideation and clinical improvement among adolescents hospitalized in a tertiary child and adolescent psychiatry inpatient unit. Methods: This retrospective observational study included 75 adolescents aged 12–18 years who were hospitalized in a tertiary child and adolescent psychiatry inpatient unit between November 2023 and June 2025. Sociodemographic and clinical characteristics were obtained from medical records. Clinical improvement was evaluated using the Clinical Global Impression–Improvement (CGI-I) scale. Group comparisons were conducted using chi-square or Fisher’s exact tests for categorical variables and the Mann–Whitney U test for continuous variables. Multivariate logistic regression analyses were performed to determine independent predictors of suicidal ideation and clinical improvement. Results: Clinical improvement was evaluated in the full sample of adolescents (n = 75), and longer length of stay was independently associated with clinical improvement during hospitalization. Among adolescents admitted with suicidal ideation (n = 45), major depressive disorder, previous suicide attempt, irritability at admission, and fewer siblings were identified as independent predictors of suicidal ideation. In addition, female adolescents had higher rates of suicide attempts and non-suicidal self-injury, whereas psychotic disorders were more common among male adolescents. Conclusions: Suicidal ideation in hospitalized adolescents is strongly associated with affective pathology and prior suicidal behavior. Longer inpatient treatment duration appears to facilitate clinical improvement. These findings highlight the importance of early suicide risk stratification and adequate treatment duration in adolescent psychiatric inpatient care. Full article

Background: Suicide prevention strategies in university settings largely rely on detecting explicit suicidal ideation. However, students experiencing severe psychiatric distress may not endorse suicidal thoughts and therefore remain unidentified by ideation-centered screening models. This study aimed to identify and clinically characterize university students with high depressive symptoms, poor sleep quality, and elevated impulsivity who deny suicidal ideation in order to examine whether they represent a vulnerable yet overlooked subgroup. Methods: This cross-sectional secondary analysis included 814 undergraduate students from the National Sleep Research Resource (ANSWERS dataset). Participants were classified into three groups based on median splits of depressive symptoms (CES-D), sleep quality (PSQI), impulsivity (UPPS-P), and the presence or absence of suicidal ideation in the past three months: Invisible (high symptoms without ideation), Visible (high symptoms with ideation), and Healthy (low symptoms without ideation). Group differences were examined using ANOVA and chi-square tests. Multivariate logistic regression was conducted to assess independent predictors of suicidal ideation. Results: The Invisible group comprised 11.8% of the sample. Compared with Healthy participants, these individuals showed poorer sleep quality and higher levels of thwarted belongingness and perceived burdensomeness (all p < 0.001). Cannabis use was most prevalent in the Invisible group (54.2%), exceeding both Visible and Healthy groups (p < 0.001). In adjusted analyses, depressive symptoms (OR = 1.10, 95% CI: 1.08–1.12) and sleep disturbance (OR = 1.06, 95% CI: 1.01–1.12) independently predicted suicidal ideation, whereas impulsivity did not. Conclusions: A clinically meaningful subgroup of students experience severe psychological distress without endorsing suicidal ideation yet show behavioral and interpersonal vulnerability. These findings highlight a limitation of ideation-focused screening and support broader, symptom-informed mental health assessment strategies in university populations. Full article

