Terapia de Aceptación y Compromiso en conducta suicida: una revisión sistemática / Acceptance and Commitment Therapy on suicidal behavior: a systematic review

El suicidio se ha convertido en un problema social y de salud pública a nivel mundial. En este sentido, la Terapia de Aceptación y Compromiso (ACT) podría ser eficaz en su abordaje, existiendo evidencia sobre la relación entre algunos de sus componentes y la conducta suicida. Así, el presente estudio tuvo por objetivo realizar una revisión sistemática sobre la eficacia de ACT en conducta suicida. Para ello se siguió el protocolo PRISMA, empleando las siguientes bases de datos: PsycInfo, PubMed, Scopus y PsicoDoc. Inicialmente se obtuvieron 108 publicaciones potencialmente relevantes, de las cuales, finalmente, 13 fueron incluidas en la revisión. La calidad de los estudios se analizó a través de un instrumento de evaluación de riesgo de sesgos. Como resultados, a nivel general se observaron disminuciones estadísticamente significativas en ideación suicida (IS) y factores de riesgo de suicidio. Además, algunos estudios señalaron relaciones estadísticamente significativas entre un aumento de flexibilidad psicológica y la disminución de IS. Si bien los datos apuntaron a una posible eficacia de ACT en la reducción de IS, es necesario llevar a cabo mayor número de estudios experimentales que contemplen la complejidad de la conducta suicida y exploren los procesos de cambio implicados.(AU)

Suicide has emerged as a pressing global issue affecting both so-ciety and public health.In this context, Acceptance and Commitment Therapy (ACT) could prove effective in its approach, supported by evi-dence of the relationship between certain components of ACT and suicidal behavior. Thus, the present study aims to conduct a systematic review on the efficacy of ACT in suicidal behavior. For this, the PRISMA protocol was followed, using thefollowing databases: PsycInfo, PubMed, Scopus and PsicoDoc. Initially, 108 potentially relevant publicationswereobtained,13ofwhichwerefinallyincludedinthereview.Weanalyzedstudy qualityus-ingariskofbiasassessmentinstrument.Asaresult,statisticallysignificantdecreases in suicidal ideation (SI) and suicide risk factors were observed. In addition, some studies indicated statistically significant relationships be-tween increased psychological flexibility and decreasedSI.WhilethedatasuggestedthepotentialeffectivenessofACTinreducingsuicidal ideation (SI), more experimental studies are needed to consider the complexity of suicidal behavior and explore the processes of changeinvolved.(AU)

Risk of suicide and suicide-related events in subjects treated with antiseizure medications.

INTRODUCTION: In the United States, it is reported that 1.4% of the general population commits suicide. It has been postulated that antiseizure medications (ASMs) can lead to the development of suicidal ideation and suicidal behavior; however, this risk is still very low and has yet to be precisely established. AREAS COVERED: This narrative review evaluates the risk of suicide-related events (SREs) in subjects taking ASMs for various neurological disorders. Screening tools for suicidal ideation and suicidal behavior are also discussed. References for this article were found using PubMed/MEDLINE. EXPERT OPINION: Although some ASMs can be associated with SREs, this is not yet clearly established. The mechanisms involved in suicide risk in subjects taking ASMs are multifactorial. The bidirectional relationship between depression and epilepsy, as well as other associations, should be kept in mind when interpreting any impact of ASMs in PWE. Screening for SREs, close monitoring of subjects taking ASMs are the most appropriate strategies to minimize suicide risk. More efforts should be made to achieve accurate risk stratification through prognostic models that could be applied to subjects taking ASMs. Studies exploring the association between ASMs and suicide should consider ASMs individually and control for prior SREs.

The Impact of COVID-19 on Suicidal Behavior in King Abdulaziz Medical City in Saudi Arabia.

