Search Results (884)

The growing prevalence of mental health problems and suicidality among university students highlights the need to identify potentially modifiable psychological pathways that can inform preventive interventions. This study investigated the association between implicit health beliefs and suicidal ideation among Chinese college students and examined whether lifestyle behaviors and anxiety symptoms jointly explained this relationship. A cross-sectional survey was conducted among 1964 college students using the Lay Theories of Health Scale, 24-H Movement Behaviors Questionnaire, 7-item Generalized Anxiety Disorder, and Beck Suicide Ideation Scale. Serial mediation analyses were performed to test the indirect effects of lifestyle behaviors and anxiety symptoms. Implicit health beliefs were directly associated with lower suicidal ideation (direct effect: −0.0562, 95% CI: −0.0767 to −0.0357). In addition, lifestyle behaviors (indirect effect: −0.0049, 95% CI: −0.0086 to −0.0015), anxiety symptoms (indirect effect: −0.0644, 95% CI: −0.0770 to −0.0523), and their serial mediation pathway (indirect effect: −0.0018, 95% CI: −0.0035 to −0.0002) significantly mediated this association, accounting for 55.82% of the total effect. These findings suggest that implicit health beliefs may be associated with suicidal ideation, with lifestyle behaviors and anxiety symptoms statistically accounting for part of this association. Targeting these modifiable potential pathways may help inform the development of theory-driven psychological interventions to reduce suicidal ideation and promote mental health among higher education students. Full article

This study examined direct and indirect associations of Machiavellianism, narcissism, psychopathy, and sadism with suicidal ideation through depression, anxiety, and stress in psychiatric patients. A cross-sectional sample of 210 patients completed the Short Dark Tetrad (SD4), Depression Anxiety Stress Scales-21 (DASS-21), and Suicidal Ideation Attributes Scale (SIDAS). Regression paths were estimated using robust maximum likelihood, whereas indirect effects were evaluated using 10,000 bootstrap resamples. Because 92 participants (43.8%) had SIDAS = 0, two-part sensitivity analyses separated the occurrence from the severity of suicidal ideation; additional analyses excluded the two smallest diagnostic groups. Depression, stress, and anxiety correlated with SIDAS (r = 0.560, 0.509, and 0.466, respectively). The sadism–stress–SIDAS indirect effect was significant in the primary model (B = 0.147; 95% bootstrap CI [0.037, 0.291]), after covariate adjustment (B = 0.126; 95% bootstrap CI [0.016, 0.266]), and after excluding psychotic and bipolar groups (B = 0.115; 95% CI [0.006, 0.259]). In two-part analyses, depression was associated with SIDAS occurrence, whereas stress and sadism were associated with severity among participants with SIDAS > 0. The findings support a stress-related indirect association between sadism and suicidal ideation, but causal interpretation is not warranted. Full article

Suicide is a serious public health concern and a major cause of premature mortality among individuals with psychotic disorders. Although several risk factors for suicide have been established, much remains unknown about how these factors generalize to populations experiencing psychosis. Existing literature has described an “insight paradox,” whereby improvements in insight have been associated with increased emotional distress. However, the extent to which insight is associated with suicide-related outcomes across psychotic disorders has not been comprehensively synthesized. This scoping review aimed to examine the relationship between insight and suicidality in psychosis, identify patterns and gaps within the literature, and summarize potential mechanisms underlying this association, with secondary consideration of illness stage. A scoping review was conducted following PRISMA-ScR guidelines, with 26 studies meeting inclusion criteria. Overall, greater insight was more frequently associated with increased suicidality than with null findings, although considerable heterogeneity existed across insight domains, suicide-related outcomes, and study methodologies. Notably, no study identified greater insight as a protective factor against suicidality. Findings suggest that interventions promoting insight should also address accompanying emotional and psychosocial challenges, such as self-stigma and hopelessness, and remain cognizant of associated suicidality risk. Future research should further clarify the mechanisms underlying the insight paradox. Full article

