Search Results (691)

Objectives: This study explored the relationship between physical activity, generalized anxiety disorder, and suicidal risk among South Korean adolescents, considering individual characteristics. Methods: The study analyzed raw data from the 2023 Youth Health Behavior Survey conducted by the Korea Disease Control and Prevention Agency. A total of 52,880 adolescents’ data (weighted to 2,581,964) were analyzed using a complex sample design. Results: Physical activity level had a negative effect on anxiety. Anxiety had a positive effect on suicidal risk, including thoughts, plans, and attempts. Physical activity level indirectly affected suicidal risk negatively by mediating anxiety. Individual characteristics such as gender, alcohol consumption, smoking, drug use, and household economic status also influenced suicidal risk. Conclusions: This study emphasizes that effectively reducing adolescent suicide rates requires a multifaceted approach. Such an approach should include promoting physical activity, addressing mental health challenges like anxiety, and providing tailored support for vulnerable populations. Full article

Background/Objectives: Mental health awareness is rising; thus, neurological and psychiatric side effects also benefit from increased attention from the medical and scientific community. Ibuprofen is a well-known non-steroidal anti-inflammatory drug (NSAID) that is often available over-the counter (OTC) for both adults and children, expressing good efficacy in reducing pain and fever through non-selective cyclooxygenase inhibition. As ibuprofen has already been associated with different neuropsychiatric disorders, the aim of this study was to perform an up-to-date analysis of such signals detected in the cases reported in EudraVigilance (EV). Methods: The disproportionality analysis offered a contextual insight into the real-world situation depicted in the analyzed database. Results: From the total cases reported for ibuprofen (n = 58,911), 13.9% contained nervous system disorders (n = 8214) and 10.7% entailed psychiatric disorders (n = 6295). The cases were distributed between all age groups, with a sensible higher incidence in teenagers and in women in general. Severe cases, including deaths, have been reported. By comparison with ketoprofen, acetylsalicylic acid, and diclofenac, ibuprofen presented a higher probability of reporting psychiatric and behavioral symptoms. Regarding cognitive and attention disorders and disturbances, no disproportionate signal was observed between ibuprofen and all other NSAIDs. Sleep disturbances (hypersomnia, narcolepsy and sleep paralysis) are reported as more probable for ibuprofen than for acetylsalicylic acid, naproxen, and diclofenac. A higher risk of reporting suicidal and self-injurious behaviors was noted for ibuprofen versus all other selected NSAIDs. A limitation of the study can be noted as due to suspected causality, not an established one, and EV reports cannot accurately determine adverse drug reaction frequencies. Conclusions: Considering that ibuprofen is easily accessible as an OTC drug and the higher probability of reporting several neuropsychiatric adverse effects as shown by this study, patient counseling, when possible, and general education for the public are valuable tools in managing these adverse reactions. Full article

Background/Objectives: Problematic polydrug use represents a relevant public health concern, with strong relationships with mental health problems and suicide behavior. Existing studies have just focused on problematic use, overlooking the potentially cumulative effect of coexisting substance use and addictive behaviors. This study aims to analyze the association between the polydrug use profile (no problematic use, problematic use of a single drug, and polydrug use) and mental health outcomes, specifically anxiety symptoms, depressive symptoms, and suicide behavior. Methods: A sample of 1307 Spanish young adults (66.2% male; M = 21.2 years, SD = 3.31) were assessed for problematic use of substances and behavioral addictions as well as for the internalizing symptoms and suicide behavior. Participants were categorized into three groups: no problematic drug use (n = 880), problematic single drug use (n = 316), and polydrug use (n = 111). Results: Results showed an increasing level in depressive symptoms and suicide behavior with polydrug use, with significant differences between groups (p < 0.05). Moreover, both groups of problematic use presented higher levels of anxiety than no-use participants, regardless of the number of use modalities. Conclusions: These findings suggest that problematic polydrug use is associated with greater clinical severity, particularly in terms of depressive symptoms and suicide behavior, while anxiety remains elevated even when a problematic single drug pattern is observed. This study highlights the importance of considering polydrug use in dual diagnosis and the need for an integrative clinical approach. Full article

