Suicidal ideation

Last updated
Suicidal ideation
Other namesSuicidal thoughts, suicidal ideas
Stuckelberg Sappho 1897.jpg
Sappho, an 1897 portrait by Ernst Stückelberg
Specialty Psychiatry, psychology

Suicidal ideation, or suicidal thoughts, is the thought process of having ideas, or ruminations about the possibility of completing suicide. [1] It is not a diagnosis but is a symptom of some mental disorders, use of certain psychoactive drugs, and can also occur in response to adverse life circumstances without the presence of a mental disorder. [2]

Contents

On suicide risk scales, the range of suicidal ideation varies from fleeting thoughts to detailed planning. Passive suicidal ideation is thinking about not wanting to live or imagining being dead. [3] [4] Active suicidal ideation involves preparation to kill oneself or forming a plan to do so. [3] [4]

Most people who have suicidal thoughts do not go on to make suicide attempts, but suicidal thoughts are considered a risk factor. [5] During 2008–09, an estimated 8.3 million adults aged 18 and over in the United States, or 3.7% of the adult U.S. population, reported having suicidal thoughts in the previous year, while an estimated 2.2 million reported having made suicide plans in the previous year. [6] In 2019, 12 million U.S. adults seriously thought about suicide, 3.5 million planned a suicide attempt, 1.4 million attempted suicide, and more than 47,500 died by suicide. [7] [8] Suicidal thoughts are also common among teenagers. [9]

Suicidal ideation is associated with depression and other mood disorders; however, many other mental disorders, life events and family events can increase the risk of suicidal ideation. Mental health researchers indicate that healthcare systems should provide treatment for individuals with suicidal ideation, regardless of diagnosis, because of the risk for suicidal acts and repeated problems associated with suicidal thoughts. [10] [11] There are a number of treatment options for people who experience suicidal ideation.

Definitions

The ICD-11 describes suicidal ideation as "thoughts, ideas, or ruminations about the possibility of ending one's life, ranging from thinking that one would be better off dead to formulation of elaborate plans". [1]

The DSM-5 defines it as "thoughts about self-harm, with deliberate consideration or planning of possible techniques of causing one's own death". [12]

The U.S. Centers for Disease Control and Prevention defines suicidal ideation "as thinking about, considering, or planning suicide". [13]

Terminology

Another term for suicidal ideation is suicidal thoughts. [5]

When someone who has not shown a history of suicidal ideation experiences a sudden and pronounced thought of performing an act which would necessarily lead to their own death, psychologists call this an intrusive thought. A commonly experienced example of this is the high place phenomenon, [14] also referred to as the call of the void, the sudden urge to jump when in a high place. [15]

Euphemisms related to mortal contemplation include internal struggle, [16] voluntary death, [17] and eating one's gun. [18]

Risk factors

The risk factors for suicidal ideation can be divided into three categories: psychiatric disorders, life events, and family history.

Psychiatric disorders

Suicidal ideation is a symptom of many mental disorders and can occur in response to adverse life events without the presence of a mental disorder. [2]

There are several psychiatric disorders that appear to be comorbid with suicidal ideation or considerably increase the risk of suicidal ideation. [19] For example, many individuals with borderline personality disorder exhibit recurrent suicidal behavior and suicidal thoughts. One study found that 73% of patients with borderline personality disorder have attempted suicide, with the average patient having 3.4 attempts. [20] The following list includes the disorders that have been shown to be the strongest predictors of suicidal ideation. These are not the only disorders that can increase the risk of suicidal ideation. The disorders in which risk is increased the greatest include: [21]

Medication side effects

Antidepressant medications are commonly used to decrease the symptoms in patients with moderate to severe clinical depression, and some studies indicate a connection between suicidal thoughts and tendencies and taking antidepressants, [26] increasing the risk of suicidal thoughts in some patients. [27]

Some medications, such as selective serotonin reuptake inhibitors (SSRIs), can have suicidal ideation as a side effect. Moreover, these drugs' intended effects, can themselves have the unintended consequence of increased individual risk and collective rate of suicidal behavior: Among the set of persons taking the medication, a subset feel bad enough to want to attempt suicide (or to desire the perceived results of suicide) but are inhibited by depression-induced symptoms, such as lack of energy and motivation, from following through with an attempt. Among this subset, a "sub-subset" may find that the medication alleviates their physiological symptoms (such as lack of energy) and secondary psychological symptoms (e.g., lack of motivation) before or at lower doses than it alleviates their primary psychological symptom of depressed mood. Among this group of persons, the desire for suicide or its effects persists even as major obstacles to suicidal action are removed, with the effect that the incidences of suicide and suicide attempts increase. [28]

