Analysis of risk factors of suicidal ideation in adolescent patients with depression and construction of prediction model

BACKGROUND Major depressive disorder is a common mental illness among adolescents and is the largest disease burden in this age group.Most adolescent patients with depression have suicidal ideation(SI);however,few studies have focused on the factors related to SI,and effective predictive models are lacking.AIM To construct a risk prediction model for SI in adolescent depression and provide a reference assessment tool for prevention.METHODS The data of 150 adolescent patients with depression at the First People's Hospital of Lianyungang from June 2020 to December 2022 were retrospectively analyzed.Based on whether or not they had SI,they were divided into a SI group(n=91)and a non-SI group(n=59).The general data and laboratory indices of the two groups were compared.Logistic regression was used to analyze the factors influencing SI in adolescent patients with depression,a nomogram prediction model was constructed based on the analysis results,and internal evaluation was performed.Receiver operating characteristic and calibration curves were used to evaluate the model’s efficacy,and the clinical application value was evaluated using decision curve analysis(DCA).RESULTS There were differences in trauma history,triggers,serum ferritin levels(SF),highsensitivity C-reactive protein levels(hs-CRP),and high-density lipoprotein(HDLC)levels between the two groups(P<0.05).Logistic regression analysis showed that trauma history,predisposing factors,SF,hs-CRP,and HDL-C were factors influencing SI in adolescent patients with depression.The area under the curve of the nomogram prediction model was 0.831(95%CI:0.763–0.899),sensitivity was 0.912,and specificity was 0.678.The higher net benefit of the DCA and the average absolute error of the calibration curve were 0.043,indicating that the model had a good fit.CONCLUSION The nomogram prediction model based on trauma history,triggers,ferritin,serum hs-CRP,and HDL-C levels can effectively predict the risk of SI in adolescent patients with depression.

Suicide Ideation and Its Associated Factors among Men in Selected Compounds of Lusaka, Zambia

Background: Globally, it is estimated that more than 800,000 individuals die by suicide each year, making suicide one of the biggest causes of death worldwide. Additionally, suicide kills far more males than women, more so in developing regions that are characterized by economic distress due to low income. Although the number of suicide cases has been seen to increase from 2013 to date, limited studies provide information on the factors influencing the trend. Therefore, this study aimed at investigating the prevalence of suicidal ideation and factors associated with suicide in males in selected compounds of Lusaka. Methods: The study used an analytical quantitative cross- sectional study design that involved 367 men in Mtendere and Kaunda Square townships in Lusaka district, Zambia. A structured questionnaire was used to collect data from participants, which was analyzed using Statistical Package for Social Sciences (SPSS) version 26.0. The Chi-square, Fisher’s exact test and Wilcoxon rank sum tests were used to test relationships among variables at a five percent level of significance. Ethical approval and clearance was obtained from the National Health Research Authority. Results: Participants had a median age of 29 years (IQR, 27 - 32 years), 216 (58.9%) were single and 278 (75.8%) attained tertiary education. Under a quarter, 75 (20.4%) reported suicide ideations, and 97 (26.4%) reported low social support. For most participants, 347 (94.7%) experienced at least one stressful life event, and 359 (97.8%) experienced severe levels of stress. Under half, 170 (46.3%) were alcohol dependent, while 54 (14.7%) used alcohol harmfully. Suicide ideation was significantly associated with marital status (p Conclusion: Suicide ideation is relatively high among men in Mtendere and Kaunda Square townships, mainly influenced by marital status, education level, social support, stressful events alcohol abuse. Efforts must be channeled towards suicide awareness campaigns, and establishment of supportive environments in health facilities which can make it easy for men to open up about their struggles.