INTRODUCTION:  During the COVID-19 pandemic, there has been a global increase in mental health issues, including suicidal behaviors. This study focuses on assessing the impact of the pandemic on the prevalence and characteristics of suicidal behavior at King Abdulaziz Medical City in Riyadh, Saudi Arabia. METHODS: A retrospective cohort study was conducted on 580 patients from January 2017 to December 2022, focusing on those aged 18 and above referred for suicide evaluation. Data were collected via chart reviews and analyzed using Statistical Product and Service Solutions (SPSS, version 25; IBM SPSS Statistics for Windows, Armonk, NY). RESULTS: Our study reviewed 580 patient charts, with 555 (95.7%) meeting the inclusion criteria. The majority of participants were in the 18-29 age group (66.7%). We observed an increase in the number of cases undergoing suicide attempt assessment post COVID-19, with 296 incidents (53.3%) from March 2020 to December 2022 (about a year and eight months), compared to 259 incidents (46.7%) from January 2017 to March 2020 (over three years). A significant post-pandemic increase was noted in individuals with secondary education or higher (p = 0.004). No significant changes were found in other demographic variables or in the profiles of individuals with an intention to end life before and after the pandemic. CONCLUSION: The study highlights the nuanced impact of the COVID-19 pandemic on suicidal behavior in Saudi Arabia, revealing an increased demand for suicide assessments, particularly among educated individuals. However, no corresponding increase was observed in the rate of high-intent suicidal cases or other significant variables. The findings underscore the complexity of factors influencing suicidal behavior during the pandemic and the need for targeted mental health interventions. Future research, ideally supported by a national database, is essential for a comprehensive understanding of suicidal behavior in Saudi Arabia.

Ostracism Predicting Suicidal Behavior and Risk of Relapse in Substance Use Disorders.

INTRODUCTION: The present study investigated the predictive relationship between ostracism and suicidal behaviors in individuals with substance use disorders. It also attempts to highlight the mediating role of the risk of relapse between ostracism and suicidal behavior. METHODS: The study was based on a cross-sectional survey design. The sample comprised 100 men aged between 30 to 45 years (M = 35.25, SD = 3.06) from Karachi. The purposive sampling technique was employed. The study employed demographic forms and three self-reporting measures: the Ostracism Experience Scale (OES-A), the Advance Warning of Relapse Questionnaire 3.0 (AWARE), and the Suicide Behaviors Questionnaire-Revised (SBQ-R). RESULTS: Ostracism significantly predicted relapse risk and suicidal behavior. Risk of relapse positively predicted both dimensions of ostracism (ignored: r = 0.33, p < 0.01; excluded: r = 0.43, p < 0.01) and suicidal behavior (r = 0.35, p < 0.01). Additionally, the risk of relapse strongly correlated with overall ostracism score (r = 0.43, p < 0.01). However, no significant mediating effect of ostracism on suicidal behavior was found. The effect was mediated through the risk of relapse (B indirect = 0.12, 95% CI = 0.04, 0.23). These findings suggest that ostracism increases the likelihood of recurrence, which in turn is associated with suicidal behavior. The mediation model explained 17% of the variation in suicidal behavior. CONCLUSION: The findings propose the importance of addressing ostracism as a risk factor for suicidal behavior and relapse in substance use disorders. The results suggest that reducing the adverse effects of ostracism and improving social support for individuals can have a significant impact on their mental health.

Impact of unmet health-related need on suicidal behavior in Korean adults: a retrospective nationwide cohort study.

