UNASSIGNED: Chronic pain is a leading cause of disability, severely impairing an individual\'s daily activity and quality of life. In addition, this condition may contribute to suicidal thoughts by leading to neuropsychological impairments, a perceived lack of meaning in life, and pain-related catastrophizing. This systematic review aimed to comprehensively investigate the prevalence and associated factors of suicidal behaviors (SBs) including suicidal ideation (SI) and suicide attempt (SA) or its complete, in individuals with chronic pain.
UNASSIGNED: Five electronic databases were searched up to October 4, 2022. Only observational studies investigating the prevalence of SB in individuals with chronic pain were included. The methodological quality of the included studies was assessed using the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement. A meta-analysis was conducted to quantify the prevalence of SB in the population, and the command \"Metaprop\" was used in STATA/MP 16. In addition, factors explaining the association between chronic pain and SB identified through regression analysis were investigated.
UNASSIGNED: A total of 19 studies were included in this review (N = 3,312,343). The pooled lifetime prevalence of SI and SA was 28.90% (95% confidence interval, 17.95 to 41.26%) and 10.83% (5.72 to 17.30%), respectively, in a mixed sample comprising various chronic pain conditions. Importantly, the pooled prevalence of past 2-week SI was as high as 25.87% (18.09 to 34.50%). The methodological quality of the included studies was not optimal, and studies using validated SB assessment tools were lacking. Potential protective factors against SB in this population included pain coping and self-efficacy, older age, certain race/ethnicity groups, and marriage.
UNASSIGNED: This systematic review and meta-analysis demonstrated the high prevalence of SB in individuals with chronic pain. Specifically, around 1 in 4 individuals with chronic pain had SI within the last 2 weeks. However, there was considerable heterogeneity in the pooled prevalence of SB in this population.

OBJECTIVE: To summarize the evidence on the effectiveness that psychological and/or spiritual interventions may have to change the levels of meaning, measured with the Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being Scale (FACIT-Sp), in adults diagnosed with cancer.
METHODS: Systematic review with meta-analysis and meta-regression. CINAHL (via EBSCOhost), Embase, PubMed, PsycINFO (via ProQuest), and the Cochrane Library were searched from inception to 21st October 2022. Manual searches were conducted. Only randomized clinical trials (RCTs) were included. The risk of bias was assessed with the Cochrane Risk of Bias tool 2. The Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) approach was used to judge the certainty of the evidence.
RESULTS: Eight RCTs were included (N = 1682). Although some individual studies showed positive effects to enhance meaning using mindfulness or dignity therapy, the overall and individual meta-analyses showed a lack of effect of psychological and spiritual interventions in comparison to comparator interventions (MD (95%CI) = -0.19 (-0.45 to 0.06), p = 0.11, Tau2 = 0.0015, I2 = 2%). Publication bias was undetected (Egger\'s test = 0.35). Furthermore, no RCTs were judged to have a low risk of bias and the overall certainty of the evidence was judged as low. Meta-regression and subgroups meta-analyses also found possible sources of heterogeneity such as some cancer characteristics, the educational stage, or the religious affiliation.
CONCLUSIONS: Despite some RCTs may show promising results following mindfulness or dignity therapy, no effects were observed in the meta-analysis. Moreover, important methodological and clinical concerns precluded us to make sound clinical recommendations with the available evidence. OPEN SCIENCE FRAMEWORK DOI REGISTRATION: https://doi.org/10.17605/OSF.IO/4YMTK .

To summarize current evidence on the potential cross-sectional and longitudinal association between meaning or purpose in life and subjective happiness or life satisfaction among cancer patients.
A systematic review with meta-analysis and meta-regression was conducted. CINAHL (via EBSCOhost), Embase, PubMed, and PsycINFO (via ProQuest) were searched from inception to 31 December 2022. In addition, manual searches were performed. The risk of bias in cross-sectional and longitudinal studies was assessed using the Joanna Briggs Institute Checklist for Analytical Cross-Sectional Studies and the Quality in Prognosis Studies tool, respectively. Certainty in the evidence was judged using the Grading of Recommendations, Assessment, Development, and Evaluations approach. Meta-regressions and sensitivity analyses were performed to explore potential sources of heterogeneity.
We included 13 cross-sectional studies, comprising 12 different samples, and a longitudinal study. A total of 4968 individuals with cancer were interviewed across included studies. Certainty in the evidence was judged as very low for all outcomes, which was associated to serious concerns on risk of bias and imprecision of the results, and very serious concerns on indirectness of evidence. The assessed studies showed a marked heterogeneity in terms of participants\' clinical (i.e., disease stage) and sociodemographic factors. A lack of reporting of these clinical and sociodemographic aspects were also evident among included studies.
The wide number of methodological flaws detected in this systematic review preclude to make any clinical recommendation. More rigorous high-quality observational studies should guide future research on this topic.