Background: Climate change is being recognized as a factor associated with increased suicidal behavior, especially in the older adult population. Extreme temperatures, thermal anomalies, and intense weather events can amplify pre-existing physical, psychological, and social vulnerabilities, increasing the risk of suicidal ideation and behavior in older adults. Objectives: This systematic review aims to map the literature on the relationship between climate change and suicidal behavior in older people, identifying risk and protective factors, as well as the prevention and intervention strategies aimed at this age group. Methods: A systematic review was conducted according to PRISMA guidelines. The literature search was performed in the EBSCO PsycINFO, Scopus and MEDLINE (PubMed) databases in the period 2007–2025, using combinations of the keywords “climate change”, “global warming”, “older adults”, “elderly”, “suicide”, “suicidal ideation” and related terms. Out of 35 studies, 16 articles were included in the final analysis. Results: Five thematic areas emerged from the analysis of the studies: (1) risk factors, (2) protective factors, (3) sociodemographic factors, (4) prevention and intervention strategies and (5) variables associated with suicidal behavior. Across the included studies, suicidal ideation, non-fatal attempts, and suicide mortality were examined with differing frequency and are reported separately in the thematic synthesis rather than pooled, reflecting the heterogeneity of outcome definitions and study designs. Significant limitations in the literature remain, including the paucity of longitudinal studies, the widespread use of aggregate data and the limited integration of environmental, social, and psychological factors. Conclusions: Climate change and extreme weather events may contribute to suicidal behavior in older adults. It is therefore necessary to develop multidimensional approaches that address structural vulnerabilities and promote the active role of older adults in climate resilience and social cohesion. Full article

This study examined the conditional indirect association between negative parenting attitudes and suicidal ideation via the mediation of academic helplessness, and investigated whether organized youth activity participation moderated this indirect association. Data were drawn from Wave 6 (2023) of the Korean Children and Youth Panel Survey (KCYPS 2018), with a final sample of 2224 adolescents aged 17–18 years. Gender and subjective health perception were included as control variables. PROCESS Macro Models 4 and 7 were applied to test the indirect effect and analyze the moderated mediation effect, respectively. Negative parenting attitudes were significantly associated with suicidal ideation, and the partial mediating role of academic helplessness was also significant. Organized youth activity participation significantly moderated the association between negative parenting attitudes and academic helplessness, and the indirect effect of negative parenting attitudes on suicidal ideation via academic helplessness varied significantly as a function of the level of organized youth activity participation. These findings suggest that organized youth activities may function as a possible effect modifier, consistent with the principles of behavioral activation theory, attenuating the indirect association from negative parenting attitudes to suicidal ideation via academic helplessness. Practical implications of these findings for research and practice concerning adolescent suicidal ideation are discussed. Full article

Background/Objectives: Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are increasingly used for the treatment of overweight and obesity because of their established efficacy in achieving clinically meaningful weight loss. However, concerns have emerged regarding their potential association with neuropsychiatric outcomes, including depressive and anxiety symptoms, manic or hypomanic symptoms, and suicidal ideation or behavior. This systematic review aimed to synthesize the available evidence on neuropsychiatric outcomes associated with GLP-1 RA use in adults with overweight or obesity. Methods: A systematic search of PubMed/MEDLINE, Scopus, and Web of Science was conducted following PRISMA 2020 guidelines. Eligible studies included randomized controlled trials, longitudinal observational studies, and cross-sectional studies evaluating neuropsychiatric outcomes associated with GLP-1 RAs in adults with overweight or obesity. Risk of bias was assessed using RoB 2, ROBINS-I, and the Joanna Briggs Institute Critical Appraisal Checklist according to study design. Given the clinical and methodological heterogeneity of the included studies, findings were synthesized narratively in accordance with SWiM guidance, and certainty of evidence was assessed at the outcome level using GRADE. Results: Fourteen studies were included, comprising four randomized studies, nine longitudinal observational studies, and one analytical cross-sectional study. Randomized evidence showed no consistent worsening of depressive symptoms or imbalance in suicide-related outcomes, whereas observational findings were heterogeneous. For depression, observational HRs ranged from 0.63 to 2.95 across different populations and comparators, while randomized studies showed small or no between-group differences in depressive symptoms. For suicide-related outcomes, observational HRs/aHRs ranged from 0.27 to 2.06, while suicidal ideation or behavior was uncommon in randomized studies and showed no consistent treatment imbalance. Anxiety-related findings were also heterogeneous, and manic or hypomanic symptoms were not systematically assessed. GRADE certainty was low for depressive symptoms and very low for anxiety and suicide-related outcomes. Conclusions: Current evidence does not demonstrate a consistent increase in adverse neuropsychiatric outcomes associated with GLP-1 receptor agonists in adults with overweight or obesity. Although some studies reported neutral or potentially beneficial associations, observational findings were heterogeneous, and the certainty of evidence was low or very low across the assessable outcomes. These findings do not establish a class-wide neuropsychiatric safety effect, particularly given differences among individual agents, study populations, and baseline psychiatric characteristics. Further prospective studies specifically designed to assess neuropsychiatric outcomes, including individuals with pre-existing psychiatric disorders, are warranted. Full article

