Autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD) significantly impact mental health, increasing the risk of severe behaviors, including suicidality. This case report examines a 13-year-old boy with ASD and ADHD who presented to the emergency department with homicidal and suicidal ideations. Despite being prescribed risperidone and carbamazepine, his noncompliance with medication and therapy, combined with significant social stressors like physical abuse by his stepfather and his mother\'s mental health issues, exacerbated his condition. His aggressive actions toward siblings and self-harm attempts highlight the severe behavioral manifestations of these conditions. The case underscores the necessity for comprehensive and consistent intervention strategies, robust support systems, and regular follow-ups to manage ASD and ADHD effectively and mitigate the risk of severe outcomes.

UNASSIGNED: Standardized definitions of suicidality phenotypes, including suicidal ideation (SI), attempt (SA), and death (SD) are a critical step towards improving understanding and comparison of results in suicide research. The complexity of suicidality contributes to heterogeneity in phenotype definitions, impeding evaluation of clinical and genetic risk factors across studies and efforts to combine samples within consortia. Here, we present expert and data-supported recommendations for defining suicidality and control phenotypes to facilitate merging current/legacy samples with definition variability and aid future sample creation.
UNASSIGNED: A subgroup of clinician researchers and experts from the Suicide Workgroup of the Psychiatric Genomics Consortium (PGC) reviewed existing PGC definitions for SI, SA, SD, and control groups and generated preliminary consensus guidelines for instrument-derived and international classification of disease (ICD) data. ICD lists were validated in two independent datasets (N = 9,151 and 12,394).
UNASSIGNED: Recommendations are provided for evaluated instruments for SA and SI, emphasizing selection of lifetime measures phenotype-specific wording. Recommendations are also provided for defining SI and SD from ICD data. As the SA ICD definition is complex, SA code list recommendations were validated against instrument results with sensitivity (range = 15.4% to 80.6%), specificity (range = 67.6% to 97.4%), and positive predictive values (range = 0.59-0.93) reported.
UNASSIGNED: Best-practice guidelines are presented for the use of existing information to define SI/SA/SD in consortia research. These proposed definitions are expected to facilitate more homogeneous data aggregation for genetic and multisite studies. Future research should involve refinement, improved generalizability, and validation in diverse populations.

BACKGROUND: Different parameters of suicide attempts treated since the implementation of the Attention to Suicide Risk Program (ARSUIC) in 2012 at the Hospital Ramón y Cajal in Madrid Region are described in this paper.
METHODS: The sample was composed of 107 patients and the information was collected through a questionnaire created ad hoc with the following variables: type of suicidal ideation; drug use immediately prior to the attempt; method (in case of drug overdosing: drug/s used); location; accessibility to rescue; planning; intentionality; criticism; and brakes.
RESULTS: Descriptive statistics were obtained and a comparison by gender was made through the χ2 and contingency coefficients tests. The data from the retrospective longitudinal study showed that the most common profile was of patients with unstructured ideas of death and no previous drug use who took an unplanned drug overdose in the family home, with the intention of self-harm or avoidance of discomfort, especially with benzodiazepines. Patients tend to ask for help afterwards and criticise the attempt, but potential restraints are often not recorded in the clinical report. Regarding the dissimilarities based on gender, statistically significant differences were found in prior alcohol consumption, in favour of men and in the overdose method, specifically with benzodiazepines, in favour of women.
CONCLUSIONS: Knowing the types of attempts at self-harm is essential for improving prevention, understanding and patient management.

UNASSIGNED: Suicide attempts are a fundamental problem in health care systems and are known for their complex and multifaceted nature. This study aimed to explore the reasons for suicide attempts and to identify associated factors in western Iran.
UNASSIGNED: In Asadabad, western Iran, a cross-sectional study was carried out between April 2020 and March 2021. A nonrandom sampling method was used to select 110 participants, ages 15-35. Structured questionnaires such as the Beck Anxiety Inventory (BAI), the Beck Depression Inventory (BDI-II), and the Suicide Motivation Scale (IMSA) were used to gather the data. Multiple linear regression, one-way analysis of variance, Pearson\'s correlation coefficient, and independent t tests were all used in the data analysis.
UNASSIGNED: The majority of participants (59.1%) were female, with a mean age of 25.78 years. The most common reason for suicide attempts (43.6%) was family issues, and the most popular means (66.4%) were pills and medication. Eighty-nine percent of participants had symptoms of depression. The mean scores were calculated for motivation for suicide attempts (32.46 ± 16.11), depression (34.60 ± 20.50), and anxiety (34.14 ± 15.69). The analysis showed that the motivation for suicide attempts and anxiety was greater in single persons than in married and divorced persons (p < 0.05). Motivation for suicide attempts was also greater in low- to middle-income individuals with a history of divorce (p < 0.05). The multiple regression model showed that anxiety, sex, education, and medical history significantly influenced the motivation for suicide attempts (p < 0.001).
UNASSIGNED: The results showed that a wide range of social, economic, and cultural factors and psychiatric disorders, including anxiety and depression, are involved in suicide attempts. This study aimed to design interventions and strategies to prioritize mental health, improve life skills to control stressful events, and focus on high-risk groups (women, married people, people with low education levels, and those with a history of physical and mental illnesses) for suicide prevention in health promotion programs.