Socio-Psychological Factors of Rising Trend of Suicidal Ideation among Indigenous Workforce: Evidence from Himalayan Range

Apart from socio-economic disparities,indigenous people of the Himalayan range in Asia face an increasing trend of suicides.The tragic suicidal events usually go unaddressed,and no strategies are presently in place to mitigate suicides in the future.This study aims to explain the prevailing causes of suicidal ideation to come up with some policy recommendations.Through a preliminary survey,we identified social stigma,social isolation,lack of healthcare facilities,and domestic violence as the potential reasons for suicidal ideation.We identified individuals with suicide ideation for further data collection to test the relationships between the identified variables and suicidal ideation.A quantitative,explanatory and cross-sectional design was used to test the hypotheses.Inferential statistics were applied to the data containing 314 responses,and the results revealed that all the predictive variables influence the formation of suicidal ideation.The study uncovered some new dimensions of social stigma and social isolation that are common among the indigenous people.The results also indicate that some domestic violence is socially acceptable and considered a normal familial matter.Thefindings have theoretical and practical implications.We have identified new dimensions of social stigma,social isolation,and domestic violence that are new additions to the existing bank of literature.It provides insights to encourage public authorities,healthcare providers,and NGO managers to play their role in the right direction to mitigate the problem.This study opens further venues for researchers to investigate the complex issue of suicide more deeply.

Depression and Suicidal Ideations among Older Persons Living with HIV/AIDS in Mbarara City, Southwest Uganda

Background: Due to the increase in longevity and use of antiretroviral treatment, Uganda has had a growing population of older persons living with HIV/AIDS. However, there is a paucity of information on the mental health of the elderly living with HIV/AIDS. In this cross-sectional study, we determined the prevalence of, and associated factors for depression and suicidal ideation among older persons living with HIV/AIDS in Mbarara city, southwest Uganda. Methods: Older persons (150 females, 115 males), with mean age = 64.2 (±5.1) years, accessing health services from three purposively selected HIV/AIDS care centers in Mbarara city, southwest Uganda were recruited. Data on depression and suicidal ideation were collected using a Patient Health Questionnaire (PHQ-9) validated in Uganda, and a structured questionnaire was used to collect data on clinical and socio-demographic characteristics. Data were analysed using logistic regression. Results: Approximately 8.3% and 12.1% had depression and suicidal ideation, respectively. The factors associated with lowering the likelihood of depression were: an increase in the number of family members they stayed with and having no having any problems with their ARVs. On the other hand, earning more than 100,000 Uganda shillings was associated with reducing the risk of suicidal ideations among the participants. Conclusion: Approximately 8 to 12 in 100 older persons living with HIV/AIDS in Uganda have experienced depression or suicidal ideation. Family support and financial control were instrumental factors associated with depression and suicidal ideations, respectively. We recommended strengthening family structures and creating more avenues for financial independence among older persons living with HIV/AIDS to reduce the burden of depression, and suicidal behaviours among this vulnerable population.

Depression and Suicidal Ideations among Prisoners of the Douala Central Prison

Introduction: The prison environment is a conducive environment for the development of psychiatric pathologies such as depression and suicidal ideation. To date, no related study has been conducted in Douala, Cameroon. We have therefore undertaken to study the prevalence of these pathologies and their related factors among inmates of the Douala Central Prison. Method: We conducted a cross-sectional study of 309 prisoners over a 6-month period from 1 January to 31 June 2022. This involved prisoners aged 18 years and over, who were consenting and able to read and write. Data were collected during individual interviews using a structured questionnaire. Depression was assessed by the BECK Short Form Depression Inventory and suicidal ideation was assessed by the MINI. These data were processed using the SPSS version 25.0 software. The related factors were studied in bivariate and multivariate analysis. Results: Most of the prisoners were male (97%), and more than half knew their criminal status. The prevalence of depression was 33.7% and that of suicide ideation was 22.7%. Among the factors associated with depression were receiving social visits and suicidal ideation. A history of physical/psychological abuse, repeated offences and prison violence were protective factors. Factors associated with suicidal ideation were the absence of social visits, physical abuse in childhood, smoking in prison and depression. Suicidal ideation was independently associated with depression as well as depression being independently associated with suicidal ideation. Conclusion: About 1/3 of the prisoners had depression and almost 1/4 had suicidal ideations. As a result of this and the related factors, there is a need to reorganize psychiatric care within our prison context.