Background: Suicide among emerging adults has become a significant global public health concern. Suicidal ideation is the prerequisite for suicide, and social support is recognized as a key protective factor against suicidal ideation. However, the relationship between the strength and consistency of social support and suicidal ideation among undergraduate students remains unclear. This study synthesized empirical studies to quantify the relationship between social support and suicidal ideation among undergraduate students and determine the different correlations between various sources of social support and suicidal ideation. Methods: A systematic review and meta-analysis was conducted following PRISMA 2020 guidelines. Five electronic databases (Web of Science, Scopus, PubMed, ProQuest, and ScienceDirect) were searched for studies published from 2016 to 2025. Eligible studies reported quantitative associations between social support and suicidal ideation among undergraduate students. Correlation coefficients were transformed using Fisher’s z and pooled using a random-effects model. Heterogeneity was evaluated using Cochran’s Q and I² statistics. Risk of bias assessments, moderator analysis, sensitivity analysis, subgroup analysis, and publication bias assessments were conducted. Results: Fifteen studies with sixteen independent effect sizes and more than 26,000 participants were included. The meta-analysis showed a moderate negative association between social support and suicidal ideation (pooled r = −0.33, 95% CI [−0.40, −0.25]) under a random-effects model. A high heterogeneity was observed among studies (I² = 97%, p < 0.001). There are no studies classified as having a high risk of bias. The standardized sample size demonstrated a significant moderating effect (β = 0.2568, p = 0.0022). Sensitivity analysis confirmed the stability of the pooled effect. Subgroup analysis indicated that the strength of the association between social support and suicidal ideation did not differ significantly between Asian and non-Asian studies. No significant publication bias was detected (Egger’s p = 0.19). Narrative synthesis further suggested that family support showed the most consistent protective association compared with friends’ support and support from others. Conclusions: Social support is moderately and consistently associated with reduced suicidal ideation among undergraduate students. These findings highlight social connectedness, particularly family support, as a central interpersonal protective factor and strengthen social support’s role in university suicide prevention initiatives. Full article

Introduction: Workplace mobbing is a psychosocial risk factor associated with adverse mental health outcomes, including depression, anxiety, and suicidal ideation. Accurate assessment of this phenomenon is essential for both research and applied settings; however, validated brief instruments in Spanish remain limited. The Luxembourg Workplace Mobbing Scale (LWMS) is a short measure with sound psychometric properties that allows efficient evaluation of exposure to workplace mobbing. Objective: Translation and validation of the LWMS into Spanish in adults. Methods: A total of 345 adults (51.3% women) participated, completing a sociodemographic questionnaire and psychological instruments. Statistical analyses were conducted using structural equation modelling and item response theory. Results: The LWMS demonstrated adequate content validity; a unidimensional structure (CFI = 0.99, RMSEA = 0.04 [90% CI: 0.001, 0.092], SRMR = 0.02); and reliability (ω = 0.79, H = 0.86 and r_xx = 0.78). In addition, significant associations were found with depressive symptoms (r = 0.37, p = 0.001), generalised anxiety (r = 0.38, p = 0.001), and suicidal ideation (r = 0.27, p = 0.001). Item 2 showed the highest discrimination and information, and the scale proved to be accurate at higher levels of workplace mobbing. Conclusions: The Spanish version of the LWMS shows solid evidence of validity and reliability, supporting its use as a brief and precise instrument for assessing workplace mobbing in adult populations. Its strong psychometric performance and clinical relevance make it suitable for research, screening, and preventive interventions in occupational settings. Full article

Objective: This study examined psychological resilience (PR) as a potential moderator and mediator of the association between borderline personality symptoms (BPS) and suicidal ideation (SI) among university students. Method: A cross-sectional design was used with (N = 257) university students. Moderation and mediation were tested in separate, theory-guided models using the PROCESS macro for SPSS, version 28. The moderation model (Model 1) and the mediation model (Model 4) were estimated with heteroskedasticity-consistent standard errors (HC3). In the adjusted analyses, sex, age, previous psychological consultation, previous psychotropic medication use, and family history of mental illness were entered as covariates. The indirect effect was evaluated using percentile bootstrap confidence intervals based on (5000) resamples. Results: BPS was positively correlated with SI, whereas PR was negatively correlated with both BPS and SI. In the adjusted moderation model, BPS was positively associated with SI (b = 0.118, p < 0.001) and PR was negatively associated with SI (b = −0.204, p = 0.048), but the interaction term was not significant (b = −0.001, p = 0.820) with negligible explained variance (ΔR² = 0.0003). In the adjusted mediation model, BPS was significantly associated with lower PR (a: b = −0.135, p < 0.001), and PR was associated with lower SI while controlling for BPS and the covariates (b: b = −0.216, p = 0.028). The total effect of BPS on SI was significant (c: b = 0.146, p < 0.001), and the direct effect remained significant after including PR (c′: b = 0.117, p < 0.001). The indirect effect was significant (ab = 0.029; 95% bootstrap CI [0.005, 0.061]). Conclusions: Psychological resilience did not moderate the association between BPS and suicidal ideation, but it showed a statistically significant indirect association consistent with the proposed mediation model. Higher BPS were associated with lower resilience, which in turn was associated with higher suicidal ideation. These findings suggest that resilience-related targets may complement interventions addressing core BPS-related risk processes, while the cross-sectional design precludes causal conclusions. Full article

