The Zero Suicide model in addiction treatment settings: Recognizing the need for feasibility and implementation data

The Zero Suicide (ZS) model is a promising approach for preventing all suicides across health care settings. ZS provides guidelines for health care systems to implement best practices in suicide prevention. Patients with substance use disorders are at increased risk for suicide, but no known research has investigated how to integrate the ZS model into […]

Transgender individuals are at higher risk for suicidal ideation and preparation than cisgender individuals in substance use treatment

Introduction: This study describes the differences and similarities in mental health, substance use, and substance use treatment outcomes between people presenting for SUD treatment who identified as transgender and those who identified as cisgender men or women. Methods: We compared 64 individuals who self-identified as transgender and presented for SUD treatment to samples of cisgender men and […]

Differential characteristics of bipolar I and II disorders: A retrospective, cross-sectional evaluation of clinical features, illness course, and response to treatment

Background The distinction between bipolar I and bipolar II disorder and its treatment implications have been a matter of ongoing debate. The aim of this study was to examine differences between patients with bipolar I and II disorders with particular emphasis on the early phases of the disorders. Methods 808 subjects diagnosed with bipolar I […]

Estimated average treatment effect of psychiatric hospitalization in patients with suicidal behaviors: A precision treatment analysis

Objectives  To estimate the association of psychiatric hospitalization with subsequent suicidal behaviors using observational data and develop a preliminary predictive analytics individualized treatment rule accounting for heterogeneity in this association across patients. Design, Setting, and Participants  A machine learning analysis of retrospective data was conducted. All veterans presenting with suicidal ideation (SI) or suicide attempt (SA) from […]

Major depression with co-occurring suicidal thoughts, plans, and attempts: An increasing mental health crisis in US adolescents, 2011–2020

This study aimed to examine national trends and disparities in the prevalence and treatment of adolescent 12-month major depressive episode (MDE) with co-occurring suicidal thoughts, plans, and attempts. Publicly available data for adolescents aged 12–17 in the 2011–2020 National Survey on Drug Use and Health were analyzed. Bivariate and multivariable logistic regression analyses were conducted. […]

Young people’s pathways to specialist suicide prevention service and the influence of caregiver prior suicidality and mental health treatment

Aim. Timely help-seeking and pathways to care (PtC) have been linked to positive outcomes in suicidal adolescents. While the importance of formal contacts is recognised, caregivers also play a significant role in these pathways. Caregiver’s familiarity with mental health issues may influence an adolescent’s  PtC. This study explores the relationship between a caregiver’s prior suicidality […]

Remote blended treatment for individuals with suicidal ideation: A single-arm proof-of-concept trial

Introduction: New digital treatment formats may reduce barriers to treatment for individuals with suicidal ideation. This study aimed to investigate the feasibility of a remote blended care programme for this population, defined as acceptability, demand, practicality, adaptation, indications of efficacy and safety. Methods: We conducted a mixed-methods single-arm trial for proof-of-concept. Participants were eligible if they were […]

The suicidal person: Anew look at a human phenomenon

Konrad Michel, a leading psychiatrist and acclaimed expert, draws on decades of experience to offer necessary new ways of understanding–and preventing–suicide. After one of his first patients died by suicide, Michel devoted himself to researching self-harm. Writing vividly and personally, he recounts more than forty years of working with and learning from suicidal patients. Michel […]

Substance abuse treatment: Group therapy

This guide helps counselors improve their skills in leading group therapy sessions for substance use treatment. The guide discusses types of group therapy, confidentiality, client placement, group development, stages of treatment, how-to tips, training, and supervision.

Effects of community-based caring contact in reducing thwarted belongingness among postdischarge young adults with self-harm: Randomized controlled trial

Background: For patients with self-harm behaviors, the urge to hurt themselves persists after hospital discharge, leading to costly readmissions and even death. Hence, postdischarge intervention programs that reduce self-harm behavior among patients should be part of a cogent community mental health care policy. Objective: We aimed to determine whether a combination of a self-help mobile […]

Feasibility and acceptability on continuous identity cognitive therapy as a recovery-oriented suicide treatment for veterans: A study protocol

Background: Suicide is a leading cause of death among Veterans, with rates significantly higher than the general population. To address this issue, it is crucial to develop and implement more effective treatments for Veterans with suicidal thoughts and/or behaviors, particularly those in the post-acute suicidal episode (PASE) stage. The present study aims to establish the […]

Nightmares in borderline personality disorder: Narrative review

BACKGROUND: Borderline personality disorder (BPD) patients commonly suffer from nightmares. Still, the prevalence of this issue does not match the little clinical attention it usually receives. Nightmares impact sleep and daily functioning and may play a role in BPD symptomatology, including suicidality. Since BPD has been linked with high rates of suicide, the potential connection […]

Nonmedical social determinants, syndemic conditions, and suicidal thoughts and behaviors in a treatment-seeking community sample: A latent class analysis

Objective: Knowledge gaps remain regarding whether syndemic conditions identify treatment-seeking individuals most at risk for suicidal thoughts and behaviors (STB). We employed latent class analysis to: (1) model treatment-seeking individuals’ syndemic conditions, (2) examine latent classes across nonmedical social determinants, and (3) assess associations between class membership and STB. Method: Participants were 982 individuals presenting at a […]

Successful treatment of suicidal risk: What helped and what was internalized?