The changes in people\'s way of life through the years raise questions on how they address existential needs and concerns, particularly those related to life and death and spiritual connections. Through a scoping review, we surveyed studies on meaning in life, death anxiety, and spirituality within the lesbian, gay, and bisexual (LGB) community. We determined the extent to which these variables have been studied among LGB participants. A total of 28 eligible articles were reviewed. Six studies were found about meaning in life, five studies about death anxiety, and 16 studies about spirituality. Results suggest that meaning in life was derived from experiences related to parenthood, couplehood, and work satisfaction. Studies on death anxiety among LGB participants, which date back to the 1980 and 1990s, indicated the need to conduct present studies in this area. The review showed that LGB members distinguished between spirituality and religion, giving them more positive recognition of the former than the latter. The forms of spiritual expression were anchored to religious practices, for some, and other expressions of belief and faith outside the confines of formally established religions. Spiritual expressions generally accorded the LGB members direction and satisfaction in life. Not all segments of the LGB community were represented in the studies. The available studies, dominantly quantitative, centered only on the LGB experience. Target age groups varied across the studies. The review indicates that future studies can work on exploring these existential factors considering the emerging contexts and paradigms. Future research can focus on determining what factors contribute to meaning in life, given the changes in time.

Meaning in life and acceptance of cancer are critical for patients to adjust to a cancer diagnosis and to improve psychological wellbeing. Little is known about the relationship between meaning in life and the acceptance of cancer. This study provides a systematic review of the associations between meaning in life and the acceptance of cancer in cancer patients. CINAHL, MEDLINE, PsycINFO, and SCOPUS databases were searched until 15 March 2021. Studies were included if they quantitatively examined the association between meaning in life and the acceptance of cancer in adult cancer patients/survivors and if they were published in peer-reviewed journals or in books. The study quality was assessed using Joanna Briggs Institute critical appraisal tools. Of the 4907 records identified through database searches, only 3 studies quantitatively examined the associations between meaning in life and the acceptance of cancer. The total sample involved 464 women with cancer. All three studies reported positive correlations between meaning in life and the acceptance of cancer (ranging from r = 0.19 to r = 0.38), whereas meaning in life did not predict the acceptance of cancer. Overall, the meaning in life-acceptance relationship has not been sufficiently investigated, though it has relevant theoretical and clinical implications for coping with cancer. High-quality studies are needed to better understand the relationship between meaning in life and the acceptance of cancer.

BACKGROUND: Hikikomori is a phenomenon describing people who exhibit behaviors of self-secluding themselves at home for long durations of time and usually only having face-to-face social interactions with none other than family. Existing interventions for hikikomori are inconclusive and the majority are absent in using a theoretical framework to guide its components. Therefore, applicability of the psychosocial recovery framework of Connectedness, Hope and Optimism, Identity, Meaning in Life, and Empowerment (CHIME) towards hikikomori care was reviewed.
METHODS: Five databases were searched in April 2020 with the search formula from a published systematic review on hikikomori combined with search terms specific to domains of the CHIME framework. Articles included in the review were of the English language, of all publication years, peer-reviewed, quantitative or qualitative research studies and case studies, included study designs that were observational or interventional in nature, and involved populations of socially withdrawn youth.
RESULTS: CHIME\'s comprehensive structure and organized approach could guide researchers or service providers in determining areas needing assessments, measurement, and areas of focus. It is suggested that the CHIME framework is applicable after modifying a specific dimension-\'meaning of mental illness experiences\' into \'meaning of the hikikomori experience\'. Thematic overlap occurred between the domains of connectedness, identity, and meaning. Yet, additional dimensions or domains such as trust building, non-linearity, and spatiality can be included for addressing specific limitations in this application, which would help towards catering services to help hikikomori in recovery or in increasing quality-of-life of those individuals\' while entrapped in this withdrawn lifestyle.
CONCLUSIONS: CHIME framework could be applicable towards hikikomori care after applying the suggested modifications. Additionally, many knowledge gaps were found in literature during this review that warrants further investigation to improve hikikomori care.