Background/Objectives: Hypothyroidism, including subclinical hypothyroidism, may affect mental health in children and adolescents through disturbances of neurotransmission and dysregulation of the hypothalamic–pituitary–thyroid and stress axes. Anxiety disorders are common in this population and frequently coexist with somatic symptoms overlapping those of hypothyroidism, complicating diagnosis and treatment. This study aimed to evaluate the association between levothyroxine treatment for hypothyroidism and the need for psychiatric interventions in children and adolescents with anxiety disorders. Methods: A retrospective cohort study was performed using data from the TriNetX global research network. Patients aged 5–18 years with diagnoses of hypothyroidism (ICD-10: E03) and anxiety disorders (ICD-10: F41) were included. Two propensity score–matched cohorts were analysed: patients treated with levothyroxine (n = 1861) and untreated patients (n = 1861). Outcomes included psychiatric hospitalisations, use of selective serotonin reuptake inhibitors and tricyclic-like antidepressants, frequency of psychiatric and psychotherapeutic consultations, and the occurrence of suicidal ideation and self-harm. Results: Levothyroxine treatment was associated with lower odds of SSRI use (OR = 0.58; p < 0.001), fewer psychiatric consultations (OR = 0.48; p < 0.001), and lower recorded use of psychotherapy (OR = 0.75; p = 0.029). Suicidal ideation and self-harm were recorded less frequently in the treated group (OR = 0.53; p = 0.001). No significant differences were observed in psychiatric hospitalisation rates. Use of tricyclic-like antidepressants was uncommon and did not differ significantly between groups. Conclusions: Among children and adolescents with comorbid anxiety disorders, levothyroxine treatment for hypothyroidism is associated with lower recorded utilization of certain psychiatric services and lower recorded rates of suicidal ideation and self-harm. Due to the retrospective design, causal inferences cannot be made, and the findings should be considered hypothesis-generating, requiring confirmation in prospective studies with standardised psychiatric outcome measures. Full article

Introduction: Increasing rates of youth suicide are a growing concern worldwide. The single highest risk factor for suicide is a prior suicide attempt; however, knowledge around the broader factors that may increase the likelihood of the initial suicide attempt is limited. Understanding these risk factors is critical for clinicians to inform the development of early intervention strategies. This study examines the characteristics of a specific cohort of young people attending a tertiary mental health service in Melbourne, Victoria, following a suicide attempt or with persistent suicidal ideation. Method: A file audit of all young people attending the service was conducted from the commencement of the new service in 2022 through to the end of 2024. One hundred and seventy-one files were examined for specific data, including items such as age, gender, gender diversity, socio-economic factors and neurodivergence. Results: One-sample z proportion tests showed significantly higher proportions of young people who were LGBTIQIA+, transgender, gender diverse or non-binary (TGDNB), neurodivergent, not engaged in employment, education or training (NEET), and international students in the clinical cohort compared with the Australian population. Almost one-fifth of the cohort reported a history of trauma. Discussion: The study provides insight into characteristics observed among a cohort of suicidal young people. Findings highlight that young people from several marginalised groups were more frequently observed in this clinical cohort. The findings have implications for youth mental health services, supporting earlier identification of potential factors associated with suicidality so that prevention strategies can be implemented in a timely manner. Full article

