Suicide

Sher, Leo; Oquendo, María A.

doi:10.1016/j.mcna.2022.03.008

Cited by 39 publications

(10 citation statements)

References 76 publications

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“…From an individual standpoint, it will be highly advantageous to promote a healthy lifestyle, treat mental illnesses, and establish solid relationships with families and social communities. These steps should be taken from a sociocultural perspective, including removing obstacles to mental healthcare and drug rehab, reducing media exposure to suicidal behavior and the influence of those who have committed suicide, and limiting access to fatal substances ( 32 , 33 ); The need for early detection, assessment, therapy, and referral of people at risk of suicide behavior to professionals is emphasized at the national level. Overall, as no single strategy clearly outperforms the others, combinations of evidence-based preventative strategies at the individual and population level may be more beneficial ( 34 ).…”

Section: Discussionmentioning

confidence: 99%

Identification of risk factors for attempted suicide by self-poisoning and a nomogram to predict self-poisoning suicide

Zheng

Fan

et al. 2023

Front. Public Health

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PurposeSuicide is a global concern, especially among young people. Suicide prediction models have the potential to make it easier to identify patients who are at a high risk of suicide, but they have very little predictive power when there is a positive value for suicide mortality. Therefore, the aim of the study is to uncover potential risk factors associated with suicide by self-poisoning and further to provide a trustworthy nomogram to predict self-poisoning suicide among poisoned patients.MethodsThis study prospectively enrolled 237 patients who were treated for poisoning at the Fifth Medical Center of PLA General Hospital (Beijing) between May 2021 and May 2022. Patient's basic characteristics, daily activities, mental health status, and history of psychological illnesses were gathered to examine their predictive power for self-poisoning suicide. On developing a prediction model, patients were split 8:2 into a training (n = 196) group and a validation (n = 41) group at random via computer. The training group worked on model development, while the validation group worked on model validation. In this study, the Hosmer and Lemeshow test, accuracy, and area under the curve were the primary evaluation criteria. Shapley Additive exPlanations (SHAP) was determined to evaluate feature importance. To make the prediction model easy for researchers to utilize, it was presented in nomogram format. Two risk groups of patients were identified based on the ideal cut-off value.ResultsOf all poisoned patients, 64.6% committed suicide by self-poisoning. With regard to self-poisoning attempted suicide, multivariate analysis demonstrated that female gender, smoking, generalized anxiety disorder-7 (GAD-7), and beck hopelessness scale-20 (BHS-20) were significant risk factors, whereas married status, relatively higher education level, a sedentary time of 1–3 h per day, higher sport frequency per week, higher monthly income were significant protective features. The nomogram contained each of the aforementioned nine features. In the training group, the area under curve (AUC) of the nomogram was up to 0.938 (0.904–0.972), whereas in the validation group, it reached a maximum of 0.974 (0.937–1.000). Corresponding accuracy rates were up to 0.883 and 0.927, respectively, and the P-values for the Hosmer and Lemeshow test were 0.178 and 0.346, respectively. SHAP demonstrated that the top three most important features were BHS-20, GAD-7, and marital status. Based on the best cut-off value of the nomogram (40%), patients in the high-risk group had a nearly six-time larger likelihood of committing suicide by self-poisoning than patients in the low-risk group (88.68 vs. 15.38%, P < 0.001). The dynamic nomogram was made available at the following address: https://xiaobo.shinyapps.io/Nomogramselfpoisoningsuicide/.ConclusionsThis study proposes a prediction model to stratify patients at a high risk of suicide by self-poisoning and to guide individual preventive strategies. Patients in the high-risk group require further mental health counseling to alleviate anxiety and hopelessness, healthy lifestyle like quitting smoking and exercising more, and restriction of access to poison and psychiatric drugs.

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Section: Discussionmentioning

confidence: 99%

Identification of risk factors for attempted suicide by self-poisoning and a nomogram to predict self-poisoning suicide

Zheng

Fan

et al. 2023

Front. Public Health

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“…There was less overlap among individuals in the DS and SI ( n = 6) groups and among individuals in the DS and history of suicidality ( n = 9) groups. The overlap between mental distress indicators is not unexpected, given the hypothesized causal relationship between depression and suicidal thoughts and behaviors ( 65 – 67 ). We statistically controlled for this relationship in the suicidality models by adding the depression screen covariate to the logistic regression model as the fourth and final step in model building, as is detailed in Section 2.3.…”

Section: Discussionmentioning

confidence: 91%

Behavioral and psychosocial factors related to mental distress among medical students