Background/Objectives: Suicide-risk assessment during child and adolescent psychiatric hospitalization draws on patient report, clinical history, and professional observation. Whether nocturnal autonomic physiology is concurrently associated with a structured admission-window assessment after accounting for depressive symptoms and self-reported suicidal ideation remains uncertain. Methods: We analyzed 212 hospitalized children and adolescents receiving inpatient care for a major depressive episode. All had a Nurses’ Global Assessment of Suicide Risk (NGASR) rating, self-report measures, covariates, and first admission-night non-contact autonomic data. Principal component analysis was used to derive a nocturnal autonomic dysregulation factor from heart-rate and heart-rate-variability (HRV) summaries. Ordinary least squares regression with HC3 robust standard errors estimated its concurrent association with NGASR after adjustment for age, sex, BMI, Beck Depression Inventory score, and Chinese Beck Scale for Suicide Ideation score. Score-appropriate sensitivity analyses used Poisson, negative-binomial, and predefined NGASR-category models. Results: Higher autonomic dysregulation was associated with higher NGASR after adjustment for depressive symptoms and self-reported suicidal ideation (standardized beta = 0.182, 95% CI 0.067 to 0.297; p = 0.002; q = 0.005), accounting for an additional 3.2 percentage points of explained variance. The association was similar in a robust Poisson model (incidence-rate ratio = 1.059, 95% CI 1.022 to 1.097; p = 0.001) and remained stable after adjustment for subjective sleep quality, AHI, sleep efficiency, and monitoring timing. Separate component models showed larger associations for SDNN and RMSSD than for heart rate or LF/HF, but did not decompose the composite effect. Conclusions: Admission-window nocturnal autonomic dysregulation showed a modest concurrent association with clinical suicide-risk assessment after adjustment for depressive symptoms and self-reported suicidal ideation. The finding does not establish disclosure-independent assessment, temporal improvement of admission assessment, or prediction of future suicidal behavior. Full article

Background/Objectives: Diet is a key modifiable determinant of mental health; however, the prospective association between dietary patterns and new-onset suicidal ideation remains poorly elucidated. Methods: We enrolled 7480 participants from demolition resettlement communities in Jining, Zoucheng, and Weifang in Shandong Province, China, during 2021–2023. Data were used from two waves (baseline and 1-year follow-up) in this study. Dietary patterns were determined using principal component analysis based on food frequency questionnaire data. Incident suicidal ideation was assessed using the ninth item of the Patient Health Questionnaire-9. Multivariable logistic regression, stratified analysis, and sensitivity analysis were used to examine associations of different dietary patterns with the risk of incident suicidal ideation. Results: Among participants, 193 (2.58%) reported incident suicidal ideation. After full multivariable adjustment, the livestock–poultry–seafood dietary pattern was significantly inversely associated with incident suicidal ideation (Q3 vs. Q1; odds ratio = 0.67; 95% confidence interval: 0.45–0.97), whereas no significant association was identified when the pattern score was modelled continuously (OR = 0.92; 95% CI: 0.79–1.06; p = 0.239). Stratified analyses revealed stronger inverse associations among men, older adults, overweight individuals, and participants who did not use dietary supplements, but all interaction p-values exceeded 0.05, with no statistically confirmed subgroup disparities. After excluding participants with baseline depression, participants with baseline anxiety, and individuals with missing covariates in sensitivity analysis, the inverse association remained statistically stable. Conclusions: Our findings suggested a modest inverse association between higher adherence to the livestock–poultry–seafood dietary pattern and new-onset suicidal ideation in this observational cohort. Full article