Background and Objectives: Suicide is one of the leading causes of death worldwide. Identifying psychopathological factors and personality traits associated with suicidal ideation is crucial for improving prevention. This study investigates the association between current suicidal ideation—measured by item 4 of the Brief Psychiatric Rating Scale-24 items (BPRS-24)—and personality traits assessed with the Personality Inventory for DSM-5 (PID-5) in a transdiagnostic outpatient psychiatric population. The association of BPRS-24 item 4 with early traumatic experiences, attachment styles, and dissociative phenomena is also explored as a secondary objective. Materials and Methods: We propose a secondary analysis on a sample of 137 individuals receiving care at an academic community mental health center. Personality traits were assessed using the PID-5, while attachment styles were assessed with the Experiences in Close Relationships-Revised (ERC-R), childhood traumas with the Childhood Experience of Care and Abuse Questionnaire (CECA.Q), and dissociative experiences with the Dissociative Experience Scale II (DES-II). Suicidal ideation was measured with item 4 of the BPRS-24. Associations were examined using Spearman’s correlation and ordinal logistic regression models, adjusted for age, sex assigned at birth, and global clinical severity (CGI-S). Results: We found statistically significant associations between suicidal ideation and the PID-5 trait of depressivity (OR = 1.80, 95 % CI 1.23–2.63, p = 0.002, p-value adjusted Holm’s method 0.012). However, this association lost significance after adjusting for depressive symptoms (BPRS-24 item 3), suggesting a mediating role of depression. We found no significant associations with childhood trauma, attachment styles, or dissociative experiences. Conclusions: Our findings suggest a potential link between specific personality traits and suicidal ideation, mediated by depressive symptomatology. We explore how future studies may evaluate PID-5 as a clinical tool to support the identification of individuals at long-term risk of suicidality or for targeting specific populations for tailored interventions. Full article

Objectives: Social isolation is an important public health issue that is becoming increasingly prevalent among adolescents today. Recognizing the risk of social isolation in children and adolescents during their developmental years can contribute to the prevention of depression and anxiety disorders, as well as risky behaviors such as suicide and substance abuse. Valid and reliable measurement tools are needed to assess social isolation in adolescents. There is a lack of surveys to identify gaps in social isolation among Turkish adolescents. This study aims to adapt the Social Isolation Questionnaire (QIS) scale, which was developed for adolescents, to Turkish culture and to evaluate its psychometric properties. Methods: This descriptive and methodological study was conducted between July and November 2024 with 1922 adolescents. Data were collected using an introductory information form, the QIS, and the UCLA Loneliness Scale. In the evaluation of the data, explanatory and confirmatory factor analysis, Cronbach’s alpha, split-half, item–total score correlation, and test–retest analysis were used. Results: The average age of the adolescents was 13.97 ± 1.67 years (min = 12, max = 17). A total of 50.6% of the adolescents were male and 49.4% were female. A total of 81.2% of the adolescents had a nuclear family structure. Exploratory factor analysis revealed a three-factor structure explaining 55.97% of the variance. The factor loadings were greater than 0.30, and all fit indices were greater than 0.90. The total Cronbach’s α value of the scale was 0.83, while the values for the subdimensions ranged from 0.73 to 0.75. Conclusions: The Turkish version of the QIS is a valid and reliable measurement tool for assessing social isolation in adolescents. This questionnaire can be used by health professionals and researchers to identify adolescents at risk of social isolation and plan appropriate mental health interventions. This questionnaire can be used in studies focusing on adolescent mental health and well-being, contributing to the development and implementation of strategies in line with the Sustainable Development Goals. Full article

School refusal behavior, defined as a child’s prolonged voluntary absence from school for reasons unrelated to illness and/or economic hardship, is a growing concern in Japan. The COVID-19 pandemic has worsened this issue by disrupting children’s lives. This review summarizes the prevalence, contributing factors, and health implications of school refusal, particularly in the context of COVID-19. A literature review of government reports and PubMed-indexed studies indicates that school refusal in Japan has been rising for eleven years, reaching a record 340,000 cases in 2023. Middle school students (6.7%) were the most affected, followed by elementary school students (2.1%). The pandemic intensified school-related, family-related, and child-related risk factors. School closures disrupted routines, reduced peer interactions, and increased social isolation, contributing to higher rates of anxiety and depression. Reports of suicides and mental health disorders among children have also surged. Family stressors, including economic hardship and parental mental health struggles, further exacerbate school refusal. Additionally, remote learning has widened socioeconomic disparities in access to education, leaving vulnerable children at greater risk. Addressing school refusal requires a multifaceted approach involving schools, families, healthcare providers, and policymakers. School-based interventions, mental health approach, and flexible educational programs would be essential. The Japanese government’s “COCOLO Plan” represents progress toward a more inclusive education system, and a comprehensive, interdisciplinary strategy is needed. Ensuring all children receive the necessary support to reengage with education is critical to overcoming the long-term challenges posed by school refusal. Full article