We aimed to evaluate the association of unmet health-related need with suicidal behaviors among Korean adults. We included 26,219 adults (13,937 men and 17,788 women) aged ≥ 19 years from the Korea National Health and Nutrition Examination Survey (2015-2020). Suicidal behavior included suicidal plan and attempt. We analyzed the odds ratios and 95% confidence intervals of suicidal behaviors according to unmet health-related need via multivariable logistic regression analysis and performed stratified analyses according to sex, age, income, education, and type of insurance. Of the participants, 9.6% had unmet health-related need. Suicidal plans and attempts had 1.3% and 0.5% of the participants, respectively. The prevalence of suicidal plans and attempts was 0.9% and 0.4% among participants without unmet health-related need and 3.1% and 1.0% among those with such need, respectively. The odd ratios of suicidal plans and attempts increased significantly among participants with unmet health-related need compared to those without. In subgroup analysis, most subgroups showed similar results, except for suicidal plan and attempt in the 45-64 age group, high education, and medical care and suicidal attempt in 19-44 age group, low-income, and unmarried. Unmet health-related need was independently associated with suicidal plan and attempt. A policy alternative is needed for these associations.

Suicidal behavior and associated factors among holy water users at Northwest, Ethiopia, 2023: an institution based cross-sectional study.

Background: Suicide is a serious cause of mortality that affects families, communities, and the entire country. Because of a lack of national systematic reporting for cause-specific mortality, a high level of stigma, and religious non-acceptance, suicidal behavior is an under-reported and concealed cause of death in the majority of low- and middle-income countries. Objective: The aim of this study was to assess the prevalence of suicidal behavior and associated factors among holy water users at the Andassa Saint George Monastery, 2023. Methods: An institution-based cross-sectional study was conducted at the Andassa Saint George Monastery from 5 April to 5 May 2023. A systematic random sampling method was utilized to select 423 study participants and the Suicidal Behaviors Questionnaire-Revised was used to assess suicidal behavior. The data were gathered using the epicollect5 software with a face-to-face interview method then exported to SPSS-25 for analysis. A binary logistic regression model was used and all variables in a bivariate analysis with a p-value of less than 0.25 were entered into a multivariable logistic regression model, and statistical significance was declared at a p-value of less than 0.05. Results: The prevalence of suicidal behavior among holy water users was 9.7% (95% CI: 7.1-12.4). Being female [2.632 (1.206-5.748)], living alone [2.52 (1.06-5.97)], and having depression [3.03 (1.32-6.99)], epilepsy [3.82 (1.28-11.40)], and diabetes mellitus [3.37 (1.229-9.25)] were significantly associated with suicidal behavior. Conclusion: In this study, almost 1 in 10 had engaged in suicidal behavior in their lifetime. Several risk factors for suicidal behavior were identified, including being female, living alone, and having diabetes mellitus, epilepsy, and depression.

Association of screen-based activities and risk of self-harm and suicidal behaviors among young people: A systematic review and meta-analysis of longitudinal studies.

Emerging evidence suggests that screen-based activities are associated with self-harm and suicidal behaviors. This study aimed to examine these associations among young people through a meta-analysis. We systematically searched EBSCO pshyARTICLES, MEDLINE (via PubMed), EMBASE, and Web of Science from their inception to April 1, 2022, and updated on May 1, 2024. Longitudinal studies reporting the association between various screen-based activities and subsequent self-harm and suicidal behaviors in young people aged 10 to 24 were included. Nineteen longitudinal studies were included in the qualitative synthesis, and 13 studies comprising 43,489 young people were included in the meta-analysis, revealing that total screen use is significantly associated with the risks of self-harm and suicidal behaviors. Cyberbullying victimization was also related to these adverse outcomes. Subgroup analyses indicated that social media use and problematic screen use are significant risk factors for self-harm and suicidal behaviors. Study quality was appraised using the Newcastle-Ottawa Scale, and potential publication bias was deemed unlikely to affect the results significantly. These findings suggest that screen-based activities should be considered in the management and intervention strategies for self-harm and suicidal behaviors in young people.

Glial Markers of Suicidal Behavior in the Human Brain-A Systematic Review of Postmortem Studies.

