Previous findings have indicated that self-harm and suicide are associated with different rates, and different risk and protective factors in South Asian people compared with White people in the UK. Substantial qualitative research has explored experiences of self-harm and suicide in South Asian people.

The study aims to review the existing qualitative evidence on self-harm and suicidal behaviours in South Asian communities in the UK.

Systematic searches were conducted on Medline, EMBASE, PsycINFO, CINAHL, Open Dissertations and the British Library Ethos databases. We selected qualitative studies from both journals and grey literature that included South Asian participants who were resident in the UK and presented perceptions or experiences of self-harm and/or suicidal behaviour. Analysis was undertaken based on the meta-ethnographic approach.

Fifteen studies were included in the analysis. Experience of self-harm was discussed based on three aspects: behind self-harm, functions of self-harm and recovery from self-harm. ‘Behind self-harm’ refers to factors associated with self-harm and suicide. ‘Functions of self-harm’ captures the meaning attributed to self-harm and suicide. ‘Recovery from self-harm’ encapsulates personal and professional help, and practical suggestions for the improvement of mental health services.

Although some similarities with the majority White population were present, there were also crucial differences that need consideration when shaping health policies, improving access to health services and developing culturally sensitive psychosocial interventions for self-harm and suicide specific to South Asian communities in the UK.

Understanding premature mortality risk from suicide and other causes in youth mental health cohorts is essential for delivering effective clinical interventions and secondary prevention strategies.

To establish premature mortality risk in young people accessing early intervention mental health services and identify predictors of mortality.

State-wide data registers of emergency departments, hospital admissions and mortality were linked to the Brain and Mind Research Register, a longitudinal cohort of 7081 young people accessing early intervention care, between 2008 and 2020. Outcomes were mortality rates and age-standardised mortality ratios (SMR). Cox regression was used to identify predictors of all-cause mortality and deaths due to suicide or accident.

There were 60 deaths (male 63.3%) during the study period, 25 (42%) due to suicide, 19 (32%) from accident or injury and eight (13.3%) where cause was under investigation. All-cause SMR was 2.0 (95% CI 1.6–2.6) but higher for males (5.3, 95% CI 3.8–7.0). The mortality rate from suicide and accidental deaths was 101.56 per 100 000 person-years. Poisoning, whether intentional or accidental, was the single greatest primary cause of death (26.7%). Prior emergency department presentation for poisoning (hazard ratio (HR) 4.40, 95% CI 2.13–9.09) and psychiatric admission (HR 4.01, 95% CI 1.81–8.88) were the strongest predictors of mortality.

Premature mortality in young people accessing early intervention mental health services is greatly increased relative to population. Prior health service use and method of self-harm are useful predictors of future mortality. Enhanced care pathways following emergency department presentations should not be limited to those reporting suicidal ideation or intent.

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.

According to international studies, at least 70% of BPD in adolescence are comorbid with MDD.

To determine the clinical and psychopathological markers of MDD in BPD in adolescence.

Clinical psychopathological interview, SCID-II, Hamilton Depression Rating Scale (HDRS). Sample: N=73 male and female, age: 18-25 with MDD and BPD.

MDD comorbid with BPD in adolescence is characterized by polymorphism of its’ psychopathological manifestations due to the structure of BPD and the input of the age factor. In the studied sample 31 (42,5%) with both MDD and BPD also revealed addictions; 24 patients (32,9%) - anxiety and obsessive-compulsive (OCD) disorders, 18 patients (24,7%) had overvalued ideas. The high contingency of MDD with autoaggressive actions confirmed their high suicidal risk (53 patients). Among them - 31 patients (58,5%) - had non-suicidal self-harm (NSSI), 7 patients – (13,2%) had suicidal attempt (SA), and 15 patients (28,3%) had NSSI and suicidal attempts (NSSI+SA). The highest incidence of NSSI and NSSI+SA was noted in MDD with addictive disorders: NSSI – N=20 (80,00%), NSSI+SA - N=5 (20,00%), SA – N=0. MDD with BPD and anxiety disorders: NSSI – N=9 (56,25%), NSSI+SA – N= 6 (37,50%), SA–N=1 (6,25%). MDD with BPD and overvalued ideas: NSSI – N=2 (16,67%), NSSI +SA – N= 4 (33,33%), SA N=6 (50,0%), (results p<0.01).