A Systemic Functional Interpretation of English Expletives at the Ideational and Interpersonal Level

This thesis put the expletives into the whole language system to analyze, using the frame of the Halliday's(1985) System-Functional Linguistics Theory. The expletives can be analyzed on the sentential level, including the ideational function and the interpersonal function.

Childhood maltreatment and suicide ideation: A possible mediation of social support

BACKGROUND Existing literature suggests a positive link between childhood maltreatment(CM)and suicide ideation(SI).Nevertheless,whether social support significantly mediates this association remains unknown.AIM To investigate whether social support significantly mediates the association between CM and SI.METHODS In this cross-sectional study of 4732 adolescents from southwest China,we intended to discuss the association between CM and multiple types of SI.In addition,the mediation of major types of social support in this association was also investigated.A self-administrated questionnaire was used to collect the data.A series of multivariate logistic regression models were employed to estimate the association between different types of CM,social support,and SI.The possible mediation of social support in the association between CM and SI was assessed using the path model.RESULTS Based on the cutoffs for subscales of Childhood Trauma Questionnaire,928(19.61%),1269(26.82%),595(12.57%),2337(49.39%),and 3067(64.81%)respondents reported physical abuse,emotional abuse,sexual abuse,physical neglect,and emotional neglect,respectively.Among all the social sources,parental support presented as a significant mediator in the association between emotional maltreatment,both abuse and neglect,and all three types of SI:1-wk,1-year,and lifetime.Parental social support mediated 5.31%and 29.23%,4.80%and 24.50%,and 7.04%and 44.42%of the overall emotional abuse-SI and emotional neglect-SI associations,respectively.CONCLUSION Our findings suggest that improving parental social support might be effective in preventing suicidal risk related to childhood emotional maltreatment in adolescents.

Suicide ideation, depression and HIV among pregnant women in rural South Africa

Background: Despite public perception to the contrary, pregnancy does not offer a protective effect for suicide ideation. In low and middle income countries (LMIC) multiple concurrent risk factors including unplanned pregnancies, testing for HIV, intimate partner violence and depression may increase suicide risk among pregnant women. We examine suicide ideation among women attending routine antenatal care in rural South Africa. Method: A consecutive series of 109 women in the second half of pregnancy were enrolled in a cross-sectional study at a large primary health care facility in a rural area of KwaZulu-Natal with high HIV prevalence. Using a mixed-methods approach, women were assessed using the Major Depression Section of the Structured Clinical Interview for Depression (SCID) for DSM-IV diagnosis;qualitative interview data were collected on women’s experiences of suicide ideation and plans. Women were assessed two weeks after routine HIV testing as part of Prevention of Mother-to-Child Transmission (PMTCT) screening. Results: Both HIV-positive (49/109) and HIV-negative (60/109) women were assessed. Depression was high (51/109, 46.7%) and equally common amongst HIV-positive and negative women. Suicide ideation was high (30/109, 27.5%) with thoughts of self harm closely linked to suicide plans. Age, previous history of depression and current depression were significantly associated with suicide ideation. Close to equal numbers of HIV-positive and negative women were suicidal. Suicide methods were frequently violent and most women cited family and partnership conflict related to an unplanned pregnancy or their newly HIV-positive status as triggers to their suicide ideation. Conclusions: Rates of suicide ideation among pregnant women testing for HIV are high. Testing HIV-positive causes considerable distress, and among HIV-negative women unplanned and unwanted pregnancies are important risk factors for suicide ideation. Pregnancy brings women into increased contact with the health services with important opportunities for prevention and intervention.