In 2003, the U.S. Food and Drug Administration (FDA) issued the agency's strictest warning for manufacturers of all antidepressants (including tricyclic antidepressants [TCAs] and monoamine oxidase inhibitors) [29] due to their association with suicidal thoughts and behaviors. [30] Further studies disagree with the warning, especially when prescribed for adults, claiming more recent studies are inconclusive in the connection between the drugs and suicidal ideation. [30]

Individuals with anxiety disorders who self-medicate with drugs or alcohol may also have an increased likelihood of suicidal ideation. [31]

Most people are under the influence of sedative-hypnotic drugs (such as alcohol or benzodiazepines) when they die by suicide, [32] with alcoholism present in between 15% and 61% of cases. [33] Use of prescribed benzodiazepines is associated with an increased rate of suicide and attempted suicide. The pro-suicidal effects of benzodiazepines are suspected to be due to a psychiatric disturbance caused by side effects, such as disinhibition, or withdrawal symptoms. [34]

Life events

Life events are strong predictors of increased risk for suicidal ideation. Furthermore, life events can also lead to or be comorbid with the previously listed psychiatric disorders and predict suicidal ideation through those means. Life events that adults and children face can be dissimilar and for this reason, the list of events that increase risk can vary in adults and children. The life events that have been shown to increase risk most significantly are: [35]

Family history

Relationships with parents

According to a study conducted by Ruth X. Liu of San Diego State University, a significant connection was found between the parent–child relationships of adolescents in early, middle and late adolescence and their likelihood of suicidal ideation. The study consisted of measuring relationships between mothers and daughters, fathers and sons, mothers and sons, and fathers and daughters. The relationships between fathers and sons during early and middle adolescence show an inverse relationship to suicidal ideation. Closeness with the father in late adolescence is "significantly related to suicidal ideation". [50] Liu goes on to explain the relationship found between closeness with the opposite sex parent and the child's risk of suicidal thoughts. It was found that boys are better protected from suicidal ideation if they are close to their mothers through early and late adolescence; whereas girls are better protected by having a close relationship with their father during middle adolescence.

An article published in 2010 by Zappulla and Pace found that suicidal ideation in adolescent boys is exacerbated by detachment from the parents when depression is already present in the child. Lifetime prevalence estimates of suicidal ideation among nonclinical populations of adolescents generally range from 60% to 75% and in many cases its severity increases the risk of suicide. [51] Parents who are unaccepting of their child's expressed LGBT sexuality, especially in a predominantly Christian culture as exists in South Korea, creates a hotbed for suicidal ideation (see under LGBT youth below).

Prevention

Suicide prevention sign on the Golden Gate Bridge 2.jpg
Crisis Counseling at Golden Gate Bridge.jpg
As a suicide prevention initiative, these signs on the Golden Gate Bridge promote a special telephone that connects to a crisis hotline, as well as a 24/7 crisis text line.
Crisis hotlines, such as the National Suicide Prevention Lifeline, enable people to get immediate emergency telephone counselling. Lifelinelogo.svg
Crisis hotlines, such as the National Suicide Prevention Lifeline, enable people to get immediate emergency telephone counselling.
A caring letter written by hand Caringletterhw.jpg
A caring letter written by hand

Early detection and treatment are the best ways to prevent suicidal ideation and suicide attempts. [52] [ citation needed ] If signs, symptoms, or risk factors are detected early then the individual might seek treatment and help before attempting to take their own life. In a study of individuals who did die by suicide, 91% of them likely had one or more mental illnesses. However, only 35% of those individuals were treated or being treated for a mental illness. [53] This emphasizes the importance of early detection; if a mental illness is detected, it can be treated and controlled to help prevent suicide attempts. Another study investigated strictly suicidal ideation in adolescents. This study found that depression symptoms in adolescents as early as 9th grade is a predictor of suicidal ideation. Most people with long-term suicidal ideation do not seek professional help.[ citation needed ]

The previously mentioned studies point out the difficulty that mental health professionals have in motivating individuals to seek and continue treatment. Ways to increase the number of individuals who seek treatment may include:

A study conducted by researchers in Australia set out to determine a course of early detection for suicidal ideation in teens stating that "risks associated with suicidality require an immediate focus on diminishing self-harming cognitions so as to ensure safety before attending to the underlying etiology of the behavior". A Psychological Distress scale known as the K10 was administered monthly to a random sample of individuals. According to the results among the 9.9% of individuals who reported "psychological distress (all categories)" 5.1% of the same participants reported suicidal ideation. Participants who scored "very high" on the Psychological Distress scale "were 77 times more likely to report suicidal ideation than those in the low category". [54]

In a one-year study conducted in Finland, 41% of the patients who later died by suicide saw a healthcare professional, most seeing a psychiatrist. Of those, only 22% discussed suicidal intent on their last office visit. In most of the cases, the office visit took place within a week of the suicide, and most of the victims had a diagnosed depressive disorder. [55]

There are many centers where one can receive aid in the fight against suicidal ideation and suicide. Hemelrijk et al. (2012) found evidence that assisting people with suicidal ideation via the internet versus more direct forms such as phone conversations has a greater effect. In a 2021 research study, Nguyen et al. (2021) propose that maybe the premise that suicidal ideation is a kind of illness has been an obstacle to dealing with suicidal ideation. [56] They use a Bayesian statistical investigation, in conjunction with the mindsponge theory, [57] to explore the processes where mental disorders have played a very minor role and conclude that there are many cases where the suicidal ideation represents a type of cost-benefit analysis for a life/death consideration, and these people may not be called "patients".