Objectives: To analyze adolescent suicide rates during the COVID-19 pandemic, examine the relationship between bullying, cyberbullying, and suicidal behavior, and identify evidence-based prevention strategies. Methods: A systematic review of 26 peer-reviewed articles (published between 2020 and 2025) was conducted across five databases. Studies were appraised for quality using STROBE and SRQR guidelines. Results: The pandemic significantly impacted adolescent mental health, increasing depression, anxiety, and suicidal ideation, particularly among females and vulnerable populations. Notably, while traditional bullying decreased during school closures (78.2% reduction), cyberbullying reports saw a substantial increase (with a 264.4% spike documented in national helpline data). Key risk factors included social isolation, excessive social media use, pre-existing mental health conditions, and low socioeconomic status. Protective factors included family support and access to mental health services. Conclusions: COVID-19 created a significant adolescent mental health crisis. The shift to cyberbullying represents a critical emerging threat. Effective prevention requires a multitiered approach including universal screening, telehealth, and social–emotional learning programs while addressing the persistent shortage of mental health professionals. Full article

Objective: Intolerance of uncertainty (IU) is a transdiagnostic cognitive construct associated with anxiety, emotional dysregulation, and psychopathology across multiple clinical conditions. This study aimed to adapt the Intolerance of Uncertainty Index A (IUI-A) into Turkish and evaluate its psychometric properties in a high-risk clinical adolescent sample. Methods: One hundred forty adolescents aged 12–17 years (Mage = 15.71, SD = 1.39; 84.3% female) were recruited from a Child and Adolescent Psychiatry Outpatient Clinic. The sample comprised adolescents presenting with suicidal ideation without a prior attempt (SI; n = 42, 30%) or a history of at least one suicide attempt (SA; n = 98, 70%). The majority met criteria for at least one psychiatric diagnosis, with depressive disorder (77.1%) and anxiety-spectrum conditions most prevalent. Analyses included exploratory and confirmatory factor analysis, internal consistency estimation, and assessments of convergent, discriminant, and known-groups validity. Results: EFA supported a two-factor model (Inhibitory IU and Prospective IU) explaining 61.04% of the variance. CFA indicated partially acceptable fit (χ²/df = 2.48, RMSEA = 0.102, CFI = 0.900, TLI = 0.882, SRMR = 0.054), with RMSEA and TLI falling outside conventional thresholds. Internal consistency was strong (α = 0.933, ω = 0.935). IUI-A scores correlated strongly with the IUS-12, and the SA group scored significantly higher on both IU subscales, with group differences persisting after adjustment for key covariates. Conclusion: The Turkish IUI-A provides preliminary, though methodologically provisional, evidence of validity and reliability for assessing IU in high-risk adolescent populations, with several limitations requiring further investigation. Full article

Background/Objectives: Older adults have high rates of suicide, but there is little research on age-specific correlates of suicide. The purpose of this study was to examine risk and protective factors for suicidal ideation and attempts across adult and older adult age groups in a racially diverse sample. Methods: Using a cross-sectional analysis of California Health Interview Survey (CHIS) data from 2021 to 2024 (N = 92,397) linked with 2020 CDC/ATSDR Social Vulnerability Index data, the analytic sample was 64,263 California adults selected by address-based sampling and stratified by age: 45–64 years (31.5% of the overall pooled sample), 65–74 years (12.6%), and ≥785 years (9.1%). Outcomes were lifetime suicidal ideation and attempts. Weighted logistic regression models examined risk and protective factors. Results: Approximately 19% of the sample reported lifetime suicidal ideation, and 6% reported lifetime attempts. Psychological distress, childhood exposure to household mental illness or suicidality, and poor self-rated health were risk factors across all age groups, with associations strengthening with age. Among those with lifetime ideation, these risk factors showed even larger associations in older adults. Protective factors included indicators of sociodemographic vulnerability. Conclusions: Suicide risk and protective factors differ substantially across older adulthood. Findings highlight the need for tailored interventions and integration of suicide screening into primary care for older adults. Full article

