PubMed HealthSearch

SEARCH · PubMed Health

Results for “suicidal ideation”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 19 recordsLinked to original sources

Suicide ideation: its relation to depression, suicide and suicide attempt.

A random sample of 3,935 adults from a general population were interviewed and asked to report how often they had thoughts of suicide as well as their opinion on the frequency of suicide ideation in others. Depression was found to be related to the respondent's reports of his/her own suicidal thoughts and to reports of frequent suicide ideation in others. A total of 5.4 percent of the respondents reported some degree of suicide ideation in the previous month and 9.1 percent reported that others think about suicide once a month or more. When the demographic characteristics of those who report suicide ideation in themselves or others were compared to those of suicide attempters and committers, some consistencies were found, suggesting that such questions may be useful in identifying those "at risk." Nevertheless, sufficient discrepancies were found which suggest that there may be a number of factors which increase or decrease the likelihood that someone with thoughts of suicide will attempt or commit suicide. Follow-up studies are necessary to uncover such factors and the degrees to which they influence the occurrence of suicide.

Adolescent

Social disconnection integrates genetic and proteomic risks in suicidal ideation and depression.

Suicidal ideation (SI) and major depressive disorder (MDD) are complex psychiatric conditions arising from the interplay of genetic liability, molecular processes, and psychosocial factors. While these dimensions have been extensively studied in isolation, their joint contribution to SI and MDD remains unclear. This study integrates multi-modal data to elucidate these synergistic effects and develop robust models for individual-level risk stratification. Leveraging longitudinal multi-modal data from 13,085 UK Biobank participants, we integrated genomic, proteomic, and social connection profiles. We developed interpretable risk scores using a rigorous supervised machine learning framework encompassing diverse linear and ensemble classifiers. Permutation importance was employed to quantify feature contributions and derive transparent, weighted risk metrics across diverse classifiers. These scores were validated through association, interaction, and mediation analyses. Social connection-based risk scores significantly differentiated cases and controls across the two suicidal ideation phenotypes at 2017 and 2023 with cross-sectional analyses (AUCs: 0.70 - 0.73), outperforming proteomic-only models. Functional dimensions of social connection emerged as the most informative predictors. Longitudinal analyses revealed that social risk scores at baseline predicted suicidal ideation onset six years later, independent of demographic covariates. Interaction analyses demonstrated that polygenic risk for suicide attempt significantly interacted with both social and proteomic risk features in relation to depression. Structural equation models further confirmed that social disconnection acts as a key mediator linking genetic predisposition to MDD and SI. Social disconnection is a critical risk factor mediating the impact of genetic vulnerability on psychiatric outcomes. Integrating social, genetic, and molecular data supports a multilevel framework for risk stratification and highlights the potential of socially oriented interventions to mitigate biological risk.

Humans

Suicidal wishes and depression in suicidal ideators: a comparison with attempted suicides.

A depression inventory was administered to a sample of psychiatric patients who had some suicidal ideation. A factor analysis of their responses to the inventory resulted in a factorial structure similar to that obtained for attempted suicides. The suicidal ideators were found to have higher depression scores on the inventory than the attempted suicides. It was suggested that this study supported the notion that individuals who show differing kinds of suicidal behavior nonetheless may show similar psychological phenomena.

Cognition

Gender differences in the psychosocial correlates of suicidal ideation among adolescents.

Gender differences in the psychosocial correlates of suicidal ideation were studied. A sample of 613 high school students (ages 14-19) completed measures of suicidal ideation, depression, hopelessness, life stress, loneliness, alcohol and drug use, and reasons for living. The results of a discriminant function analysis indicated that males reported higher loneliness and substance abuse scores than females whereas females reported greater suicidal ideation, depression, and reasons for living. The results of multiple regression analyses found that, although the same four variables, depression, hopelessness, substance abuse, and few reasons for living emerged as significant predictors of suicidal ideation in both samples, the predictive equation accounted for more of the variance in ideation scores in females (57%) than in males (46%). In a final analysis a discriminant function analysis of the subscales of the reasons for living inventory revealed that females have a greater fear of death and injury whereas males have a greater fear of social disapproval over having suicidal thoughts. This may account for the greater rate of suicide completing among males. Fear of social disapproval, more anger and impulsivity, and less help-seeking behavior among males are offered as potential variables to explain the observed gender differences.

