The suicide is serious public health problem with far-reaching social, emotional and economic consequences. The world trend is significant input of both suicide itself and suicide-like attempts into external causes of mortality, tangible challenge to health life, especially in the youngest population. The WHO estimates that currently more than 700,000 suicides occur worldwide yearly, and each one deeply affect others persons. Russia takes one the first places in the world with its rate of teenage suicides. The suicide of adolescents aged 10-24 years is actual social demographic problem. The process of rapid physical, cognitive and psycho-social growth of this contingent affect feelings, thinking, decision-making and interaction with outside world, causing development of behavioral models corresponding to individual specific of responses to impacting environmental factors. Purpose of the study is, on basis of results of mental health monitoring from analytical materials on population suicidal behavior with emphasis on children and adolescent contingent, to present general conception of suicide as social phenomenon, to make brief historical excursus into becoming and development of problem; to discuss min terminology applied; to present corresponding statistics and to reveal difficulties in obtaining information.

UNASSIGNED: Alcohol use disorder (AUD) is associated with suicidal behavior, but prospective clinical studies are lacking.
UNASSIGNED: To compare clinical characteristics and 6-month outcomes in persons with and without AUD who self-harm.
UNASSIGNED: 804 adults (mean age 33, age range 18-95, 541 women and 263 men, 666 with suicide attempts and 138 with non-suicidal self-injuries at index) at three Swedish university hospitals took part in a research interview that included the Mini International Neuropsychiatric Interview (MINI). Subsequent non-fatal suicidal behavior within six months was identified by record review; suicides were identified by national register.
UNASSIGNED: At index, 39% of the men and 29% of the women had AUD. Over two thirds of these cases (69%) were identified by the MINI, but not by clinical AUD diagnosis. While trait impulsivity was more common among persons with AUD than those without (56% vs 36%, P adj = <.001), impulsivity in connection with the index attempt was noted in half of the participants in each group (48% vs 52%, P adj = 1). Subsequent suicidal behavior (fatal/non-fatal) occurred in 67 persons with AUD (26%) and in 98 without AUD (18%), a 60% higher risk among persons with AUD (OR = 1.60, 95% [CI 1.13-2.28], P = .009). Four persons with AUD (2%) and six without (1%) died by suicide within 6 months.
UNASSIGNED: Almost a third of patients presenting at psychiatric emergency settings after self-harm fulfilled criteria for AUD, but clinicians often missed this diagnosis. Risk for subsequent suicidal behavior was elevated in patients with AUD. Educational interventions to improve recognition of alcohol use disorder may aid clinicians in the assessment and management of patients who present with self-harm.

BACKGROUND: Non-suicidal self-injury (NSSI) is common among adolescents receiving inpatient psychiatric treatment and the months post-discharge is a high-risk period for self-injurious behavior. Thus, identifying predictors that shape the course of post-discharge NSSI may provide insights into ways to improve clinical outcomes. Accordingly, we used machine learning to identify the strongest predictors of NSSI trajectories drawn from a comprehensive clinical assessment.
METHODS: The study included adolescents (N = 612; females n = 435; 71.1%) aged 13-19-years-old (M = 15.6, SD = 1.4) undergoing inpatient treatment. Youth were administered clinical interviews and symptom questionnaires at intake (baseline) and before termination. NSSI frequency was assessed at 1-, 3-, and 6-month follow-ups. Latent class growth analyses were used to group adolescents based on their pattern of NSSI across follow-ups.
RESULTS: Three classes were identified: Low Stable (n = 83), Moderate Fluctuating (n = 260), and High Persistent (n = 269). Important predictors of the High Persistent class in our regularized regression models (LASSO) included baseline psychiatric symptoms and comorbidity, past-week suicidal ideation (SI) severity, lifetime average and worst-point SI intensity, and NSSI in the past 30 days (bs = 0.75-2.33). Only worst-point lifetime suicide ideation intensity was identified as a predictor of the Low Stable class (b = -8.82); no predictors of the Moderate Fluctuating class emerged.
CONCLUSIONS: This study found a set of intake clinical variables that indicate which adolescents may experience persistent NSSI post-discharge. Accordingly, this may help identify youth that may benefit from additional monitoring and support post-hospitalization.

