Suicide ideation and psychotropic recreational drug use by adolescents: a systematic review and meta-analysis

ABSTRACT BACKGROUND: Adolescence is characterized by complex and dynamic changes, often involving experimentation, including the use of psychotropic substances. Although it is well-established that recreational psychotropic drugs are associated with suicide ideation in adults, evidence of this association in adolescents remains limited. OBJECTIVE: To investigate the relationship between suicide ideation and psychotropic recreational drug use among adolescents. DESIGN AND SETTING: Systematic review with meta-analysis developed at Universidade Federal de Uberlândia (UFU) and Universidade Estadual de Campinas (UNICAMP), Brazil. METHODS: A search across eight electronic databases for observational studies, without language or publication year restrictions, was conducted. The Joanna Briggs Institute tool was used to assess the risk of bias. Random-effects meta-analyses and odds ratios were used to measure the effects. RESULTS: The search yielded 19,732 studies, of which 78 were included in the qualitative synthesis and 32 in the meta-analysis. The findings indicated that suicidal ideation was 1.96 times more likely (95% confidence interval, CI = 1.47; 2.61) for adolescents who used some drug recurrently and 3.32 times more likely (95%CI = 1.86; 5.93) among those who abused drugs. Additionally, adolescents who used cannabis were 1.57 times more likely (95%CI = 1.34; 1.84) to experience suicide ideation compared with non-users, while cocaine users had 2.57 times higher odds (95%CI = 1.47; 4.50). CONCLUSIONS: Psychotropic recreational drug use is associated with suicidal ideation among adolescents regardless of current or previous use, abuse, or type of substance used. SYSTEMATIC REVIEW REGISTRATION: Registered in the PROSPERO database under the identification number CRD42021232360. https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021232360.

The effects of short video app-guided loving-kindness meditation on college students' mindfulness, self-compassion, positive psychological capital, and suicide ideation.

OBJECTIVE: The study investigated the effects of a short video app guided loving-kindness meditation (LKM) on college students' mindfulness, self-compassion, positive psychological capital, and suicide ideation. The purpose of the study is to investigate the intervention effect of LKM training on suicidal ideation among college students with the help of the short video application and to provide an empirical basis for the exploration of early suicide intervention strategies for college students. METHODS: We recruited 80 college students from a university in China. The final 74 eligible participants were divided into two groups: app use group (n = 37) and the control group (n = 37). The app group accepted an 8-week app use interference, while the control group underwent no interference. We measured four major variable factors (mindfulness, self-compassion, positive psychological capital, and suicide ideation) before and after the app use intervention. RESULTS: In the app group, self-compassion and positive psychological capital were significantly higher, and suicide ideation was significantly lower than the control group. In the control group, there were no noticeable differences in any of the four variables between the pre-test and post-test. CONCLUSIONS: Our findings demonstrate that the short video app guided LKM may help to improve self-compassion, and positive psychological capital, and reduce suicide ideation. The finding of the short video app-guided LKM's effect extends our understanding of the integrative effects of positive psychology and digital media on the reduction of suicide ideation.

Attachment, suicidal behavior, and self-harm in childhood and adolescence: a study of a cohort of Brazilian schoolchildren.