Suicide is a leading cause of death among construction workers, particularly younger and lower-skilled employees. Barriers such as stigma, low mental health literacy, and traditional masculine norms hinder help-seeking in this male-dominated sector. Few mental health interventions are tailored to this context. This study developed a co-designed, theory-informed training to improve mental health literacy, reduce stigma, and increase help-seeking among construction workers in Ireland. Using the Medical Research Council’s framework, the training was developed with the Theory of Planned Behavior (TPB), Behavior Change Techniques, and extensive stakeholder co-design. Two systematic reviews, a broad literature review, and focus groups with industry managers informed the content and structure. The training will be pilot-tested using validated measures: the Literacy of Suicide Scale (LOSS), the Stigma of Suicide Scale (SOSS), and the General Help-Seeking Questionnaire (GHSQ), the results of which will be the subject of a separate study. CAIRDE is a promising, evidence-based training that addresses key mental health barriers in Irish construction. Embedding the TPB within a co-design methodology has resulted in the development of a training program that is underpinned by theoretical fidelity and cultural relevance and provides a framework for other male-dominated industries to draw upon. Future work should address remaining challenges related to stigma and help-seeking, and explore broader implementation through integration into mandatory safety training. Full article

Suicide, a major contributor to global mortality rates, especially among young patients, remains insufficiently integrated into public health initiatives despite notable progress in identifying its determinants. The prediction of suicidal behavior remains complex, often relying on subjective assessments rather than objective biomarkers. Single nucleotide polymorphisms (SNPs) such as rs110402 (CRHR1 gene), rs3800373 (FKBP5 gene), and rs2289656 (NTRK2 gene) have been linked to physiological mechanisms involving stress response and activation of the hypothalamic–pituitary–adrenal (HPA) axis, which contributes to anxiety and stress regulation. This study aimed to assess stress-related gene polymorphisms in individuals with suicidal behavior compared to controls. According to our results, the presence of the A allele of rs2289656 was associated with a protective effect, while the GG genotype conferred a higher susceptibility to suicidal behaviors. Significant associations were observed between trauma and abuse history and the rs110402 polymorphism in CRHR1 gene, highlighting a protective role for the GG genotype and increased predisposition to stress-related psychiatric conditions and suicidal behavior for A allele carriers. No valid associations were found for rs3800373 in the FKBP5 gene, although suggestive trends related to depression and self-aggression were noted. Our findings underscore the need to identify reliable biomarkers associated with suicide risk, highlighting the importance of integrating hereditary and psychosocial data to better understand the underlying mechanisms and to support the development of effective early interventions. Full article

Online psychotherapy for patients with suicidal behavior was considered inappropriate by the Brazilian Federal Psychology Council prior to the COVID-19 pandemic. Due to the need for physical distancing, this restriction was temporarily suspended. This study aims to analyze the perceptions of Brazilian clinical psychologists regarding online psychotherapy for patients with suicidal behavior in the context of the COVID-19 pandemic, to generate a theoretical understanding of this experience. It is a qualitative, exploratory, longitudinal study based on the Constructivist Grounded Theory framework. Ten clinical psychologists who conducted online psychotherapy for patients with suicidal behavior during the pandemic were interviewed at two moments, with an interval of approximately two years: the first round was conducted from December 2020 to March 2021, followed by a second round between November and December 2022. Data analysis led to four categories: (1) Reflecting on suicidal behavior; (2) Addressing specificities of online interventions; (3) Managing suicidal behavior in online psychotherapy; (4) Evaluating online psychotherapy for patients with suicidal behavior. The theoretical model “Pathways of care: main roads and access routes in online psychotherapy for suicidal behavior” was constructed. It was concluded that online psychotherapy for patients with suicidal behavior is complex and requires caution but is feasible and can be important in specific circumstances. This makes it an additional resource for suicide prevention and mental health promotion. Full article

