Correlations between neutrophil/lymphocyte, platelet/lymphocyte, and monocyte/lymphocyte ratios (NLR, PLR, and MLR, respectively) and psychopathological and clinical variables in the context of mood disorders are increasingly emerging in international scientific literature, being the former one of the most studied. The estimation of suicidal risk associated to affective disorders could benefit from such rapidly and easily available biomarker of inflammation, if significant in this regard.

The present review would like to focus on any existing correlations between NLR and suicidal risk in patients with mood disorders.

We sourced articles on the topic found in major scientific literature databases, combining the keywords “neutrophil/lymphocyte ratio”, “NLR”, “mood disorders”, “major depressive disorder”, “bipolar disorder” and “suicide risk”.

There are congruent findings of significantly higher NLR values in depressed patients attempting suicide than in depressed patients with no suicidal behaviors or healthy controls. In addition, violent means appear typical in this subgroup of depressed suicidal patients, suggesting that patients with higher levels of NLR are at risk of attempting suicide and to be successful in self-harming. Similar results have been found in patients with bipolar disorder, showing a positive correlation between NRL and suicide risk, evaluated by the Suicide Behaviors Questionnaire-Revised (SBQ-R). Moreover, in patients with a positive family history for suicide attempts, NRL was found to be a significant positive predictor of suicide risk.

These findings, although limited, support the notion that NLR might be a useful marker for suicide vulnerability in both BD and MDD patients.

No significant relationships.

Latvia is listed as a country with one of the highest suicide mortality rates in European Union (National Statistical System of Latvia, 2021).

To assess the sequences for reporting of suicidal behaviours (SB) in Latvian general population.

The study is based on secondary data of the Health Behaviour Among Latvian Adult Population survey, provided by the Centre for Disease Prevention and Control of Latvia (representative sample of the Latvian population aged 15-64 in 2010, 2012, 2014; 15-74 in 2016, 2018; (n=16,105). Respondents were asked to report the occurrence of life-weariness (LW), death wishes (DW), suicidal ideation (SI), suicidal plans (SP), suicide attempts (SA) during the previous year.

Statistically significant differences between genders were found for LW (Χ²=17.118; df=1; p<0.001; AR=±4.1), DW (Χ²=17.764; df=1; p<0.001; AR=±3.8) and any type of SB (Χ²=15.721; df=1; p<0.001; AR=±3.8). Frequencies of individual sequences of reporting last year SB are presented in Table.

Further research is warranted to identify vulnerable groups in the Latvian general population in relation to suicidality and thus to develop targeted preventive measures.

This work has been developed with financing from the European Social Fund and Latvian state budget within the project no. 8.2.2.0/20/I/004 “Support for involving doctoral students in scientific research and studies at Rīga Stradiņš University.

The Covid pandemic has mental health consequences. This study examined service user suicides for thirteen months during the pandemic and “lock down” restrictions in Ireland .It compares variables from this group with a previous 2016 study examining service user suicides conducted in Ireland. Despite a previous trend of improving suicide there was an increase in people who were involved with mental health services completing suicide during the pandemic.

To hypothesize that social disequilibrium caused by the Covid pandemic and its control measures may remove the benefit of protective factors in suicide.

The 2016 study used the Suicide Support and Information System- Psychological Autopsy Model as its methodology.The Rosenberg criteria were used to make a determination of suicide. This 2021 study used an anonymous clinical record review to repeat some key variables identified in the SSIS-PAM work. Statiscal comparisons were made.

The pandemic group had a different pattern of suicide with low levels of significance between four variables. The majority were female, in a relationship, had jobs, no history of self-harm, no family history of mental illness, less addiction problems and in-patient care. Like the 2016 group they did have diagnoses of mental illness, were in regular contact with services and were prescribed medication. Their suicides were predominantly hanging and drowning.

During the pandemic suicide increased. Protective factors such as relationships and employment were increased in pandemic suicides who also had less vulnerability factors such as addiction problems and self-harm. “Real time” suicide data collection such as a suicide observatory model might identify more significant trends.

No significant relationships.