Previous studies have shown that psychological stress and mental health problems increase the risk for cardiovascular disease (CVD) events, such as heart attack or stroke. Furthermore, after CVD events, the majority of patients report large stress. However, psychological treatments have only modest effects in CVD patients. Therefore, it has been argued that new conceptual models are needed to understand the aetiology of stress and mental health problems in CVD patients. Therefore, this study included a systematic literature review and a conceptual model on the role of meaning in life for psychological stress, mental health, and CVD risks.
A systematic literature review was conducted on relationships between CVD and meaning in life. PRISMA/MOOSE review guidelines were followed. These findings were used to build a conceptual model.
The literature review included 113 studies on meaning and CVD. The included studies described meaning as a predictor of cardiovascular risks and health, meaning-centered needs of patients in conversations with medical staff, meaning-centered changes after CVD events, meaning-centered coping with CVD, meaning as motivator of CVD-related lifestyle changes, and meaning as an element in psychological treatments of CVD patients. In sum, the literature showed that a central clinical concern for patients is their question how to live a meaningful life despite CVD. Meaning-centered concerns seem to lead to lower motivation to make lifestyle changes, more psychological stress, lower quality-of-life, worse physical well-being, and increased CVD risk. The ability to live a meaningful life after CVD events is related with lower stress, better mental health, and several biomarkers.
An evidence-based conceptual framework was developed for the relationship between meaning and CVD. It may be hypothesized CVD patients may benefit from psychological therapies focused on meaning.

Increasing meaning in life (MiL) among people experiencing disease or adversity may improve coping and resilience. The purpose of this review is to characterize the effects of MiL interventions.
A systematic search of PubMed, PsycInfo, and Google Scholar was conducted encompassing the following parameters: meaning in life, purpose in life, or sense of purpose with randomized controlled trials.
Randomized controlled trials (RCTs) of interventions with at least one outcome that measured improvement in MiL and were published in English between January 2000 and January 2020.
33 randomized controlled trials (k = 35) were identified. Data were coded by authors and a research assistant for intervention type, control group type, and risk of bias. The random effects model of Review Manager 5.3 was used to produce SMD and evaluate heterogeneity.
The effect size for studies with a passive control group was SMD = 0.85 (95% CI 0.54 to 1.17) and for studies with an active control group was SMD = .032 (95% CI 0.09 to 0.55). Mindfulness programs produced the largest effect size (1.57) compared to passive controls, while narrative programs produced the largest effect relative to active controls (0.61). There was considerable heterogeneity in most estimates.
Several interventions increase MiL, including some that are relatively brief and do not require licensed professionals.

Background: Suicidality and brain tumors are two life-threatening conditions and, somewhat unexpectedly, the associations between them have scarcely been reported. Objective: In this study, we aimed to provide a brief literature review of epidemiological studies on suicidal ideation (SI) and suicidal behavior (SB) in patients with brain tumors. To illustrate various aspects of brain tumors that potentially underlie the emergence of suicidality, the review is supplemented with a clinical exemplar of a long-term survivor of brain tumor (glioblastoma) who experienced persistent SI. Furthermore, we discuss putative both neurobiological (including anatomical and immunological) and psychosocial mechanisms that might be accountable for the development of SI and SB in patients with brain tumors. Conclusions: While the etiology of this phenomenon appears to be multifactorial and still remains a subject of much debate, it is of critical importance to identify patients for which a psychiatric evaluation could recognize, in a timely manner, a possible suicide risk and alleviate the deep related suffering, by appropriate psychopharmacological and supportive and psychotherapeutic interventions.

OBJECTIVE: To evaluate the effects of a mind map-based life review programme (MBLRP) on psychological distress, hope, meaning in life and self-transcendence in cancer patients undergoing chemotherapy.
METHODS: Eighty-four cancer patients undergoing chemotherapy from a university-affiliated hospital in Fujian, China. The participants were randomly allocated to a MBLRP group (n = 40) or usual care group (n = 44). Data were collected at baseline (T0), on the second day (T1) and four weeks after the programme (T2) using the Distress Thermometer, Meaning in Life Questionnaire, Herth Hope Scale and Self-transcendence Scale.
RESULTS: No significant interaction effects for time and group membership were found for psychological distress either at T1 (t = -1.707, p = .090) or at T2 (t = -1.123, p = .263). The interaction effects for T1 and group membership were statistically significant for meaning in life (t = 3.487, p = .001) and hope (t = 5.313, p < .001), but not statistically significant for self-transcendence (t = 0.148, p = .882). The interaction effects for T2 and group membership were statistically significant for meaning in life (t = 2.592, p = .01), hope (t = 5.215, p < .001) and self-transcendence (t = 2.843, p = .005).
CONCLUSIONS: The MBLRP could improve hope, meaning in life and self-transcendence in cancer patients undergoing chemotherapy.