Adolescent

Early detection measures and triage procedures for suicide ideation in chronic pain patients.

There is a dearth of writings about early detection of potential suicide patients in chronic pain centers. Early detection measures used at the Vanderbilt Pain Control Center include a Symptom Checklist-90, with questions about depressive symptomatology and "Thoughts of Ending Your Life"; medical and psychological interviews; monitoring of changes in emotional disturbance; and, if warranted, administration of the Scale of Suicidal Ideation. Three case studies are presented that indicate that the results of an assessment measure should be tempered with clinical judgment. Suicidal behavior, including suicidal ideation, is a medical emergency; therefore, there is great need for early detection and triage measures.

Adult

Effects of Digital Mental Health Screening Alone and With the Online MINDBODYSTRONG CBT-Based Program on Burnout, Depression, Anxiety, Healthy Behaviors, and Suicidal Ideation in at-Risk Nurses at 3- and 6-Months Post-Intervention: An RCT.

BACKGROUND: Burnout and mental distress among nurses are global public health epidemics that adversely affect nurse well-being and healthcare quality. Evidence-based, scalable mental health interventions are urgently needed. AIMS: To evaluate the 3- and 6-month outcomes of a randomized controlled trial (RCT) comparing a psychologically safe, digital mental health screening and referral program alone versus the same screening and referral program combined with the video-based online MINDBODYSTRONG (MBS) cognitive behavioral therapy (CBT)-based skills-building program among nurses at risk for mental distress. METHODS: 501 nurses were recruited from professional organizations and healthcare systems across the United States by email and randomized to either mental health screening and referral (standard care) or standard care plus the MBS cognitive behavioral skills-building intervention (the intervention). All study activities were conducted remotely. Follow-up surveys administered at 3- and 6-months assessed anxiety, depression, suicidal ideation, burnout, healthy lifestyle beliefs, and healthy lifestyle behaviors using valid and reliable scales. RESULTS: Compared with the screening and referral only group, participants in the intervention group had greater reductions in anxiety and depression and significantly greater increases in healthy lifestyle beliefs and behaviors at 3 and 6 months post-intervention. After controlling baseline risk, the intervention group had a lower risk of suicidal ideation than the screening and referral group at 3 months (relative risk ratio [RRR] = 0.717; 95% CI: 0.320-1.606) and 6 months (RRR = 0.329; 95% CI: 0.101-1.072). The intervention group also had a significantly lower risk of burnout at 6 months (RRR: 0.698, 95% CI: 0.528, 0.929, p = 0.012). Nurses who completed more MBS sessions had less suicidal ideation at 6 months and those who completed more MBS skills-building activities had less burnout at 3 and 6 months. LINKING ACTION TO EVIDENCE: Integrating psychologically safe mental health screening combined with the scalable online CBT-based intervention, MBS, can produce sustained improvements in burnout, mental health symptoms, including suicidality, and healthy lifestyle beliefs and behaviors among nurses experiencing mental distress.

Humans

Cognitive aspects of suicidal behavior.

Recent efforts to quantify various aspects of suicide ideation are described. The Suicide Intent Scale, Hopelessness Scale, and the Scale for Suicide Ideation all assess components of the individual's suicidal ruminations. Hopelessness seems to account for the bulk of the relationship between depression and suicidal intent. The Scale for Suicide Ideation seems to show promise as a predictive instrument, as a dependent variable in research on treatment efficacy, and as a tool for clinical assessment of suicide potential. Implications for further research and clinical practice are discussed.

Cognition

Effects of H-coil TMS on suicidality in major depression: A secondary analysis of data from a multisite randomized trial comparing accelerated to once-a-day stimulation.