Psychopathological relations between BPD and MDD in youth are different due to additional comorbid conditions, like addictions, anxiety and OCD, overvalued ideas and have clinical implications in terms of suicidal and NSSI risks, individualized interventions and prognosis.

No significant relationships.

No significant relationships.

Nonsuicidal self-injury (NSSI) is highly prevalent in clinical and non-clinical adolescent populations. Non-clinical studies focus on high school students thus vocational school students are underrepresented in research and prevention programs, despite being exposed to higher levels of stressful life events, a factor associated with NSSI and suicide.

This study aimed to explore NSSI, suicidal behavior and life events among adolescents in clinical and non-clinical, i.e. both high school and vocational school settings.

A clinical (n=202) and non-clinical (n=161) sample of 13-18-year-old adolescents were assessed with the Mini International Neuropsychiatric Interview Kid, the Deliberate Self-Harm Inventory, and the Life Events List. Data were analyzed with R version 3.6.1., using Wilcoxon tests and negative binomial regression models.

The prevalence of suicidal behavior (W=7.306, p<.001), NSSI (W=9.652, p<.001), and life events (W=10.410 p<.001) were significantly higher in the clinical than in the non-clinical group. The relationship between NSSI and suicidal behaviour was significantly stronger in the clinical group (95% CI: [.56,.72]) than in the nonclinical group (95% CI: [.24,.52]). The interaction between NSSI and life events (Χ2(1)=10.49, p<.01) was associated with suicidal behavior. Interpersonal events were associated with both suicidal behavior and had a moderating effect on the NSSI–suicidal behavior relationship.

NSSI is highly prevalent and is strongly associated with suicidal behavior in clinical and non-clinical adolescent populations. Our result call attention to the necessity of including adolescents from various educational settings in NSSI research and prevention projects during which life events, especially interpersonal events, might require special attention.

No significant relationships.

No published research in Ethiopia has examined the prevalence of suicidal ideation and suicide attempts and associated factors among patients with substance use disorder.

The main aim of this study was to assess the prevalence of suicidal ideation, suicide attempt and associated factors among patients with substance use disorders.

An institution-based cross-sectional study was conducted from 5 May to 13 June 2019 in Addis Ababa. A total of 408 patients were identified using a systematic sampling technique. Data were collected through interviews using the suicidality module of the Composite International Diagnostic Interview. Data were entered into EpiData and analysed using SPSS. Logistic regression analyses were employed. Variables with P < 0.05 were considered to be statistically significant with 95% confidence intervals.

Prevalence rates of suicidal ideation and attempt were found to be 39.5% and 18.6%, respectively. Family history of mental illness (adjusted odds ratio (AOR) = 3.60, 95% CI: 2.17, 5.97), comorbid mental illness (AOR = 3.61, 95% CI: 2.11, 6.16), perceived stigma related to substance misuse (AOR = 4.00, 95% CI: 2.26, 7.07) and alcohol use (AOR = 7.49, 95% CI: 1.99, 28.19) were associated with suicidal ideation. Being female (AOR = 2.46, 95% CI: 1.08, 5.70), family history of suicide (AOR = 3.08, 95% CI: 1.68, 5.64), comorbid mental illness (AOR = 4.09, 95% CI: 2.23, 7.49) and khat use (AOR = 3.73, 95% CI: 1.24, 11.17) were associated with suicide attempt.

The prevalence of suicidal ideation and attempt were both found to be high. In particular, patients who had a comorbid mental illness were at high risk of both suicidal ideation and attempt. Therefore, special attention should be given to those with a family history of suicide or comorbid mental illness.

The use of distance-based interventions (DBIs) to reduce suicidal ideation and behaviours are an increasingly relevant form of intervention. DBIs are more affordable, scalable and available than traditional face-to-face interventions, helping to narrow the gap between needed and provided care.

To evaluate the overall effectiveness of DBIs against suicidal ideation and behaviours.

We systematically searched Web of Science, Scopus and PubMed for all DBIs primarily aimed at reducing suicidal ideation and behaviours. Data were analysed with a robust variance estimation corrected, multi-level meta-analysis.