Suicide is a major public health priority, and its molecular mechanisms appear to be related to glial abnormalities and specific transcriptional changes. This study aimed to identify and synthesize evidence of the relationship between glial dysfunction and suicidal behavior to understand the neurobiology of suicide. As of 26 January 2024, 46 articles that met the inclusion criteria were identified by searching PubMed and ISI Web of Science. Most postmortem studies, including 30 brain regions, have determined no density or number of total Nissl-glial cell changes in suicidal patients with major psychiatric disorders. There were 17 astrocytic, 14 microglial, and 9 oligodendroglial studies using specific markers of each glial cell and further on their specific gene expression. Those studies suggest that astrocytic and oligodendroglial cells lost but activated microglia in suicides with affective disorder, bipolar disorders, major depression disorders, or schizophrenia in comparison with non-suicided patients and non-psychiatric controls. Although the data from previous studies remain complex and cannot fully explain the effects of glial cell dysfunction related to suicidal behaviors, they provide risk directions potentially leading to suicide prevention.

An examination of the mediating role of maladaptive emotion regulation strategies in the complex relationship between interpersonal needs and suicidal behavior.

Background: Studies have shown that psychological factors, notably interpersonal needs and emotion regulation, play a significant role in suicidal behavior. Interpersonal needs are significant contextual components that affect emotion regulation and contribute to a wide range of dysfunctional behaviors, such as suicidal behavior. It has been postulated that emotion regulation mediates the associations between proximal and distal risk factors of suicidal behavior. Method: The sample consisted of 340 community-dwelling individuals (62.5% women; SD = 0.48) with an age range of 18 through 55 (M = 30.23; SD = 8.54) who completed the interpersonal needs questionnaire, the suicide behaviors questionnaire-revised, and the cognitive emotion regulation questionnaire. The Structural Equation Modeling (SEM) approach was utilized to evaluate a mediation model. Results: The findings indicate that interpersonal needs (i.e., perceived burdensomeness r = .55, p <.01 and thwarted belongingness r = .25, p <.01) and putatively maladaptive cognitive emotion regulation strategies (i.e., self-blame; r = .38, p <.01, catastrophizing; r = .55, p <.01, rumination; r = .40, p <.01, and other blame; r = .44, p <.01) have strong associations with suicidal behavior, and these strategies have a mediating effect on the association between interpersonal needs and suicidal behavior. Conclusions: Our findings show that contextual-interpersonal needs, which underpin suicidal behavior, are significantly influenced by maladaptive emotional processes. Thus, therapeutic outcomes might be enhanced by focusing on the content of the associated cognitions and trying to reduce maladaptive regulatory processes like rumination and catastrophization.

Pregnancy loss and suicidal behavior: Investigating the mediating role of depressive mood.

BACKGROUND: Pregnancy loss is arguably a traumatic and stressful life event that potentially impacts the emotional and behavioral health of those who experience it, especially adolescents. Research assessing this relationship has primarily focused on adult women populations. METHODS: Using data from National Longitudinal Study of Adolescent to Adult Health, a cross-sectional research design was employed to investigate whether pregnancy loss outcomes are associated with depressive mood and suicidal behavior (i.e., suicidal thoughts and suicide attempt) among adolescent girls (N = 6, 913). We also investigated the mediating effect of depressive mood. Initially, an all-encompassing pregnancy loss variable was used, which included abortions and miscarriages. Acknowledging the differences between these pregnancy loss outcomes, we created separate measures for each. RESULTS: Using the all-encompassing pregnancy loss variable, findings from logistic regression analyses showed that pregnancy loss is positively and significantly associated with depressive mood and suicidal behaviors. Depressive mood mediated the relationship between pregnancy loss and suicidal behaviors. Miscarriage was positively and significantly associated with suicidal thoughts as well as attempting suicide. Depressive mood mediated the relationship between miscarriage and suicidal thoughts, while only partially mediating the relationship between miscarriage and suicide attempt. No significant effects were observed for abortion on outcomes of interest. LIMITATIONS: Cross-sectional analyses were performed limiting our ability to make casual inferences. CONCLUSIONS: Pregnancy loss is associated with depressive mood and suicidal behavior, especially among adolescent girls who experience a miscarriage. Adolescent pregnancy and pregnancy loss should remain a focus of scholars and health professionals.