Suicidal Ideation among Depressed People Living with HIV/AIDS in Nigeria, West Africa

Objective: Transient suicide thoughts are common to some people throughout the course of HIV disease and often do not indicate significant risk of suicide. However, persistent suicidal thoughts with associated feelings of hopelessness and intent to die are very serious and must be assessed promptly and carefully. The aim of this study, therefore, was to examine the relationship between depression, hopelessness, psychosocial stressors and suicidal ideation in PLWHAs. Methods: This was a hospital based, cross sectional, descriptive study, of one hundred and seventy depressed adult HIV/AIDS patients of Kwara State Specialist Hospital, Ilorin. Depression and suicidal assessment were evaluated using the PHQ-9 scale. A score of >9 or any affirmative response to question 9 of the PHQ-9 scale necessitated suicidal risk assessment. The social determinant questionnaire was used to evaluate social cohesion and negative life events. Results: The prevalence of depression among the HIV/AID patient was 56.7%. Twenty nine (17.1%) were hopeless, twenty eight (16.5%) had at one time or the other thought of taking their lives, six (3.5%) had plan to take their lives. There was strong statistical association between depression, hopelessness (p-value = 0.000) thought of taking life (p-value = 0.000) and plan to take their lives (p-value = 0.030). Conclusion: The significant correlations between hopelessness, depression and suicidal ideation are important markers that should alert clinicians to underlying suicide risk in HIV-positive patients. In addition, low social cohesion and stressful life events were found to be risk factors for depression and suicide. Clinicians should routinely enquire about suicidality in PLWHAs to assist early diagnosis and intervention.

Treatment priority for suicide ideation and behaviours at an Australian emergency department

AIM: To investigate the treatment priority given to selfharmers presenting to a hospital emergency department(ED) in Queensland, Australia, over the period 2005-2010. METHODS: The main outcome measure of this study was the treatment priority given to persons presenting with suicide ideation and communication(SIC) or self-harming behaviour. Treatment priority was measured using the Australasian Triage Scale, which ranks patients from 1(in need of immediate treatment) to 5(assessment and treatment to start within 120 min). Ordered logistic regression was used to assess the broad demographic and treatment-related factors associated with more urgent triage categories and to in-vestigate which methods of non-fatal suicidal behaviour(NFSB) were prioritised as most urgent.RESULTS: Most cases of NFSB were between 15 and 34 years. A larger proportion of persons presenting for SIC were aged 35 to 44 years. Over 50% of male presentations and 38% of female presentations were for SIC. Those cases prioritised as being more urgent had significantly greater odds of being older, presented after an act of self-harm rather than SIC, and had used multiple methods of NFSB. These individuals also had greater odds of being male and having made past presentations for SIC or NFSB. Among males, those presenting after ingestion of drugs had the greatest odds of receiving immediate attention compared to SIC. "Cutters" were considered as the least "urgent" subjects, and had a greatest risk of waiting 60 to 120 min for treatment compared to suicide ideators. Among females, those presenting with chemicals, poisons and gases had the greatest odds of receiving immediate attention compared to SIC. Females who presenting after cutting themselves had lower odds of receiving immediate treatment than those who presented with SIC. CONCLUSION: ED staff seems to judge the urgency of cases based on demographic factors such as age and gender, as well as method of NFSB.

Effects of Stress, Depression, and Problem Drinking on Suicidal Ideation among Korean Workers

The mental health of workers is an important issue that affects not only individuals and their families but also workplaces and communities.Therefore,it is necessary to regularly evaluate and analyze workers’mental health status,including levels of stress,depression,and addictive behaviors to apply thesefindings in creating mental health promotion programs.This study aims to provide basic data that would facilitate early intervention for workers’mental health problems by analyzing factors such as stress,depression,and problem drinking that can affect suicidal ideation.From April 15 to October 25,2019,a survey was conducted with 165 workers across six workplaces in a Korean city.Analysis was performed using descriptive statistics,correlation,and simple and multiple regression analyses using the R statistics program 4.0.3.There was no difference in suicidal ideation scores based on the participants’general characteristics,while there was a significant positive correlation among stress,depression,problem drinking,and suicidal ideation.In addition,severe depression,severe stress,and severe problem drinking had significant effects on suicidal ideation,and among the subitems of stress,somatic symptoms had an effect on suicidal ideation.In addition,severe stress,somatic symptoms,depression,and severe problem drinking had a significant effect on suicidal ideation in males but not in females.It is necessary to identify the effects of stress,depression,drinking problems,and suicide on workers’mental health,and evaluate their mental health systemati-cally and regularly to recognize whether active psychiatric treatment and nursing intervention are necessary as well as preventive management.In addition,it is meaningful to pay attention to the suicide ideation of adult workers and provide basic data to promote systematic public health policies on mental health.