Depression is associated with a high risk of suicidal thoughts (ST) and behaviour (SB). Suicidality and depression have partially shared genetic underpinnings and family history of mood disorders (FH) can reflect genetic impact on specific features of depression. Thus, in depressed patients, FH may affect suicidality and its associations with other risk factors, such as personality traits.

We conducted a cross-sectional study to test the impact of FH on the association between suicidality and personality traits in depressed patients.

200 depression in- and outpatients (64% (n=128) women, mean age (M(SD):36,21(15,09)) were enrolled. 28% (n=56) reported FH (“FH+” cohort), other patients comprised the “FH-” cohort. Columbia-Suicide Severity Rating Scale (C-SSRS) was used to assess ST and SB during the most suicidal period of life. Personality traits were assessed by Cloninger Temperament and Character Inventory (TCI-125). Information about FH and history of suicide attempts (SA) was obtained during the clinical interview.

Personality traits and suicidality characteristics (ST, SB, SA) did not differ between FH+ and FH- patients. In FH+, no differences in TCI-125 scores between suicide attempters and non-attempters were found, while in FH-, attempters had higher scores of TCI-125 “Novelty seeking” (p=0.002) and “Self-transcendence” (p=0.031) subscales. Multiple correlations between ST, SB and TCI-125 subscales were found only in FH-, In FH+, only one correlation (between ST and TCI-125 “Persistence” subscale (r=-0.288, p=0.038) was found.

Our results showed a weakened association between personality traits and suicidality in depressed patients with FH of mood disorders, although more data on larger samples are needed.

The study was supported by RSF grant # 20-15-00132

Description of a structured work of primary prevention, based on a survey of the prevalence of suicidal behavior in the Brazilian population throughout life, performed by an academic service of psychiatry and chemical dependence. We describe a survey of the probability of suicide attempt in an academic internment service focused on psychiatry and drug addiction in the city of Rio de Janeiro.

Raise awareness of the need to call for help and 24-hour distress hotline phone outreach. Calculate a possible demand for mental health services to patients with severe suicidal behavior aiming at the necessary equipment to attend this population.

Clarification actions through the press, development of a suicide prevention lecture program given in schools, surveillance cameras, military institutions, companies and laws, promotion of public events with music, activities, distribution of t-shirts, booklets and leaflets.Using the mental health care implementation system: identifying the patient, raising their needs and available resources, breaking resistance, advocating and treating, we raised in this institution that from January 01, 2019 to September 01, 2019, 137 patients were hospitalized with a serious suicide attempt.

According to a survey of the prevalence of suicidal behavior in the Brazilian population over the course of life, where out of 100 patients, 17 had suicidal thoughts, 5 planned, 3 attempted suicide and 1 was treated in the emergency room.

The suicide prevention program has been very successful as the press promotes of the telephone number for immediate relief. His survey highlighted the need to create a specific suicide treatment and prevention program.

No significant relationships.

Determination of antisuicidal factors (AF) in balance with risk factors for suicidal behavior (SB) is essential for treatment and prophylactic measures.

Study AF in a sample of schizophrenic recovered patients (F.20, ICD-10) according to operational criteria R.P. Liberman et al. (2002).

The content analysis of published self-reports of a sample (n = 13) of Russian and foreign psychiatrists and clinical psychologists with psychotic experience was used as a part of a more extensive qualitative analysis of «wounded healers».

In the history of > ½ (i.e., 7) ex-patients, repeated SPs (aborted suicides), as well as non-suicidal self-harm (e.g., self-cutting), were noted during the active period of the disease, and in four of them – during untreated psychosis. Following AFs can be distinguished in recovery state: clinical (absence of potentially suicidogenic residual depression or/and anxiety, according to criteria N.C. Andreasen et al. (2005) social (professional goals, coping with stigmatization), and existential (e.g., hope, gaining a whole Self).

AF is an important integral component of recovery in schizophrenia as a process of personality development despite a burden of severe mental disorders.

No significant relationships.

