Global cross-cultural validation of a brief measure for identifying potential suicide risk in 42 countries.

OBJECTIVES: This study aimed to examine the psychometric properties of the P4 suicide screener in a multinational sample. The primary goal was to evaluate the reliability and validity of the scale and investigate its convergent validity by analyzing its correlation with depression, anxiety, and substance use. STUDY DESIGN: The study design is a cross-sectional self-report study conducted across 42 countries. METHODS: A cross-sectional, self-report study was conducted in 42 countries, with a total of 82,243 participants included in the final data set. RESULTS: The study provides an overview of suicide ideation rates across 42 countries and confirms the structural validity of the P4 screener. The findings indicated that sexual and gender minority individuals exhibited higher rates of suicidal ideation. The P4 screener showed adequate reliability, convergence, and discriminant validity, and a cutoff score of 1 is recommended to identify individuals at risk of suicidal behavior. CONCLUSIONS: The study supports the reliability and validity of the P4 suicide screener across 42 diverse countries, highlighting the importance of using a cross-cultural suicide risk assessment to standardize the identification of high-risk individuals and tailoring culturally sensitive suicide prevention strategies.

Historical milestones regarding torsion of the scrotal organs.

PURPOSE: The clinical syndrome of the acute scrotum, whereby the spermatic cord or appendix testis becomes twisted, commonly affects young men. Our knowledge of this condition, however, is of relatively recent origin. MATERIALS AND METHODS: We performed an historical survey of torsion of the scrotal organs dating back to 1703. In Bologna in 1703 Morgagni observed the first hydatid on the caput epididymis. He described 10 hydatid cases of the testis and epididymis producing, in his opinion, the fluid of hydroceles. The first illustration of appendix testis dates from Cooper 1841. Later these testicular appendages, or hydatids, were shown to be vestigial remnants of either the müllerian duct or the wolffian structures, depending on location. Actual torsion of the appendix testis was mentioned by Ombrédanne in 1913 but the first case report was published in 1922 by Colt. Appendix testis torsion was first schematically illustrated in 1923 by Mouchet and was characterized by Dix in 1931 in a manner that is still valid today. Interestingly, the great majority of case reports since 1932 have originated from America. In 1810 Hunter described a typical case of testicular torsion, and in 1840 Delasiauve presented the first case of surgically treated testicular torsion. A schematic and original illustration of a contorted undescended testis was published in 1894 by Lauenstein. RESULTS: Testicular torsion was, and still is, a true urological emergency but the historical survival rate of the testis was extremely low. Searching for improvement in clinical diagnosis, physicians have noted helpful specific signs, 1 of which is that the period of ischemia determines loss of the testis. CONCLUSIONS: The historical development of diagnosis of torsion of the appendix testis and spermatic cord highlights the ever present need for careful examination, a high index of suspicion and timely therapy.