Non-Violent Communication and Its Impact on Suicidal Ideations and Coping with Stress Styles

One of the important dimensions of violence is suicide, or violence directed toward self that many people suffer from nowadays. In the meantime, adolescents and especially girls are more likely to be harmed. The purpose of this study was to evaluate the effect of group training with non-violent communication (NVC) method on suicidal ideations and coping with stress styles of adolescent girls. The target community in this research was availably selected from the charity centers of Tehran suburbs. In this study, 15 adolescent girls were in the experimental group and 15 in the control group. The criteria for entering the research were students aged 11 to 19 years and the vulnerable socio-economic income. Eight training sessions of NVC were presented for the experimental group in the pre-test and post-test intervals, while no intervention was performed for the control group. Data collection instruments were Beck’s scale for suicidal ideation (BDI) and Endler & Parker’s coping inventory for stressful situations (CISS). After statistical analysis, the effectiveness of this training was investigated on dependent variables by multivariate analysis of covariance. Eventually, the results showed a significant difference between the experimental and control groups (p < 0.05). The finding of the study showed that NVC training can reduce suicidal ideations in adolescent girls who are socially and economically vulnerable. According to the findings, non-violent communication training has a higher effect on emotion-focused coping style compared to other stress coping styles.

Self-Efficacy as a Suicidal Ideation Predictor: A Population Cohort Study in Rural Japan

Background: Self-efficacy has been widely studied in suicide, both in its causality and treatment effects. However, the evidence of causality is still ambiguous and there is a lack of generalizability. The aim of this study was to examine the relationship between self-efficacy and suicidal ideation through a population cohort study. Methods: The community-based household survey using a self-administered questionnaire was conducted in a rural area of Japan, Happo Town, in Akita Prefecture with community residents aged 30 and over at two respective time points by local health volunteers. The baseline survey was conducted in 2010 with a response rate of 88.9% (n = 6044). Among them, 3812 residents met the inclusion criteria for the follow-up survey in 2012 where the response rate was 75.3% (n = 2869). Exposure variables to suicidal ideation included demographic details, depression and self-efficacy. The Institutional Review Board and the Ethics Committee of Akita University approved the study protocol and all subjects signed informed consent. Results: A total number of 2105 participants (76.4%) without suicidal ideation in the baseline study were enrolled into the follow-up study, and 8.2% of them had developed suicidal ideation. These participants with suicidal ideation were significantly less likely to be married/cohabitant;they had worse subjective health, poorer self-perceived economic status, stronger depressive mood, and lower self-efficacy scores. The odds ratio of the self-efficacy scores at follow-up survey for participants who had developed suicidal ideation were about 2 times lower than at baseline (95% confidence interval = 1. 53 - 3.06). After adjusting for all confounding factors, the association was still significant (OR = 1.66, 95% CI = 1.15 - 2.42). Conclusion: This result suggests that suicidal ideation may be prevented by increasing self-efficacy. We suggest that self-efficacy can be an effective tool for identifying people with suicidal ideation, and increasing self-efficacy can be strategically beneficial for larger suicide prevention.

Variables associated with suicide ideation and plans in a Japanese population

The purpose of our study was to clarify variables associated with suicide ideation and plans in a Japanese population. We conducted a random-sampling survey on mental health and suicide using a self-administered questionnaire for Hamamatsu City residents aged 15-79 yrs between May and June, 2008. This included questions about gender, age, outpatient treatment, alcohol problems, depression, living ar-rangements, marital status, annual family income, industry types as well as suicide ideation and plans. The correlation between these variables and suicide ideation or plans was then analyzed with multiple logistic regression analysis by gender. A total of 1051 responded to this questionnaire (response rate, 53.9%). Variables statistically associated with suicide ideation in males included alcohol problems, depression, lower annual family income, and ac-commodations/eating/drinking services, while in females, the variables were younger age, outpatient treatment, depression, living alone, being single, being separated, lower annual family income, accommodations/eating/drinking services and unemployment. On the other hand, variables statistically associated with suicide plans in males were younger age, alcohol problems, depression, and lower annual family income, while in females they were younger age, alcohol problems, depression, being separated, lower annual family income, manufacturing, and accommodations/eating/drinking services. Ex-cept for industry types, variables associated with suicide ideation or plans were consistent with previous studies. The reason why workers engaging in manufacturing, or accommoda-tions/eating/drinking services were more likely to have suicide ideation or plans may be attributed to the structures and/or stresses unique to those industries.