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High-quality clinical care and research on suicidal thoughts and behaviors (STBs) depends on availability and implementation of reliable and valid measures of STBs. In contrast to studies examining STB risk factors, screening instruments, or treatment, little research has rigorously examined the content, characteristics, and psychometric properties of STB measures themselves. This systematic review (1) identified STB measures that conform to empirically supported definitions of STBs, and (2) identified peer-reviewed papers reporting on the psychometric properties of these measures in adults. Data on psychometric properties and other measure characteristics were extracted. A total of 21 eligible measures were identified in the first stage. In the second stage, 70 articles (with 79 independent samples) were included with psychometric data in adult samples for 19 measures. Although there was support for strong internal consistency and content validity across many measures, face validity and clinical utility concerns were prevalent. Few measures comprehensively assessed suicidal behaviors, and interview-based assessments tended to show the strongest psychometric properties and clinical utility. Findings are discussed in the context of recommendations for improving existing measures, including future research to increase utility and translatability across clinical settings, delivery methods, and diverse populations.

BACKGROUND: More than half of those who die by suicide do not communicate about suicide prior to their death. This project describes the emotional state and decision-making among \"unplanned\" attempt survivors to inform a conceptual model and suicide prevention interventions.
METHODS: This qualitative study purposefully sampled patients who reported having no suicidal thoughts on a standardized mental health questionnaire within 60 days (about 2 months) prior to a nonfatal suicide attempt documented in the health record. Participants verbally consented to telephone interview participation. Semistructured audio-recorded interviews elicited suicide attempt survivor descriptions of their emotional state and experiences in the days, hours, and minutes leading up to their suicide attempt. Interviews were transcribed and analyzed using grounded theory. The biopsychosocial theory of emotion regulation informed conceptual model development.
RESULTS: Participants (N = 26) described 2 distinct \"phases\" prior to the attempt. First, a phase of increasing life stressors, transitory and nonspecific suicidal thoughts, and a reluctance to disclose experiences. Second, an overwhelming emotional state led to a sudden suicide attempt and nondisclosure due to the rapidity and intensity of the experience. These results informed the conceptual model and intervention development to manage unplanned and overwhelming urges to attempt suicide.
CONCLUSIONS: Qualitative analysis informed the development of an intervention for the high-intensity \"hot\" period preceding an attempt, including specific steps to manage a highly intense emotional state in combination with overwhelming urges to kill oneself.
CONCLUSIONS: Future research is needed to evaluate whether and how this intervention helps support people with a chance of \"unplanned\" suicide attempts.

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.

UNASSIGNED: Child maltreatment is associated with a higher probability of mental disorders and suicidal behavior in adolescence. Therefore, accurate psychometric instruments are essential to assess this.
UNASSIGNED: To validate the Spanish version of the Childhood Trauma Questionnaire-Short Form (CTQ-SF) in adolescents with suicide attempts.
UNASSIGNED: Multisite cohort study of 208 adolescents with suicide attempts using data from the following scales: Mini International Neuropsychiatric Interview (MINI), Columbia Suicide Severity Rating Scale (C-SSRS), Patient Health Questionnaire (PHQ-9), and CTQ-SF. Statistical analysis: CTQ-SF scores analyzed by descriptive statistics. Internal consistency: McDonald\'s omega and Cronbach\'s alpha. Concurrent validity with PHQ-9 and C-SSRS scores: Spearman correlation coefficient. Structural validity: Confirmatory factor analysis.
UNASSIGNED: Floor and ceiling effects: Physical abuse and neglect as well as sexual abuse demonstrated high floor effects (50.0, 35.1, and 61.1% of adolescents, respectively). No ceiling effects were found. The CTQ-SF had excellent internal consistency (McDonald\'s omega = 0.94), as did the majority of its subscales (Cronbach\'s alpha 0.925-0.831) except for physical neglect (0.624). Its concurrent validity was modest, and the emotional neglect subscale had the lowest Spearman correlation coefficients (0.067-0.244). Confirmatory factor analysis: Compared with alternative factor structures, the original CTQ-SF model (correlated 5-factor) exhibited a better fit [S-B χ 2 = 676.653, p < 0; RMSEA (90% CI = 0.076-0.097) = 0.087; SRMR = 0.078; CFI = 0.980; TLI = 0.978].
UNASSIGNED: The Spanish CTQ-SF is a reliable, valid instrument for assessing traumatic experiences in adolescents at high risk of suicide. It appears appropriate for use in routine clinical practice to monitor maltreatment in this group.

