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Purpose of Review Bipolar disorder has the highest rate of suicide of all psychiatric conditions and is approximately 20–30 times that of the general population. The purpose of this review is to discuss findings relevant to bipolar disorder and suicide. Recent Findings Risk factors include male gender, living alone, divorced, no children, Caucasian, younger age (< 35 years), elderly age (> 75 years), unemployment, and a personal history of suicide attempt and family history of suicide attempt or suicide completion, as well as predominant depressive polarity. Suicide is associated with the depressed or mixed subtypes, not mania. Although there are emerging treatments for bipolar depression, such as ketamine and TMS, lithium remains the only medication associated with lowered suicide rates in bipolar disorder. Summary Understanding clinical and demographic risk factors for suicide in bipolar disorder remains the best way to prevent suicidal behavior. Early intervention and treatment with anti-suicidal medications, such as lithium, along with close observation and follow-up is the best way to mitigate suicide in patients with bipolar disorder.

Bullying is a risk factor for the physical and mental health of adolescents. The advent of new technologies has resulted in a brand-new type of bullying, cyberbullying (CB). The co-occurring effects of cyberbullying and traditional bullying(TB) forms of bullying on adolescent mental health are unclear. We performed a meta-analysis to explore the unique and combined effects of CB and TB on adverse psychological outcomes in victims by conducting a joint study of both types of bullying. By doing so, we provide the basis for a comprehensive community bullying prevention program. The database PubMed, PsyclNFO, and Web of Science were searched for studies from 2010 to 2021. The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) reporting guideline was followed for data abstraction, and the NIH tool was used to evaluate study-level risk of bias. 42 studies with 266,888 participants were identified. Random-Effect models were used for our study. The moderator analysis was used to explore the moderator of prevalence. Studies with three groups of victims (TB only, CB only, and Both) and two groups of victims (TB and CB) were compared in subgroup analysis. The mean victimization rate was 24.32% (95% CI 20.32–28.83%) for TB and 11.10% (95% CI 9.12–13.44%) for CB. Roughly one-third of TB victims were also victimized by CB. Conversely, only about one-third of CB victims were free from TB. The estimated ORs for depression, suicidal ideation, suicide attempts, and self-harm in the three-group (TB only, CB only and Both) analysis were: depression [TB only: 3.33 (2.22–5.00); CB only: 3.38 (2.57–4.46); Both: 5.30 (2.43–11.56)]; suicidal ideations [TB only: 3.08 (2.12–4.46); CB only: 3.52 (2.38–5.20); Both: 6.64 (4.14–10.64)]; self-harm [TB only: 2.70 (1.86–3.91); CB only: 3.57 (3.20–3.98); Both: 5.57 (2.11–16.00)]; and suicide attempts: [TB only: 2.61 (1.50–4.55); CB only: 3.52 (2.50–4.98); Both: 7.82 (3.83–15.93)]. TB and CB victimization among youth are a matter of public health concern. Victimization appears to be a marker of greater psychopathological severity, particularly suicide-related issues.

BackgroundSuicide is a major public health problem and a cause of premature mortality. With a view to prevention, a great deal of research has been devoted to the determinants of suicide, focusing mostly on individual risk factors, particularly depression. In addition to causes intrinsic to the individual, the social environment has also been widely studied, particularly social isolation. This paper examines the social dimension of suicide etiology through a review of the literature on the relationship between suicide and social isolation.MethodsMedline searches via PubMed and PsycINFO were conducted. The keywords were “suicid*” AND “isolation.”ResultsOf the 2,684 articles initially retrieved, 46 were included in the review.ConclusionsSupported by proven theoretical foundations, mainly those developed by E. Durkheim and T. Joiner, a large majority of the articles included endorse the idea of a causal relationship between social isolation and suicide, and conversely, a protective effect of social support against suicide. Moreover, the association between suicide and social isolation is subject to variations related to age, gender, psychopathology, and specific circumstances. The social etiology of suicide has implications for intervention and future research.

Synthesizing evidence to examine changes in suicide-related outcomes before and during the pandemic can inform suicide management during the COVID-19 crisis. We searched 13 databases as of December 2022 for studies reporting both the pre- and peri-pandemic prevalence of suicidal ideation, suicide attempts, or rate of death by suicide. A random-effects model was used to pool the ratio of peri- and pre-pandemic prevalence of suicidal ideation and attempt (Prevalence Ratio—PR) and rate of death by suicide (Rate Ratio; RR). We identified 51, 55, and 25 samples for suicidal ideation, attempt, and death by suicide. The prevalence of suicidal ideation increased significantly among non-clinical (PR = 1.142; 95% CI: 1.018–1.282; p = 0.024; k = 28) and clinical (PR = 1.134; 95% CI: 1.048–1.227; p = 0.002; k = 23) samples, and pooled estimates differed by population and study design. Suicide attempts were more prevalent during the pandemic among non-clinical (PR = 1.14; 95% CI: 1.053–1.233; p = 0.001; k = 30) and clinical (PR = 1.32; 95% CI: 1.17–1.489; p = 0.000; k = 25) participants. The pooled RR for death by suicide was 0.923 (95% CI: 0.84–1.01; p = 0.092; k = 25), indicating a nonsignificant downward trend. An upward trend of suicidal ideation and suicide attempts was observed during the COVID-19 pandemic, despite suicide rate remaining stable. Our findings suggest that timely prevention and intervention programs are highly needed for non-clinical adult population and clinical patients. Monitoring the real-time and long-run suicide risk as the pandemic evolves is warranted.