Assessment

Assessment seeks to understand an individual by integrating information from multiple sources such as clinical interviews; medical exams and physiological measures; standardized psychometric tests and questionnaires; structured diagnostic interviews; review of records; and collateral interviews. [58]

Interviews

Psychologists, psychiatrists, and other mental health professionals conduct clinical interviews to ascertain the nature of a patient or client's difficulties, including any signs or symptoms of illness the person might exhibit. Clinical interviews are "unstructured" in the sense that each clinician develops a particular approach to asking questions, without necessarily following a predefined format. Structured (or semi-structured) interviews prescribe the questions, their order of presentation, "probes" (queries) if a patient's response is not clear or specific enough, and a method to rate the frequency and intensity of symptoms. [59]

Standardized psychometric measures

Management

Treatment of suicidal ideation can be problematic due to the fact that several medications have actually been linked to increasing or causing suicidal ideation in patients. Therefore, several alternative means of treating suicidal ideation are often used. The main treatments include: therapy, hospitalization, outpatient treatment, and medication or other modalities. [5]

Diet

There are no specific diets that can treat suicidal ideation.

Therapy

In psychotherapy a person explores the issues that make them feel suicidal and learns skills to help manage emotions more effectively. [5] [61]

Hospitalization

Hospitalization allows the patient to be in a secure, supervised environment to prevent suicidal ideation from turning into suicide attempts. In most cases, individuals have the freedom to choose which treatment they see fit for themselves. However, there are several circumstances in which individuals can be hospitalized involuntarily. These circumstances are:

Hospitalization may also be a treatment option if an individual:

Outpatient treatment

Outpatient treatment allows individuals to remain at their place of residence and receive treatment when needed or on a scheduled basis. Being at home may improve quality of life for some patients, because they will have access to their personal belongings, and be able to come and go freely. Before allowing patients the freedom that comes with outpatient treatment, physicians evaluate several factors of the patient. These factors include the patient's level of social support, impulse control and quality of judgment. After the patient passes the evaluation, they are often asked to consent to a "no-harm contract". This is a contract formulated by the physician and the family of the patient. Within the contract, the patient agrees not to harm themself, to continue their visits with the physician, and to contact the physician in times of need. [5] There is some debate as to whether "no-harm" contracts are effective. These patients are then checked on routinely to assure they are maintaining their contract and avoiding dangerous activities (drinking alcohol, driving fast and not wearing a seat belt, etc.).

Medication

Prescribing medication to treat suicidal ideation can be difficult. One reason for this is that many medications lift patients' energy levels before lifting their moods. This puts them at greater risk of following through with attempting suicide. Additionally, if a person has a comorbid psychiatric disorder, it may be difficult to find a medication that addresses both the psychiatric disorder and suicidal ideation.

Antidepressants may be effective. [5] Often, SSRIs are used instead of TCAs as the latter typically have greater harm in overdose. [5]

Antidepressants have been shown to be a very effective means of treating suicidal ideation. One correlational study compared mortality rates due to suicide to the use of SSRI antidepressants in certain counties. The counties which had higher SSRI use had a significantly lower number of deaths caused by suicide. [62] Additionally, an experimental study followed depressed patients for one year. During the first six months of that year, the patients were examined for suicidal behavior including suicidal ideation. The patients were then prescribed antidepressants for the six months following the first six observatory months. During the six months of treatment, experimenters found suicidal ideation reduced from 47% of patients down to 14% of patients. [63] Thus, it appears from current research that antidepressants have a helpful effect on the reduction of suicidal ideation.