The incidence of suicide is much higher in people with mental health disorders, estimating that up to 9 out of 10 people who commit suicide suffer from at least one of them. For this reason, suicide is considered by many authors as the most serious complication of psychiatric disorders. The literature and the experience of clinicians support the potential usefulness of specific measures and programs aimed at its prevention.

Congruently, throughout the last decade, consecutive strategic mental health plans in the Autonomous Community of Madrid, Spain, have included suicide prevention plans among their priorities, setting the objective of reducing suicidal behavior in the population of Madrid by implementing practical measures in the healthcare system.

In the presented work we aim to summarize the multidisciplinary therapeutic process in the context of this program and the results obtained during its years of experience.

Retiro Community Mental Health Treatment Center launched a specific program in 2013 to meet these objectives. This initiative, that received the name PRISURE (Spanish acronym for Suicide Risk Prevention Program in Retiro), is an outpatient intervention program for immediate care, as the first appointment is scheduled within a week after referral. Intensive, comprehensive and multidisciplinary care is provided for patients with moderate to severe suicide risk.

All professional categories that work in the Community Mental Health Treatment Center actively participate. In parallel with clinical performance, these professionals also carry out coordination tasks with other entities that are dedicated to suicide prevention, as well as with patients’ and families’ associations.

No significant relationships.

An important task of psychiatrists and psychologists is the prevention of suicidal behavior in adolescents.

Highlighting the stages of the formation of reflexive skills for the development of training sessions on the prevention of adolescent suicide.

Analysis of the results of theoretical and empirical studies of reflection and suicide by psychiatrists and psychologists.

Reflexive skills are a system of deliberate actions aimed at understanding and evaluating “I” and one’s own behavior. Theoretical analysis made it possible to distinguish three stages in the formation of reflexive skills. EMOTIONAL - evaluation of “I” as the basis of positive emotions. COGNITIVE - understanding (awareness) of one’s own capabilities for solving a problem. OPERATIONAL - solving a problem based on an assessment of the “I” and an understanding of their capabilities.

The identification of three stages of the formation of reflexive skills, as prevention of adolescent suicide, makes it possible to develop an effective training program for adolescents at risk in the Centers for psychiatric and psychological assistance.

No significant relationships.

Alcohol-based hand sanitizers containing ethanol or isopropanol are being used in order to prevent person-to-person transmission during the COVID-19. Early signs and symptoms of this ingestion include nausea, vomiting, headache, abdominal pain, blurred vision, loss of coordination, and decreased level of consciousness. After hand sanitizer ingestion we have to suspect about methanol poisoning, monitoring the start of anion-gap metabolic acidosis, seizures, and blindness is essential. Treatment includes supportive care, acidosis correction, and the administration of an alcohol dehydrogenase inhibitor. In servere cases hemodialysis may be required.

To present a case of an 29-year-old woman who was taken to the emergency department after voluntary ingestion of alcohol-based hand sanitizer in a suicide attempt. To describe the most common side effects of hand sanitizer ingestion and the literature review.

Clinical case presentation and literature review of similar cases.

A 29-year-old woman, with diagnosis of borderline personality disorder and previous suicide attempts was taken to the emergency department after 3 hours of voluntary ingestion of an unknown quantity of alcohol-based hand sanitizer. Initial laboratory findings showed laboratory a blood methanol concentration of 66 mg/dL, with an anion gap of 30 mEq/L, arterial blood pH of 7.2, serum bicarbonate concentration of 12 mEq/L. Patient complained of abdominal pain and nervoussness.

Most common signs and symptoms of alcohol-based hand sanitizer ingestion include nausea, vomiting, headache, abdominal pain, blurred vision, loss of coordination, and decreased level of consciousness. Treatment includes supportive care, acidosis correction, the administration of an alcohol dehydrogenase inhibitor and sometimes may be required.

No significant relationships.

Suicide can be defined as a deliberate act performed by the individual, whose intention is the death, in a conscious, intentional, even if ambivalent way, using a means that he believes to be lethal. They are also part of what we usually call suicidal behavior: thoughts, plans and attempted suicide.