BACKGROUND: Attachment influences the development and the formation of the self and subjectivity and, just as early adverse events, may be related to the occurrence of mental disorders, suicidal behavior, and self-harm throughout life. This study aimed to analyze the effect of mental representation of attachment in children on suicidal behavior and self-harm throughout childhood and adolescence, considering the mediating role of internalizing problems. METHODS: Based on a cohort of 500 students (mean age 8 years, SD 1.2) sampled from public schools in a Brazilian southeastern metropolis, 316 children were followed for eight years in three waves (2006, 2008, 2012). The following data from the research baseline (2005) were used: family drawing, maternal and family variables, and sociodemographic data. The mental representation of attachment (independent variable) was measured by the Family Drawing Global Scale, discriminating between secure attachment and non-secure attachment. Suicidal behavior/self-harm (dependent variable) and internalizing problems were evaluated in three research waves through CBCL and YSR (ASEBA). Descriptive analysis, calculation of frequencies and p-values of the variables of interest, as well as modeling of structural equations, were performed. RESULTS: The prevalence throughout the study was: 17.1% [CI 13.3-20.8] for suicidal ideation and 8.9% [CI 5.6 - 12.2] for self-harm; there was a recurrence at one time in 16.5% [IC 12.6 - 20.3] and in two or more moments in 4.1% [CI 2.0 - 6.3] of the sample. Female gender (p = 0.035), internalizing disorders (p < 0.01), and non-secure attachment (p = 0.035) were associated with the occurrence of suicidal behavior/self-harm. The modeling indicated that 92,2% of the total effect of attachment (p = 0.069) on suicidal behavior/self-harm was due to direct effect, the other 7,8% of the effect being mediated by internalizing problems, adjusted for the confounding variables sex, skin color/race, and social stratum. The total effect showed a positive value, which indicates an increase in suicidal behavior/self-harm when the non-secure attachment is present. The approximate OR of non-secure attachment on the total effect (direct + indirect) was 1.15, indicating that, when adjusting for confounding variables, there was a 15% increase in suicidal behavior/self-injury from non-secure attachment. CONCLUSIONS: The study supports the hypothesis that there is a relationship between disruptive attachment patterns (non-secure attachment) developed during infancy and suicidal and self-harm behavior during childhood and adolescence. These findings validate the concern about the first thousand days of childhood as a critical period for child growth and development, but also for the mental health of children and adolescents.

Depression symptoms and suicide risk of internal medicine residents before and after first year of the COVID-19 pandemic.

Introduction: Depression is a mental health disorder characterized by the presence of sadness or loss of the ability to feel pleasure, with a high incidence in patients with COVID 19. The investigations have focused on patient care and little on the care of health personnel, these being the ones with the highest mortality rate, so the objective of the study was to investigate the prevalence of depression symptoms and suicide risk and understand the association of depressive disorder and suicide risk with levels of serum cholesterol and low levels of serum cortisol among internal medicine fellows in a specialist medical hospital in Leon, Guanajuato, Mexico, before and after COVID-19. Methods: In this longitudinal study, internal medicine residents were initially monitored for 2months before starting to care for patients with COVID-19. Participants were asked to fill out depression symptoms and suicide risk surveys. We measured the serum cholesterol and cortisol of each participant, and again after 11months of treating COVID-19 patients. Results: Depression symptoms and suicide risk were assessed; significant differences were found between the two time periods for depression (p < 0.01), and no difference was found for suicide risk (p = 0.182). We found a significant correlation between serum cholesterol levels and suicide risk (r = 0.366, p < 0.01); we also found differences in serum cortisol levels (p < 0.01) and cholesterol (p < 0.0001) before and after the pandemic. Conclusion: Caring for patients with COVID-19 in the hospital contributed to an increase in levels of depression symptoms and suicidal ideation, as well as differences in levels of cortisol and cholesterol in resident physicians of internal medicine; among the possible reasons for this change could be the conditions of personal protection while treating patients, the uncertainty in the first months of not knowing how the virus was transmitted and not having or knowing when vaccinations would be available, as well as the lack of a strategy of adequate mental health support from the institutions dedicated to their academic training.

Suicide risk and associated factors in healthcare workers seeking psychological support during COVID-19: a cross-sectional study.

Healthcare workers have been one of the groups most severely affected by the COVID-19 pandemic, leaving them with serious psychological effects. Some of these effects have not been treated promptly, leading to further psychological symptoms. The objective of this study was to evaluate suicide risk in healthcare workers seeking psychological help during the COVID-19 pandemic, and factors associated with this risk on participants that were searching for treatment during the COVID-19 pandemic. This is a cross-sectional study analyzing data from 626 Mexican healthcare workers seeking psychological help due to the COVID-19 pandemic through the www.personalcovid.com platform. Before they entered treatment, the Plutchik Suicide Risk Scale, the Depression Scale of the Center for Epidemiologic Studies, the Pittsburgh Sleep Quality Index, and the Professional Quality of Life Measure, were administered. Results: 49.4% (n = 308) presented suicide risk. The most severely affected groups were nurses (62%, n = 98) and physicians (52.7%, n = 96). Predictors of suicide risk in healthcare workers were secondary traumatic stress, high depressive affect, low positive affect, emotional insecurity and interpersonal problems, and medication use. Conclusions: The suicidal risk detected was high, found mostly in nurses and doctors. This study suggests the presence of psychological effects on healthcare workers, despite the time that has elapsed since the onset of the pandemic.