A history of self-injurious thoughts and behaviors (SITBs) is consistently cited as one of the strongest predictors of future suicidal behavior. However, stark discrepancies in the literature raise questions about the true magnitude of these associations. The objective of this study is to examine the magnitude and clinical utility of the associations between SITBs and subsequent suicide ideation, attempts, and death. We searched PubMed, PsycInfo, and Google Scholar for papers published through December 2014. Inclusion required that studies include at least one longitudinal analysis predicting suicide ideation, attempts, or death using any SITB variable. We identified 2179 longitudinal studies; 172 met inclusion criteria. The most common outcome was suicide attempt (47.80%), followed by death (40.50%) and ideation (11.60%). Median follow-up was 52 months (mean = 82.52, s.d. = 102.29). Overall prediction was weak, with weighted mean odds ratios (ORs) of 2.07 [95% confidence interval (CI) 1.76-2.43] for ideation, 2.14 (95% CI 2.00-2.30) for attempts, and 1.54 (95% CI 1.39-1.71) for death. Adjusting for publication bias further reduced estimates. Diagnostic accuracy analyses indicated acceptable specificity (86-87%) and poor sensitivity (10-26%), with areas under the curve marginally above chance (0.60-0.62). Most risk factors generated OR estimates of <2.0 and no risk factor exceeded 4.5. Effects were consistent regardless of sample severity, sample age groups, or follow-up length. Prior SITBs confer risk for later suicidal thoughts and behaviors. However, they only provide a marginal improvement in diagnostic accuracy above chance. Addressing gaps in study design, assessment, and underlying mechanisms may prove useful in improving prediction and prevention of suicidal thoughts and behaviors.

Background Given the wide range of depressive disorders, suicidal ideation and suicide attempts in various military studies around the world, determining the exact prevalence of these disorders in line with health planning as well as care and treatment service designing for military forces can be useful. The aim of the present meta-analysis was to determine the pooled prevalence of depressive disorders, suicide thoughts, and attempts in the military. Methods The present systematic review and meta-analysis study was performed based on PRISMA criteria in 5 steps of the search strategy, screening and selection of articles, data extraction, evaluation of article quality and meta-analysis. International databases (PubMed (Medline), Scopus, Web of science, Embase (Elsevier), PsycInfo (Ovid), Cochrane CENTRAL (Ovid)) were searched using related keywords extracted from Mesh and Emtree. After screening and final selection of articles, data were extracted and qualitative evaluation was performed using the NOS checklist. Results The results of meta-analysis showed that the prevalence of depression in active military forces and veterans was 23% (%95 CI: 20–26%) and 20% (%95 CI: 18–22%), respectively. In addition, the prevalence of suicidal ideation and attempts in the military was 11% (%95 CI: 10–13%) and 11% (%95 CI: 9–13%), respectively. The prevalence of suicide ideation and attempts in drug-using military was 18% (%95 CI: 7–33%) and 30% (%95 CI: 23–36%), respectively. The prevalence of suicidal ideation and attempts in military consuming alcohol were 9% (%95 CI: 4–13%) and 8% (%95 CI: 7–10%), respectively. In militaries with AIDS / HIV, the prevalence of suicide attempts was 5% (%95 CI: 4–8%). Conclusion Therefore, it is necessary to develop and design training and intervention programs in order to increase the awareness of the military, especially veterans, to prevent the occurrence of suicide and depression.

Suicide attempt (SA), which is one of the strongest predictors of completed suicide, is common in major depressive disorder (MDD) but its prevalence across epidemiological studies has been mixed. The aim of this comprehensive meta-analysis was to examine the pooled prevalence of SA in individuals with MDD. A systematic literature search was conducted in PubMed, Embase, PsycINFO, Web of Science and Cochrane Library from their commencement date until 27 December 2017. Original studies containing data on prevalence of SA in individuals with MDD were analyzed. In all, 65 studies with a total of 27 340 individuals with MDD were included. Using the random effects model, the pooled lifetime prevalence of SA was 31% [95% confidence interval (CI) 27-34%], 1-year prevalence was 8% (95% CI 3-14%) and 1-month prevalence was 24% (95% CI 15-34%). Subgroup analyses revealed that the lifetime prevalence of SA was significantly associated with the patient setting, study region and income level, while the 1-month prevalence of SA was associated with only the patient setting. This meta-analysis confirmed that SA was common in individuals with MDD across the world. Careful screening and appropriate interventions should be implemented for SA in the MDD population.