Background: This study examined the predictive effect of parental marital satisfaction on suicidal behaviors among preadolescents and adolescents in China, with positive youth development (PYD) attributes as a mediator. Methods: A total of 3665 matched pairs of students (aged 9–19, 51.3% boys) and their parents completed questionnaires, with parental marital satisfaction reported by parents and suicidal behaviors (ideation, plan, and attempt) and PYD attributes reported by students. Results: The prevalence of overall suicidal behavior was 15.5% in this sample, with a higher prevalence observed among those with lower parental education levels. Hierarchical regression and structural equation modeling analyses revealed that: (1) after controlling for socio-demographic variables, parental marital satisfaction negatively predicted suicidal behaviors; (2) PYD attributes negatively predicted suicidal behaviors, accounting for the largest proportion of variance (ΔR² range = 0.036–0.102); (3) parental marital satisfaction was positively correlated with PYD attributes; and (4) PYD attributes partially mediated the predictive relationship between parental marital satisfaction and suicidal behavior, with a significant indirect effect (β = −0.06) accounting for 56.6% of the total effect. Conclusions: This study illuminates protective pathways through which a positive family environment cultivates individual competencies, ultimately contributing to reduced suicidal behavior. Full article

Background/Objectives: Finasteride and dutasteride are 5α-reductase inhibitors that block the conversion of testosterone to dihydrotestosterone, reducing androgenic stimulation of tissues such as the prostate and hair follicles. Used mainly for benign prostatic hyperplasia and androgenic alopecia, finasteride selectively inhibits type-2 5α-reductase isoenzyme, while dutasteride inhibits both type-1 and type-2. Although sexual adverse effects like erectile dysfunction are well-documented, emerging evidence suggests possible neuropsychiatric reactions—including depression, suicidal ideation, and cognitive decline—potentially linked to reduced neurosteroid synthesis, such as that of allopregnanolone. Causality cannot be inferred from spontaneous reporting data. This study aimed to assess pharmacovigilance signals for psychopathological disorders associated with finasteride and dutasteride in the FAERS database. Methods: Cleaned FAERS data referring to years up to 2025 after deduplication were analyzed, excluding non-serious cases and those without the drug as the sole suspect (MedDra 29.0). Reporting Odds Ratios (RORs) with 95% CIs were calculated to compare psychiatric reactions between finasteride and dutasteride. Python 3.11 was used to screen and summarize relevant cases, accounting for differences in total case numbers. Results: This pharmacovigilance study analyzed FAERS data to assess the neuropsychiatric and sexual adverse reactions associated with finasteride and dutasteride. Depression, anxiety, suicidality, and libido-related issues were reported more frequently for finasteride, especially in younger men using low-dose therapy for alopecia. Potential mechanisms include reduced neurosteroid synthesis, androgen/sex-hormone axis disruption, altered hippocampal neurogenesis, and dopaminergic changes. Conclusions: A baseline psychiatric assessment and the regular monitoring of mood, sexual function, and suicidal ideation are recommended. Limitations include under-reporting, reporting bias, and a lack of incidence data. The findings underscore the need for ongoing surveillance and controlled studies to clarify the clinical significance of these signals. Full article

The mental health of veterinary professionals has become an increasing concern due to the high levels of psychological distress and suicide risk reported in this profession. The present study examined the association between emotional exhaustion and suicidal ideation, considering the mediating role of depressive, anxiety, and stress symptoms. A total of 216 Spanish veterinary professionals completed standardized questionnaires assessing emotional exhaustion, affective symptoms, and suicidal ideation. The results revealed a high prevalence of emotional exhaustion, with more than half of the participants reporting high or very high levels. In addition, a considerable proportion of the sample reported experiencing at least one indicator of suicidal ideation during the previous year. Emotional exhaustion was associated with higher levels of depression, anxiety, and stress. However, the mediation analysis indicated that only depressive symptoms explained the relationship between emotional exhaustion and suicidal ideation, whereas anxiety and stress did not show a significant mediating effect. Overall, the model accounted for a substantial proportion of the variance in suicidal ideation. These findings highlight the central role of depression in the link between emotional exhaustion and suicidal ideation, underscoring the need for early detection and prevention of depressive symptoms in veterinary professionals. Full article