Although research is largely in favor of the use of antidepressants for the treatment of suicidal ideation, in some cases antidepressants are claimed to be the cause of suicidal ideation. Upon the start of using antidepressants, many clinicians will note that sometimes the sudden onset of suicidal ideation may accompany treatment. This has caused the Food and Drug Administration (FDA) to issue a warning stating that sometimes the use of antidepressants may actually increase suicidal ideation. [62] Medical studies have found antidepressants help treat cases of suicidal ideation and work especially well with psychological therapy. [64] Lithium reduces the risk of suicide in people with mood disorders. [65] Tentative evidence finds clozapine in people with schizophrenia reduces the risk of suicide. [66]

Others

Dialectical behavior therapy

Transcranial magnetic stimulation

Electroconvulsive therapy

LGBT youth

Suicidal ideation rates among lesbian, gay, bisexual, transgender (LGBT) youth are significantly higher than among the general population. [67] Suicidal ideation, which has a higher prevalence among LGBT teenagers compared to their cisgender and heterosexual peers, has been attributed to minority stress, bullying, and parental disapproval. [68] [69]

South Korea

South Korea has the 4th highest rate of suicide in the world and the highest in the OECD. Within these rates, suicide is the primary cause of death for South Korean youth, ages 10–19. [70] While these rates are elevated, suicidal ideation additionally increases with the introduction of LGBT identity. [71]

