Search Results (132)

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

Background: Hypothermia, occurring when core temperature drops below 35 °C, can lead to death when the body’s heat loss exceeds its heat production. This study investigates two hypothermia-related deaths, exploring the utility of immunohistochemistry, specifically focusing on chromogranin A (CgA) as a potential diagnostic tool. The aim is to assess whether CgA expression in neuroendocrine tissues can be considered a reliable indicator of premortem stress response in fatal hypothermia cases. Case Presentation: In the first case, a 67-year-old man was found on a snowy road 24 h after his disappearance. The autopsy revealed cold-induced skin lesions, gastric hemorrhages, and cerebral and pulmonary edema. Positive CgA immunostaining was observed in the pancreatic islets and adrenal medulla. In the second case, a 49-year-old man was found dead in a wooded area with indications of suicide. Both cases were examined with attention to macroscopic findings and histological samples from major neuroendocrine organs. As in previous cases, CgA immunostaining was positive in the pancreatic islets and adrenal medulla. Staining intensity was moderate to strong, consistent with heightened neuroendocrine activity, supporting the hypothesis of systemic stress prior to death. Conclusions: Although CgA is a potentially valuable adjunct in hypothermia diagnosis, careful consideration of cadaveric preservation is emphasized, particularly when bodies are preserved before autopsy. Further studies with larger sample sizes are needed to confirm its diagnostic specificity and to distinguish true pathological patterns from postmortem artifacts. 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

Background: Finasteride, a 5α-reductase inhibitor, is used for androgenetic alopecia and benign prostatic hyperplasia. However, concerns have emerged about its psychiatric side effects, including suicidality. This study analyzed finasteride-related reports from the FDA Adverse Event Reporting System (FAERS) to identify potential safety signals. Methods: Adverse events reported from 2015 to 2024 were extracted using preferred terms, quantified using Bayesian analysis and disproportionality metrics, including empirical Bayesian geometric mean (EBGM), information component (IC), reporting odds ratio (ROR), and proportional reporting ratio (PRR). Results: Most were male (87%), with 43% aged 18–40 years, primarily using finasteride for hair loss. Disproportionality metrics for suicidality-related events fluctuated between 2019 and 2024. In 2019, the ROR was 27.51 (95% CI: 23.22–32.58), the PRR was 21.96 (95% CI: 18.54–26.01), the EBGM was 20.50, and the IC was 4.36. A slight decline was observed in 2020, a surge in 2021, and a peak in 2022 (ROR 34.64 (95% CI: 28.36–41.88), PRR 27.82 (95% CI: 22.30–34.61), EBGM 24.96, IC 4.64). Although a sharp rise in suicidality reports was noted in 2024, the rates of ROR and PRR dropped to 19.04 (95% CI: 17.02–21.30) and 16.53 (95% CI: 14.78–18.50), respectively. Serious outcomes such as disability (18.7%), life-threatening events (12.9%), and death (7.5%) were also noted. Conclusions: The upward trend in suicidality-related safety signals among young male users since 2019, which peaked in 2024, reflects emerging safety concerns among finasteride users, reinforcing the need for pharmacovigilance. Collaborative action among healthcare professionals, regulatory authorities, and pharmaceutical companies, along with clear warnings and mental health assessments before and throughout finasteride therapy, can mitigate potential psychiatric risks and enhance patient safety. Full article