Objective: suicide attempts and suicide death fall within a category of psychological disorders that is under the influence of economic, social, and cultural factors. Awareness of the prevalence of this phenomenon is essential for the adoption of preventive policies. Accordingly, the current study was carried out in order to determine the prevalence of suicide attempts and suicide deaths via Meta-analysis in Iran. Method: This study is a systematic review and meta-analysis of articles published between 2010 and 2021 to estimate the prevalence of suicide attempts and suicide deaths in Iran. Accordingly, databases including Web of Science, PubMed, Scopus, Cochrane Library, Science Direct, Google Scholar, SID, and Magiran were searched and all related articles were extracted by the statistical tests of random and fixed effects model, meta-regression, and funnel plot using the STATA software. These articles were then analyzed. Results: A total of 20 studies were entered into the systematic review, with a total of 271,212 attempted suicides and 22,780 suicide deaths. Accordingly, the prevalence of suicide attempts in the whole population was 131.0 (CI 95%: 124.0 – 137.0) per 100,000 people (152 per 100,000 women and 128 per 100,000 men). Moreover, the prevalence of suicide death was 8.14 (CI 95% 7.8 – 8.5) per 100,000 people in the general population (5.0 per 100,000 women and 9.1 per 100,000 men). Conclusion: According to these findings, Iran can be ranked among the countries with a low prevalence of suicide attempts and completed suicides (compared to the global average). Although the trend of completed suicides is declining, the trend of suicide attempts is increasing and has often affected young people.

Background The phenomenon of suicide risk (SR) represents a psychiatric, social and environmental emergency. The acute psychiatric ward as the Italian Service for Psychiatric Diagnosis and Care (SPDC) represents the place where SR is high due to the acute and serious conditions of people hospitalized. The objective of this study was to evaluate the characteristics of subjects admitted to a SPDC over a 6-year period for SR represented by: suicidal ideation, attempted and failed suicide. Methods With a retrospective single-center observational design, we collected hospitalizations from 01/01/2017 to 31/12/2022 in the SPDC of AUSL-Modena for SR, analyzed the modality of SR and compared the demographic and clinical variables of subjects with SR with those hospitalized for other clinical reasons in the same period. Data were statistically analyzed. Results In the 6-year of study period, we collected 2,930 hospitalizations in the SPDC of AUSL- Modena and among them, 68% ( n  = 528) were carried out due to SR, which represented the second leading cause of hospitalization (18%), in particular among females (Pearson Chi2 = 17.41, p  < 0.001). Individuals with SR were more frequently voluntary admitted (Pearson Chi2 = 215.41, p  < 0.001) for a shorter period (7.36 ± 8.16 vs 11.66 ± 15.93, t = 6.03, t-test, p  < 0.001) and less frequently repeated the hospitalization during the study period for the same reason (Pearson Chi2 = 6.0, p  = 0.014). The most frequent psychiatric disorders associated with SR were depressive, personality and adjustment disorders, which represented the most common factor associated with SR (68%), followed by family/relationship problems (12%) and alcohol/substance abuse (8%). We highlighted three kinds of suicidal risk: suicidal ideation (40%), often associated with personality disorders and substance use disorders, drug ingestion (30%) concomitant with conflicting family relationships and use of violent means (30%) associated with depressive disorders (Pearson Chi2 = 42.83, p  = 0.002). Conclusions Our study provides a real-world setting evaluation of subjects hospitalized for SR and, in accordance with literature, suggests that suicidal behavior is the product of many clinical and social factors’ interaction, that occurred in a crucial moment of life in vulnerable individuals. The identification of subjects at SR represents the first step of preventive multi-professional interventions.

A large body of research suggests that child maltreatment (CM) is associated with adolescent suicidal ideation and attempts. These studies, however, have not been critically examined and summarized in a manner that allows us to draw firm conclusions and make recommendations for future research and clinical work in this area. In this review, we evaluated all of the research literature to date examining the relationship between CM and adolescent suicidal ideation and attempts. Results generally suggest that childhood sexual abuse, physical abuse, emotional abuse, and neglect are associated with adolescent suicidal ideation and attempts across community, clinical, and high-risk samples, using cross-sectional and longitudinal research designs. In most studies, these associations remain significant when controlling for covariates such as youth demographics, mental health, family, and peer-related variables. When different forms of CM are examined in the same multivariate analysis, most research suggests that each form of CM maintains an independent association with adolescent suicidal ideation and suicide attempts. However, a subset of studies yielded evidence to suggest that sexual abuse and emotional abuse may be relatively more important in explaining suicidal behavior than physical abuse or neglect. Research also suggests an additive effect—each form of CM contributes unique variance to adolescent suicide attempts. We discuss the current limitations of this literature and offer recommendations for future research. We conclude with an overview of the clinical implications of this research, including careful, detailed screening of CM history, past suicidal behavior, and current suicidal ideation, as well as the need for integrated treatment approaches that effectively address both CM and adolescent suicidal ideation and suicide attempts.