See also

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References

  1. 1 2 World Health Organization, ICD-11 for Mortality and Morbidity Statistics, ver. 09/2020, MB26.A Suicidal ideation
  2. 1 2 Barry, Lisa C. Passive Suicidal Ideation in Older Adults: Implications for Suicide Prevention, American Journal of Geriatric Psychiatry 27, no. 12 (December 2019): 1411 ("... growing evidence points toward a subgroup of individuals who endorse passive SI [suicidal ideation] in later life outside the context of clinical depression.")
  3. 1 2 Falcone, Tatiana; Timmons-Mitchell, Jane (2018-05-18). "Mood Disorders and Suicide". Suicide Prevention: A Practical Guide for the Practitioner. Springer. p. 38. ISBN   978-3-319-74391-2.
  4. 1 2 Kumar, Updesh (2017-10-26). "Suicidal Ideation in Adolescents–A Transcultural Analysis". Handbook of Suicidal Behaviour. Springer. p. 269. ISBN   978-981-10-4816-6.
  5. 1 2 3 4 5 6 7 Gliatto, MF; Rai, AK (March 1999). "Evaluation and Treatment of Patients with Suicidal Ideation". American Family Physician . 59 (6): 1500–6. PMID   10193592. Archived from the original on 2006-09-25. Retrieved 2007-01-08. Open Access logo PLoS transparent.svg
  6. Crosby, Alex; Beth, Han (October 2011). "Suicidal Thoughts and Behaviors Among Adults Aged ≥18 Years --- United States, 2008-2009". Morbidity and Mortality Weekly Report. 60 (13). Archived from the original on 2015-01-07. Retrieved 2015-01-08.
  7. CDC. "Facts About Suicide". Archived from the original on 2022-01-07. Retrieved 2022-01-09.
  8. Substance Abuse and Mental Health Services Administration (2020). "Key substance use and mental health indicators in the United States: Results from the 2019 National Survey on Drug Use and Health". Archived from the original on 2021-10-09. Retrieved 2022-01-09.
  9. Uddin, R; Burton, NW; Maple, M; Khan, SR; Khan, A (2019). "Suicidal ideation, suicide planning, and suicide attempts among adolescents in 59 low-income and middle-income countries: a population-based study" (PDF). The Lancet Child & Adolescent Health. 3 (4): 223–233. doi:10.1016/S2352-4642(18)30403-6. hdl: 10072/387579 . PMID   30878117. S2CID   81982117. Archived (PDF) from the original on 2020-02-18. Retrieved 2019-11-29.
  10. Griffin, E.; Kavalidou, K.; Bonner, B.; O'Hagan, D.; Corcoran, P. (2020). "Risk of repetition and subsequent self-harm following presentation to hospital with suicidal ideation: A longitudinal registry study". eClinicalMedicine. 23: 100378. doi:10.1016/j.eclinm.2020.100378. ISSN   2589-5370. PMC   7280762 . PMID   32529177.
  11. Kleiman, Evan M. (2020). "Suicidal thinking as a valuable clinical endpoint". eClinicalMedicine. 23: 100399. doi: 10.1016/j.eclinm.2020.100399 . ISSN   2589-5370. PMC   7298405 . PMID   32566922.
  12. Diagnostic and statistical manual of mental disorders (DSM-5). Arlington: American Psychiatric Publishing. 2013. p. 830. ISBN   978-0-89042-555-8.
  13. Klonsky, E. David; May, Alexis M.; Saffer, Boaz Y. (2016-03-28). "Suicide, Suicide Attempts, and Suicidal Ideation" (PDF). Annual Review of Clinical Psychology. 12 (1): 307–330. doi: 10.1146/annurev-clinpsy-021815-093204 . ISSN   1548-5943. PMID   26772209.
  14. Adam, David (2014). "How OCD creates prisoners of the mind". New Scientist. 222 (2966): 36–39. Bibcode:2014NewSc.222...36A. doi:10.1016/s0262-4079(14)60832-0.
  15. Demont, Marc, and Of Male Friendship. "Gender Studies: Masculinity Studies."
  16. Brown, Gregory K.; et al. (2005). "The internal struggle between the wish to die and the wish to live: a risk factor for suicide". American Journal of Psychiatry. 162 (10): 1977–1979. doi:10.1176/appi.ajp.162.10.1977. PMID   16199851.
  17. Miller, Franklin G.; Meier, Diane E. (1998). "Voluntary death: a comparison of terminal dehydration and physician-assisted suicide". Annals of Internal Medicine. 128 (7): 559–562. doi:10.7326/0003-4819-128-7-199804010-00007. PMID   9518401. S2CID   34734585.
  18. Baker, Thomas E (2009). "Dell P. Hackett and John M. Violanti, Police Suicide: Tactics for Prevention". Journal of Police and Criminal Psychology. 24 (1): 66–67. doi:10.1007/s11896-008-9037-4. S2CID   142153854.
  19. Hemelrijk, E; Van Ballegooijen, W; Donker, T; Van Straten, A; Kerkhof, A (2012). "Internet-based screening for suicidal ideation in common mental disorders". Crisis: The Journal of Crisis Intervention and Suicide Prevention. 33 (4): 215–221. doi:10.1027/0227-5910/a000142. PMID   22713975. S2CID   21192564.
  20. Soloff, PH; Kevin, GL; Thomas, MK; Kevin, MM; Mann, JJ (1 April 2000). "Characteristics of Suicide Attempts of Patients With Major Depressive Episode and Borderline Personality Disorder: A Comparative Study". American Journal of Psychiatry. 157 (4): 601–608. doi:10.1176/appi.ajp.157.4.601. PMID   10739420. S2CID   27150913.