Implicit measures of suicide vulnerability: Investigating suicide-related information-processing biases and a deficit in behavioral impulse control in a high-risk sample and healthy controls.

OBJECTIVE: Relevant implicit markers of suicidal thoughts and behaviors (STBs) have only been studied in isolation with mixed evidence. This is the first study that investigated a suicide attentional bias, a death-identity bias and a deficit in behavioral impulsivity in a high-risk sample and healthy controls. METHOD: We administered the Death Implicit Association Test, the Modified Suicide Stroop Task, and a Go/No-Go Task to inpatient suicide ideators (n = 42), suicide attempters (n = 40), and community controls (n = 61). RESULTS: Suicide ideators and attempters showed a suicide attentional bias and a death-identity bias compared to healthy controls. Ideators and attempters did not differ in these implicit information-processing biases. Notably, only attempters were more behaviorally impulsive compared to controls; however, ideators and attempters did not significantly differ in behavioral impulsivity. Moreover, implicit scores were positively intercorrelated in the total sample. CONCLUSION: In line with the Cognitive Model of Suicide, ideators and attempters display suicide-related information processing biases, which can be considered as implicit cognitive markers of suicide vulnerability. Furthermore, attempters have elevated levels of behavioral impulsiveness. These results are highly relevant in the context of crisis intervention strategies and warrant further research.

National Trends in Emergency Department Visits for Suicide Attempts and Intentional Self-Harm.

OBJECTIVE: This study estimated national annual trends and characteristics of emergency department visits for suicide attempts and intentional self-harm in the United States from 2011 to 2020. METHODS: Data were from the National Hospital Ambulatory Medical Care Survey, an annual cross-sectional national sample survey of emergency departments. Visits for suicide attempts and intentional self-harm were identified using discharge diagnosis codes (ICD-9-CM for 2011-2015; ICD-10-CM for 2016-2020) or reason-for-visit codes. The annual proportion of emergency department visits for suicide attempts and intentional self-harm was estimated. RESULTS: The weighted number of emergency department visits for suicide attempts and intentional self-harm increased from 1.43 million, or 0.6% of total emergency department visits, in 2011-2012 to 5.37 million, or 2.1% of total emergency department visits in 2019-2020 (average annual percent change, 19.5%, 95% CI=16.9, 22.2). Visits per capita increased from 261 to 871 visits per 100,000 persons (average annual percent change, 18.8%, 95% CI=17.6, 20.0). The increase in visits was widely distributed across sociodemographic groups. While suicide attempt and intentional self-harm visits were most common among adolescents, adults age 65 or older demonstrated the largest increase (average annual percent change, 30.2%, 95% CI=28.5, 32.0). Drug-related diagnoses were the most common co-occurring diagnosis among suicide attempt and intentional self-harm visits. Despite the rise in emergency department visits for suicide attempts and intentional self-harm, less than 16% included an evaluation by a mental health professional. CONCLUSIONS: A significant national increase in emergency department visits for suicide attempts and intentional self-harm occurred from 2011 to 2020, as a proportion of total emergency department visits and as visits per capita. These trends underscore an urgent need to improve the continuum of mental health care for individuals with suicidal symptoms.

Control in relation to suicidal ideation and nonfatal suicidal behavior among older adults: a systematic review.