Background/Objectives: The rising prevalence of mental health disorders among adolescents underscores the need for early intervention. Of concern is the increasing consumption of sugar-sweetened beverages (SSBs) and high-caffeine drinks, which may adversely affect adolescent mental health. This study examined their association with stress perception, depressive symptoms, suicidal ideation, and loneliness among Korean adolescents. Methods: Data were derived from the 2022 Korea Youth Risk Behavior Survey, a nationally representative dataset comprising 51,850 Korean adolescents aged 12–18 years. Beverage consumption frequency was categorized into three groups: none, 1–4 times per week, and ≥5–6 times per week. Logistic regression models were employed to estimate adjusted odds ratios (AORs) and 95% confidence intervals (CIs) for mental health conditions, adjusting for potential confounders. Results: Compared with non-consumers, adolescents who consumed SSBs ≥5–6 times per week exhibited significantly higher odds of stress perception (AOR 1.35, 95% CI 1.24–1.46), depressive symptoms (AOR 1.32, 95% CI 1.19–1.46), suicidal ideation (AOR 1.23, 95% CI 1.09–1.39), and loneliness (AOR 1.44, 95% CI 1.28–1.61). Similarly, frequent consumption of high-caffeine drinks (≥5–6 times per week) was associated with increased odds of stress perception (AOR 2.13, 95% CI 1.99–2.29), depressive symptoms (AOR 1.75, 95% CI 1.62–1.88), suicidal ideation (AOR 2.04, 95% CI 1.86–2.24), and loneliness (AOR 1.72, 95% CI 1.59–1.87). Conclusions: Frequent consumption of SSBs and high-caffeine drinks is significantly associated with adverse mental health outcomes among Korean adolescents. Given the increasing intake of these beverages, targeted public health interventions are warranted to mitigate their potential negative impact on adolescent mental well-being. Full article

Background/Objectives: Suicide is among the biggest causes of death in the world. In recent years, suicide rates have increased remarkably in developing countries such as Türkiye. Therefore, there is a need to understand the psychological mechanisms underlying suicidal ideation and behaviors. Within this context, this study aimed to examine the complex relationships between psychological strain and suicide rumination. Methods: The study was conducted on 470 university students because young adults constitute the largest suicide risk group in Türkiye. Results: The findings showed that psychological strain was a significant predictor of suicide rumination. Additionally, depression was found to play a mediating role between psychological strain and suicide rumination. Furthermore, both resilient coping and perceived social support were shown to play a moderating role in the relationships among psychological strain, depression, and suicide rumination. The results confirmed the Strain Theory of Suicide in a sample from Türkiye. Conclusions: These findings are expected to contribute to psychologists, psychiatrists and public health specialists’ development of suicide prevention and intervention programs for university students. These suicide prevention and intervention efforts may focus on enhancing resilient coping and perceived social support in combating psychological strain and depression. Full article

Background/Objectives: Traumatic brain injury is one of the leading causes of death and disability. When traumatic brain injury is repeated over time, it can lead to the development of Chronic Traumatic Encephalopathy, a chronic neurodegenerative disease commonly observed in individuals who engage in contact sports or military personnel involved in activities with a high risk of repeated head trauma. At autopsy, the examination of the brain reveals regional atrophy, corresponding to high concentrations of glutamate receptors. Microscopically, the primary findings are the deposition of neurofibrillary tangles and neuropil threads. The aim of this study is to highlight the clinical and histopathological characteristics of Chronic Traumatic Encephalopathy, providing diagnostic support to forensic pathologists. Additionally, it seeks to aid in the differential diagnosis of similar conditions. Methods: A review of literature was conducted following the PRISMA criteria. Of 274 articles, 7 were selected. Results: According to these papers, most patients were male and exhibited neurological symptoms and neuropsychiatric impairments, and a proportion of them committed suicide or had aggressive behavior. Conclusions: Chronic Traumatic Encephalopathy remains largely underdiagnosed during life. The definitive diagnosis of Chronic Traumatic Encephalopathy is established post-mortem through the identification of pathognomonic tauopathy lesions. Early and accurate antemortem recognition, particularly in at-risk individuals, is highly valuable for its differentiation from other neurodegenerative conditions, thereby enabling appropriate clinical management and potential interventions. Full article

