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.

Depression and Suicidal Risk in HIV-Infected Adults at Brazzaville University Hospital: Prevalence and Associated Factors

Introduction: Highly active antiretroviral tritherapies have improved the quality of life of people living with HIV (PVVIH) and extended their life expectancy. However, the nervous system is faced with a neurotropic virus that evolves chronically, sometimes creating neurological disorders directly or indirectly linked to stigmatization or therapeutic effects. Objective: to determine the prevalence of depression associated with suicidal risk (SR) and identify associated factors. Patients and method: This was a prospective descriptive and analytical study from January 1 to November 30, 2022, including all HIV-positive patients receiving or not receiving antiretroviral therapy. The study took place in the infectious diseases department of Brazzaville University Hospital. This department has an inpatient capacity of 36 beds, and an outpatient capacity of 25 patients per day, three times a week. This is the largest center for PVVIH in Brazzaville. The Patient Heath Questionnaire 9 (PHQ-9) was used to assess the degree of depression and suicidal risk. Therapeutic adherence was assessed using the Morisky questionnaire. Data were analyzed using SPSS version 23 software. Qualitative variables were expressed as numbers and percentages, and quantitative variables as means and standard deviations. Statistical tests were used according to their applicability criteria. For all tests, the significance threshold was set at 0.05. Results: A total of 150 patients were consulted, constituting the sample size. The prevalence of depression and suicidal risk was 32%. These patients had an average age of 42.83 ± 10.24 years, were female (n = 101;67.3%), Christian (n = 97;64%), single (n = 68;45.3%). Stigmatization (n = 75;50%) was the reason for attempted suicide. HIV was perceived as treatable (n = 103;68.7%), unlucky (n = 62;41.3%). Patients were WHO stage 1 (n = 105;70%). RS was present in 47 cases (31.3%). Factors associated with depression and suicidal risk were age (p = 0.000), residence (p = 0.028), suicide attempt (p = 0.000), desire to procreate (p = 0.000) and ARV (antiretrovirals) side effects (p Conclusion: The prevalence of depression and suicidal risk was high, in line with stigma and socio-economic conditions. The associated factors were in line with those identified in the literature. Mental health needs to be integrated into the overall care of people living with HIV.

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.

Lethal means and suicide prevention among military veterans

Dear Editor,Suicide amongst the military veteran population is a significant publichealthproblemintheUnitedStates.TheNational VeteranSuicidePreventionAnnualReportrevealedthat6261 died by suicide in 2019[1]. The lingering effects of the coronavirus disease 2019 (COVID-19) pandemic may account for an increase in veteran suicide rates[1].

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.

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.

Suicide Attempts in a General Hospital: A Case-Control

Objective: This study aims is to conduct a comparative analysis of the clinical and sociodemographic profiles of individuals referred to Consultation-Liaison Psychiatry (CLP) at a tertiary general hospital, specifically focusing on those seeking assistance due to suicide attempts (TS) versus CLP requests for other reasons (non-TS) between the years 2010 and 2020. Additionally, we aim to assess factors associated with suicide attempts. Method: This retrospective controlled study involves a thorough examination of medical records encompassing 3913 patients who received CLP services at the Hospital de Base (HB) and the Children and Maternity Hospital (HCM) of São José do Rio Preto Medical School Foundation (Funfarme) from June 2010 to June 2020. The patient cohort is categorized into two groups: those with requests for SA (n = 677) and those with requests for other reasons. Results: In the SA group, as opposed to the non SA group, statistically significant differences were observed for gender (predominantly female), employment status (employed), marital status (single), and age (younger). Notably, a higher prevalence of psychiatric antecedents (88.7%, n = 555 vs. 73.6% n = 2018) was found in the SA group, indicating a significant association. The frequency of SA requests remained stable over the years. Among the SA group, mood disorders were the most prevalent (39%, n = 372), followed by disorders related to substance use (21.2%, n = 202), and personality disorders (16%, n = 152). A history of previous suicide attempts emerged as a crucial factor for the recurrence of SA (p-value ≤ 0.001). Exogenous intoxication emerged as the most frequently employed method in attempts (79.6%, n = 539), particularly prevalent among patients diagnosed with mood disorders (41%, n = 314). A significant association was observed between the method of attempt and the nosological psychiatric diagnosis (χ2 = 42.277;p ≤ 0.001). Regarding outcomes, the majority of patients were referred for outpatient follow-up (23%, n = 336) in specialized mental health services or at the Primary Healthcare Unit, highlighting the general hospital’s pivotal role in integrating patients into the broader healthcare network. Conclusion: Variables such as gender (female), age group (young adults), and psychiatric history exhibited stronger associations with suicide attempts compared to the group assisted by CLP for other reasons. Furthermore, a noteworthy correlation between the method employed and the psychiatric diagnosis was identified.

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.