Factors Associated with Suicidal Ideation and Suicide Attempt in Brazilian Transgender Youth.

The rates of suicidal ideation and suicide attempts among transgender youths are high. However, in Brazil, there are no studies about these outcomes in this population. The present study aims to investigate the prevalence of suicidal ideation and suicide attempts in Brazilian transgender youths (binary and non-binary), in association with predictor variables, following the Minority Stress Theory. The predictor variables analyzed were depressive symptoms, discrimination, gender distress, deprivation, social support, and gender identity support from parents and friends. Participants were recruited through an online survey. The final sample consisted of 213 participants, aged 13 to 25 years old. Two equal regression analyses were performed, one for each outcome. Out of the total, 103 (48.6%) identified as transgender boys, 44 (20.8%) as transgender girls, and 65 (30.7%) as non-binary. The mean age was 18.53 years (SD 2.50). The study found that 57.6% of the sample had depressive symptoms, 72.3% experienced suicidal ideation, and 42.7% had attempted suicide. In the final model, the variables that were associated with suicidal ideation were deprivation, gender distress, and depressive symptoms. As for suicide attempts, the variables deprivation and depressive symptoms were correlated. Further studies on this population should be conducted to analyze protective factors for these outcomes.

Street scars: Suicide ideation and suicide attempt among street-involved adolescents and youth in southern Brazil.

OBJECTIVE: To measure the prevalence of suicidal ideation and attempts as well as suicide attempts' associated factors among street-involved youth in southern Brazil. PARTICIPANTS AND SETTING: Cross-sectional study was conducted with street-involved adolescents and children from Porto Alegre and Rio Grande, Brazil. METHODS: A respondent-driven sampling strategy was used to access this hard-to-reach population quickly and efficiently. Descriptive, bivariate, and multivariate analyses were conducted, with the latter being binary logistic regression. RESULTS: The prevalence of suicide attempts was 16.3%, while the frequency of suicidal ideation was 30.9%. Most participants were male, aged between 16 and 18 years, with no ties to school and family. Almost half of the sample had been in a street situation for five years or more, and two-thirds reported spending more than seven hours a day on the streets. Variables independently associated with suicide attempts were aged 19-21 years old, with reduced ties with school and family, having had an experience of sexual abuse, and lifetime use of crack. CONCLUSIONS: Public policies targeting the strengthening ties of street-involved children, adolescents, and youth with school and family might reduce their vulnerability to threats, such as sexual abuse and use of crack, and hence focus on decreasing suicide attempts.

The effects of short video app-guided loving-kindness meditation on college students' mindfulness, self-compassion, positive psychological capital, and suicide ideation

Abstract Objective The study investigated the effects of a short video app guided loving-kindness meditation (LKM) on college students' mindfulness, self-compassion, positive psychological capital, and suicide ideation. The purpose of the study is to investigate the intervention effect of LKM training on suicidal ideation among college students with the help of the short video application and to provide an empirical basis for the exploration of early suicide intervention strategies for college students. Methods We recruited 80 college students from a university in China. The final 74 eligible participants were divided into two groups: app use group (n = 37) and the control group (n = 37). The app group accepted an 8-week app use interference, while the control group underwent no interference. We measured four major variable factors (mindfulness, self-compassion, positive psychological capital, and suicide ideation) before and after the app use intervention. Results In the app group, self-compassion and positive psychological capital were significantly higher, and suicide ideation was significantly lower than the control group. In the control group, there were no noticeable differences in any of the four variables between the pre-test and post-test. Conclusions Our findings demonstrate that the short video app guided LKM may help to improve self-compassion, and positive psychological capital, and reduce suicide ideation. The finding of the short video app-guided LKM's effect extends our understanding of the integrative effects of positive psychology and digital media on the reduction of suicide ideation.

The impact of mindfulness on suicidal behavior: a systematic review.