Suicide is a growing public health concern in Brazil, with significant increases in mortality rates over the last decade and disparities among vulnerable populations. This study aimed to systematically synthesize the recent literature reviews on suicidality and suicide prevention in Brazil, providing an overview of key findings, research gaps, and implications for future studies. This systematic review of reviews follows a pre-registered PROSPERO protocol (CRD42024561892). Searches across five databases (MEDLINE, Scopus, CINAHL, SciELO and LILACS) identified 10 eligible reviews, published between 2019 and 2024, including systematic, integrative, narrative reviews, and meta-analyses. The reviews examined populations such as Indigenous peoples, adolescents, university students, older adults, and healthcare professionals. Findings showed that the risk of suicidal behavior was associated with mental health conditions, social vulnerability, and limited access to mental health services. Particularly high suicide rates were observed among Indigenous populations and adolescents. Across reviews, a lack of interventional studies, limited geographical coverage, and the inadequate training of health professionals were recurrent themes. This review highlights the urgent need for culturally sensitive suicide prevention strategies, greater research investment in underserved populations, and improved healthcare training and coordination. These findings aim to support the development of more effective national suicide prevention policies. Full article

Background: Gastrointestinal (GI) cancer patients face a four-fold higher suicide risk than the general US population. This study explores psychosocial aspects of GI cancer patient experiences, assessing suicidal ideation and behavior, mental distress during treatment phases, and psychosocial factors on mental health. Methods: A two-phase mixed-methods approach involved a web-based survey and follow-up interviews. Quantitative data analysis validated mental health and suicidal ideation constructs, and correlation analyses were performed. The patient journey was charted from diagnosis to treatment. Results: Two hundred and two individuals participated, with 76 from the rural Appalachian region and 78 undergoing treatments. Quantitative analysis showed a higher prevalence of passive suicidal ideation than active planning. The post-treatment recovery period was the most emotionally challenging. Qualitative data emphasized emotional support and vulnerability to isolation. Care quality concerns included individualized treatment plans and better communication. Patients also needed clear, comprehensive information about treatment and side effects. The in-depth interview with four GI cancer patients revealed a healthcare system prioritizing expedient treatment over comprehensive care, lacking formal psychological support. AI emerged as a promising avenue for enhancing patient understanding and treatment options. Conclusions: Our research advocates for a patient-centric model of care, enhanced by technology and empathetic communication. Full article

Background: Anhedonia, defined as the diminished capacity to experience pleasure, represents a core negative symptom in first-episode psychosis (FEP) with profound implications for functional outcomes and long-term prognosis. Despite its clinical significance, comprehensive understanding of anhedonia prevalence, underlying mechanisms, and optimal intervention strategies in early psychosis remains limited. Objectives: To systematically examine the prevalence and characteristics of anhedonia in FEP patients, explore neurobiological mechanisms, identify clinical correlates and predictive factors, and evaluate intervention efficacy. Methods: Following PRISMA 2020 guidelines, we conducted comprehensive searches across PubMed, Embase, PsycINFO, and Web of Science databases from January 1990 to June 2025. Studies examining anhedonia and negative symptoms in FEP patients (≤24 months from onset) using validated assessment instruments were included. Quality assessment was performed using appropriate tools for study design. Results: Twenty-one studies comprising 3847 FEP patients met inclusion criteria. Anhedonia prevalence ranged from 30% at 10-year follow-up to 53% during acute phases, demonstrating persistent motivational deficits across illness trajectory. Factor analytic studies consistently supported five-factor negative symptom models with anhedonia as a discrete dimension. Neuroimaging investigations revealed consistent alterations in reward processing circuits, including ventral striatum hypofunction and altered network connectivity patterns. Social anhedonia demonstrated stronger associations with functional outcomes compared to other domains. Epigenetic mechanisms involving oxytocin receptor methylation showed gender-specific associations with anhedonia severity. Conventional antipsychotic treatments showed limited efficacy for anhedonia improvement, while targeted psychosocial interventions demonstrated preliminary promise. Conclusions: Anhedonia showed high prevalence (30–53%) across FEP populations with substantial clinical burden (13-fold increased odds vs. general population). Meta-analysis revealed large effect sizes for anhedonia severity in FEP vs. controls (d = 0.83) and strong negative correlations with functional outcomes (r =·−0.82). Neuroimaging demonstrated consistent ventral striatum dysfunction and altered network connectivity. Social anhedonia emerged as the strongest predictor of functional outcomes, with independent suicide risk associations. Conventional antipsychotics showed limited efficacy, while behavioral activation approaches demonstrated preliminary promise. These findings support anhedonia as a distinct treatment target requiring specialized assessment and intervention protocols in early psychosis care. Full article