OBJECTIVE: Suicide rates are markedly high among children with foster care involvement. Transition-age youth (TAY) who age-out of the foster care system are at particularly high risk.
METHODS: Analyzing data from the California Youth Transitions to Adulthood Study (n=727), this paper explores the descriptive characteristics of TAY who engage in suicidal behavior with the goals of better identifying, understanding, and supporting those at risk. We report rates of suicidal ideation and suicide attempt at four interview waves (ages 17, 19, 21, 23) and examine differences in rates by sociodemographic characteristics, past maltreatment, and behavioral health disorders.
RESULTS: At age 17, 42% of California Youth Transitions to Adulthood Study participants had thought of committing suicide and 24% had attempted suicide. Across ages, sexual minority youth reported significantly higher rates of suicidal ideation and behavior than their heterosexual peers. We also found that youth with (1) maltreatment experiences (both before and during foster care); (2) major depressive disorder, anxiety disorder or post-traumatic stress disorder; and (3) alcohol/substance abuse disorders were significantly more likely than their peers without these characteristics/diagnoses to engage in suicidal behavior at certain ages. Youth with comorbid psychiatric and substance use disorders were consistently at elevated risk.
CONCLUSIONS: Routine screening for suicidal behavior among TAY is important for child welfare service providers to consider. Youth at risk may benefit from more consistent assessment, mental health care, and targeted mental health intervention. Future research is needed to shed light on mechanisms linking certain sociodemographic, experiential, and behavioral health characteristics with suicidal behavior in TAY.

BACKGROUND: Contradictory findings link trait conscientiousness in mid- and late life to increased healthspan and lifespan, as well as to death by suicide. It remains unclear whether conscientiousness is associated with higher odds of attempting suicide or with more severe suicidal behavior among attempters, and whether its relationship to suicide risk varies with aging-related stressors, such as declining health.
METHODS: In this cross-sectional study comprising 313 depressed adults aged ≥40 years and participating in the Longitudinal Research Program in Late-Life Suicide (Pittsburgh, USA), we employed logistic and linear regression to test whether conscientiousness was associated with the presence of recent suicidal behavior (≤2 years) and with intent severity in recent attempters (n = 84). We further tested whether the above relationships varied based on mental, cognitive, and physical health status, measured as depression severity, cognitive functioning, and the presence/absence of severe physical illness.
RESULTS: Participants were 62.1 years old on average (SD = 7.6), 85% White, and 53% female. Recent attempters had a mean age of 61.8 years at their most recent attempt (SD = 8.5), had lower cognitive functioning and were more likely severely physically ill than comparisons. Conscientiousness was positively associated with a higher likelihood of recent suicidal behavior overall (adjusted OR = 1.44, 95% CI = 1.09, 1.90, p = .010), but not in case of co-occurring severe physical illness (interaction OR = 0.54, 95% CI = 0.30, 0.97, p = .039). Conscientiousness was also positively associated with suicidal intent at the most recent attempt (adjusted β = 1.60, SE = 0.62, p = .012), explaining 7% of its variance, although this association lost significance after adjusting for other personality dimensions.
CONCLUSIONS: Highly conscientious middle-aged and older adults may be at increased risk of resolute suicidal behavior, although conscientiousness may not confer additional suicide risk among those severely physically ill.