OBJECTIVES: This review aims to evaluate and synthesize quantitative and qualitative findings on perceived control and value placed on control within the context of suicidal ideation or nonfatal suicidal behaviors in older adults. METHOD: A comprehensive literature search was completed in June 2022, October 2022, and November 2023. Included studies focused on perceived control or value placed on control and on suicidal ideation or nonfatal suicidal behavior. Studies were published in English and included older adults (≥ 60 years) in separate analyses. Studies focusing on self-efficacy were excluded. RESULTS: Twelve studies with 10 unique samples of 1487 total participants from eight countries were assessed. Quantitative studies indicated that perceived control and value placed on control are significant correlates of suicidal ideation and nonfatal suicidal behaviors, while qualitative studies highlighted that individuals who survive suicide attempts often specify decreased perceived control as a reason for their attempts. CONCLUSION: Results of this review indicate that perceived control and value placed on control are relevant variables when studying suicidal ideation and nonfatal suicidal behavior. This conclusion should be considered preliminary. Future research should examine heterogeneous samples, adopt gold standard assessments, and assess covariates in the associations.

Self-harm and suicidal behaviors in children: perspectives of mental health clinicians.

OBJECTIVE: Presentations for self-harm and suicidal behaviors are increasing in children and young people, although less is known about these presentations in children aged 12 years and under. This study aims to understand how mental health clinicians in public health services conceptualize, identify and respond to self-harm and suicidal behaviors in children. METHODS: 26 mental health clinicians provided their perspectives through interviews or focus groups. Participant responses were analyzed using reflexive thematic analysis. RESULTS: Mental health clinicians described how self-harm and suicidal behaviors may present differently in children compared with adolescents, particularly with the methods used. Using developmentally appropriate language and including parents or carers when screening for self-harm and suicidal behaviors was recommended by clinicians. The inclusion of parents or carers throughout the treatment process was important for clinicians, including helping parents understand their child's behavior and manage their own distress. Clinicians also highlighted the benefit of collaborating with schools to support children, yet noted primary school staff require training in responding to child self-harm and suicidal behavior. The limited services available for children 12 years and under including emergency care services, was identified as a problem. CONCLUSIONS: Findings highlight the importance of timely assessment and interventions which include mental health and medical clinicians, parents, carers, and school staff to support children with self-harm and suicidal behaviors.

Effectiveness of physical barriers to prevent suicide by jumping from high-risk bridges: From an integrative review to a northern Italian province's paradigm.

Background: Although uncommon, suicide by jumping is almost always lethal and can be significantly elevated locally due to the availability of tall structures including bridges and other high-risk locations. Empirical evidence suggests that restricting access to certain suicide methods is highly effective at preventing suicide, prompting the construction of physical barriers in many high-risk jumping locations. However, some have argued that these measures are too costly and only lead to method or location substitution. Objectives: To examine whether physical barriers are effective at preventing suicide by jumping or whether method or location substitution occur. Methods: An integrative review of the most representative literature. Results: Results clearly show that physical barriers are highly effective at preventing suicide by jumping with little to no method or location substitution occurring. Furthermore, their cost is far outweighed by the monetary benefits of averted suicides. Conclusions: Using the Italian pre-alpine/alpine areas as a paradigm, we argue that local topography and socioeconomic particularities led to significantly elevated rates of suicide in general, and of suicide by jumping from bridges in particular, especially among young adults who are more vulnerable to economic crises and show elevated susceptibility to impulsive acts, a known characteristic associated with suicide by jumping, which makes the issue even more topical and clinically relevant. As these finding are easily generalized to other territories with similar topographical and/or economic characteristics, we end with a call to action, urging local authorities to heed the scientific evidence and take the necessary steps to improve suicide prevention.

Clinicopathological determinants of suicidal thoughts and behavior in patients with post-stroke depression in South-West Nigeria.