INTRODUCTION: Mindfulness-based interventions (MBI) have been growing progressively as treatment options in the field of mental health. Aim: To assess the impact of mindfulness-based interventions for reducing suicidal thoughts and behaviors. METHODS: A systematic review was performed in December 2020 using PubMed, PsycINFO, EMBASE, SciELO, Pepsic, and LILACS databases with no year restrictions. The search strategy included the terms ('mindfulness' OR 'mindfulness-based') AND ('suicide' OR 'suicidal' OR 'suicide risk' OR 'suicide attempt' OR 'suicide ideation' OR 'suicide behavior'). The protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO), CRD42020219514. RESULTS: A total of 14 studies met all inclusion criteria and were included in this review. Most of the studies presented Mindfulness-Based Cognitive Therapy as the MBI assessed (n=10). An emerging and rapidly growing literature on MBI presents promising results in reduction of suicide risk, particularly in patients with MDD. Four studies assessing other MBI treatment protocols (Mindfulness-Based Stress Reduction; Daily Mindfulness Meditation Practice; Mind Body Awareness and Mindfulness-Based Cognitive Behavior Therapy) all demonstrated that MBI reduces factors associated with suicide risk. CONCLUSION: MBI might target specific processes and contribute to suicide risk reduction.

Prevalence and Factors Associated With Suicide Ideation in Colombian Caribbean Adolescent Students.

The study aimed to know the prevalence of and some factors associated with suicide ideation in high school adolescents from a Colombian Caribbean city. A cross-sectional analytical study was designed with probability sampling. An expected prevalence of 50% and an alpha error of 5% were estimated. High-school students from public and private institutions were invited to participate. One thousand four hundred sixty-two adolescents participated in, they were aged between 13 and 17 years, and 33.6% of students reported suicide ideation. Suicide ideation was associated with depression risk (OR = 4.54, 95% CI 2.35-8.77), family dysfunction (OR = 4.54, 95% CI 2.35-8.77), sexual violence (OR = 1.92 CI95% 1.33-2.76) and low academic achievement (OR = 1.97, 95% CI 1.42-2.73). It is concluded that 33.6% of adolescents enrolled in secondary education reported suicide ideation and was associated with depression risk, family dysfunction, sexual abuse, and poor academic achievement.

The impact of mindfulness on suicidal behavior: a systematic review

Abstract Introduction Mindfulness-based interventions (MBI) have been growing progressively as treatment options in the field of mental health. Aim: To assess the impact of mindfulness-based interventions for reducing suicidal thoughts and behaviors. Methods A systematic review was performed in December 2020 using PubMed, PsycINFO, EMBASE, SciELO, Pepsic, and LILACS databases with no year restrictions. The search strategy included the terms ('mindfulness' OR 'mindfulness-based') AND ('suicide' OR 'suicidal' OR 'suicide risk' OR 'suicide attempt' OR 'suicide ideation' OR 'suicide behavior'). The protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO), CRD42020219514. Results A total of 14 studies met all inclusion criteria and were included in this review. Most of the studies presented Mindfulness-Based Cognitive Therapy as the MBI assessed (n=10). An emerging and rapidly growing literature on MBI presents promising results in reduction of suicide risk, particularly in patients with MDD. Four studies assessing other MBI treatment protocols (Mindfulness-Based Stress Reduction; Daily Mindfulness Meditation Practice; Mind Body Awareness and Mindfulness-Based Cognitive Behavior Therapy) all demonstrated that MBI reduces factors associated with suicide risk. Conclusion MBI might target specific processes and contribute to suicide risk reduction.

Influence of COVID-19 Pandemic Uncertainty in Negative Emotional States and Resilience as Mediators against Suicide Ideation, Drug Addiction and Alcoholism.

This research uses structural equation modeling to determine the influence of uncertainty due to the COVID-19 pandemic as an independent variable in the negative emotional states and resilience (as mediating variables) vs. drug addiction, alcoholism, and suicide ideation as dependent variables in 5557 students from a public state university in Northern Mexico. The five variables are related through eight hypotheses and tested using partial least squares. We used an adapted questionnaire sent by email in May 2020. Findings show that uncertainty facing the COVID-19 pandemic had a direct and significant influence on negative emotional states and a significant inverse effect on resilience; in the trajectory, drug addiction and alcoholism, and suicide ideation are explained.