Suicide is the 10th leading cause of death in US adults. Standard once-daily repetitive transcranial magnetic stimulation (rTMS) can reduce suicidal ideation. Yet, antidepressant and anti-suicidal effects often take several weeks to emerge, while rapid improvement is often required. Accelerated TMS has been proposed as a strategy to hasten therapeutic response. A recent FDA-regulated multicenter trial evaluated accelerated intermittent theta burst Deep TMS with the H1-coil versus standard high-frequency Deep TMS in MDD. Both groups demonstrated high remission and response rates for depression, with the accelerated protocol showing non-inferiority and a shorter time to remission. The goal of this exploratory secondary analysis was to evaluate the impact of these two H-coil TMS dosing paradigms on suicidal ideation. The Scale for Suicide Ideation (SSI), as well as suicidality items of HDRS, MADRS and CUDOS were collected and analyzed. On all scales, both accelerated and standard Deep TMS protocols were associated with meaningful reductions in suicidality. The accelerated protocol achieved a faster onset of improvement. Comparison between the timeline of improvement in suicidality and in overall depressive symptoms found a trend for faster improvement in suicidality, especially with the accelerated protocol. These findings highlight the importance of treatment frequency in determining time to clinical benefit and support the use of scalable accelerated protocols for patients requiring more rapid symptom relief.

Humans

Alcohol use disorder and childhood adversity in the association between polygenic risk and suicidality.

OBJECTIVE: Suicidal ideation (SI) and suicide attempt (SA) are both influenced by genetic, behavioral, and environmental factors. Alcohol use disorder (AUD) and adverse childhood experiences (ACEs) may mediate or moderate the effects of genetic liability for suicidality. METHODS: Using data from 10,275 participants (43.8% female; 47.2% African-like genetic ancestry [AFR], 52.8% European-like genetic ancestry [EUR]), we tested whether polygenic scores (PGS) for SI and SA predicted lifetime suicidality outcomes. We evaluated whether AUD partially accounted for these associations and ACEs moderated the direct and indirect associations. RESULTS: The SA PGS was significantly associated with SA (AFR: b&#xa0;=&#xa0;0.36, SE&#xa0;=&#xa0;0.01; EUR: b&#xa0;=&#xa0;0.17, SE&#xa0;=&#xa0;0.01; both ps&#xa0;<&#xa0;2e-16), but the SI PGS was not associated with SI (p&#xa0;>&#xa0;0.55). AUD statistically mediated the association between the SA PGS and SA, accounting for approximately 2% of the total association in AFR individuals and 10% in EUR individuals (both ps&#xa0;<&#xa0;2e-16). Notably, the proportion of the association that was accounted for by AUD decreased as ACEs exposure increased, from 4.30% to 0.54% in AFR individuals and from 13.31% to 3.44% in EUR individuals. In contrast, there was only very modest mediation and no moderated mediation for SI. CONCLUSIONS: Particularly among individuals with lower ACEs exposure, AUD accounted for a meaningful proportion of the association between genetic liability to SA and lifetime SA. These findings highlight different correlates across suicidality phenotypes and suggest potential clinical relevance for AUD in the association between genetic liability and SA.

Adult

Personality and suicidal history in psychiatric patients.

The study sample comprised 575 psychiatric referrals for whom MMPI data were available. Patients were categorized according to suicidal history. The attempted suicide and nonsuicidal patients were differentiated significantly on the D, PD, MF, DY, ES, NE, EX, HO, SD, IP, ANX, and UNC scales. Important differences between the sexes emerged; whereas for men the profiles of the suicidal ideation and nonsuicidal patients were similar, for women those of the suicidal ideation and suicide attempt were similar. Male and female suicide attemptors correspond closely in the pattern and degree of deviation from the nonsuicidal patients of their own sex. The study indicates that patients who have a history of suicide attempts constitute a more psychologically disturbed group and points to a need for further examination of the meaning of suicidal ideation for men and women.

Adjustment Disorders

Classification of suicidal behaviors. II. Dimensions of suicidal intent.

A factor analysis of a scale to assess suicidal intent showed four major dimensions: expectancies and attitudes, premeditation, precautions against intervention, and oral communication. Certain types of actions associated with attempted suicide such as seeking help or social isolation appear to be revealing of particular behavioral patterns or motives. Dealing with intent only as a global concept is an oversimplification. Suicidal ideation and suicidal acts are seen as complex patterns of behavior requiring increasingly thorough analyses for better understanding, prediction, and prevention.

Attitude

Sense of coherence, self-esteem, depression and hopelessness as correlates of reattempting suicide.

