Suicidal ideation among Viennese high school students

OBJECTIVE: Suicidality spans a spectrum ranging from suicidal thoughts to suicidal acts, and suicidal ideation is more prevalent in youth populations, suggesting important developmental issues. We assessed the prevalence of lifetime suicidal ideation and associated psychosocial factors among Viennese high school students. METHOD: An anonymous self-report survey assessing demographic characteristics and the major psychiatric risk factors of teenage suicide was completed by students at three Viennese high schools (n = 214; mean age 15.4 years). RESULTS: Eighty-one (37.9%) high school students reported having had suicidal thoughts at some point in their lives, girls significantly more often than boys (48.5% vs. 29.1%, P = 0.004). Furthermore, lifetime suicidal ideation in Viennese high school students was associated with living in broken-home families, cigarette smoking, substance problems (alcohol/drugs), self-reported depression, and high school type (the highest prevalence was in grammar school). After adjusting for confounders, we found that female gender, substance problems, school type and cigarette smoking were significantly associated with lifetime suicidal ideation in Viennese high school students. CONCLUSIONS: The psychosocial factors associated with adolescent suicidal ideation require attention in the contexts of suicide prevention and mental health promotion.     

Loneliness,affective disorders,suicidal ideation,and the use of psychoactive substances in a sample of adolescents during the COVID-19 pandemic: A cross-sectional study

Problem

The global coronavirus (COVID-19) pandemic has been challenging for adolescents. Indeed, with the closure of schools and social centers and reduction of extracurricular activities, increased social isolation has compounded difficulties in and with school performance, loneliness, and social networking. Increased risk of mental health problems, substance abuse, affective disorders, suicidal ideation, and suicide has been reported in adolescents.

Methods

This cross-sectional study assesses the association between loneliness, depression, anxiety, suicidal ideation, the use of social networks, and school achievement in a sample of Italian adolescents during the COVID-19 pandemic. This study also explores emotional dysregulation through the association between affective disorders (depression and anxiety), substance use, and social networks. The sample comprises adolescents in the first and second grades of high school during the pandemic; participants received an email explaining the purpose of the e-research. Data were collected using the Strengths and Difficulties Questionnaire, the Achenbach System of Empirically Based Assessment, and the Loneliness Scale.

Findings

A total of 505 adolescents completed the web survey. Data revealed that students experienced difficulties with loneliness, problems with school achievement, and extracurricular activities. The mean scores for depression and anxiety were close to the borderline range. A total of 14.3% of adolescents intentionally harmed themselves or attempted suicide.

Conclusions

This study raises concerns about the impacts of the pandemic on adolescents that require the attention of adult reference figures who deal with adolescents, such as parents, teachers, and healthcare professionals. Results indicate the necessity of providing early interventions aimed at the prevention of psychopathologies and the promotion of adolescent mental health due to the pandemic.     

普通高中应届三年级学生心理健康状况调查

目的了解普通高中三年级学生心理健康状况．探讨影响其心理健康的因素。方法采用症状自评量表对卫辉市高级中学186名高中三年级学生进行问卷调查。结果136名学生中34（18．23％）名存在不同程度的心理问题,其中焦虑因子分明显高于国内常模青年组。心理问题以敌对强迫、抑郁、偏执为主。结论普通高中三年级学生的心理素质较以往有了很大提高．但与国内常模青年组比较仍有明显差距．应引起教师和心理卫生工作者的重视。     

Optimism and its relationship to depression, coping, anger, and life events in rural adolescents.

Optimism is a stable personality trait that has important implications for behavior, yet little attention has been given to examining optimism in adolescents. This article describes levels of optimism in rural adolescents and the relationship of optimism with depression, coping, anger, and life events. The identification of optimism may be a vulnerability factor when screening adolescent mental health and, as such, has implications for the psychiatric nurse clinician.     

The relationship of suicidal ideation with psychological pain and anger rumination in patients with major depressive disorder

ObjectıveThe study was conducted to determine the association between ruminating anger and mental pain with suicidal ideation in patients diagnosed with major depression disorder.MethodsThe study with 156 patients diagnosed with major depressive disorder was carried out in a cross-sectional study design. Personal Information Form, Reflection on Anger Scale, Psychological Pain Scale and Beck Depression Scale were used.ResultsIt was concluded that there was a statistically equal directional and linear relationship between the Meebunney and Beck depression scores of all patients diagnosed with a major depressive disorder and the total reflective anger score and its sub-dimensions. Suicidal attempts and psychological pain and depression levels were found to be effective in the increase in suicidal ideation in the patients with major depressive disorder.ConclusionsStudies with larger samples are recommended to determine the factors that may pose a risk of suicidal ideation in patients diagnosed with majör depressive disorder.     