  21. Harris, EC; Barraclough, B (1997). "Suicide as an outcome for mental disorders. A meta analysis". The British Journal of Psychiatry. 170 (3): 205–228. doi:10.1192/bjp.170.3.205. PMID   9229027. S2CID   33824780.
  22. "The Link Between Suicide and Autism | Psychology Today". www.psychologytoday.com. Retrieved 2022-04-18.
  23. 1 2 3 4 5 6 7 8 9 American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). Arlington, VA: American Psychiatric Publishing. doi:10.1176/appi.books.9780890425596. hdl:2027.42/138395. ISBN   978-0-89042-559-6.
  24. Lemon, TI; Shah, RD (2013). "Needle exchanges – a forgotten outpost in suicide and self-harm prevention". Journal of Psychosomatic Research. 74 (6): 551–552. doi:10.1016/j.jpsychores.2013.03.057.
  25. Lemon, TI (2013). "Suicide ideation in drug users and the role of needles exchanges and their workers". Journal Psych Med. 6 (5): 429. doi:10.1016/j.ajp.2013.07.003. PMID   24011693.
  26. Teicher, M. H.; Glod, C. A.; Cole, J. O. (March 1993). "Antidepressant drugs and the emergence of suicidal tendencies". Drug Safety. 8 (3): 186–212. doi:10.2165/00002018-199308030-00002. ISSN   0114-5916. PMID   8452661. S2CID   36366654.
  27. Reeves, Roy R.; Ladner, Mark E. (2010). "Antidepressant-Induced Suicidality: An Update". CNS Neuroscience & Therapeutics. 16 (4): 227–234. doi:10.1111/j.1755-5949.2010.00160.x. ISSN   1755-5949. PMC   6493906 . PMID   20553304.
  28. "The most commonly prescribed type of antidepressant". Mayo Clinic. Retrieved 2020-10-08.
  29. Selvaraj, Vithyalakshmi; Veeravalli, Snehamala; Ramaswamy, Sriram; Balon, Richard; Yeragani, Vikram K. (2010). "Depression, suicidality and antidepressants: A coincidence?". Indian Journal of Psychiatry. 52 (1): 17–20. doi: 10.4103/0019-5545.58890 . ISSN   0019-5545. PMC   2824975 . PMID   20174513.
  30. 1 2 Fornaro, Michele; Anastasia, Annalisa; Valchera, Alessandro; Carano, Alessandro; Orsolini, Laura; Vellante, Federica; Rapini, Gabriella; Olivieri, Luigi; Di Natale, Serena; Perna, Giampaolo; Martinotti, Giovanni (2019-05-03). "The FDA "Black Box" Warning on Antidepressant Suicide Risk in Young Adults: More Harm Than Benefits?". Frontiers in Psychiatry. 10: 294. doi: 10.3389/fpsyt.2019.00294 . ISSN   1664-0640. PMC   6510161 . PMID   31130881.
  31. Bolton, James; Cox, Brian; Clara, Ian; Sareen, Jitender (November 2006). "Use of alcohol and drugs to self-medicate anxiety disorders in a nationally representative sample". The Journal of Nervous and Mental Disease. 194 (11): 818–825. doi:10.1097/01.nmd.0000244481.63148.98. ISSN   0022-3018. PMID   17102705. S2CID   7515999.
  32. Youssef NA, Rich CL (2008). "Does acute treatment with sedatives/hypnotics for anxiety in depressed patients affect suicide risk? A literature review". Annals of Clinical Psychiatry. 20 (3): 157–69. doi:10.1080/10401230802177698. PMID   18633742.
  33. Vijayakumar L, Kumar MS, Vijayakumar V (May 2011). "Substance use and suicide". Current Opinion in Psychiatry. 24 (3): 197–202. doi:10.1097/YCO.0b013e3283459242. PMID   21430536. S2CID   206143129.
  34. Dodds TJ (March 2017). "Prescribed Benzodiazepines and Suicide Risk: A Review of the Literature". The Primary Care Companion for CNS Disorders. 19 (2). doi: 10.4088/PCC.16r02037 . PMID   28257172.
  35. Fergusson, DM; Woodward, LJ; Horwood, LJ (2000). "Risk factors and life processes associated with the onset of suicidal behavior during adolescence and early adulthood". Psychological Medicine. 30 (1): 23–39. doi:10.1017/s003329179900135x. PMID   10722173. S2CID   5803465.
  36. 1 2 3 Gonzalez, VM (2012). "Association of solitary binge drinking and suicidal behavior among emerging adult college students". Psychology of Addictive Behaviors. 26 (3): 609–614. doi:10.1037/a0026916. PMC   3431456 . PMID   22288976. Open Access logo PLoS transparent.svg
  37. 1 2 3 Valenstein, H; Cronkite, RC; Moos, RH; Snipes, C; Timko, C (2012). "Suicidal ideation in adult offspring of depressed and matched control parents: Childhood and concurrent predictors". Journal of Mental Health. 21 (5): 459–468. doi:10.3109/09638237.2012.694504. PMID   22978501. S2CID   9842249.
  38. McDermott, Elizabeth; Hughes, Elizabeth; Rawlings, Victoria (February 2018). "Norms and normalisation: understanding lesbian, gay, bisexual, transgender and queer youth, suicidality and help-seeking". Culture, Health & Sexuality. 20 (2): 156–172. doi: 10.1080/13691058.2017.1335435 . ISSN   1369-1058. PMID   28641479.
  39. Smith, Michael (2004). "Suicidal ideation, plans, and attempts in chronic pain patients: factors associated with increased risk". Pain. 111 (1–2): 201–208. doi:10.1016/j.pain.2004.06.016. PMID   15327824. S2CID   6745062.