This meta-analysis aims to estimate the association between adolescent depression and adult suicidal behavior, while systematically evaluating gender differences reported in literature. A random-effects model was used to determine the pooled association, reporting odds ratios (ORs) with corresponding 95 % confidence intervals (CIs). Nine articles comprising over 6084 adolescents together showed that people with a history of depression in adolescence are more likely to gain suicidal behaviors during adulthood (OR = 3.97, 95 % Cl: 2.79, 5.63). Sex-specific analysis indicated that males who experienced depression in adolescence developed a higher incidence of suicidal behavior in adulthood compared to females with a similar history (Males: OR = 3.61, 95 % Cl: 1.02, 12.78; Females: OR = 3.56, 95 % Cl: 1.71, 7.43). Furthermore, suicide attempts emerged as the predominant outcome among various suicidal behaviors (OR = 3.43, 95 % Cl: 1.75, 6.71). This meta-analysis provides robust evidence that depression in adolescence significantly increases the risk of suicidal behavior in adulthood.

暂无摘要。

BACKGROUND: Considering the limited information on suicide determinants, especially in low- and middle-income countries, the establishment and promotion of a suicide registration system are among the prominent strategies for suicide prevention programs around the world. The multicenter suicide registry is designed to collect standardized data from the two provinces of Iran according to the latest World Health Organization (WHO) guidelines.
METHODS: The Suicidal Behavior Registration Program is a multicenter study designed in five stages, including literature review, infrastructure establishment, database design, training, data analysis, and examining opportunities and challenges. The research samples cases of suicide attempts and self-harm from hospitals in the provinces of Tehran and Ilam.
RESULTS: The multicenter suicide registration program was carried out for 8 months in the two provinces of Tehran and Ilam. During the study period, data of 1382 people were registered, of which 7 cases in Ilam resulted in death. The study uncovered significant differences in socio-demographic, psychological status, and suicide characteristics in the two provinces.
CONCLUSIONS: The design and implementation of the suicide registration program help researchers and policymakers make more innovative and effective interventions to prevent suicide by creating a comprehensive database of suicidal behavior determinants.