Living as a chameleon: girls, anger, and mental health.

One's practice as a school nurse affords numerous privileges. One that stands out in my mind is the privilege of bearing witness to the lives of countless girls as they navigated their own aspirations and the expectations of the culture. The stories they iterated to me in my school nurse office form the basis for this discussion regarding the relationship between anger and mental health. I've come to realize that as a school nurse, I was an anger-story listener. In so being, I was given the opportunity and responsibility to influence positive mental health for numerous girls and young women. This feminist qualitative research project explored girls' lived experiences of anger. The findings suggest that experiences of disrespect, dismissal, denied agency, and a denial of the right to verbalize anger eventually led to self-silencing and an eventual disconnect from this important emotion. The girls described strategies associated with the societal response to their anger that are likened here to the ultra-adaptive strategies that chameleons show to survive.     

Drinking,other substance use and suicidal ideation in middle adolescence: a population study

Aims To assess the relationship between self-reported suicidal ideation and alcohol and other substance use among 14-16-year-olds. Design, setting, participants A cross sectional school survey of 16 464 subjects aged 14-16 years in two Finnish regions. Findings Alcohol use frequency and any use of substances other than alcohol were significantly associated with suicidal ideation. Of girls (boys) who reported drinking weekly, 8% (7%) reported severe suicidal ideation compared with 1% (0.7%) of those not drinking. Of girls (boys) who reported use of substances other than alcohol five times or more, 13% (21%) reported severe suicidal ideation, compared with 1.3% (1.1%) of those who had no use of substances other than possibly alcohol. These associations persisted in multivariate analyses controlling for depressive symptoms and sociodemographic background. Conclusions Frequent alcohol use and use of substances other than alcohol independently indicate a risk for adolescent suicidal ideation and may thus represent an early warning signal for attempted suicides. School and health service personnel should pay attention to adolescents who drink frequently or experiment with or use drugs to improve the identification of suicidality and the possibilities for early intervention.     

Needs and Strengths Associated With Acute Suicidal Ideation and Behavior in a Sample of Adolescents in Mental Health Treatment: Youth and Family Correlates

This study examined a comprehensive set of adolescent and family needs and strengths associated with acute suicidal ideation and/or behavior among youth using mental health services in Indiana (U.S.). Youth (n = 3292) were assessed with the Child and Adolescent Needs and Strengths questionnaire. Findings revealed that mental health issues (depression, psychosis) were the most important cofactors of acute suicidal ideation and/or behavior, followed by high-risk behaviors and psychosocial adjustment (nonsuicidal self-injury, harmful behavior, aggression, sleep disruption), and strengths (optimism). Family and caregiver needs were not significant predictors after controlling for other variables. Prevention and outpatient treatment among adolescents should encompass a wide array of individual needs and strengths.     

Re-Arrest Among Juvenile Justice-Involved Youth: An Examination of the Static and Dynamic Risk Factors

The purpose of this study is to investigate the static and dynamic risk factors for re-arrest among detained youth by examining gender, race/ethnicity, age, special education, and mental health variables (i.e., anger/irritability, depression/anxiety, somatic complaints, suicide ideation, thought disturbances, and traumatic experiences). The demographic profiles of detained youth with one admit were also compared with those with multiple admits to the juvenile detention center. With regard to static risk factors, older, White, and special education were significantly at risk of re-arrest. Concerning dynamic risk factors, only anger/irritability predicted re-arrest. Practice implications are also discussed.     

Factors affecting the presence of depression,anxiety disorders,and suicidal ideation in patients attending primary health care service in Lithuania