OBJECTIVE: To evaluate the clinico-pathological determinants of suicidal thoughts and behavior in patients with post-stroke depression (PSD) in a teaching hospital in south-west Nigeria. METHOD: A cross-sectional study was carried out in Lagos State University Teaching Hospital and it involved 89 consecutively selected outpatients with post-stroke depression (diagnosed using the depression module of Mini International Neuropsychiatric Inventory). Socio-demographic and clinical factors questionnaire, Mini-Mental State Examination, National Institute of Health Stroke Scale, and Beck Scale of Suicidal Ideation (BSSI) were administered to the participants. BSSI total score was used as a measure of suicidal thoughts. Ethical approval was obtained from the ethics and research committee of Lagos State University Teaching Hospital. RESULT: Time since stroke (the time since onset of the most recent stroke) had a significant negative correlation with suicidal thoughts (r = -0.263, p = 0.013). In the same vein, the probability of attempting suicide significantly reduces with time since stroke, Odds Ratio = 0.925, p = 0.047. CONCLUSION: Suicidal thoughts and behavior occur early in patients with post-stroke depression. The identification of shorter time since stroke as a correlate of suicidal thoughts and behavior among this patient population underscores the need for performing early assessment and prompt intervention for the at-risk individuals.

National trends and correlates of treatment resistance in major depressive episode and associated suicidal ideation and behaviors among adults in the United States.

OBJECTIVE: To examine recent 12-year trends in prevalence of suicidal ideation and behaviors (SIBs) among US adults experiencing a past-year treatment-resistant depression (TRD). METHODS: Using data from the National Survey of Drug Use and Health, we estimated the annual percentage of individuals aged ≥18 with TRD who reported past-year SIBs, and estimated linear trends adjusting for potentially confounding factors from 2009 to 2020. RESULTS: Of estimated 237.5 million US adults, 7.1 % met diagnostic criteria for a past-year major depressive episode (MDE) between 2009 and 2020. Of these, 9.7 % met criteria for TRD. The proportion reporting past-year suicidal ideation in TRD ranged from 39.5 % (95 % confidence interval [CI], 32.1-47.3 %) in 2009-2010 to 43.4 % (95 % CI, 36.7-503 %) in 2019-2020, with an average annual percent change (AAPC) of 1.3 % (95 % CI, -0.7 % to 3.3 %). The prevalence of past-year suicide attempts in TRD was 7.3 % across the study period (AAPC, 0.1 %; 95 % CI, -4.3 % to 4.7 %). Past-year SIBs were significantly associated with an increased likelihood of meeting criteria for TRD among adults with MDE (adjusted odds ratio [AOR], 1.53; 95 % CI, 1.35-1.75 for suicidal ideation; AOR, 2.17; 95 % CI, 1.79-2.62 for suicide attempts). No significant differences were observed between 2019 and 2020, reflecting the COVID-19 pandemic. CONCLUSION: Among individuals with TRD, proportions of SIBs are high. These findings underscore an urgent need for suicide prevention efforts in this high-risk population, including preventive services across diverse settings and accessibility to evidence-based pharmacological and non-pharmacological interventions.

Suicidal Behavior of Australian Males, From an Ethnicity Perspective.

BACKGROUND: Suicide is the 10th leading cause of death among Australian males. Despite the cultural diversity in Australia, there is a significant research gap in knowledge of suicidal behavior among Australian males from ethnically and culturally diverse backgrounds. The study aimed to estimate the prevalence and risk of suicidal behaviors among Australian males based on ethnicity, with an emphasis on those from ethnic-minority backgrounds. METHODS: We used data from the first wave of the Australian Longitudinal Study on Male Health. Multiple logistic regression models were used to determine the risk of suicidal behavior (lifetime suicide attempt, lifetime suicidal ideation, recent suicidal ideation) by ethnicity. RESULTS: Among ethnic minority males, Pacific Islander males also had the highest prevalence of lifetime suicide attempts (12.2%), while Middle Eastern (2.3%) and South-/North-East Asian males (2.9%) had the lowest rates. South American males had the highest recent suicidal ideation (18.2%), followed by Pacific Islanders (14.2%). The highest prevalence of lifetime suicidal thoughts was reported among males of mixed ethnicity (23.0%), followed by South American (14.6%) and Pacific Islander (13.5%) males. Most ethnic-minority groups had a lower risk of lifetime suicidal ideation compared with Australian males. Evidence regarding differences in recent suicidal ideation and lifetime suicide attempts between ethnic-minority and Australian-background males was inconclusive. CONCLUSION: Evidence was found of differences in suicidal behaviors among Australian males based on ethnicity. Future research should use inclusive methodologies to confirm these associations and explore the underlying factors contributing to higher rates of suicidal behavior in specific populations.