Impacto do estresse de minoria em sintomas depressivos, ideação suicida e tentativa de suicídio em pessoas trans / Impact of minority stress in depressive symptoms, suicide idea and try suicide in trans

Resumo O estresse de minoria aborda a relação entre preconceito (percebido, antecipado e internalizado) e saúde mental em pessoas pertencentes a grupos minoritários, assim como fatores de proteção aos estressores. Este trabalho avaliou a prevalência de sintomas depressivos, ideação suicida e tentativa de suicídio em pessoas trans brasileiras, e sua relação com estresse de minoria, passabilidade, apoio social e apoio à identidade trans. Participaram 378 pessoas, por meio de questionário respondidos on-line e nos serviços hospitalares a que frequentavam. Desses, 67,20% apresentaram sintomas depressivos, 67,72% ideação suicida e 43,12% tentativa de suicídio. Foram realizadas três análises de regressão de Poisson, em dois passos, conforme os desfechos. Nos três desfechos houve associação positiva com o preconceito internalizado e negativa com o apoio social, sendo essas as únicas associações na tentativa de suicídio. Nos sintomas depressivos e na ideação suicida, também se associou positivamente o preconceito antecipado e negativamente a passabilidade e o apoio à identidade trans. Percebe-se a vulnerabilidade das pessoas trans para os desfechos negativos de saúde mental e a importância de enfrentar o preconceito em nível individual e social, assim como promover o apoio social e à identidade trans.

Abstract Minority stress comprehends the relationship between prejudice (perceived, anticipated and internalized) and mental health in people belonging to minority groups, as well as protective factors for stressors. This study evaluated the prevalence of depressive symptoms, suicidal ideation and attempted suicide in Brazilian trans people, and it`s relationship with minority stress, passability, social support and trans identity support. 378 people participated through a questionnaire answered online and in the hospital services they attended. Of these, 67.20% had depressive symptoms, 67.72% suicidal ideation and 43.12% attempted suicide. Three Poisson regression analyzes were performed in two steps, according to the outcomes. In the three outcomes there was a positive association with internalized prejudice and a negative association with social support, which were the only associations in the suicide attempt. Depressive symptoms and suicidal ideation were also positively associated with anticipated prejudice and negatively passability and support for trans identity. The vulnerability of transgender people to negative mental health outcomes and the importance of addressing prejudice on an individual and social level, as well as promoting social support and transgender identity support are perceived.

What kills the agricultural worker? A systematic review on suicide.

INTRODUCTION: The aim of this research is fourfold: (i) analyze which countries have the most publications on suicide among agricultural workers, (ii) understand the factors that lead to either suicide or intent, (iii) identify the methods of suicide or attempted suicide, and (iv) propose preventive measures so that rural agricultural workers are not exposed to risk factors to suicide. METHODS: A literature review was conducted for the period 1996-2019; the Scopus, Lilacs, PubMed/MEDLINE, and Science Direct databases were searched, resulting in 44 articles deemed relevant to this research. RESULTS: Agricultural workers were considered to be workers who perform agricultural activities, as either employees or employers. Australia, China, India, and Brazil had the most publications, and the causes of suicide were mostly easy access to or exposure to pesticides, and socioeconomic factors, such as masculinity, conditions of poverty, and social isolation. CONCLUSION: Compared with other workers, agricultural workers can be a group at risk, with a great number of factors leading to suicide. Based on the available literature, proposals for suicide prevention are suggested.

Reduciendo la ideación suicida en adolescentes con terapia de perspectiva temporal. Un estudio experimental / Reducing suicidal ideation in adolescents with time perspective therapy. An experimental study