Background: In this article we focused on analyzing surveyed patient-generated responses based on two outcome questions derived from a suicide-specific framework called the Collaborative Assessment and Management of Suicidality (CAMS): Q1 – “Were there any aspects of your treatment that were particularly helpful to you? If so, please describe these. Be as specific as possible.” […]

Efficacy of a digital mental health intervention embedded in routine care compared with treatment as usual in adolescents and young adults with moderate depressive symptoms: Protocol for randomised controlled trial

Introduction: There are unmet mental health needs of depressed adolescents and young adults (AYAs) across the USA. Behavioural technology adequately integrated into clinical care delivery has potential to improve care access and efficiency. This multisite randomised controlled trial evaluates how a coach-enhanced digital cognitive behavioural intervention (dCBI) enhances usual care for depressed AYAs in paediatric practices […]

Esketamine nasal spray for major depressive disorder with acute suicidal ideation or behavior: Description of treatment access, utilization, and claims-based outcomes in the United States

Aims: To describe real-world esketamine nasal spray access and use as well as healthcare resource use (HRU) and costs among adults with evidence of major depressive disorder (MDD) with suicidal ideation or behavior (MDSI). Methods: Adults with ≥1 claim for esketamine nasal spray and evidence of MDSI 12 months before/on the date of esketamine initiation (index date) […]

Risk factors for suicide attempt during outpatient care in adolescents with severe and complex depression

Background: Young people receiving tertiary mental health care are at elevated risk for suicidal behavior, and understanding which individuals are at increased risk during care is important for treatment and suicide prevention. Aim: We aimed to retrospectively identify risk factors for attempted suicide during outpatient care and predict which young people did or did not attempt during care. Method: Penalized […]

The relationship between working alliance and treatment outcome in an internet-based grief therapy for people bereaved by suicide

Background Working alliance is an important component in the therapy process, however its’ role in bereavement interventions has rarely been studied. This study investigates the relationship between working alliance and treatment outcome, the change of working alliance throughout therapy and patient characteristics as predictors of working alliance. Methods Data from a randomized controlled trial including […]

Suicidal behavior (2nd ed.)

The book is invaluable as a compact how-to reference for clinicians in their daily work and as an educational resource for students and for practice-oriented continuing education. Its reader-friendly structure makes liberal use of tables, boxed clinical examples, and clinical vignettes. The book, which also addresses common obstacles in treating individuals at risk for suicide, […]

Differential spatial-social accessibility to mental health care and suicide

In recent years, the United States has been experiencing historically high suicide rates. In the face of mental health care provider shortages that leave millions needing to travel longer to find providers with schedule openings, if any are available at all, the inaccessibility of mental health care has become increasingly central in explaining suicidality. To […]

Specific psychological treatment versus treatment as usual in adolescents with self-harm: Systematic review and meta-analysis

Background: Despite recent advances in the understanding and treatment of self-harm, poor engagement with therapy remains a serious problem. Aims: To investigate whether offering specific psychological treatment (SPT) leads to better engagement than offering treatment as usual (TAU) in adolescents who have self-harmed. Methods: Data sources were identified by searching Medline, PsychINFO, EMBASE, and PubMed for randomized controlled […]

Investigation of the relationship between psychiatry visit and suicide after deliberate self-harm: Longitudinal national cohort study

Background: Deliberate self-harm (DSH) along with old age, physical disability, and low socioeconomic status are well-known contributors to suicide-related deaths. In recent years, South Korea has the highest suicide death rate among all Organization for Economic Co-operation and Development countries. Owing to the difficulty of accessing data of individuals with DSH behavior who died by […]

Designing clinical trials to assess the impact of pharmacological treatment for suicidal ideation/behavior: Issues and potential solutions

Suicide is a serious and growing public health concern yet randomized controlled trials (RCTs) that inform pharmacologic treatment remain limited. We emphasize the overall need for such trials and review the literature to highlight examples of trials that have aimed to study patients at elevated risk of suicide. We discuss key examples of existing psychotropic […]