Suicidal Ideation and Attempts during Middle Childhood: Associations with Subjective Quality of Life and Depression

Background: Confronted to the increasing suicide rate in children, clinicians have to better understand and predict suicide-related behaviours (SRBs) in children with and without depressive symptoms. Aims: To investigate associations among suicidal tendencies (thoughts and/or attempts), depression and children’s perceptions of subjective quality of life. Methods: This was a cross-sectional study of 157 children of 6 - 13-year-old. Results: Children who attempted or thought of suicide reported goodless subjective quality of life than nonsuicidal children did, and children who thought of or attempted suicide reported higher levels of depressive symptoms than nonsuicidal children. Limitations: A more rigorous approach to investigating suicidal ideation and depressive symptomatology as a diagnostic interview based on the DSM-IV-TR will be valuable to future progress in understanding children’s suicidality. Conclusions: Results may reflect the confirmation of depressive symptoms as risk factors for suicidality and underline the high importance of social and emotional life context among suicidal children. For this reason, more effective recognition and comprehension of the underlying affective and social conditions of children with suicidality have special importance to prevent future suicidal behaviour during adolescence.

Proposed Scales for Measuring Suicidal Ideation in Adult Cancer Patients

Suicidal ideation, which can occur in oncology patients, is associated with suffering and a reduced quality of life. Empirical studies indicate that the incidence of suicide in people with cancer is approximately twice that of the general population. Objective: This cross-sectional descriptive study was designed to establish the prevalence of suicidal ideation in adult oncology patients based on a combination of scales to measure this variable. Method: A battery of three instruments (Scale for Suicidal Ideation. Item 9 of Beck’s Depression Inventory, and a semi-structured interview) was used to make estimates that are not based on just one test and can thus make a comprehensive evaluation of suicidal ideation in the study sample. Four approximations, based on different items from suicidal ideation assessment scales, were developed to determine the most sensitive combination for identifying the presence of suicidal ideation in adult cancer patients. Results: The highest prevalence of suicidal ideation found with the proposed scales was 24.5% (CI = 16%-33%) with Scale 1;23.6% (CI = 15.2%-32%) with Scale 2;and 19.1% (CI = 11.3%-26.9%) with Scale 4. The lowest prevalence of suicidal ideation was 17.3% (CI = 9.8%-24.8%) with Scale 3. Conclusions: Suicidal behavior in the oncology patient should be assessed;however, there is a need to select sensitive instruments that can be applied easily and are suitable for the target group, which faces difficulties in participating in extensive evaluations.

A Systemic-functional Approach to Ideational Metaphor in English Nursery Rhymes

Ideational metaphor is a typical type of grammatical metaphor. The analysis of grammatical metaphor in English nursery rhymes from the perspective of ideational metaphor, which tries to explore possible evidence of the existence of ideational metaphor in the language of young children-nursery rhymes. Children learn probably many equally complex systems as that of human language.

Associations between Physical Activity,Depression,Self-Esteem,and Suicide Ideation in Adolescents