Background: To assess temporal trends in psychiatric hospitalizations among adolescents admitted to a general pediatric ward in Forlì, Italy, between 2016 and 2025 and to examine diagnostic patterns and their association with sex and age, using the individual patient as the primary unit of analysis. Methods: Single-center retrospective study including all hospitalizations for psychiatric disorders in patients aged 10–17 years over a 10-year period. Each discharge episode was assigned to a single dominant diagnostic category. The primary analyses were conducted at the level of the individual patient (first admission), while episode-level analyses were retained as a pre-specified sensitivity analysis reflecting inpatient burden. Results: A total of 165 adolescents (210 hospitalization episodes) were included; mean (SD) age was 14.47 (1.73) years, and females were 77% of patients (80.5% of episodes). Admissions increased significantly over time (patients: IRR 1.20 per year, 95% CI 1.13–1.27; p < 0.001), with 124/165 (75.2%) patients first admitted in 2021–2025. Suicidal ideation/attempt (27.3%) and eating disorders (15.2%) were the most frequent diagnoses, and both showed a significant upward trend. Overall, diagnosis was associated with sex (p = 0.004): most diagnoses, including the two most frequent, were female-predominant, whereas psychomotor agitation was over-represented in males. Age at admission increased modestly over time and was higher in 2021–2025. Twenty-seven patients accounted for 45 readmissions, concentrated in the most severe diagnoses. Conclusions: Psychiatric hospitalizations of adolescents in a general pediatric ward rose substantially over the decade, especially from 2021, driven mainly by suicidal ideation/attempt and eating disorders. Findings were robust to analysis at the patient level and support the role of the general pediatric ward as a sentinel setting for severe adolescent mental distress. Full article

Background/Objectives: The rising prevalence of severe adolescent obesity has increased the number of young patients referred for bariatric surgery. The psychiatric and psychosocial profiles of adolescents and of adult women undergoing this treatment remain insufficiently characterized. This study compared preoperative and postoperative psychiatric, psychosocial, and metabolic profiles of adolescents and adult women undergoing bariatric surgery. Methods: This prospective cohort study recruited 77 consecutive female patients (32 adolescents aged <18 years; 45 adult women aged 18–25 years) at a single bariatric center in Poland between December 2022 and December 2023. All participants underwent comprehensive preoperative and one-year postoperative assessments including laboratory testing, standardized psychiatric interviews, and psychometric screening with the Beck Depression Inventory (BDI) and the Patient Health Questionnaire-9 (PHQ-9). Results: Preoperatively, adolescents were more severely affected for their age (median BMI-for-age z-score 3.53) and waited longer between the first obesity clinic visit and surgery. Adolescents more frequently reported self-harm behaviors and moderate-to-severe depression on the BDI, whereas adult women more often reported psychoactive substance use. Both groups achieved comparable improvements in laboratory and comorbidity outcomes at one year, although relative weight loss was greater in adult women (median total weight loss 37.6% vs. 28.4%, p < 0.0001). Postoperatively, a greater proportion of adolescents than adult women improved with respect to social anxiety (50.0% vs. 13.3%, p = 0.0007) and BDI depression severity (53.1% vs. 24.4%, p = 0.02), whereas a greater proportion of adult women improved with respect to psychoactive substance use (46.7% vs. 12.5%, p = 0.003). Generalized anxiety and suicidal ideation declined within both groups, but the extent of improvement did not differ significantly between them. These differences persisted, and for several outcomes became larger, after adjustment for the reduction in BMI, which was smaller in adolescents. Conclusions: In this observational cohort, bariatric surgery was associated with distinct psychiatric and psychosocial outcome profiles in adolescents compared with adult women. Because the study was uncontrolled and included no non-surgical comparison group, these findings are hypothesis-generating and cannot establish a causal effect of surgery or of its timing; confirmation in larger, multicenter studies with appropriate comparison groups is required. Comprehensive multidisciplinary perioperative care and tailored postoperative psychological support appear important for both age groups. Full article