  40. Dugas, E; Low, NP; Rodriguez, D; Burrows, S; Contreras, G; Chaiton, M; et al. (2012). "Early Predictors of Suicidal Ideation in Young Adults". Canadian Journal of Psychiatry. 57 (7): 429–436. doi: 10.1177/070674371205700706 . PMID   22762298.
  41. "Cyberbullying Research Summary – Cyberbullying and Suicide" (PDF). Cyberbullying Research Center. Archived (PDF) from the original on 4 September 2012. Retrieved 3 July 2012.
  42. "The relationship between bullying, depression and suicidal thoughts/behaviour in Irish adolescents". Department of Health and Children. Archived from the original on 1 September 2014. Retrieved 3 July 2012.
  43. Hogh, Annie; Gemzøe Mikkelsen, Eva; Hansen, Åse Marie (2010). "Chapter 4: Individual Consequences of Workplace Bullying/Mobbing". In Einarsen, Stale; Hoel, Helge; Zapf, Dieter; Cooper, Cary (eds.). Bullying and Harassment in the Workplace: Developments in Theory, Research, and Practice. Boca Raton, Florida: CRC Press. ISBN   9781439804896. OCLC   1087897728.
  44. Richardson, JD; St Cyr, KC; McIntyre-Smith, AM; Haslam, D; Elhai, JD; Sareen, J (2012). "Examining the association between psychiatric illness and suicidal ideation in a sample of treatment-seeking Canadian peacekeeping and combat veterans with posttraumatic stress disorder PTSD". Canadian Journal of Psychiatry. 57 (8): 496–504. doi: 10.1177/070674371205700808 . PMID   22854032.
  45. 1 2 Thompson, R; Litrownik, AJ; Isbell, P; Everson, MD; English, DJ; Dubowitz, H; et al. (2012). "Adverse experiences and suicidal ideation in adolescence: Exploring the link using the LONGSCAN samples". Psychology of Violence. 2 (2): 211–225. doi:10.1037/a0027107. PMC   3857611 . PMID   24349862. Open Access logo PLoS transparent.svg
  46. Carpenter, KM; Hasin, DS; Allison, DB; Faith, MS (2000). "Relationships between obesity and DSM-IV major depressive disorder, suicidal ideation, and suicide attempts: Results from a general population study". American Journal of Public Health. 90 (2): 251–257. doi:10.2105/ajph.90.2.251. PMC   1446144 . PMID   10667187.
  47. Cha, CB; Najmi, S; Park, JM; Finn, CT; Nock, MK (2010). "Attentional bias toward suicide-related stimuli predicts suicidal behavior". Journal of Abnormal Psychology. 119 (3): 616–622. doi:10.1037/a0019710. PMC   2994414 . PMID   20677851. Open Access logo PLoS transparent.svg
  48. Valenstein, Helen (2012). "Suicidal ideation in adult offspring of depressed and matched control parents: Childhood and concurrent predictors". Journal of Mental Health. 21 (5): 459–468. doi:10.3109/09638237.2012.694504. PMID   22978501. S2CID   9842249.
  49. Briere, John (1986). "Suicidal thoughts and behaviours in former sexual abuse victims". Canadian Journal of Behavioural Science. 18 (4): 413–423. doi:10.1037/h0079962.
  50. Liu, Ruth X. (December 2005). "Parent-Youth Closeness and Youth's Suicidal Ideation; The Moderating Effects of Gender, Stages of Adolescence, and Race or Ethnicity". Youth & Society. 37 (2): 160–162. doi:10.1177/0044118X04272290. S2CID   144519020.
  51. Zappulla, Carla (2010). "Relations between suicidal ideation, depression, and emotional autonomy from parents in adolescence". Journal of Child and Family Studies. 19 (6). Springer Science + Business Media LLC: 747–756. doi:10.1007/s10826-010-9364-9. S2CID   145370728 . Retrieved 10 April 2012.[ permanent dead link ]
  52. Harmer, Bonnie; Lee, Sarah; Rizvi, Abid; Saadabadi, Abdolreza (2024). "Suicidal Ideation". StatPearls. StatPearls Publishing. PMID   33351435 . Retrieved 2 June 2024.
  53. 1 2 Cavanagh, JO; Owens, DC; Johnstone, EC (1999). "Life events in suicide and undetermined death in south-east Scotland: a case-control study using the method of psychological autopsy". Social Psychiatry and Psychiatric Epidemiology. 34 (12): 645–650. doi:10.1007/s001270050187. PMID   10703274. S2CID   31350280.
  54. Chamberlain, P; Goldney, R; Delfabbro, P; Gill, T; Dal Grande, L (2009). "Suicidal Ideation: The Clinical Utility of the K10". Crisis. 30 (1): 39–42. doi:10.1027/0227-5910.30.1.39. PMID   19261567.
  55. Halgin, Richard P.; Susan Whitbourne (2006). Abnormal psychology: clinical perspectives on psychological disorders. Boston: McGraw-Hill. pp. 267–272. ISBN   978-0-07-322872-3.
  56. Nguyen, MH; Le, TT; Nguyen, HKT; Ho, MT; Nguyen, TTH; Vuong, QH (2021). "Alice in Suicideland: Exploring the Suicidal Ideation Mechanism through the Sense of Connectedness and Help-Seeking Behaviors". Int. J. Environ. Res. Public Health. 7. 18 (7): 3681. doi: 10.3390/ijerph18073681 . PMC   8037954 . PMID   33916123.
  57. Vuong, QH; Napier, Nancy K. (2015). "Acculturation and global mindsponge: an emerging market perspective". International Journal of Intercultural Relations. 49: 354–367. doi:10.1016/j.ijintrel.2015.06.003.