Objective. The aim of this study was to establish prevalence, recognition, and risk factors for mental disorders and suicidal ideation in PC patients. Design. A cross-sectional survey based on standard mental health evaluation. Setting. Lithuanian primary care. Subjects. 998 patients from four urban PC clinics. Main outcome measures. Current mental disorders and suicidal ideation assessed using the Mini International Neuropsychiatric Interview (MINI). Results. According to the MINI, 27% of patients were diagnosed with at least one current mental disorder. The most common mental disorders were generalized anxiety disorder (18%) and major depressive episode (MDE) (15%), followed by social phobia (3%), panic disorder (3%), and post-traumatic stress disorder (2%). Some 6% of patients reported suicidal ideation. About 70% of patients with current mental disorder had no documented psychiatric diagnosis and about 60% received no psychiatric treatment. Greater adjusted odds for current MDE were associated with being widowed or divorced patients (odds ratio, OR = 1.8, 95% CI 1.2–2.8) and with lower education (OR = 1.6, 95% CI 1.1–2.3), while greater adjusted odds for any current anxiety disorder were found for women (OR = 1.9, 95% CI 1.3–2.8) and for patients with documented insomnia (OR = 2.2, 95% CI 1.2–4.2). Suicidal ideation was independently associated with use of antidepressants (OR = 5.4, 95% CI 1.7–16.9), with current MDE (OR = 2.9, 95% CI 1.5–5.8), and with excessive alcohol consumption (OR = 2.0, 95% CI 1.1–3.8). Conclusions. Depression, anxiety disorders, and suicidal ideation are prevalent but poorly recognized among PC patients. The presence of current MDE is independently associated with marital status and with lower education, while current anxiety disorder is associated with female gender and insomnia. Suicidal ideation is associated with current MDE, and with antidepressants and alcohol use.Key Words: Anxiety disorder, depression, general practice, Lithuania, primary care, recognition, suicidal ideation

• Primary care (PC) services have a key role in provision of mental health for patients with mild to moderate mental disorders.
• Mental health issues are prevalent among PC patients but are poorly identified and managed.
• Presence of depression is associated with loss of spouse and lower education; presence of anxiety disorder is associated with female gender and insomnia.
• Suicidal ideation is associated with current depression, antidepressant use and excessive alcohol consumption.

     

Adolescent Suicide Risk Screening in the Emergency Department

Objectives: Many adolescents who die by suicide have never obtained mental health services. In response to this, the National Strategy for Suicide Prevention recommends screening for elevated suicide risk in emergency departments (EDs). This cross‐sectional study was designed to examine 1) the concurrent validity and utility of an adolescent suicide risk screen for use in general medical EDs and 2) the prevalence of positive screens for adolescent males and females using two different sets of screening criteria. Methods: Participants were 298 adolescents seeking pediatric or psychiatric emergency services (50% male; 83% white, 16% black or African American, 5.4% Hispanic). The inclusion criterion was age 13 to 17 years. Exclusion criteria were severe cognitive impairment, no parent or legal guardian present to provide consent, or abnormal vital signs. Parent or guardian consent and adolescent assent were obtained for 61% of consecutively eligible adolescents. Elevated risk was defined as 1) Suicidal Ideation Questionnaire‐Junior [SIQ‐JR] score of ≥31 or suicide attempt in the past 3 months or 2) alcohol abuse plus depression (Alcohol Use Disorders Identification Test‐3 [AUDIT‐3] score of ≥3, Reynolds Adolescent Depression Scale‐2 [RADS‐2] score of ≥76). The Beck Hopelessness Scale (BHS) and Problem Oriented Screening Instrument for Teenagers (POSIT) were used to ascertain concurrent validity. Results: Sixteen percent (n = 48) of adolescents screened positive for elevated suicide risk. Within this group, 98% reported severe suicide ideation or a recent suicide attempt (46% attempt and ideation, 10% attempt only, 42% ideation only) and 27% reported alcohol abuse and depression. Nineteen percent of adolescents who screened positive presented for nonpsychiatric reasons. One‐third of adolescents with positive screens were not receiving any mental health or substance use treatment. Demonstrating concurrent validity, the BHS scores of adolescents with positive screens and the POSIT scores of those with positive screens due to alcohol abuse and depression indicated substantial impairment. The addition of alcohol abuse with co‐occurring depression as a positive screen criterion did not result in improved case identification. Among the subgroup screening positive due to depression plus alcohol abuse, all but one (>90%) also reported severe suicide ideation and/or a recent suicide attempt. This subgroup (approximately 17% of adolescents who screened positive) also reported significantly more impulsivity than other adolescents who screened positive. Conclusions: The suicide risk screen showed evidence of concurrent validity. It also demonstrated utility in identifying 1) adolescents at elevated risk for suicide who presented to the ED with unrelated medical concerns and 2) a subgroup of adolescents who may be at highly elevated risk for suicide due to the combination of depression, alcohol abuse, suicidality, and impulsivity.     

Posttraumatic stress disorder, depression, and suicide in veterans

Suicidal behavior is a critical problem in war veterans. Combat veterans are not only more likely to have suicidal ideation, often associated with posttraumatic stress disorder (PTSD) and depression, but they are more likely to act on a suicidal plan. Especially since veterans may be less likely to seek help from a mental health professional, non-mental-health physicians are in a key position to screen for PTSD, depression, and suicidal ideation in these patients. The authors discuss the association of PTSD, depression, and suicide in veterans, keys to assessment of suicide risk, and interventions.     