Background: Burnout, defined by emotional exhaustion, depersonalization, and reduced personal accomplishment, is a major occupational health concern among healthcare professionals. Burnout has been linked to depression, anxiety, and medical errors, but its association with suicidality in healthcare settings remains insufficiently explored. Objective: To investigate the association between burnout dimensions and suicidality among healthcare professionals, and to identify occupational and demographic factors influencing this relationship. Methods: A cross-sectional study was conducted among 195 healthcare professionals in Romania, recruited through voluntary participation in an anonymized online survey. Burnout was assessed using an adapted tool inspired by the Maslach Burnout Inventory, while suicidality outcomes included suicidal ideation, self-harm, and suicide attempts. Descriptive statistics were calculated for demographic and professional variables. Pearson correlations and multivariable linear regression analyses, adjusted for age, professional experience, and shift work, were performed to evaluate associations between burnout dimensions and suicidality. Results: Emotional exhaustion (r = 0.42, p < 0.001) and depersonalization (r = 0.37, p < 0.001) were positively correlated with suicidality, while reduced personal accomplishment was negatively correlated (r = −0.29, p = 0.002). In multivariable regression, emotional exhaustion remained the only statistically significant independent predictor of suicidality after adjustment for demographic and occupational characteristics. Younger age and rotating/night-shift work were associated with higher suicidality in unadjusted analyses but were not independent predictors after multivariable adjustment. Strong correlations between burnout dimensions and physical symptoms highlighted the interplay between psychosocial strain and somatic health. Conclusions: Burnout, particularly emotional exhaustion, was independently associated with suicidality among healthcare professionals, while depersonalization demonstrated a significant unadjusted association that did not remain statistically significant after multivariable adjustment. Younger clinicians, shift workers, and those with less experience appear especially vulnerable. These findings emphasize that burnout is a multifactorial construct with both psychological and somatic dimensions, shaped by systemic workplace stressors. These findings support further evaluation of systematic screening, organizational reforms, mentorship programs, and confidential mental health support as potential components of suicide-prevention strategies for healthcare professionals. Full article

Gambling disorder (GD) is associated with severe psychosocial impairment, impulsive dyscontrol, affective instability, and increased suicidal risk. Pharmacological options remain limited, particularly for patients whose presentation is dominated by transdiagnostic dimensions such as impulsivity, emotional dysregulation, and suicidal vulnerability. Lithium may be relevant because of its anti-suicidal properties and potential effects on affective instability and behavioral dyscontrol. We describe a 40-year-old man with sports-betting-related GD who presented after a suicidal crisis in the context of financial collapse and marital conflict. He entered a structured multimodal program including psychiatric care, lithium carbonate, individual psychotherapy, psychoeducational and self-help groups, family intervention, and social support. During multimodal treatment, which included lithium carbonate titrated to 600 mg/day, the patient was observed to show progressive affective stabilization, remission of suicidal ideation, reduced gambling urges, and sustained abstinence, with one brief lapse that was rapidly contained. Psychometric reassessment showed selective improvement across gambling-related and functional domains, including reduced functional impairment and markedly reduced gambling-related cognitive distortions; however, global psychopathological distress remained substantially stable, and the GPQ subtype shift was interpreted only descriptively. Although causal inference is limited by the single-case design and multimodal treatment context, this case raises the hypothesis that lithium may have contributed, within a multimodal intervention, to the stabilization of core vulnerability dimensions in selected GD presentations, particularly impulsivity, affective dysregulation, and suicidality. Full article