Resumen El suicidio es una de las principales causas de muerte en el mundo, problema que en los últimos años ha venido en aumento sostenido para la población adolescente. En particular, la ideación suicida se ha relacionado fuertemente con el intento suicida, un predictor directo del suicidio; sin embargo, se encuentran escasas estrategias para disminuir la ideación suicida diseñadas principalmente para la depresión. Considerando las posibilidades terapéuticas de la teoría de Zimbardo sobre la perspectiva temporal equilibrada, en el presente estudio se diseñó una intervención breve basada en la perspectiva del tiempo para adolescentes con el objetivo de evaluar el efecto de una intervención de perspectiva temporal en la modificación de indicadores de ideación y conducta suicida en adolescentes. De este modo, se realizó un estudio experimental, donde 82 participantes de 15 a 19 años fueron asignados a una intervención experimental o a un grupo control. Los participantes del grupo experimental (n = 43) participaron durante 8 sesiones del programa de intervención de perspectiva del tiempo denominado "Serenamente". Las mediciones pre-post se realizaron sobre las variables de ideación suicida (Okasha), el perfil temporal (ZTPI) y la calidad de vida (SF-36). Como resultados, se encontró que la intervención reduce la ideación suicida en un 41 %; y que, posiblemente, mejora la salud física de quienes reciben este tipo de tratamiento. Los resultados son un avance promisorio con fines preventivos en contextos educativos y de salud.

Abstract Suicide is one of the leading causes of death in the world, a problem that has been steadily increasing in recent years for the adolescent population. In particular, suicidal ideation has been strongly associated with suicide attempt, a direct predictor of suicide; however, few strategies to decrease suicidal ideation designed primarily for depression are found. Considering the therapeutic possibilities of Zimbardo's theory on balanced time perspective, in the present study a brief intervention for adolescents based on that theory was designed with the aim of evaluating the effect of a time perspective intervention on the modification of indicators of suicidal ideation and behavior in adolescents. Thus, an experimental study was conducted, where 82 participants aged 15 to 19 were assigned to either an experimental intervention or a control group. The participants of the experimental group (n = 43) engaged in eight sessions of the time perspective intervention program called "Serenity". Pre-post measurements were made on the variables of suicidal ideation (Okasha), time profile (ZTPI) and quality of life (SF-36). Results show that the intervention reduces suicidal ideation by 41%; and that, possibly, it improves the physical health of those who receive this type of treatment. The results are a promising advance for preventive purposes in educational and health contexts.

Factores asociados a la ideación suicida y el dolor crónico en pacientes adultos mayores asistidos en un hospital general de la ciudad de Buenos Aires / Associated factors with suicidal ideation and chronic pain in elderly patients assisted in a general hospital of the city of Buenos Aires

Introducción: el siguiente estudio tuvo como finalidad explorar algunas características demográficas asociadas al dolor crónico y el desarrollo de ideas de suicidio en una población de pacientes mayores de 65 años. Método: se realizó un estudio observacional y analítico de corte transversal mediante el relevamiento de datos a partir historias clínicas de pacientes mayores de 65 años que concurrieron a los consultorios externos del equipo de geriatría del Servicio de Psiquiatría del Hospital Italiano de Buenos Aires, entre junio de 2018 y diciembre de 2018. Resultados: se incluyó en el estudio un total de 222 pacientes, de los cuales 50 (23%) presentaron indicadores de dolor crónico y 33 pacientes (14,6%) lo hicieron de ideación suicida. Mediante estudio de correlación se estableció que estar ocupado, padecer dolor crónico y haber tenido más de una internación psiquiátrica son factores que incrementan el riesgo de presentar ideación suicida. Las variables ideación suicida, edad, y el estado civil ‒separado o divorciado en comparación con estar casado‒ son factores asociados a la presencia de dolor crónico. Conclusiones: el dolor crónico y la ideación suicida son factores que contribuyen a aumentar la fragilidad en personas mayores y deben ser estudiados en mayor profundidad para comprender los distintos modos de expresión de la patología psiquiátrica en esta población. (AU)

Introduction: the following study aimed to explore some demographic characteristics associated with chronic pain and the development of suicidal ideas in a population of patients over 65 years. Method: an cross-sectional observational and analytical study was carried out by collecting data from clinical histories of patients over 65 years of age who attended the external offices of the geriatrics team of the Psychiatry service of the Italian Hospital of Buenos Aires between June 2018 and December 2018. Results: a total of 222 patients were included in the study, of which 50 (23%) presented indicators of chronic pain and 33 patients (14.6%) had suicidal ideation. A correlation study established that being employed, suffering from chronic pain and having had more than one psychiatric hospitalization are factors that increase the risk of presenting suicidal ideation. The variables suicidal ideation, age, and separated or divorced marital status compared to being married are factors associated with the presence of chronic pain. Conclusions: chronic pain and suicidal ideation are factors that contribute to increasing frailty in elderly patients and should be studied in greater depth to understand the different modes of expression of psychiatric pathology in this population. (AU)

