Psychosocial–Environmental Risk Factors for Suicide Attempts in Adolescents with Suicidal Ideation: Findings from a Sample of 73,238 Adolescents

We determined risk factors that discriminate between suicide attempt (SA) adolescents and suicidal ideation only (SI only) adolescents using data from the 2010 Korea Youth Risk Behavior Web‐based Survey (12–19 years; N = 73,238). In males, heavy alcohol use, drug use, and high perceived sadness/hopelessness showed significant effects on the presence of SA versus the presence of SI only. In females, along with these variables, low academic achievement, poor perceived health status, high perceived stress, and unhealthy coping strategy were also significantly related to the presence of SA versus SI only. Therefore, clinical interventions targeting adolescents' psychological distress are warranted to prevent suicide.     

What Changes in Therapy? Who Changes?

SUMMARY

A central component of therapeutic change involves facilitating the capacity to move and be moved by the other. Another way of saying this might be that change entails experiencing a greater freedom of relational movement. The question of who and what actually changes in the process of therapy is the focus of the three vignettes that follow. They highlight, among other things, the recognition and acknowledgment of mutuality as an essential force within the relational matrix and the ever-changing landscape that this creates. Each of these examples of a change process bears, as well, a particular stamp of its own, and thus speaks to the unique personality of every therapeutic dyad.     

Factors of Early Suicide after Discharge: A National Linkage Study for Suicide Victims in Taiwan

Patients recently discharged from psychiatric inpatient care have a higher suicide rate. The study aimed to identify the characteristics associated with early suicide of those patients discharged from psychiatric wards in Taiwan. The results indicated that among 672 suicide victims who died within one year post‐discharge from psychiatric wards in Taiwan between 2000 and 2004, diagnosis of schizophrenia, shorter disease duration, and co‐morbidity with cancer were all significantly associated with suicide occurring within one month of discharge. Clinical diagnosis of psychiatric disorders, recent psychiatric diagnosis, and co‐morbidity with severe physical illnesses should receive special monitoring for potential suicide after discharge.     

Patient Suicide: A Survey of Therapists' Reactions

A substantial proportion of therapists will at some point in their professional life experience the loss of a patient to suicide. Our aims were to assess how therapists react to patient's suicide over time and which factors contribute to the reaction. One third of the therapists, mostly women, suffer from severe distress. The impact is not different for therapists in institutional settings and therapists in private practice. The item “overall distress” immediately after the suicide predicts emotional reactions and changes in behavior. Our data suggest that identifying the severely distressed subgroup could be done using a visual analogue scale for overall distress. As a consequence, more specific and intensified help could be provided to these individuals.     

Tryptophan Hydroxylase 1 Variant rs1800532 is Associated with Suicide Attempt in Serbian Psychiatric Patients but does not Moderate the Effect of Recent Stressful Life Events

Tryptophan hydroxylase 1 (TPH1) gene, coding for serotonin synthesizing enzyme, and recent stressful life events (SLEs) have been commonly associated with suicidal behavior. TPH1 has been also hypothesized to be involved in stress–response mechanisms. The aim of this study was to assess TPH1 variant rs1800532 and its possible interaction with recent SLEs as risk factors for suicide attempt (SA) in Serbian psychiatric patients, including 165 suicide attempters and 188 suicide nonattempters. rs1800532 and recent SLEs were independently associated with SA, while rs1800532 did not moderate the effect of recent SLEs on SA vulnerability among Serbian psychiatric patients.     

The Media and Suicide: Evidence‐Based on Population Data over 9 Years in Taiwan

The relationship between the regional distribution densities of different media and the suicide death rate was explored by analyzing the annual total, male, and female suicide rates and media densities from 23 cities/counties in Taiwan during 1998–2006 by univariate and multivariate regression adjusted for five socioeconomic factors. The regional density of newspapers was significantly inversely related to the total, male, and female suicide rates, while that of television sets was not. The density of in‐home personal computers was significantly positively related to the total and male suicide rates, but not the female suicide rate. The results indicate that media reporting on suicide can be beneficial, instead of harmful, depending on the content.     

Telehealth Monitoring of Patients with Schizophrenia and Suicidal Ideation

A telehealth system was developed to monitor risk following hospitalization for suicidal ideation. We hypothesized that 3 months of telehealth monitoring will result in a greater reduction in suicidal ideation. Veterans with schizophrenia admitted with recent suicidal ideation and/or a suicidal attempt were recruited into a discharge program of VA Usual Care with daily Health Buddy© monitoring (HB) or Usual Care (UC) alone. Fifteen of 25 were randomized to HB and 10 received UC. Daily adherence in the use of the HB system during months 1–3 was, respectively, 86.9%, 86.3%, and 84.1%. There were significant improvements in Beck Scale for Suicide Ideation scores in HB participants. There were no changes in depressive symptoms. Telehealth monitoring for this population of patients appears to be feasible.