BACKGROUND: Among the existing issues related to the health and quality of life of Russian adolescents, suicidal behavior is being actively discussed; however, the available comprehensive measures for prevention of suicide and attempts at suicide at this age do not provide an adequate solution. This is due to the fact that suicide is an integrative phenomenon, and the act of suicide itself is interpreted, in essence, as the \"tip of the iceberg\". What is especially clearly manifested in adolescence is the fact that the readiness to commit suicide is associated not so much with the level of severity of mental pathology and personality dysfunction, but with the general social context lack of well-being of total trouble. Therefore, suicide prevention cannot be based purely on the timely identification of persons at risk for mental pathology.
OBJECTIVE: The purpose of this work is to analyze the available literature on current approaches that have demonstrated their efficacy in reducing suicidal behavior in adolescents.
METHODS: The authors performed a narrative review of the relevant literature published between 2012 and 2021. They analyzed the works presented in the PubMed, MEDLINE, and Web of Science electronic databases. Descriptive analysis was used to generalize the data obtained.
RESULTS: The article discusses preventive approaches to suicidal behavior in adolescents, which are most often studied, and which are also used in practical healthcare. It outlines the problems associated with the implementation and evaluation of the efficacy of these preventive programs.
CONCLUSIONS: The continuing high rate of suicide among adolescents calls for an urgent concerted effort to develop, disseminate, and implement more effective prevention strategies. School-based approaches are the most convenient in practical terms, but they require systematic and long-term use of anti-suicidal programs. Digital interventions can reduce the economic burden of their use, including assessing suicidal risk and identifying psychopathology associated with suicidality.
UNASSIGNED: В ряду имеющихся проблем, связанных со здоровьем и качеством жизни российских подростков, тема суицидального поведения достаточно активно обсуждается, однако имеет недостаточное решение при реализации комплексных мер по профилактике суицидов и суицидальных попыток в этом возрасте. Связано это с тем, что суицид является интегративным феноменом, а непосредственно сам суицидальный акт интерпретируется по сути как «вершина айсберга». Особенно ярко проявляется в подростковом возрасте тот факт, что суицидальная готовность связана не столько с уровнем выраженности психической патологии и личностной дисфункции, сколько с общим социальным контекстом тотального неблагополучия. В связи с этим, профилактика самоубийств не может базироваться только лишь на своевременном выявлении лиц из группы риска по психической патологии.
UNASSIGNED: Целью данной работы является анализ доступных литературных источников, касающихся современных подходов, показавших свою эффективность в уменьшении уровня суицидального поведения в подростковой среде.
UNASSIGNED: Был выполнен нарративный обзор релевантных литературных источников, опубликованных в период с 2012 г. по 2021 г. Авторы проанализировали работы, представленные в электронных базах данных PubMed, MEDLINE и Web of Science. Для обобщения полученных данных применялся метод описательного анализа.
UNASSIGNED: В статье рассмотрены профилактические подходы к суицидальному поведению подростков, которые наиболее часто исследуются, а также используются в практическом здравоохранении. Обозначены проблемы, связанные с внедрением и оценкой эффективности данных профилактических программ.
UNASSIGNED: Сохраняющийся высокий уровень самоубийств среди подростков требует срочных согласованных усилий по разработке, распространению и внедрению более эффективных стратегий профилактики. Школьные подходы являются наиболее удобными в практическом плане, однако они требуют системного и долгосрочного использования антисуицидальных программ. Цифровые вмешательства могут уменьшить экономическую нагрузку при их применении, в том числе при оценке суицидального риска и выявлении ассоциированной с суицидальностью психопатологии.