Hallazgos psicométricos de la escala para ideación suicida del centro de estudios epidemiológicos en adolescentes escolarizados de samacá, boyacá, colombia / Psychometric findings of the suicidal ideation scale of the center of epidemiological studies in school enrolled adolescents in samacá, boyacá, colombia

RESUMEN El Centro de Estudios Epidemiológicos (CES) de los Estados Unidos introdujo con la escala para depresión (CES-D) y otra escala para cuantificar en forma rápida ideación suicida (CES-IS) durante las dos semanas más recientes; sin embargo, se conoce poco del rendimiento psicométrico de este instrumento. El objetivo fue verificar el desempeño psicométrico de la CES-IS en adolescentes escolarizados de un municipio de Boyacá, Colombia. Se realizó un estudio de validación con la participación de 363 estudiantes de un municipio de características rurales en edades entre 10 y 17 años (media=13; DE=1,8); 55,4% de los estudiantes de sexo femenino y 44,5% de sexo masculino. Los adolescentes diligenciaron los cuatro ítems de la CES-IS, una versión de diez ítems de la (CES-D-10) y la escala de Rosenberg para autoestima (ERA). Se estimó la consistencia interna (alfa de Cronbach y omega de McDonald), la estructura dimensional (análisis factorial confirmatorio, AFC) y la convergencia con la CES-D-10 (correlación de Spearman, rs). Las puntuaciones en la CES-IS se observaron entre 4 y 20 (M=6,1; DE=3,5; Me=4, RIC=4-7) y en la CES-D entre 11 y 44 (M=23,3; DE=6,8; Me=22; RIC=18-27). La CESIS mostró alfa de Cronbach de 0,86 y omega de McDonald de 0,87, una dimensión que explicó el 71,2% de la varianza, los indicadores de ajuste RMSEA=0,00; IC90% 0,00-0,09; CFI=1,00; TLI=1,00; y SRMR=0,01, correlación convergente de rs=0,59 (p=0,001) con la CES-D-10 y correlación divergente de rs=-0,38(p=0,001) con la ERA. Se concluye que la CES-IS en adolescentes de un municipio de Boyacá presenta alta consistencia interna, una estructura unidimensional y alta convergencia con la CES-D-10 y divergencia con la ERA. Se necesita investigar el rendimiento de este instrumento en adolescentes colombianos con otras características distintivas.

ABSTRACT The Center for Epidemiological Studies (CES) of the United States introduced, along with the Depression Scale (CES-D) and another scale to rapidly quantify suicidal ideation (CED-IS) during the two most recent weeks. However, little is known about the psychometric performance of this instrument. The objective of this study was to verify the psychometric performance of the CES-IS in school enrolled adolescents from a small town in Boyacá, Colombia. A validation study was carried out with the participation of 363 students between 10 and 17 years of age (mean=13, SD=1.8); 55.4% female students and 44.5% male students. The adolescents completed the four items of the CES-IS, a ten-item version of the CES-D-10 and the Rosenberg Self-esteem Scale (RSS). Internal consistency (Cronbach alpha and McDonald omega), dimensional structure (confirmatory factorial analysis, AFC) and convergence with CES-D-10 (Spearman correlation, rs) were estimated. The CES-IS scores were observed between 4 and 20 (M=6.1, SD=3.5, Me=4, IQR=4-7) and the CES-D between 11 and 44 (M=23.3, SD=6.8, Me=22, IQR=18-27). The CES-IS showed Cronbach alpha of 0.86 and McDonald's omega of 0.87, a dimension that explained 71.2% of the variance, the adjustment indicators RMSEA=0.00, 90%CI 0.00-0.09; CFI=1.00, TLI=1.00 and SRMR = 0.01, convergent correlation of rs=0.59 (p=0.001) with the CES-D-10 and divergent correlation of rs=-0.38 (p=0.001) with the RSS. It is concluded that the CES-IS among adolescents of a small town in Boyacá, Colombia, has high internal consistency, a onedimensional structure and high convergence with CES-D-10 and divergence with the RSS. It is necessary to investigate the performance of this instrument in Colombian adolescents with other distinctive characteristics.