Background:In contemporary society,it has been widely witnessed that a surprising number of adolescents suffer emotional and mental health problems,and such turmoil is very often carried over into adulthood with serious implications for adjustment during the post-adolescent years.The purpose of the current study is to investigate the associations of physical activity with self-esteem,depression,and suicidal ideation.In addition,this study examined whether self-esteem and depression mediate the relationship between physical activity and suicide ideation in adolescents.Methods:The study participants were 946(male:527,female:419)who attended junior high and high schools in Seoul,Korea.The self-esteem scale,leisure time physical activity scale,the self-rating depression scale,and the suicide ideation scale were used to identify adolescents’mental health and physical activity.Descriptive analysis,correlation analysis,and Structural Equation Modeling were conducted to test the study hypothesis.Results:Results indicated that physical activity was significantly correlated with depression,self-esteem,and suicide ideation.Based on each variable’s correlations,the finding revealed that physical activity was significantly associated with self-esteem,depression,and suicide ideation.In addition,depression and self-esteem had significant mediating effects on the relationship between physical activity and suicide ideation.Conclusion:The study suggests that the suicide prevention intervention should incorporate physical activity involvement with self-esteem and depression to strengthen the protective combined effect of the intervention on suicide ideation and suicide attempts.

Epidemiology of Depression and Suicide Ideation in Patients With Psoriasis:A Metaanalysis of Prospective Cohort Studies

Objective:Psoriasis is an immune-mediated inflammatory,chronic,recurrent skin disease associated with a high risk of developing psychiatric disorders,especially depression and suicidal ideation,leading to functional disability and poor quality of life.This study was conducted to comprehensively review and assess the epidemiologic association between psoriasis and the risk ratios(RRs)of depression or suicidal ideation.Methods:Five databases(PubMed,Wanfang Database,CNKI,The Cochrane Library,and EMBASE)were searched for prospective cohort studies on the prevalence of depression and/or suicidal ideation in patients with psoriasis updated to February 2,2023.Two independent reviewers evaluated and extracted the data,which were then pooled into a summary RR with corresponding 95%confidence interval(CI)using random-effects models.Results:Sixteen cohort studies comprising 1,166,840 patients with psoriasis and 3,294,205 controls were eligible for the final analysis.The pooled RR for depression was 1.43(95%CI=1.13-1.81)in patients with psoriasis and1.55(95%CI=1.40-1.71)in patients with psoriatic arthritis.In the subgroup analysis,Asian patients with psoriasis(RR=1.38,95%CI=1.17-1.63)had a lower pooled RR for depression than non-Asian patients(RR=1.45,95%CI=1.07-1.97),and patients with moderate-to-severe psoriasis(RR=1.69,95%CI=1.15-2.50)showed a higher RR for depression than patients with mild psoriasis(RR=1.60,95%CI=1.06-2.42).We also found no increase in the RR for suicidal ideation among people with psoriasis(RR=1.25,95%CI=0.95-1.65).Conclusion:Patients with psoriasis are at an increased risk of depression.Among patients with psoriasis,those with psoriatic arthritis,those who are non-Asian,and those with moderate-to-severe psoriasis are at higher risk for depression.However,the available evidence does not support an association between psoriasis and suicidal ideation.

Suicide in Digestive System Cancers: A Scoping Review

Digestive system cancers are important causes of morbidity and mortality worldwide.Cancer patients are more likely to commit suicide.The objective of this scoping review is to provide a comprehensive and updated summary of the existing literature on suicide among patients with digestive system cancers to identify the incidence and risk factors relevant to suicide in these populations.The PRISMA-Scr(Preferred Reporting Items for Systematic reviews and Meta-Analyses extension protocol for scoping reviews)protocol was used.The review was based on relevant articles published prior to January 2022 in databases of Web of Science and PubMed.The authors identified 21 records that met the criteria for inclusion.Among the 21 articles,18(n=85.7%)reported suicide risk factors,21(n=100%)evaluated the incidence of suicide and 16(n=76.2%)involved the variation in suicide rates.Only one study comprehensively reported that the suicide rate for this population was 32.8 per 100,000 years and the standardized mortality ratio(SMR)was 1.91.Most suicides occurred in patients with pancreatic,esophageal,and gastric cancers.The factors associated with suicide in digestive system cancers included male gender,older age,the white race,single status,advanced stage of disease,and cancer metastasis.The most critical time for suicide was in the early post-diagnostic period.It is indispensable to identify suicide in these cancer patients,especially those with high-risk factors.In the future,more prospective research may be needed to provide more reliable support and care to prevent suicide.