Major Depressive Disorder (MDD) is a chronic mental disorder characterized by anhedonia, loss of desire, guilt, suicidal thoughts, and appetite changes. It is reported that individuals with MDD resort to binge eating to escape from negative feelings. In this study, we aimed to determine the relationship between binge eating behavior and the concept of psychological pain associated with emotions such as shame, guilt, and anger in individuals with MDD. We conducted the study in the Psychiatry Outpatient Clinics of Balcalı Hospital, Çukurova University Faculty of Medicine. The sample consisted of 147 individuals with MDD without psychotic symptoms and 128 healthy controls with sociodemographic characteristics similar to the MDD group. We administered a sociodemographic data form, the Hamilton Depression Rating Scale (HDRS), Psychache Scale (PS), Tolerance for Mental Pain Scale-10 (TMPS-10), Barratt Impulsiveness Scale (BIS-11), and Eating Disorder Examination Questionnaire (EDE-Q-13). Eighty-two (55.7%) of the patients with MDD were diagnosed with binge eating disorder (BED). In the group of MDD patients with BED comorbidity, the EDE-Q-13 total, binging subscale, and HDRS scores were significantly higher than those of the other groups (p < 0.05 for each group), with large to very large effect sizes (e.g., EDE-Q-13 binging d = 1.04; HDRS d = 1.91; PS d = 1.22). There was no significant difference between the MDD groups (with and without BED) regarding the BIS and BIS subscales’ subscores, PS, and TMPS scores. For participants with MDD, there was a significant same-directional correlation between EDE-Q-13 binging, HDRS, BIS, and PS scores (p < 0.05 for each), with moderate to strong effect sizes (EDE-Q-13 binging and HDRS: r = 0.398, p < 0.001; binging and PS: r = 0.273, p < 0.001; binging and BIS: r = 0.233, p = 0.005; binging and TMPS-10: r = –0.257, p = 0.002). Additionally, a negative correlation was observed between TMPS and the scores for EDE-Q-13 binging, HDRS, BIS, and PS. A linear regression analysis indicated that depression severity and BMI were the strongest predictors of binge eating behavior (R² = 0.243; f² = 0.32). Based on our results, we concluded that the presence of binge eating behavior in patients with MDD is associated with more severe depressive symptoms, psychological pain, impulsivity, and lower tolerance to psychological pain. The finding that binge eating behavior was most strongly associated with depression severity and body mass index (BMI) supports the notion that binge eating behavior is a maladaptive attitude. Longitudinal studies comparing individuals with different BMIs in different clinical samples are needed to confirm our results. Full article

Internet scams have become more sophisticated and prevalent in countries such as Canada, the US, the UK, and Australia. Australia has made some progress in effective scam intervention strategies and seen possible growth in public awareness. However, there is a lack of insight into factors associated with profound shame and embarrassment, emotional distress such as anxiety and depression, and trauma and suicide in scam victims. To fill this gap, this perspective paper aimed to provide insight into the factors associated with the negative mental health impacts of internet scams by integrating a narrative literature review with a victim case study detailing a group’s experience of an investment scam in Australia. It found that internet scams cause emotional and social issues like depression, anxiety, trauma, and isolation, mostly prolonged upon substantial loss. The author’s insight into the intensely negative mental health impacts of an investment scam allows for the presentation of a group who struggled to access adequate support and mental health care in their response to insidious organized crime. Better education, resilience-building, and support systems are needed. These shortcomings call for strategies for tailored digital mental health services such as emotionally attuned, trauma-informed digital companionship through human-like artificial intelligence (AI) applications. Full article

Perceived experiences of violence, trauma, body dissatisfaction, and body shaming emerge as interconnected factors contributing to suicide attempts among adolescents. There is a critical need to improve the understanding and prediction of suicide attempts in this vulnerable population. In this study, a primarily qualitative design was employed, supported by descriptive quantitative elements, such as code frequencies and word clouds, to explore in-depth narrative interviews of adolescents who attempted suicide. Thematic content analysis was utilized to analyze the transcripts of these narrative interviews. The study sample consisted of 22 adolescents (M_age = 16.98 years; SD = 1.624; 77% males, 19% females, 4% non-binary or transgender). The content analysis revealed two significant body-related risk factors for suicide attempts: experiences of violence or trauma and body dissatisfaction, which were associated with maladaptive coping strategies, including self-harm, substance use, and eating disorders. Acute somatic warning signs such as dissociative states, loss of control, and disconnection from one’s body suggested pronounced psychophysiological dysregulation. The findings underscore the body as a battleground, where emotional pain related to bodily experiences and perceptions manifests significantly. Future research should integrate subjective body-related experiences in risk assessments and interventions targeting adolescent suicidal behaviors. Full article

