Suicidality: An Evolutionary Concept Analysis

Keefner, Tamara Pike; Stenvig, Thomas E.

doi:10.1080/01612840.2020.1793243

Cited by 13 publications

(12 citation statements)

References 127 publications

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“…Suicidality is one of the most challenging characteristics of mental disorders 1 . It is defined by a spectrum composed of ideations about not caring about living or dying, wish to be dead, making suicide plans and attempts and suicide 2,3 . Indeed, suicide causes 1.4% of deaths worldwide 4 and is the most severe component of suicidality 3,5 .…”

Section: What Is New and Objectivementioning

confidence: 99%

“…1 It is defined by a spectrum composed of ideations about not caring about living or dying, wish to be dead, making suicide plans and attempts and suicide. 2,3 Indeed, suicide causes 1.4% of deaths worldwide 4 and is the most severe component of suicidality. 3,5 Suicidality is associated with a family history of suicide, social isolation, stressful situations throughout life, emotional dysregulation and mood disorders.…”

Section: What Is Ne W and Objec Tivementioning

confidence: 99%

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Behavioural activation and trial‐based cognitive therapy may be beneficial to reduce suicidal ideation in major depressive disorder: A post hoc study from a clinical trial

Hemanny

Sena

Oliveira

2021

Clinical Pharmacy Therapeu

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What is known and objective The suicidality spectrum is a clinical challenge because of the difficulty of its management and its association with mortality. Few studies have investigated psychotherapies for reducing the components of suicidality. In this study, we compared the effect of behavioural activation (BA), trial‐based cognitive therapy (TBCT) – both added to antidepressant (AD) treatment – and treatment as usual (TAU) in mitigating suicidal ideation in patients with major depressive disorder (MDD). Methods A post hoc study was conducted with data from a randomized clinical trial. Secondary analyses compared the treatments using scores from the items that evaluated suicidal ideation with the HAM‐D (HAM‐D‐3) and BDI (BDI‐9). A composite measurement was constructed by summing the scores from the two items (HAM‐D‐3 plus BDI‐9). Results and discussion Seventy‐six patients were analysed (BA + AD = 24; TBCT + AD = 26 and TAU = 26). In HAM‐D‐3, the BA + AD group showed a statistically greater reduction than the TAU group. In BDI‐9, the three groups did not show significant differences. In the HAM‐D‐3 plus BDI‐9, TBCT + AD reduced ideations more than the TAU group. There were no differences among the psychotherapies in any of the measures. Sensitivity analyses showed improvement in suicidal ideation in both psychotherapies compared to TAU. What is new and conclusion This is one of the few studies that evaluated the effect of BA and TBCT in lowering suicidal ideation. Adding these therapies to ADs seems to decrease suicidal ideation. We suggest the possible beneficial effects of BA and TBCT in the management of suicidal ideation in patients with recurrent MDD. Our findings need further studies to confirm these results.

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Section: What Is New and Objectivementioning

confidence: 99%

Section: What Is Ne W and Objec Tivementioning

confidence: 99%

Behavioural activation and trial‐based cognitive therapy may be beneficial to reduce suicidal ideation in major depressive disorder: A post hoc study from a clinical trial

Hemanny

Sena

Oliveira

2021

Clinical Pharmacy Therapeu

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“… 25 , 26 Suicidality is an umbrella term that includes suicidal self-injurious behaviors including suicidal ideation, suicide attempt, and suicide plan, where suicide refers to the completion of the process. 27 However, as most of the prior studies in the country failed to provide information about suicidality hierarchy, this study tried to investigate suicidality by assessing with a different tool.…”

Section: Introductionmentioning

confidence: 99%

Suicidality in Bangladeshi Young Adults During the COVID-19 Pandemic: The Role of Behavioral Factors, COVID-19 Risk and Fear, and Mental Health Problems

Mamun¹,

Al‐Mamun²,

Hosen³

et al. 2021

RMHP

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Background It is said that psychological stressors have risen during the COVID-19 pandemic, which may contribute to suicidality. A few studies were conducted investigating suicidality amid the first wave of the pandemic in Bangladesh, but none of these studies explored the predictive role of the suicidality-related factors (eg, behavior and health-related variables, COVID-19 risk, fear of COVID-19). Thus, this study aimed to investigate the prevalence of suicidality and the predictive models explaining suicidality variance among Bangladeshi young adults during the second wave of the pandemic. Methods An online-based cross-sectional survey was conducted during the second wave of the pandemic (between 1 and 13 April 2021; a year after the pandemic's inception in the country). The survey questionnaire collected information on socio-demographics, behavior and health-related variables, COVID-19 risk, fear of COVID-19, depression, anxiety, and suicidality. A total of 756 data were analyzed (male 59%; mean age 22.24 ±4.39 years), and hierarchical regression was performed considering suicidality as the dependent variable. A p -value <0.05 was set to be statistically significant with a 95% of confidence interval. Results About 8.2% reported having at least suicidal thoughts within the pandemic inception to survey time (one-year suicidal ideation). More specifically, 7.40% had only suicidal ideation, whereas 0.10% planned for suicide, 0.70% attempted suicide. None of the socio-demographic variables was significantly associated with suicidality. Taking drugs, performing less physical activity, poor self-reporting health condition, being comorbid, being at higher COVID-19 risk, having fear of COVID-19 infection, and suffering from depression and anxiety were significantly associated with a higher risk of suicidality. However, the final model including all of the studied variables explained a 17.1% (F=8.245, p <0.001) variance in terms of suicidality. Conclusion Although this study reported a lower severity of suicidality than prior Bangladeshi studies conducted during the first wave of the pandemic, a portion of people are still at risk of suicide and they should be given attention.