Background/Objectives: Excessive smartphone use has emerged as an important behavioral health concern during adolescence, a developmental period characterized by heightened psychosocial vulnerability. This study aimed to identify psychosocial and behavioral factors associated with excessive smartphone use among Korean adolescents using nationally representative data. Methods: Data were obtained from the 2024 Korean Youth Risk Behavior Web-based Survey (KYRBS), including 54,653 adolescents. Excessive smartphone use was operationally defined as average daily smartphone use of ≥300 min. Multivariable logistic regression was conducted to examine associated factors. An exploratory machine learning analysis using a Light Gradient Boosting Machine included 52,450 participants with complete predictor data. Results: Female sex, higher grade level, lower perceived socioeconomic status, higher perceived daily stress, higher anxiety symptoms, poorer sleep-related recovery, suicidal ideation, and more frequent vigorous physical activity were associated with higher odds of excessive smartphone use. The supplementary modeling approach showed patterns consistent with the regression findings, with grade level, socioeconomic status, and sex contributing prominently. Vigorous physical activity demonstrated a nonlinear association with predicted risk. Conclusions: Excessive smartphone use among adolescents appears to be shaped by developmental stage, socioeconomic context, and psychological vulnerability. These findings support prevention strategies that address emotional well-being and sleep health alongside broader structural and school-based approaches. Full article

Background: This study aimed to investigate the relationship between serum neuroactive steroids (NAS) and oxytocin and craving and psychosocial functioning in men diagnosed with methamphetamine use disorder (MUD). Methods: In this observational cross-sectional study, 40 men with MUD (PG) and 41 non-substance-use-disorder controls (CG) completed measures of emotion dysregulation (DERS-16), attachment (ECR-R), aggression (BPAQ), and suicidal ideation (BSS). PG additionally completed the Substance Craving Scale (SCS) and Addiction Profile Index (API). Serum allopregnanolone (ALLO), DHEAS, testosterone, 17β-estradiol (E2), and oxytocin were assayed. Results: The results indicated that the PG exhibited significantly higher scores than the CG across all psychological measures. Robust adjusted group effects were observed for DERS-16 (Model 1: F = 35.507, p < 0.001; Model 2: F = 18.225, p < 0.001) and trait anger (Model 1: F = 41.104, p < 0.001; Model 2: F = 16.732, p < 0.001). Notably, serum levels of ALLO, DHEAS, testosterone, E2, and oxytocin did not differ significantly between groups. However, hormonal measures were strongly intercorrelated within both groups (r ≈ 0.877–0.936, all p < 0.001). In the PG, craving demonstrated positive correlations with DHEAS (r = 0.384, p = 0.014), testosterone (r = 0.415, p = 0.008), E2 (r = 0.360, p = 0.023), and oxytocin (r = 0.350, p = 0.027). A multivariable model analyzing craving was statistically significant (R² = 0.350; F(3,36) = 6.474, p = 0.001), with composite hormonal factor (B = 2.390, p = 0.016) serving as an independent predictor, while API Excluding Craving(API-EC) (p = 0.094) and DERS-16 did not emerge as a significant factor (p = 0.056). In hormone-specific models controlling for API-EC and DERS-16, DHEAS (p = 0.012), testosterone (p = 0.007), oxytocin (p = 0.023), and E2 (p = 0.023) retained significance after false discovery rate (FDR) correction; ALLO did not (p = 0.055). Conclusions: Despite the absence of significant differences in peripheral NAS and oxytocin levels between groups, men with MUD exhibited pronounced psychosocial impairments. The craving experienced during inpatient treatment was primarily elucidated by an integrated endocrine profile. These findings underscore the necessity for larger longitudinal studies incorporating repeated hormonal assessments to further explore these relationships. Full article