Background: The suicide rate among Iraqis is rising, with many analysts attributing it to political instability, exposure to trauma, economic hopelessness, social stigma surrounding mental health as well as cultural and societal pressures. However, the prevalence of suicidal ideation and associated risk factors in Iraqi youth is unknown, requiring urgent attention and effective public health initiatives. Thus, the aim of this study was to explore rates of suicidal ideation and associated risk factors among female secondary school students in Baghdad, Iraq. Method: A cross-sectional study was conducted, utilising quantitative survey data collected in four girls’ secondary schools across Baghdad, Iraq, between August and December 2023. The survey consisted of questions relating to their demographic characteristics (age, gender, school) and a series of measures pertaining to participants’ levels of suicidal ideation, as well as factors commonly identified in the literature as predictors of suicide. Results: Four-hundred and two female participants took part. Participants were aged between 13 and 17 years (M = 15.50; SD = 1.22). In total 11.3% of the students scored in the at-risk range for suicidal behaviour and only 20.1% (n = 91) said they had not had some thoughts of suicide in the previous two weeks. Previous diagnoses of anxiety, high levels of depression and hopelessness, and poor quality of life were significant risk factors for suicidal ideation. On average, students reported moderate levels of depression and high levels of hopelessness. Conclusions: Female Iraqi secondary school students experience high levels of suicidality, alongside several other known risk factors for suicide ideation. However, a limitation of this study is that cross-sectional designs limit causal interpretation. Findings emphasise the importance of developing targeted school-based interventions to support students’ mental health. Increasing research and attention in this area is vital to not only improving the mental health of students in Iraq but also reducing the stigma around mental health and suicide. Future policies should include specific mental health support for those young people affected by conflict, displacement and family loss, integrating trauma-informed care into both mental health and educational services. Full article

Adults bereaved by the suicide or overdose death of someone close to them are vulnerable to adverse mental health outcomes, but little is known about how these individuals utilize avoidance- and approach-based coping strategies, how these strategies relate to outcomes, and what accounts for these associations. Informed by contemporary theories of bereavement, we utilize prospective data from suicide- and overdose-bereaved adults (N = 212) who completed two waves of online data collection approximately two years following the death (T1 and T2; six months apart) to examine the mediating role of meaning making in the relationship between coping strategies and grief-related mental health outcomes, such as prolonged grief (PG), posttraumatic stress (PTS), and depression. Path analysis with mediation was used to investigate the relations between coping strategies at T1, meaning making at T2, and mental health outcomes at T2. The results indicated direct effects of avoidant coping at T1 in predicting higher PG and PTS symptoms at T2, while approach-based coping at T1 indirectly predicted an improvement in all three T2 outcomes due to increased meaning making. These results suggest that avoidance-based strategies directly and indirectly contribute to poorer outcomes and impaired meaning making processes, while approach-based strategies lead to increased meaning making and adaptation to loss among suicide and overdose loss survivors. The clinical implications and future directions for research are discussed. Full article

Suicidal behavior among older military veterans is an important medical and social problem. The goal of this literature review is to discuss this underappreciated issue and identify suicide preventive interventions that can be utilized with the older military veteran population. Older veterans experience psychiatric, medical, and social problems associated with their age and/or military experience that can contribute to suicide risk. These problems include relationship losses through death or estrangement, depression, cognitive decline, loneliness, isolation, frailty, mobility issues, and chronic pain. Therefore, older veterans face a unique set of challenges. Suicide prevention in older veterans should take a multipronged approach which includes screening for suicidality, management of psychiatric and medical disorders, social assistance, safety planning, lethal means restriction, and involving family members in the veteran’s healthcare. Family members should be included in the safety planning process when possible. Gatekeeper training programs can be utilized to train individuals who are working with older veterans to reduce suicides amongst this age group. Full article