Carlos

Ahmadi

Uban

et al. 2023

Front. Public Health

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IntroductionPhysicians die by suicide at rates higher than the general population, with the increased risk beginning in medical school. To better understand why, this study examined the prevalence of mental distress (e.g., depressive symptoms and suicide risk) and behavioral and psychosocial risk factors for distress, as well as the associations between mental distress and risk factors among a sample of medical students in a pre–COVID-19-era.MethodsStudents enrolled in a large California medical school in 2018–2019 (N = 134; 52% female) completed questionnaires assessing sociodemographic characteristics, depression and suicide family history, health behaviors, and psychosocial wellbeing. Assessment scores indexing mental distress (e.g., depressive symptoms, thoughts of suicide in the past 12 months, suicide risk, and history of suicidality) and risk factors (e.g., stress, subjective sleep quality, alcohol use, impostor feelings, and bill payment difficulty) were compared across biological sex using chi-squared tests, and associations between mental distress and risk factors were determined through logistic regression.ResultsElevated mental distress indicators were observed relative to the general public (e.g., 16% positive depression screen, 17% thought about suicide in previous 12 months, 10% positive suicide risk screen, and 34% history of suicidality), as well as elevated risk factors [e.g., 55% moderate or high stress, 95% at least moderate impostor feelings, 59% poor sleep quality, 50% screened positive for hazardous drinking (more likely in females), and 25% difficulty paying bills]. A positive depression screen was associated with higher stress, higher impostor feelings, poorer sleep quality, and difficulty paying bills. Suicidal ideation in the previous 12 months, suicide risk, and a history of suicidality were independently associated with higher levels of impostor feelings.DiscussionHigher scores on assessments of depressive symptoms and suicidal thoughts and behaviors were related to several individual-level and potentially modifiable risk factors (e.g., stress, impostor feelings, sleep quality, and bill payment difficulties). Future research is needed to inform customized screening and resources for the wellbeing of the medical community. However, it is likely that the modification of individual-level risk factors is limited by the larger medical culture and systems, suggesting that successful interventions mitigate suicide risk for medical providers need to address multiple socio-ecological levels.

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“…Multiple biological factors can also contribute to the pathophysiology of adverse events [ 27 , 28 ], including suicidal events [ 29 ]. Among these, sex can contribute to suicidal behaviours.…”

Section: Discussionmentioning

confidence: 99%

Glucagon-like Peptide-1 Receptor Agonists and Suicidal Ideation: Analysis of Real-Word Data Collected in the European Pharmacovigilance Database

Ruggiero,

Mascolo,

Spezzaferri

et al. 2024

Pharmaceuticals

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Background: A potential risk of suicide associated with liraglutide or semaglutide treatments has recently emerged. Therefore, we decided to investigate the reporting probability of suicidal events among glucagon-like peptide-1 receptor agonists (GLP-1 RAs). Methods: A retrospective pharmacovigilance study of the European Pharmacovigilance database was conducted for the period from 1 January 2018 to 10 July 2023. Disproportionality analyses (reporting odds ratio, ROR) were performed to assess the reporting probability of suicidal events among GLP-1 RAs. Results: A total of 230 reports of suicidal events were identified. The most reported GLP-1 RA was liraglutide (38.3%), followed by semaglutide (36.5%) and dulaglutide (16.1%). The most reported events were suicidal ideation (65.3%) and suicide attempt (19.5%). Disproportionality analysis found a higher reporting probability of suicidal events for semaglutide than dulaglutide (ROR, 2.05; 95%CI, 1.40–3.01) and exenatide (ROR, 1.81; 95%CI, 1.08–3.05). In the same way, liraglutide was associated with a higher reporting probability of suicidal events than dulaglutide (ROR, 3.98; 95%CI, 2.73–5.82) and exenatide (ROR, 3.52; 95%CI, 2.10–5.92). On the contrary, a lower reporting probability was found for semaglutide than liraglutide (ROR, 0.51; 95%CI, 0.38–0.69). Conclusions: Suicidal events were mostly reported with semaglutide and liraglutide, which were also associated with significantly higher reporting probabilities compared to other GLP1 RAs. Although this study provides the reporting frequencies of suicide-related events with GLP-1 RAs, establishing causality requires further investigation, which will probably be addressed by the Pharmacovigilance Risk Assessment Committee of the European Medicine Agency in the future.

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Suicide

Cited by 39 publications

References 76 publications

Identification of risk factors for attempted suicide by self-poisoning and a nomogram to predict self-poisoning suicide

Identification of risk factors for attempted suicide by self-poisoning and a nomogram to predict self-poisoning suicide

Behavioral and psychosocial factors related to mental distress among medical students

Glucagon-like Peptide-1 Receptor Agonists and Suicidal Ideation: Analysis of Real-Word Data Collected in the European Pharmacovigilance Database

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