We found 38 studies, reporting 110 outcomes. Effectiveness in reducing suicidal ideation was low (standardised mean difference −0.174, 95% CI −0.238 to −0.110). DBIs were significantly less effective against suicidal behaviours than against suicidal ideation, although still effective (standardised mean difference −0.059, 95% CI −0.087 to −0.032). Human involvement had no significant effect on effectiveness.

Despite low effectiveness, DBIs might play a role in large-scale prevention efforts against suicidal ideation within a stepped care approach. Further, DBIs may be helpful in expanding mental health services in low- and middle-income countries with otherwise limited access to mental healthcare. Although the evidence for DBIs efficacy is well grounded, the technical and scientific evaluation of DBIs regarding their set up, functionality and components needs to be addressed in future studies.

Research has shown a strong relationship between hallucinations and suicidal behaviour in general population samples. Whether hallucinations also index suicidal behaviour risk in groups at elevated risk of suicidal behaviour, namely in individuals with a sexual assault history, remains to be seen.

We assessed whether hallucinations were markers of risk for suicidal behaviour among individuals with a sexual assault history.

Using the cross-sectional 2007 (N = 7403) and 2014 (N = 7546) Adult Psychiatric Morbidity Surveys, we assessed for an interaction between sexual assault and hallucinations in terms of the odds of suicide attempt, as well as directly comparing the prevalence of suicide attempt in individuals with a sexual assault history with v. without hallucinations.

Individuals with a sexual assault history had increased odds of hallucinations and suicide attempt compared to individuals without a sexual assault history in both samples. There was a significant interaction between sexual assault and hallucinations in terms of the odds of suicide attempt. In total, 14–19% of individuals with a sexual assault history who did not report hallucinations had one or more suicide attempt. This increased to 33–52% of individuals with a sexual assault history who did report hallucinations (2007, aOR = 2.85, 1.71–4.75; 2014, aOR = 4.52, 2.78–7.35).

Hallucinations are a risk marker for suicide attempt even among individuals with an elevated risk of suicidal behaviour, specifically individuals with a sexual assault history. This finding highlights the clinical significance of hallucinations with regard to suicidal behaviour risk, even among high-risk populations.

Lower parental education has been linked to adverse youth mental health outcomes. However, the relationship between parental education and youth suicidal behaviours remains unclear. We explored the association between parental education and youth suicidal ideation and attempts, and examined whether sociocultural contexts moderate such associations.

We conducted a systematic review and meta-analysis with a systematic literature search in PubMed, PsycINFO, Medline and Embase from 1900 to December 2020 for studies with participants aged 0–18, and provided quantitative data on the association between parental education and youth suicidal ideation and attempts (death included). Only articles published in English in peer-reviewed journals were considered. Two authors independently assessed eligibility of the articles. One author extracted data [e.g. number of cases and non-cases in each parental education level, effect sizes in forms of odds ratios (ORs) or beta coefficients]. We then calculated pooled ORs using a random-effects model and used moderator analysis to investigate heterogeneity.

We included a total of 59 articles (63 study samples, totalling 2 738 374 subjects) in the meta-analysis. Lower parental education was associated with youth suicidal attempts [OR = 1.12, 95% Confidence Interval (CI) = 1.04–1.21] but not with suicidal ideation (OR = 1.05, 95% CI = 0.98–1.12). Geographical region and country income level moderated the associations. Lower parental education was associated with an increased risk of youth suicidal attempts in Northern America (OR = 1.26, 95% CI = 1.10–1.45), but with a decreased risk in Eastern and South-Eastern Asia (OR = 0.72, 95% CI = 0.54–0.96). An association of lower parental education and increased risk of youth suicidal ideation was present in high- income countries (HICs) (OR = 1.14, 95% CI = 1.05–1.25), and absent in low- and middle-income countries (LMICs) (OR = 0.91, 95% CI = 0.77–1.08).

The association between youth suicidal behaviours and parental education seems to differ across geographical and economical contexts, suggesting that cultural, psychosocial or biological factors may play a role in explaining this association. Although there was high heterogeneity in the studies reviewed, this evidence suggests that the role of familial sociodemographic characteristics in youth suicidality may not be universal. This highlights the need to consider cultural, as well as familial factors in the clinical assessment and management of youth's suicidal behaviours in our increasingly multicultural societies, as well as in developing prevention and intervention strategies for youth suicide.