重点高中学生心理健康状况调查

目的 了解重点高中学生的心理健康状况。方法 采用症状自评量表(Symptom Check List 90,SCL-90)对合肥市第一中学100名高二学生进行问卷调查。结果 所得数据中焦虑分明显高于国内常模青年组，心理问题以敌对、强迫、抑郁、偏执为主。结论 重点高中学生的心理素质较以往有了很大提高，但与国内常模青年组仍有较明显的差距。本还提示，心理健康教育对心理素质的提高有一定的积极作用。     

辽河油田部分高中学生心理健康状况调查

目的探讨高中学生心理健康状况,为开展中学生心理健康教育提供依据。方法对148名高中学生采用一般资料调查表和症状自评量表进行测评分析。结果本组高中生症状自评量表评分除恐惧因子分与青少年常模比较差异无显著性外（P〉0．05）,其他因子分均显著高于青少年常模（P〈0．05或0．01）,其中因子分≥2分检出率为16．8％-40．8％,≥3分检出率为2．4％-11．1％;高一学生症状自评量表躯体化、强迫、人际关系、抑郁、焦虑因子分显著高于高二学生（P〈0．05或0．01）。结论高中学生心理健康水平相对偏低,高一新生心理问题较高二学生更为严重;学校应有针对性地加强高中学生的心理健康教育工作。     

Development of a Brief Mental Health Screen for Intimate Partner Violence Victims in the Emergency Department

Background: Emergency physicians routinely treat victims of intimate partner violence (IPV) and patients with mental health symptoms, although these issues may be missed without routine screening. In addition, research has demonstrated a strong association between IPV victimization and mental health symptoms.
Objectives: To develop a brief mental health screen that could be used feasibly in an emergency department to screen IPV victims for depressive symptoms, posttraumatic stress disorder (PTSD) symptoms, and suicidal ideation.
Methods: The authors conducted a pretest/posttest validation study of female IPV victims to determine what questions from the Beck Depression Inventory II, Posttraumatic Stress Diagnostic Scale, and Beck Scale for Suicide Ideation would predict moderate to severe levels of depressive symptoms, PTSD symptoms, and suicidal ideation. A principal components factor analysis was conducted to determine which questions would be used in the brief mental health screen. Scatter plots were then created to determine a cut point.
Results: Scores on the brief mental health screen ranged from 0 to 8. A cutoff score of 4 was used, which resulted in positive predictive values of 96% for the brief mental health screen for depression, 84% for PTSD symptoms, and 54% for suicidal ideation. In particular, four questions about sadness, experiencing a traumatic event, the desire to live, and the desire to commit suicide were associated with moderate to severe mental health symptoms in IPV victims.
Conclusions: The brief mental health screen provides a tool that could be used in an emergency department setting and predicted those IPV victims with moderate to severe mental health symptoms. Using this tool can assist emergency physicians in recognizing at-risk patients and referring these IPV victims to mental health services.     

Suicidal Ideation in Patients with Fibromyalgia: A Cross‐Sectional Study

Chronic pain, sleep disturbances, and depression, which are relevant symptoms of fibromyalgia syndrome, have been demonstrated to be associated with an increased likelihood of suicidal behaviors. Mortality from suicide has been shown to be greater among patients with fibromyalgia. This study aimed to assess the prevalence of suicidal ideation among a sample of patients with fibromyalgia and to evaluate its relationship with the clinical symptomatology of fibromyalgia. Baseline data from fibromyalgia patients willing to participate in different clinical studies were collected. Outcome measures included the Fibromyalgia Impact Questionnaire, the Beck Depression Inventory, the Pittsburgh Sleep Quality Index, the Brief Pain Inventory, and the SF‐12 Health Survey. The scores for these scales were compared between patients with and without suicidal ideation. The presence of suicidal ideation was assessed using the answer provided to item 9 of the Beck Depression Inventory. The results were adjusted by age, sex, total comorbidity, and time since diagnosis with multiple linear regression. The sample comprised 373 patients of whom one hundred and seventy‐nine (48%) reported suicidal ideation: 148 (39.7%) reported passive suicidal ideation and 31 (8.3%) active suicidal ideation. Suicidal ideation was markedly associated with depression, anxiety, sleep quality, and global mental health, whereas only weak relationships were observed between suicidal ideation and both pain and general physical health.