A School-Based Multilevel Study of Adolescent Suicide Ideation in California High Schools.

OBJECTIVES: To assess the between-school variation in suicide ideation and to estimate the contribution of school-level attributes, student-level characteristics, and 2 cross-level interactions (school by student) to student suicide ideation. STUDY DESIGN: A secondary analysis of the California Healthy Kids Survey in 2 large and representative samples of California high schools and students: 2009-2011 and 2011-2013. This is a population sample of all public high school students (grades 9 and 11) in California. Analyses were first conducted on surveys administered in the 2011-2013 academic years to 790 schools with 345 203 students and replicated on surveys administered in 2009-2011 to 860 schools with 406 313 students. RESULTS: School-level suicide ideation rates ranged between 4% and 67%, with a median of 19.3% and mean of 20.0% (SD, 5.7%). Student suicide ideation was explained by student-level characteristics (R2 = .20) and to a larger extent by school-level attributes (R2 = .55). Student-level characteristics predictive of suicide ideation included, sex, ethnic and racial affiliation, victimization, and perceptions of school climate. In both samples, school size and average level of academic achievement were not associated with rates of school suicide ideation. Schools with a larger number of girls and higher levels of victimization had higher rates of suicide ideation in both samples. The hypotheses regarding cross-level interactions were not confirmed. CONCLUSIONS: Differences among schools in student suicide ideation are meaningful. The findings suggest an emphasis on the role of schools in prevention programs, public health campaigns to reduce suicide, multilevel research, and theory development.

O comportamento suicida de idosos institucionalizados: histórias de vida / The suicidal behavior of institutionalized elderly: life stories

Resumo Neste artigo estão resumidas e analisadas 16 histórias de vida de homens e mulheres idosos que residem em nove Instituições de Longa Permanência no Estado do Rio de Janeiro e que tentaram dar cabo à vida ou têm comportamento suicida. O estudo qualitativo foi precedido por uma pesquisa do perfil de 122 idosos residentes, por meio de um formulário do qual constam: dados socioeconômicos e demográficos: nome, data de nascimento, idade, sexo, estado civil, numero de filhos vivos e mortos, nacionalidade, raça, religião, grau de instrução, profissão/ocupação, renda e tempo em que reside na instituição; e cinco perguntas que direcionaram a seleção das pessoas com ideações e tentativas de suicídio, segundo um modelo criado pelo pesquisador italiano Scocco e seu grupo. Segundo as histórias narradas pelos oito homens e oito mulheres, observam-se relevantes diferenciações por gênero tanto nos aspectos sociodemográficos como motivacionais para o comportamento suicida. Os principais fatores comuns a homens e mulheres institucionalizados em situação de risco para a morte autoinfligida são: perda de laços afetivos e de pessoas referenciais, abuso de álcool e outras drogas, inadequação à vida institucional, doenças crônicas incapacitantes e dolorosas que repercutem em solidão, desesperança e falta de sentido para a vida.

Abstract This article summarizes and analyzes 16 life histories of elderly men and women residing in nine Long Stay Institutions in the State of Rio de Janeiro and who tried to end life or have suicidal behavior. The qualitative study was preceded by a survey of the profile of 122 elderly residents, using a form that includes: socioeconomic and demographic data: name, date of birth, age, sex, marital status, number of children living and dead, nationality, race, religion, degree of education, profession / occupation, income and time in which the institution resides; And five questions that guided the selection of people with ideations and suicide attempts, according to a model created by the Italian researcher Scocco and his group. According to the stories narrated by the eight men and eight women, there are relevant gender differences in both socio-demographic and motivational aspects of suicidal behavior. The main factors common to institutionalized men and women at risk for self-inflicted death are: loss of affective and referential ties, alcohol and other drug abuse, inadequate institutional life, disabling and painful chronic diseases that lead to loneliness, hopelessness and meaninglessness to life.