Approximately, 15- 26% of patients with first-episode psychosis, including schizophrenia, are likely to have attempted suicide by their first treatment contact. Studies of suicidal behavior outside of schizophrenia have indicated grey matter volume loss in the prefrontal and orbitofrontal cortex, and aberrant brain activity in relation to emotional recognition and dysfunction.

This study aimed to investigate the functional neural correlates of suicidal behavior in early schizophrenia.

fMRI faces task was conducted (fearful face versus neutral face) in 8 participants with first-episode schizophrenia together with standardised scales including PANSS and SBQ-R. fMRI activation was compared using a two-sample t-test in participants with low and high suicidal behavior. Extent threshold is 0 voxels and significance level p<0.001 (FWE corrected). Processing of images was carried out using SPM12 and Matlab.

8 participants were recruited; 5 males and 3 females, mean age of 26.5. Results suggest that participants with higher suicidal behaviour showed reduced activation on the anterior-cingulate gyrus and medial frontal gyrus, which are parts of PFC, (p= .005). There was also a significant difference in task response accuracy, where, participants with high suicidal behaviour made more accurate responses compared to low group (t (3) = 3.65, p = .035).

This is an exploratory study, investigated the differences in brain activity in patients with schizophrenia who are at risk of completed suicide and, therefore might provide new insights into the underlying mechanisms. Further work should address how PFC activity changes with risk over time and its potential utility as a biomarker in suicide.

Depressed patients with early traumatic experiences may represent a clinically distinct subtype with worse clinical outcome. Since early traumatic experiences alter the development of systems that regulate the stress response, certain personality features may influence coping strategies, putting individuals with depression and a history of early traumatic experiences at greater risk of suicidal behaviour.

To determine whether impulsivity mediates the relationship between early traumatic experiences and suicidal behaviour in patients with major depressive disorder (MDD).

The sample included 190 patients [mean age (SD)=53.71 (10.37); females: 66.3%], with current MDD. The Childhood Trauma Questionnaire-Short Form (CTQ-SF), the List of Threatening Experiences (LTE), and the Barratt Impulsiveness Scale-11 (BIS-11) were used to assess childhood and adulthood adverse life events and impulsivity. We developed mediation models by bootstrap sampling methods.

81 (42.6%) patients had previous suicide attempts (SA). CTQ-SF-Total and BIS-11-Total scores were higher in MDD patients with previous SA. Correlation analyses revealed significant correlations between the CTQ-SF-Total and BIS-11-Total, CTQ-SF-Total and HDRS-Total, and BIS-11-Total and HDRS-Total scores. Regression models found that CTQ-SF-Total, BIS-11-Total, and HDRS-Total scores were associated with SA. Mediation analyses further revealed the association between CTQ-SF-Total and SA was mediated by the indirect effect of the BIS-11-Total score (b=0.007, 95% CI=0.001, 0.015), after controlling for sex, HDRS-Total, and LTE-Total.

Impulsivity could mediate the influence of childhood trauma on suicidal behaviour. This will help understand the role of risk factors in suicidal behaviour and aid in the development of prevention interventions focused on modifiable mediators when risk factors are non-modifiable.

Among medical students the rate of depression varies between 5-32% and it is known that the suicide rate is higher than in the general population.

Clear and current data are needed to design studies for the diagnosis and treatment of students and residents of Medicine with psychological and psychiatric disorders in order to reduce rates of suicidal behavior in this population group.

A systematic search for articles on the UpToDate, PubMed and Mendeley platforms has been conducted with the keywords “suicide”, “suicidal behavior”, “suicidal ideation”, “medicalschool” and “medical students”. We found 435 items from which a total of 42 items were selected.

The prevalence of depression is 27.2%, of which only 15.7% of them are under treatment. Burnout, has a high prevalence of 45-50%. The prevalence of suicidal ideation in the last year is 11.1%. The most commonly used method is medication overdose. Suicidal behavior is greater among students who choose to choose Psychiatry or Family and Community Medicine as a specialty.

The rate of suicidal ideation among medical students is 11.1%. Nearly one out of every three medical students suffers from depression in some degree, and only one in five is treated. The similar prevalence of burnout at all levels supposes poor management of stress from the faculty. Medical schools should reduce the associated stigma and should encourage depressed students to seek treatment.

No significant relationships.