Background: Emotion regulation and attachment styles are interrelated and are critical factors in psychopathology and treatment outcomes, particularly in youths with suicidal behavior receiving psychiatric inpatient care. This study examined the influence of emotion regulation and attachment style on psychiatric hospitalization duration among adolescents admitted due to suicidal ideation or behavior. Methods: Participants included 79 Israeli adolescents (mean age 15.35 years, 87.3% female) admitted to a tertiary psychiatric inpatient unit following a suicidal crisis. Data was collected using the Difficulties in Emotion Regulation Scale (DERS), the Experience in Close Relationships Scale (ECR), the Screen for Child Anxiety-Related Emotional Disorders (SCARED), the Patient Health Questionnaire (PHQ-9), and the Columbia-Suicide Severity Rating Scale (C-SSRS). Data were analyzed using correlation and multiple regression analyses. Results: Analysis revealed that greater emotion regulation difficulties predicted longer hospitalization duration (β = 0.41, p < 0.001), while avoidant attachment style was associated with shorter hospitalization duration (β = −0.35, p < 0.001). Notably, the level of suicidality as well as psychopathology symptoms (depression and anxiety) did not predict hospitalization duration. Conclusions: These findings underscore the important role of emotion regulation and attachment style in determining treatment duration in suicidal adolescents, beyond the severity of psychopathology and suicidality, suggesting their unique contribution to treatment planning. Clinical interventions targeting emotion regulation and attachment styles could enhance inpatient care effectiveness, offer a more personalized treatment approach and potentially reducing hospitalization duration. Full article

Suicidal behavior among adolescents and young adults represents a growing public health concern due to its high prevalence and its negative impact on psychological well-being. The aim of this study was to examine the associations between emotional regulation, attachment styles, cyberviolence, and suicidal ideation among Chilean university students. A descriptive cross-sectional design was employed with a sample of 1083 participants, using the Suicidal Ideation Frequency Inventory, the Close Relationship Experience Questionnaire (ECR-R), the Spanish Modified Version of the Trait Meta-Mood Scale (TMMS-24) and the Cyber Dating Violence Instrument for Teens (CyDAV-T). Bivariate analyses and binary logistic regression were conducted to identify significant predictors of suicidal ideation. The results revealed a high prevalence of suicidal ideation, particularly among women (19.06%; p < 0.001). Difficulties in emotion regulation were strongly associated with a higher likelihood of suicidal ideation (p < 0.001), whereas adequate (p < 0.001) or excellent (p < 0.01) regulation functioned as a significant protective factor. In addition, a disorganized attachment style was identified as a risk factor (p < 0.05), especially among women (p < 0.01). In conclusion, emotion regulation emerges as a key protective factor against suicidal ideation, underscoring the importance of implementing socioemotional training programs within university settings. Full article

Background: Major depressive disorder (MDD) is a common mental disorder characterized by a wide range of symptoms and a substantial contribution to global disease burden. Our study aimed to examine the relationships between childhood trauma, sleep quality, dissociative symptoms, posttraumatic growth, and suicidality in patients diagnosed with MDD. Methods: Our sample consisted of 115 patients with MDD and 84 healthy controls. Participants were administered the Hamilton Depression Rating Scale (HDRS), Beck Scale for Suicidal Ideation (BSSI), Pittsburgh Sleep Quality Index (PSQI), Childhood Trauma Questionnaire (CTQ-33), Dissociative Experiences Scale (DES), and Posttraumatic Growth Inventory (PTGI). Group differences were analyzed, and associations among variables within the MDD group were examined using correlation and mediation analyses. Results: Compared to healthy controls, patients with MDD had significantly higher scores on all scales except the PTGI (p < 0.001 for each). Within the MDD group, individuals with a history of suicide attempts had significantly higher CTQ total scores, physical and sexual abuse subscale scores, and DES scores than those without previous attempts. Additionally, dissociative experiences had a partial mediating role in the relationship between depression severity and suicidal ideation, as well as in the relationship between childhood traumas and sleep quality. Conclusions: The findings highlight the clinical relevance of dissociative experiences and sleep disturbances in the heterogeneous presentation of MDD and their association with illness severity and suicidality. In the follow-up and treatment process of patients with MDD, risk and protective factors should be evaluated together, and individualized treatment programs should be targeted. Full article