Prevention is a critical step in treating suicidal behavior. Create strategies to reduce and treat the ideation, planning and suicide attempt.

Based on a large increase in the number of people who present ideas, plan and attempt suicide, the Clinic created techniques for the treatment of inpatients: Life Appreciation Group, Groups applying Cognitive Behavioral Therapy, Group Dynamics, Lectures, Art Therapy and Physical activities .

The actions are developed by a multidisciplinary team that is divided by applying the various techniques and participating in all the proposed activities.

Patients who remained hospitalized fully complying with the suggested treatment and left with medical discharge had full benefit, unlike some cases of patients removed by the family against our indication.

No significant relationships.

Definitions used for suicide attempts and self-harm have been discussed for many years and is used differently in European countries, sometimes even interchangeably. Therefore, it is difficult to compare relevant rates across nations.

This study aims at estimating the rate of suicide attempts and self-harm in chosen European countries in the more recent years when distinguishing between applied definitions.

A systematic search for relevant articles published between 2010-2020 will be performed in databases such as PubMed, Embase, PsycINFO, and Web of Science. Only articles in English or Danish will be included. Data will be collected for all age groups above 15 years of age. The prevalence of suicide attempts and self-harm will be calculated by a random effect model. Subgroup analyses will be performed to compare the rates according to age.

from the performed systematic review and meta-study will be presented at the conference.

The conclusion will be presented when results have been analysed.

No significant relationships.

The last two decades have seen the timeliness of studying the connection between suicides and drunkenness

To evaluate the significance of suicidal risk factors in patients who had committed suicides while being under the effect of alcohol so as to be able to forecast suicidal risks and prevent suicides within this group

The authors have carried out an analysis of medical documentation of suicides committed in the Sverdlovsk region. The data on suicides has been taken from forensic expertise acts. The following factors have been taken into account: age, gender, social status of suicide victim, supplementary somatic pathology, and concentration of alcohol in the victim’s blood

Alcoholic addiction is a behavioral indicator of suicidal risk. The level of suicidal activity in persons with the syndrome of alcoholic addiction is much higher than within the general populace. The age of 25-49 is the peak of suicidal attempts among patients with chronic alcoholism. Genuine suicides prevail during the first stage of chronic alcoholism. The patients are inclined to demonstrate pathological suicidal reactions to social misplacement that show themselves in the form of conflicts within the family and at work. In addition to genuine suicidal attempts made by males in the state of abstinence

The results received confirm the role of the alcoholic factor in the formation of suicidal behavior and have the aim of elaborating new forms and methods to help prevent suicides committed in the state of alcoholic drunkenness

No significant relationships.

Testosterone is an anabolic androgenic steroid hormone involved in brain development, reproduction, and social behavior. Several studies have shown that testosterone can cause impulsivity in humans. This impulsivity could modify the mood and increase the risk of suicidal behaviour.

Testosterone is an anabolic androgenic steroid hormone involved in brain development, reproduction, and social behavior. Several studies have shown that testosterone can cause impulsivity in humans. This impulsivity could modify the mood and increase the risk of suicidal behaviour.

Clinical case and literature review.

A 33-years male (biological female), single, gypsy ethnicity, with an 11-years daughter. Psychiatric history of one admission in a hospitalization unit. Diagnosed of depressive disorder and personality disorder NOS. Intermittent follow-up in Mental Health consultations. 8 years later, he consulted due to gender dysphoria. He refered not to be feeling identified with his body for a long time. He rejected his sexual characteristics. After his mental evaluation, he was refered to Endocrinology Service. He had been prescribed with testosterone. Three days after starting the treatment, he maked anattempt of suicide with medication. The patient had not presented previous suicide attempts or ideation. With the withdrawal of the testosterone, the suicidal behaviour dissapeared.

Due to the association of testosterone and suicidal behavoiur, we consider that is important to pay attention to people who have just started the androgenic treatment in order to avoid a high risk of suicide. In the same way, we should focus on evaluating the hostility, impulsivity and irritability in patients strongly related to suicidal behaviour.

No significant relationships.