Sense of coherence (SOC) has been proposed as a psychological factor that predicts good health and positive adjustment. The three components of SOC: manageability, comprehensibility and meaning were assessed together with depression, hopelessness and self-esteem as factors predicting future suicidal ideation and behaviour in parasuicides. One hundred and fifty hospitalized parasuicides were evaluated on these measures and followed up after six months to determine their current level of suicidal ideation and whether they had been readmitted for a further attempt or killed themselves in the intervening period. Suicidal ideation on admission was best predicted by a low score on the SOC meaning subscale and also significantly related to the other predictor variables. Suicidal ideation at the six-month follow-up was best predicted by the SOC subscales manageability and comprehensibility. These two SOC subscales also emerged as discriminators of suicidal behaviour over the six months following admission. Overall prediction of suicidal behaviour was enhanced by also including the background variables of age, a history of previous attempts, unemployment and whether the attempter was living alone. The study ends with a discussion of the importance of widening the focus when assessing and predicting suicidal risk to include not only predictions based on pathology but also psychological factors that promote adjustment.

Adaptation, Psychological

Akathisia, suicidality, and fluoxetine.

BACKGROUND: The propose link between fluoxetine and suicidal ideation is explained by fluoxetine-induced akathisia and other dysphoric extrapyramidal reactions. METHOD: The following literature is reviewed: (1) the subjective response of schizophrenics to akathisia, including evidence that akathisia gives rise to suicidal ideation; (2) the subjective reports of patients taking fluoxetine; and (3) preclinical studies describing the role of serotonin in the extrapyramidal system and suggesting a mechanism whereby fluoxetine can induce extrapyramidal side effects. RESULTS: The literature suggests that fluoxetine-induced extrapyramidal reactions may be a mediator of de novo suicidal ideation. CONCLUSION: We propose a syndrome which we name Extrapyramidal-Induced Dysphoric Reactions, one extreme manifestation of which is the emergence of suicidal ideation. We further propose a heuristic "Four Neuron Model of the Extrapyramidal Motor System" in which increased serotonin activity, by inhibiting the nigrostriatal dopamine tract, is capable of inducing extrapyramidal side effects.

Akathisia, Drug-Induced

Urinary catecholamines and cortisol in parasuicide.

A relationship of urinary catecholamines and of urinary free cortisol with violent suicide attempts has been reported. We have reexamined this issue in patients within 24 hours of hospital admission. Suicide attempters had significantly higher norepinephrine (NE: mean +/- SD = 58.3 +/- 27.0 micrograms/24 hours; n = 27) than did control patients with suicidal ideation (mean +/- SD = 37.1 +/- 21.3; n = 10). Among suicide attempters, those who used physical means had the highest NE levels (mean +/- SD = 69.7 +/- 21.3) and those who took overdoses of antidepressants (mean +/- SD = 51.9 +/- 17.3; n = 6), benzodiazepines (mean +/- SD = 65.1 +/- 29.7; n = 5), or miscellaneous drugs (mean +/- SD = 59.1 +/- 36.5; n = 11) had lower NE values. In contrast to NE, urinary dopamine (mean +/- SD = 402.6 +/- 392 micrograms/24 hours, epinephrine (EPI: mean +/- SD = 14.3 +/- 4.0 micrograms/24 hours), the NE/EPI ratio (mean +/- SD = 8.3 +/- 0.9), urinary free cortisol (mean +/- SD = 157.9 +/- 11.5 micrograms/24 hours) and serum cortisol (mean +/- SD = 35.0 +/- 13.1 nM/l) did not differ between groups. There were no group differences in age (mean +/- SD = 36.3 +/- 16.5 years), Beck Depression Inventory score (mean +/- SD = 26.3 +/- 12.9), Beck Hopelessness Scale score (mean +/- SD = 10.0 +/- 5.6), Beck Scale for Suicidal Ideation score (mean +/- SD = 13.6 +/- 9.3), or Hamilton Rating Scale for Depression score (mean +/- SD = 19.5 +/- 9.8). In the four parasuicide groups, there was no difference in suicide intent (mean +/- SD = 13.3 +/- 7.9). These findings indicate that there is increased NE output shortly after suicide attempts. Previous reports of a low NE/EPI ratio in suicidal patients may reflect adaptive changes rather than the acute state of the patient at the time of the attempt.

Adult