The Utility of Artificial Intelligence for Mood Analysis,Depression Detection,and Suicide Risk Management

Mood disorders are often an indication or a sign of depression,and individuals suffering from mood swings may face higher probability and increased suicidal tendencies.Depression-also called“clinical depression”or a“depressive disorder”-is a mood disorder that adversely impacts how an individual feels,thinks,and handles daily activities,such as sleeping,eating,or working.To be diagnosed with depression,symptoms must be present most of the time,nearly every day for at least minimum of 2 to 3 weeks.Feeling sad or having low emotional energy may be common among people.For most,however,these feelings are transitory and can be managed by changing daily life routines.But for some,prolonged mood disorders can lead to depression and foster suicidal tendencies.Suicide is a major public health concern.Over 47,000 people died by suicide in the United States in 2017.It is the 10th leading cause of death overall according to NIMH(National Institute of Mental Health).Suicide is complicated and tragic,but it is often preventable.Identifying the warning signs for suicide and how to get help can be a major mitigating factor.In this short communication,we are reviewing the promise and limitations of AI(artificial intelligence)with its integrated tools such as ML(machine learning)and DL(deep learning)for mood analysis as a means for detecting early signs of depression and increased suicidal tendencies for possible suicide risk management.

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.

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.

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.

Self-Genital Mutilation and Attempted Suicide by Cut Throat in the Same Patient at Presentation: A Rare Event

Genital self-mutilation is an uncommon event that is commonly associated with psychotic disorders. Such injuries have also been reported secondary to complex religious beliefs and delusions regarding sexual guilt. Even though few case reports of male genital self-mutilation are available in literature, it is?rareto have a combined self-genital mutilation and attempted suicide by cut throat occurring in the same patient at presentation. We presented the case of a 38-yr-old male who presented to the accident and emergency centre of a tertiary hospital in Accra, Ghana.

Observation of Suicide Prevention in Hospitalized Patients with Depression Based on Taihe Emotion-distress Index

[Objectives]To reduce suicidal ideation and suicidal behavior through initial screening of patients with suicidal tendencies and implementing suicide prevention interventions during their hospitalization.[Methods]The Taihe Emotion-distress Index(THEI)was used to conduct pre-admission and post-discharge tests to explore the effects of suicide prevention measures during hospitalization on the alleviation of the disease and the reduction of suicidal behaviors.The study selected patients who were diagnosed with depression in the psychological outpatient department of Taihe Hospital from April 2019 to September 2019 and had to be hospitalized,including patients with moderate depressive episodes,severe depressive episodes with or without psychotic symptoms,and patients with suicidal thoughts and self-harming behaviors.[Results]The pre-admission and post-discharge test data of hospitalized patients were analyzed,and the non-parametric paired sample T test was carried out,and the result was P<0.05,showing that there are significant differences between the pre-admission and post-discharge test data.[Conclusions]The measures of suicide prevention intervention are effective to a certain extent.

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.

Understanding the Unique Characteristics of Suicide in China: National Psychological Autopsy Study

Objective To compare the characteristics of suicides in the four main demographic groups： urban males, urban females, rural males and rural females in order to help clarify the demographic pattern of suicides in China. Methods A detailed psychological autopsy survey instrument was independently administered to 895 suicide victims in family members and close associates from 23 geographically representative locations from around the country. Results Pesticide ingestion accounted for 58% （519） of all suicides and 61% （3181519） of deaths were due to unsuccessful medical resuscitation. A substantial proportion （37%） of suicide victims did not have a mental illness. Among the 563 victims with mental illness, only 13% （76/563） received psychiatric treatment. Compared to other demographic groups, young rural females who died from suicide had the highest rate of pesticide ingestion （79%）, the lowest prevalence of mental illness （39%）, and the highest acute stress from precipitating life events just prior to the suicide. Contusion Many suicides in China are impulsive acts of deliberate self-harm following acute interpersonal crises. Prevention of suicides in China must focus on improving awareness of psychological problems, improving mental health services, providing alternative social support networks for managing acute interpersonal conflicts, limiting access to pesticides, and improving the resuscitation skills of primary care providers.

Abnormal brain activity in adolescents with Internet addiction who attempt suicide: an assessment using functional magnetic resonance imaging

Internet addiction is associated with an increased risk of suicidal behavior and can lead to brain dysfunction among adolescents.However,whether brain dysfunction occurs in adolescents with Internet addiction who attempt suicide remains unknown.This observational cross-sectional study enrolled 41 young Internet addicts,aged from 15 to 20 years,from the Department of Psychiatry,the First Affiliated Hospital of Chongqing Medical University,China from January to May 2018.The participants included 21 individuals who attempted suicide and 20 individuals with Internet addiction without a suicidal attempt history.Brain images in the resting state were obtained by a 3.0 T magnetic resonance imaging scanner.The results showed that activity in the gyrus frontalis inferior of the right pars triangularis and the right pars opercularis was significantly increased in the suicidal attempt group compared with the non-suicidal attempt group.In the resting state,the prefrontal lobe of adolescents who had attempted suicide because of Internet addiction exhibited functional abnormalities,which may provide a new basis for studying suicide pathogenesis in Internet addicts.The study was authorized by the Ethics Committee of Chongqing Medical University,China(approval No.2017 Scientific Research Ethics(2017-157))on December 11,2017.