Suicide rates in people diagnosed with a psychotic disorder can be up to 50 times higher than in the general population, with the lethality of attempts being significantly higher in this group, compared to people diagnosed with other psychiatric disorders. Furthermore, it is known that being male is associated with more serious suicide attempts and higher rates of completed suicides.

To reflect on the increased risk of suicide associated with psychotic disorders.

Case report and literature review.

Case report 40-year-old male, recently diagnosed with Schizophreniform Disorder and currently with persistent positive symptoms. He was admitted to our psychiatric hospitalization unit due to a voluntary overdose of almost 100 tablets (antihypertensives, antiarrhythmics, and benzodiazepines) and alcohol. He admits taking the pills with the aim of committing suicide. Literature review: - Around 10% of people diagnosed with schizophrenia commit suicide. - In young patients diagnosed with schizophrenia, suicide is the leading cause of death. - Between 15 and 65% of patients diagnosed with schizophrenia have depressive symptoms such as hopelessness. - Depressive symptoms in these patients seem to be directly proportionally with awareness of the disease (stigma, awareness of its severity and a sudden decrease in quality of life and social integration). - The risk of suicide increases especially in the first 10 years of the disease.

Psychosis is an important risk factor of suicide and active preventive measures should be carried out in these patients.

No significant relationships.

Description of a specialized treatment program for people attempting suicide in an academic health service focused on psychiatry and drug addiction in the city of Rio de Janeiro.

Describe actions developed to treat suicidal behavior.

Based on a survey of the prevalence of suicidal behavior in the Brazilian population over a lifetime, reaching a total of 12,000 cases per year of the Brazilian population, this academic service of psychiatry and drug addiction established the following actions for hospitalized patients: 24-hour surveillance, reduced access to methods of committing suicide (forks and knives removal, shoelaces and ropes removal), strengthening the GVV (Life Valuation Group), strengthening the Cognitive Behavior Therapy application groups, conducting group dynamics, lectures, art therapy and physical activities.

Of 370 patients admitted to this service from January 1st, 2019 to September 1st, 2019, 137 had suicidal behavior and only 2 died.

Of these two cases, one abandoned treatment and the other occurred during the treatment period.

No significant relationships.

Like in the general population, in the medical community the most common mental disorders reported are depression and anxiety. Suicide risk was increased, especially in medical-related professions.

To evaluate male and female psysician suicide risk.

Review all studies involving suicides, suicide attempts or suicidal ideation in health-care workers published in the last five years.

Suicide decreased over time, especially in Europe. Some specialties might be at higher risk such as psychiatrists, general surgeons and anesthesiologists.

Psysicians are an at-risk profession of suicide, with women particularly at risk.

No significant relationships.

Melatonin is often prescribed to patients experiencing sleep disturbances, which has been linked to elevated risks of suicide. However, it remains to be assessed whether melatonin is associated with suicide and suicide attempts.

We aimed to investigate whether individuals in treatment with melatonin had higher rates of suicide and suicide attempt when compared to individuals not in treatment.

Using longitudinal data on all persons aged 10+ years living in Denmark between 2007-2016 were obtained. Data from the National Prescription Register was used to identify periods of being in treatment with melatonin based on number of tablets and daily defined dose. Suicide and suicide attempt were identified in hospital and cause of death registries.

Among 5,798,923 included individuals, 10,577 (0.18%) were in treatment with melatonin (mean treatment length 50 days). Out of 5,952 individuals who died by suicide, 22 (0.37%) were in melatonin treatment, while 134 (0.53%) out of 25,136 had a first suicide attempt. After adjustment for sex and age-group, people in treatment with melatonin were found to have a higher rate of suicide (IRR: 4.2; 95% CI, 2.7-6.4) and suicide attempt (IRR: 6.7-fold (95% CI, 5.7-7.9) when compared to those not in treatment.

Treatment with melatonin was associated with higher rates of suicide and suicide attempt. The association might be explained through mediators, such as psychiatric comorbidity and sleep disorders. Our findings indicate that attention towards these issues might be warranted.

No significant relationships.