  58. Coaley, Keith, "Introduction: Individual Differences and Psychometrics", chap. 1 in An Introduction to Psychological Assessment and Psychometrics, 2nd ed. (London: Sage, 2014), 1–34. ISBN   978-1-4462-6714-1
  59. Rogers, Richard. Handbook of Diagnostic and Structured Interviewing. New York: Guilford, 2001.
  60. Harris, K. M.; Syu, J. J.; Lello, O. D.; Chew, Y. L. E.; Willcox, C. H.; Ho, R. H. M. (2015). "The ABC's of suicide risk assessment: Applying a tripartite approach to individual evaluations". PLOS ONE. 10 (6): 6. Bibcode:2015PLoSO..1027442H. doi: 10.1371/journal.pone.0127442 . PMC   4452484 . PMID   26030590.
  61. "Suicide and suicidal thoughts - Diagnosis and treatment - Mayo Clinic". Mayo Clinic . Archived from the original on 2016-06-05. Retrieved 2016-06-03.
  62. 1 2 Simon, GE (2006). "How can we know whether antidepressants increase suicide risk?". American Journal of Psychiatry. 163 (11): 1861–1863. doi:10.1176/APPI.AJP.163.11.1861. PMID   17074930.
  63. Mulder, RT; Joyce, P. R.; Frampton, C. M. A.; Luty, S. E. (2008). "Antidepressant treatment is associated with a reduction in suicidal ideation and suicide attempts". Acta Psychiatrica Scandinavica. 118 (12): 116–122. doi:10.1111/j.1600-0447.2008.01179.x. PMID   18384467. S2CID   34987889.
  64. Zisook, S; Lesser, IM; Lebowitz, B; Rush, AJ; Kallenberg, G; Wisniewski, SR; et al. (2011). "Effect of antidepressant medication treatment on suicidal ideation and behavior in a randomized trial: An exploratory report from the Combining Medications to Enhance Depression Outcomes Study". Journal of Clinical Psychiatry. 72 (10): 1322–1332. doi:10.4088/JCP.10m06724. PMID   22075098. S2CID   20222046.
  65. Cipriani A, Hawgon K, Stockton S, et al. (27 June 2013). "Lithium in the prevention of suicide in mood disorders: updated systematic review and meta-analysis". BMJ. 346 (jun27 4): f3646. doi: 10.1136/bmj.f3646 . PMID   23814104.
  66. Wagstaff, A; Perry, C (2003). "Clozapine: in prevention of suicide in patients with schizophrenia or schizoaffective disorder". CNS Drugs. 17 (4): 273–80, discussion 281–3. doi:10.2165/00023210-200317040-00004. PMID   12665398.
  67. Haas, Ann P.; Eliason, Mickey; Mays, Vickie M.; Mathy, Robin M.; Cochran, Susan D.; D'Augelli, Anthony R.; Silverman, Morton M.; Fisher, Prudence W.; Hughes, Tonda; Rosario, Margaret; Russell, Stephen T.; Malley, Effie; Reed, Jerry; Litts, David A.; Haller, Ellen; Sell, Randall L.; Remafedi, Gary; Bradford, Judith; Beautrais, Annette L.; Brown, Gregory K.; Diamond, Gary M.; Friedman, Mark S.; Garofalo, Robert; Turner, Mason S.; Hollibaugh, Amber; Clayton, Paula J. (30 December 2010). "Suicide and Suicide Risk in Lesbian, Gay, Bisexual, and Transgender Populations: Review and Recommendations". Journal of Homosexuality. 58 (1): 10–51. doi:10.1080/00918369.2011.534038. PMC   3662085 . PMID   21213174.
    Proctor, Curtis D.; Groze, Victor K. (1994). "Risk Factors for Suicide among Gay, Lesbian, and Bisexual Youths". Social Work. 39 (5): 504–513. doi:10.1093/sw/39.5.504. PMID   7939864.
    Remafedi, Gary; Farrow, James A.; Deisher, Robert W. (1991). "Risk Factors for Attempted Suicide in Gay and Bisexual Youth". Pediatrics. 87 (6): 869–875. doi:10.1542/peds.87.6.869. PMID   2034492. S2CID   42547461.
    Russell, Stephen T.; Joyner, Kara (2001). "Adolescent Sexual Orientation and Suicide Risk: Evidence From a National Study". American Journal of Public Health. 91 (8): 1276–1281. doi:10.2105/AJPH.91.8.1276. PMC   1446760 . PMID   11499118.
    Hammelman, Tracie L. (1993). "Gay and Lesbian Youth". Journal of Gay & Lesbian Psychotherapy. 2 (1): 77–89. doi:10.1300/J236v02n01_06.
    Johnson, R. B.; Oxendine, S.; Taub, D. J.; Robertson, J. (2013). "Suicide Prevention for LGBT Students" (PDF). New Directions for Student Services. 2013 (141): 55–69. doi:10.1002/ss.20040.
  68. "New Research on LGBTQ Teen Suicide Rates". Newport Academy. 27 February 2023. Retrieved 26 May 2023.
  69. "Definition of Bisexual suicide risk". Medterms.com. October 27, 1999. Archived from the original on December 8, 2011. Retrieved August 21, 2011.
  70. Sohn, Min; Oh, Heymin; Lee, Sang-Kyu; Potenza, Marc N. (2017-10-09). "Suicidal Ideation and Related Factors Among Korean High School Students". The Journal of School Nursing. 34 (4): 310–318. doi:10.1177/1059840517734290. ISSN   1059-8405. PMID   28992754. S2CID   1207678.
  71. Kim, SungYeon; Yang, Eunjoo (February 2015). "Suicidal Ideation in Gay Men and Lesbians in South Korea: A Test of the Interpersonal-Psychological Model". Suicide and Life-Threatening Behavior. 45 (1): 98–110. doi:10.1111/sltb.12119. PMID   25220014.

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