This study explores Austrian palliative and hospice care nurses’ experiences regarding assisted suicide (AS). Following its legalization in 2022, occupational groups affected by the legislation, such as nurses, have been left without clear guidance or instructions on how to navigate this new landscape. This study aimed to explore how nurses perceive their patients’ desire to die and its connection to the symptoms experienced by the patients. A cross-sectional online questionnaire survey was disseminated to all palliative and hospice care facilities in Austria and was eventually completed by 145 nurses, focusing on their understanding of patients’ requests for AS and the severity of patients’ symptoms. Factor analysis was used to identify symptom clusters, and Spearman rank correlations were employed to explore associations between nurses’ understanding of AS and factors such as patient symptoms, nurse demographics, and attitudes toward AS. The results indicate that psychosocial factors, particularly loss of dignity (63.6%) and autonomy (76.4%), were the most frequently reported severe symptoms. Understanding patients’ decisions was significantly associated with nurses’ general support for AS (r = 0.34, p < 0.001) but not with age, work experience, or religious beliefs. Factor analysis revealed four symptom clusters, with ’loss of dignity’ showing a small but significant correlation with nurses’ understanding of patients’ requests (r = 0.17, p = 0.044). The present findings highlight the importance of integrating psychosocial support into palliative care and emphasize the need for clear guidelines and training to better support nurses in managing AS-related challenges. Full article

Objectives: This study aimed to develop a gender-specific model to understand the causal relationship between body image dissatisfaction, emotional eating, and suicide risk among bariatric surgery patients. A secondary objective was to evaluate gender differences in the associations between these variables. It was hypothesized that, independent of objective weight loss, body dissatisfaction and emotional eating would lead to increased suicide risk. Methods: A total of 109 participants completed self-report measures of suicidal ideation, body image dissatisfaction, and emotional eating before and after bariatric surgery. Results: Cross-lagged analysis indicated that pre-surgery suicide ideation significantly predicts body dissatisfaction primarily among men, independent of the extent of weight loss. High levels of pre-surgery suicide risk correlated with post-surgery body image dissatisfaction in men. The autoregressive effect of suicide ideation was stronger than that of body dissatisfaction for both genders; however, the latter was stronger among women, indicating that past dissatisfaction levels significantly influenced future dissatisfaction. Conclusions: The complex interplay between gender, body dissatisfaction, emotional eating, and suicide risk warrants further research. Full article

Objective: In the United Kingdom (UK) and most countries worldwide, midwives are professionally required to undertake an initial perinatal mental health (PMH) risk assessment at every maternity contact. However, studies have found that midwives feel that they are not well-equipped to provide effective care for women with PMH needs. This study explores how the newly qualified midwives (NQMs) are prepared through pre-registration midwifery education and placements to have sufficient confidence in their knowledge, attitude, skills, and habits (KASH) for their post-registration PMH role. Methods: This explanatory sequential mixed methods study collected survey data from two independent groups: NQMs (n = 50), who qualified from 10 UK universities, and senior specialist midwives (SSMs) (n = 32). Descriptive and inferential responses were analysed using SPSS. Statistical differences between the ranged Likert scale responses of the NQMs and SSMs were analysed using the Mann-Whitney U test. The p-value of <0.05 was considered statistically significant. The semi-structured interview phase comprised of NQMs (n = 12) and SSMs (n = 8). The qualitative data were thematically analysed using NVivo. Results: The pre-registration midwifery programme significantly prepared the NQMs to have sufficient confidence in their knowledge of the related PMH role, multidisciplinary team (MDT) role, and available services (p < 0.05) and good attitude towards women with varying PMH conditions (p < 0.0005). The NQMs had sufficient confidence in their skills in using the validated tool for PMH assessment, to build rapport to facilitate disclosure, and recognise deteriorating PMH (p < 0.01). They had regular habits of discussing PMH well-being at booking and made prompt referrals (p < 0.05). The NQMs were not prepared to have sufficient knowledge of PMH medications, perinatal suicide prevention, and the impact of maternal mental health on partners (p < 0.01) including children (p < 0.05); skills in managing PMH emergencies (p < 0.05), and to regularly discuss suicidal thoughts (p < 0.01), issues of self-harm, and debrief women following pregnancy or neonatal losses and traumatic births (p < 0.05). Some aspects were either confirmed or contradicted at the interviews. Conclusions and recommendations: The pre-registration midwifery programme prepares the NQMs to some extent for their post-registration PMH role. Perceived areas for improvement suggest implications for the development of educational, practice, policy, and preceptorship to facilitate the NQMs’ sustainable confidence in their KASH. Full article