BACKGROUND: Several studies involving various suicidal phenotypes based on the strategy of the search of genome-wide associations with single nucleotide polymorphisms have been performed recently. These studies need to be generalized.
OBJECTIVE: To systematize the findings of a number of genome-wide association studies (GWAS) for suicidal phenotypes, annotate the identified markers, analyze their functionality, and possibly substantiate the hypothesis holding that these phenotypes reflect a nonspecific set of gene variants that are relevant as relates to stress-vulnerability as a key endophenotype of suicidal behavior (SB).
METHODS: A search on the PubMed and related resources using the combinations \"suicide AND GWAS\" and \"suicidal behavior AND GWAS\" was performed. It yielded a total of 34 independent studies and meta-analyses.
RESULTS: For the 10 years since such studies emerged, they have undergone significant progress. Estimates of the SNP heritability of SB in some cases are comparable with estimates of heritability based on the twin method. Many studies show a high genetic correlation with the genomic markers of the most common mental disorders (depression, bipolar disorder, schizophrenia, post-traumatic stress disorder). At the same time, a genomic architecture specific to SB is also encountered. Studies utilizing the GWAS strategy have not revealed any associations of SB with candidate genes that had been previously studied in detail (different neurotransmitters, stress response system, polyamines, etc.). Frequently reported findings from various studies belong in three main groups: 1) genes involved in cell interactions, neurogenesis, the development of brain structures, inflammation, and the immune responses; 2) genes encoding receptors for neurotrophins and various components of the intracellular signaling systems involved in synaptic plasticity, embryonic development, and carcinogenesis; and 3) genes encoding various neuro-specific proteins and regulators.
CONCLUSIONS: In general, GWAS in the field of suicidology mainly serve the purpose of a deeper understanding of the pathophysiology of suicidal behavior. However, they also demonstrate growing capability in terms of predicting and preventing suicide, especially when calculating the polygenic risk score among certain populations (psychiatric patients) and in combination with tests of different modalities. From our point of view, there exists a set of markers revealed by the GWAS strategy that seems to point to a leading role played by stress vulnerability, an endophenotype that is formed during early development and which subsequently comes to play the role of key pathogenetic mechanism in SB.
UNASSIGNED: В последние годы накапливаются данные, полученные с использованием стратегии поиска ассоциаций различных суицидальных фенотипов с однонуклеотидными полиморфизмами, которые нуждаются в обобщении.
UNASSIGNED: Систематизировать находки полногеномного поиска ассоциаций (GWAS) по суицидальным фенотипам, аннотировать выявленные маркеры, проанализировать их функциональность и найти возможные подтверждения гипотезы о том, что они отражают неспецифический набор генных вариантов, имеющих отношение к стресс- уязвимости как к ключевому эндофенотипу суицидального поведения.
UNASSIGNED: Поиск материала осуществляли в базе данных PubMed по ключевым словосочетаниям «suicide AND GWAS», «suicidal behavior AND GWAS» с использованием взаимосвязанных источников, что позволило выявить 34 независимых исследования и метаанализа.
UNASSIGNED: За 10 лет с момента своего появления исследования этого типа продемонстрировали значительный прогресс. Оценки SNP-наследуемости суицидального поведения (СП) в ряде случаев приближаются к оценкам наследуемости близнецовым методом. Во многих исследованиях выявляется высокая генетическая корреляция с геномными маркерами наиболее распространённых психических расстройств (депрессия, биполярное расстройство, шизофрения, посттравматическое стрессовое расстройство), но в то же время обнаруживается и специфическая для СП геномная архитектура. Исследования в рамках стратегии GWAS не выявляют ассоциаций СП с наиболее детально исследованными ранее генами-кандидатами (медиаторные системы мозга, система стресс-реагирования, полиамины и др.). Повторяющиеся геномные находки относятся к трем основным группам: 1) гены, вовлечённые в межклеточные взаимодействия, формирование структур мозга, нейрогенез, воспаление и иммунные реакции; 2) гены, кодирующие рецепторы к нейротрофинам и различные компоненты внутриклеточных сигнальных систем, участвующих в синаптической пластичности, эмбриональном развитии и канцерогенезе; 3) гены, кодирующие различные нейроспецифические белки и регуляторы.
UNASSIGNED: Стратегия GWAS в сфере суицидологии в основном служит целям более глубокого понимания патофизиологии СП, но при этом демонстрирует растущий потенциал в плане предикции и превенции суицидов, особенно при расчёте полигенного риска, среди определённых контингентов (психиатрические пациенты) и в сочетании с тестами других модальностей. Выявляемый средствами GWAS набор наиболее часто повторяющихся маркеров, с нашей точки зрения, отражает ведущую роль в генезе СП феномена стресс- уязвимости — формируемого в процессе раннего развития эндофенотипа, который впоследствии играет роль ключевого патогенетического механизма суицида.

OBJECTIVE: To identify characteristics of older adult emergency department (ED) patients aged ≥65 with suicidal ideation and/or behavior.
METHODS: A single center retrospective chart review analyzed 392 patients (≥65) with suicidal ideation and/or behavior (2013-2019). Comprehensive full-text searches were used. Subgroup analyses for age and gender were conducted.
RESULTS: Depressive disorder was documented in 50% of cases. Notably, 54% of all women were prescribed antidepressants, compared to only 31% of men. Most patients had general medical conditions (74.5%) and chronic multimorbidity (71.2%). Social stress affected 40.1%; 35.7% were intoxicated upon presentation. Alcohol abuse was more common in the 65-74 age group, while dementia impacted 20% of those ≥75. Men had a six-fold higher 30-day post-discharge mortality.
CONCLUSIONS: Older ED patients with suicidal ideation and/or behavior exhibit typical characteristics. The dementia prevalence suggests tailored care for those ≥75, and the heightened post-discharge mortality rate in older men requires further research.