Parkinson’s disease(PD) is a progressive, neurodegenerative nervous system disease.Psychiatric symptoms are common in PD,it is important to consider the suicide risk of these patients.

The aim of this study is to investigate the risk of suicide in PD with a case control study and to determine the factors that may be associated.

126 Parkinson’s patients and 117 age,gender matched healthy controls were included.Montreal Cognitive Assessment Scale(MoCA),Suicide Probability Scale(SPS),Beck Hopelessness Scale(BHS),Apathy Rating Scale(AES) and Multidimensional Scale of Perceived Social Support(MSPSS) were completed by participants.The PD group completed Parkinson’s Disease Quality of Life Questionnaire(PDQ-39) and data on disease duration,Movement Disorders Society-Unified Parkinson’s Disease Rating Scale(MDS-UPDRS),levodopa-equivalent daily doses(LEDD) were obtained.Hamilton Anxiety Rating Scale(HAM-A) and Hamilton Depression Rating Scale(HAM-D) were administered to all participants.

SPS total scores were significantly lower and total scores of HAM-A,HAM-D and MSPSS were found to be significantly higher in the PD group.There was no significant difference between the two groups in terms of BHS total scores.In PD group a linear relationship was found between SPS total scores and BHS,PDQ39, HAM-A and HAM-D and an inverse relationship with AES.In the regression analysis,it was concluded that a one-unit increase in BHS total scores increased the probability of suicide by 17.1%.

It is seen that SPS scores in patients are lower than controls and observed that SPS is correlated with hopelessness,depression,anxiety and quality of life.Although the possibility of suicide is found to be low in PD,this risk increases in patients with untreated depression and anxiety.Therefore,psychiatric evaluation may be recommended in these patients.

No significant relationships.

Exposure to potentially morally injurious events (PMIEs) among combat veterans has been acknowledged as a significant stressful combat event that may lead to mental health problems, including suicide ideation (SI). Several studies have examined the risk and protective factors that can explain the conditions in which PMIEs may contribute to the development and maintenance of SI. However, the contribution of social-emotional factors has yet to be examined.

In the current study, we examined the association between PMIE-Self and SI among combat veterans and explored the mediating role of trauma-related shame and the moderation role of collective hatred in this association.

A volunteer sample of 336 Israeli combat veterans was recruited, completing self-report questionnaires in a cross-sectional study.

indicated that PMIE-Self was positively associated with SI, and trauma-related shame mediated this association. Moreover, collective hatred moderated both their direct (PMIE -SI) and indirect (PMIE-Shame-SI) association. Notably, collective hatred had an inverse role for each of the associations. Thus, collective hatred was found to comprise both a risk and a protective factor for SI following PMIE-Self.

The current findings highlight the crucial contribution of trauma-related shame and collective hatred to the association between moral injury and suicidality. Moreover, the findings demonstrate that even years after their military service release, combat veterans exposed to PMIEs may still feel consumed by painful memories and maintain premonitions of a foreshortened future. Furthermore, the findings help to better understand the dynamics of collective hatred and the challenge of modifying it.

No significant relationships.

Suicide is a dramatic suicidality complication and a significant worldwild public health problem. Sixty percent of suicidal deaths are preceded by at least one suicide attempt.

to search and estimate the factors predicting a suicidal recidivism

We conducted a retrospective descriptive survey, achieved in psychiatric departement A of Razi hospital on 60 patients hospitalized during a period of 10 years (from January 2010 to December 2019) and have committed at least a suicide attempt. Data collected from medical folders in order to explore sociodemographic and clinical characteristics of the patients.

The mean age of the sample was 30 years. A high prevalence of female was objectified. There were a low level of education for 53%, most of patients (55%) were unemployed and came from urban area. Among our patients, 39% attempted suicide for a one time. 61% of patients attempted suicide for several times. The main risk factors related to recidivism of suicidal behavior were unemployment, family history of psychiatric disorders and family instability.

The analysis of these results justifies preventive actions in order to face the increase of suicidal recidivism by searching for these associated factors. Therefore, a multidisciplinary intervention approach is required.

No significant relationships.