Purpose of Review: This review aims to describe the role of limbic system-associated membrane protein (LSAMP) in normal- and pathophysiology, and its potential implications in oncogenesis. We have summarized research articles reporting the role of LSAMP in the development of a variety of malignancies, such as clear cell renal cell carcinoma, prostatic adenocarcinoma, lung adenocarcinoma, osteosarcoma, neuroblastoma, acute myeloid leukemia, and epithelial ovarian cancer. We also examine the current understanding of how defects in LSAMP gene function may contribute to oncogenesis. Finally, this review discusses the implications of future LSAMP research and clinical applications. Recent Findings: LSAMP has been originally described as a surface adhesion glycoprotein expressed on cortical and subcortical neuronal somas and dendrites during the development of the limbic system. It is categorized as part of the IgLON immunoglobulin superfamily of cell-adhesion molecules and is involved in regulating neurite outgrowth and neural synapse generation. LSAMP is both aberrantly expressed and implicated in the development of neuropsychiatric disorders due to its role in the formation of specific neuronal connections within the brain. Additionally, LSAMP has been shown to support brain plasticity via the formation of neuronal synapses and is involved in modulating the hypothalamus in anxiogenic environments. In murine studies, the loss of LSAMP expression was associated with decreased sensitivity to amphetamine, increased sensitivity to benzodiazepines, increased hyperactivity in new environments, abnormal social behavior, decreased aggressive behavior, and decreased anxiety. Findings have suggested that LSAMP plays a role in attuning serotonergic activity as well as GABA activity. Given its importance to limbic system development, LSAMP has also been studied in the context of suicide. In malignancies, LSAMP may play a significant role as a putative tumor suppressor, the loss of which leads to more aggressive phenotypes and mortality from metastatic disease. Loss of the LSAMP gene facilitates epithelial-mesenchymal transition, or EMT, where epithelial cells lose adhesion and gain the motile properties associated with mesenchymal cells. Additionally, LSAMP and the function of the RTK pathway have been implicated in tumorigenesis through the modulation of RTK expression in cell membranes and the activation of second messenger pathways and β-catenin. Summary: Beyond its many roles in the limbic system, LSAMP functions as a putative tumor suppressor protein. Loss of the LSAMP gene is thought to facilitate epithelial-mesenchymal transition, or EMT, where cells lose adhesion and migrate to distant organs. LSAMP’s role in modulating RTK activity and downstream ERK and Akt pathways adds to a large body of data investigating RTK expression in oncogenesis. The characteristics of LSAMP defects and their association with aggressive and metastatic disease are evident in reports on clear cell renal cell carcinoma, prostatic adenocarcinoma, lung adenocarcinoma, osteosarcoma, neuroblastoma, acute myeloid leukemia, and epithelial ovarian cancer. Full article

Mood disorders mainly affect the patient’s daily life, lead to suffering and disability, increase the incidence rate of many medical illnesses, and even cause a trend of suicide. The glucocorticoid (GC)-mediated hypothalamus–pituitary–adrenal (HPA) negative feedback regulation plays a key role in neuropsychiatric disorders. The balance of the mineralocorticoid receptor (MR)/glucocorticoid receptor (GR) level contributes to maintaining the homeostasis of the neuroendocrine system. Consistently, a chronic excess of GC can also lead to HPA axis dysfunction, triggering anxiety, depression, memory loss, and cognitive impairment. The animal model induced by chronic corticosterone (CORT) administration has been widely adopted because of its simple replication and strong stability. This review summarizes the behavioral changes and underlying mechanisms of chronic CORT administration-induced animal models, including neuroinflammatory response, pyroptosis, oxidative stress, neuroplasticity, and apoptosis. Notably, CORT administration at different doses and cycles can destroy the balance of the MR/GR ratio to make dose-dependent effects of CORT on the central nervous system (CNS). This work aims to offer an overview of the topic and recommendations for future cognitive function research. Full article