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“…For the quantitative study, we determined the sample size by the sample size determination formula, N = Z 2 PQ/D2 [47], where: N = Sample size, Z = Standard deviation corresponding with 95% confidence interval in the standard normal distribution which is 1.96, P = 83.5% (0.835) was the estimated proportion of PLHIV in the target population with depression symptoms projected from before COVID-19 study in Uganda [38], D = 0.05 margin of error, Q = Estimated proportion of PLHIV in the target population without depression (1-p) = 16.5% (0.165). Thus, N = 1.96 2 *0.835*0.165/0.05 2 = 212 per study site.…”

Section: Sample Size and Samplingmentioning

confidence: 99%

Depression, suicidality, substance-use and associated factors among people living with HIV the COVID-19 pandemic in Uganda

et al. 2023

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Background Mental disorders are common in people living with HIV (PLHIV) but they are often unrecognized and untreated. Furthermore, the COVID-19 pandemic has disrupted the already limited mental health services in low resource countries such as Uganda, and yet the extent to which the COVID-19 mitigation measures have affected the mental health of PLHIV is not fully known. We aimed to determine the burden of depression, suicidality, substance use and associated factors among adult PLHIV who were seeking care at two HIV clinics in northern and southwestern Uganda. Methods We conducted a phenomenological qualitative and quantitative cross-sectional study among 431 PLHIV to determine the burden of depression, suicidality and substance-use disorders at two HIV clinics, at Lira Regional Referral Hospital and Mbarara Regional Referral Hospital in northern and southwestern Uganda respectively, during the COVID-19 lockdown. We used the Patient Health Questionnaire (PHQ-9) to assess for depression and suicidality, and the Michigan Assessment-Screening Test for Alcohol and drugs (MAST-AD) to assess for substance use disorder. We conducted descriptive statistics analysis to determine the burden of the disorders, and logistic regression to determine the associated factors. For the qualitative method we conducted in-depth interviews with 30 PLHIV and did thematic analysis. Results Of the 431 PLHIV surveyed, mean age was 40.31 ± 12.20 years; 53.1% (n = 229) had depression; 22.0% (n = 95) had suicidality; and 15.1% (n = 65) had substance-use disorder. Female gender (PR = 1.073, 95%CI 1.004–1.148, P = 0.038), lack of formal education (PR = 1.197, 95% CI 1.057–1.357, P = 0.005), substance-use disorder (PR = 0.924, 95%CI 0.859–0.994, P = 0.034) and suicidality (PR = 0.757, 95%CI 0.722–0.794, p = 0.000) were associated with depression after adjusting for confounders. Further analysis showed that being female (PR = 0.843, 95% CI 0.787–0.903, P = 0.000*) and having depression (PR = 0.927, 95% CI 0.876–0.981, P = 0.009) and owning a large business (PR = 0.886, 95% CI 0.834–0.941, p = 0.000*) were significantly associated with having a substance-use disorder. Only depression was independently associated with suicidality after adjusting for confounding factors (PR 0.108, 95%CI 0.054–0.218, p = 0.000*). For the qualitative results, there were three apriori themes: a) Burden of depression, b) substance-use, and c) suicidality among the PLHIV during the COVID-19 containment measures. Conclusion There was high prevalence of depression, suicidality and substance-use disorder in adult PLHIV in Uganda during the COVID-19 pandemic and the associated lockdown measures. The three mental health problems seem to have bidirectional relationships and gender has a lot of contribution to the relationships. Interventions aimed at any of the disorders should consider these bidirectional relationships.

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Suicidality: An Evolutionary Concept Analysis

Cited by 13 publications

References 127 publications

Behavioural activation and trial‐based cognitive therapy may be beneficial to reduce suicidal ideation in major depressive disorder: A post hoc study from a clinical trial

Behavioural activation and trial‐based cognitive therapy may be beneficial to reduce suicidal ideation in major depressive disorder: A post hoc study from a clinical trial

Suicidality in Bangladeshi Young Adults During the COVID-19 Pandemic: The Role of Behavioral Factors, COVID-19 Risk and Fear, and Mental Health Problems

Depression, suicidality, substance-use and associated factors among people living with HIV the COVID-19 pandemic in Uganda

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