The effects of psychological interventions on suicide for cancer patients: a systematic review and network meta-analysis.

Numerous psychological interventions are available for suicidal and death ideation (SDI) and suicidal behavior among cancer patients. To identify the optimal psychological interventions for reducing SDI and suicidal behavior in cancer patients. However, it remains unclear which psychological intervention is the most effective. We performed a pairwise and network meta-analysis by searching seven databases from the date of inception until 8 April 2022. An important focus of this network meta-analysis was the comparison of the effects of various psychological interventions on the reduction of SDI and suicidal behavior among cancer patients. For determining efficacy, we used standardized mean differences (SMDs) and 95% confidence intervals (CIs). Besides, a pairwise meta-analysis, inconsistency test, network meta-analysis, the surface under the cumulative rankings curve (SUCRA), comparison-adjusted funnel plot, subgroup analysis, and sensitivity analysis were also carried out. A total of 8 studies involving 1,350 patients were searched in this study. It showed that empathy therapy (SUCRA = 95.3%) has the best effect among the six interventions. Comprehensive psychological intervention (SUCRA = 77.6%) was ranked in the top two positions, followed by meaning-centered therapy (SUCRA = 40.7%). Comparison-adjusted funnel plots revealed no significant publication bias. In addition, our conclusions have not changed significantly after the sensitivity analysis. In this network meta-analysis, empathy therapy was identified as the optimal choice for reducing SDI and suicidal behaviors in cancer patients. Further multi-center and high-quality RCT studies should be conducted to make our conclusion more rigorous.

Anxiety in adolescents and subsequent risk of suicidal behavior: A systematic review and meta-analysis.

BACKGROUND: Suicide is a major public health concern, and anxiety is a prevalent developmental challenge in adolescents closely linked to suicidal behavior. This study aimed to assess the association between anxiety in adolescents and subsequent risk of suicidal behavior through a meta-analysis, offering crucial insights for suicide prevention. METHODS: Six bibliographic databases were comprehensively searched to clarify the association between adolescents anxiety and subsequent risk of suicidal behavior. We used a fixed-effects model to determine the total pooled effect size estimate and reported odds ratios and the corresponding 95 % confidence intervals. Subgroup analysis, sensitivity analysis and publication bias analysis were conducted with Stata version 15.1. RESULTS: The findings revealed a significant association between anxiety in adolescents and subsequent suicidal behavior (OR = 2.33, 95 % CI [2.00, 2.71]). Subgroup analyses indicated differences in mean effect size estimates based on clinical diagnoses and self-reported measures used to assess anxiety. The correlation strength between adolescent anxiety and subsequent suicidal behavior increased with a longer follow-up period. Furthermore, adolescents anxiety was associated with increased risk of subsequent suicidal ideation (OR = 1.97, 95 % CI [1.72, 2.25]) and attempts (OR = 3.56, 95 % CI [2.49, 5.07]). Finally, boys (OR = 2.41, 95 % CI [1.67, 3.47]) with anxiety had a greater risk of subsequent suicidal behavior than girls (OR = 2.02, 95 % CI [1.47, 2.78]). CONCLUSION: This study revealed that adolescents anxiety increases the risk of suicidal behavior, including suicidal ideation and attempts. Consequently, there is a critical need for timely interventions tailored to adolescents with anxiety to prevent future instances of suicide.