Sur psychiatrist.com
Unmasking Suicide in Youths
a Psychiatrist.com Curated Collection
(accès aux articles payant)
collection de 16 articles, *
Identifier les caractéristiques cliniques des jeunes patients susceptibles de se suicider
Repérer les signes avant-coureurs de comportements spécifiques
Déterminer si les processus de pensée des patients et même leur personnalité peuvent les exposer à un risque élevé de suicide
Déterminez si d'autres facteurs médicaux ou mentaux jouent un rôle dans le risque
Savoir quels outils sont utiles pour diagnostiquer et prévenir le suicide
Introduction by Philippe Courtet, MD, PhD, Section Editor for JCP’s Focus on Suicide
Lifetime
prevalences of suicidal ideation and suicide attempts in youth are high,
respectively around 20% and from 3% to 9% (WHO 2017), and suicide death
accounts for 8.5% of all deaths among adolescents and young adults
around the world (aged 15–29 years). In this age group, suicide is the
second leading cause of death in the United States (2016 CDC WISQARS)
and the third leading cause of death worldwide (WHO 2017). In several
countries including the United States, the rate of suicide of the
youngest has gradually increased since the turn of our century.
Additionally, the decreasing age at onset of self-harm and increasing
lethal methods indicate the need of targeted interventions in key
transition stages for young people.
Suicidal thoughts and behaviors are underpinned by environmental
risk factors that interact with psychological risk factors (eg,
affective, cognitive, social processes) and biological features (eg,
neurobiological, molecular, genetic factors). Notably, exposure to
interpersonal violence (childhood maltreatment, bullying, and community
violence) has been linked prospectively to suicide attempts and deaths.
Experiencing early life adverse events may induce changes in gene
expression through epigenetic mechanisms and may alter both brain
structure and function, facilitating maladaptive behaviors. Deciphering
this complexity may help to identify pharmacologic and environmental
interventions to reverse these long-term consequences.
Mental and substance use disorders are strong contributors to all
suicide, indicating the importance of their effective management as part
of suicide prevention strategies. The use of antidepressant drugs in
youth has been highly controversial in recent years, and the warnings
have been accused of discouraging doctors from prescribing
antidepressants when they were clinically indicated. Otherwise,
promising news about psychosocial interventions for adolescent self-harm
and the efficacy of school-based preventive interventions addressing
suicidal behaviors underline the benefit of both indicated and universal
suicide preventive intervention in young people. There is much work to
be done to better understand suicidal thoughts and behaviors among youth
and ultimately efficiently improve their prevention.
Noncompliance with the norm, at an age
when construction of identity is in process and refers to others, may
weaken the self-esteem and constitute an important suicidal actor in
adolescents though. Bullying and discrimination (related to physical
appearance, disability, or sexual orientation) that adolescents face may
increase suicidal risk. The internet has become an important platform
for information and communication about suicide among young people.
While it may be harmful (cyberbullying, “Blue Whale Challenge”) in
vulnerable youths, social media may also play a preventive role and help
to identify young people at high risk for suicidal behavior.
Individualized web-based tools, machine-learning algorithms, and mobile
apps offer new avenues for suicide prevention, whereas methodologically
robust research studies to evaluate their safety, efficacy, and
effectiveness are promptly needed.
Collection Contents
Recognizing the Clinical Characteristics of Youths at Risk
1 Clinical Differences Between Suicidal and Nonsuicidal Depressed Children and Adolescents
Rémy P. Barbe, Douglas E. Williamson, Jeffrey A. Bridge, Boris Birmaher, Ronald E. Dahl, David A. Axelson, and Neal D. Ryan
J Clin Psychiatry 2005;66(4):492–498
2 Contributing Factors and Mental
Health Outcomes of First Suicide Attempt During Childhood and
Adolescence: Results From a Nationally Representative Study
Hugo Peyre, Nicolas Hoertel, Coline
Stordeur, Gaële Lebeau, Carlos Blanco, Kibby McMahon, Romain Basmaci,
Cédric Lemogne, Frédéric Limosin, and Richard Delorme
J Clin Psychiatry 2017;78(6):e622–e630
3 Clinical Features of Depressed Children and Adolescents With Various Forms of Suicidality
Xianchen Liu, Amy L. Gentzler, Ping Tepper, Enikö Kiss, Viola Osváth Kothencné, Zsuzsanna Tamás, Ágnes Vetró, and Maria Kovacs
J Clin Psychiatry 2006;67(9):1442–1450
Transition From Self-Harm to Suicide
4 A Longitudinal Study of Nonsuicidal Self-Injury in Offspring at High Risk for Mood Disorder
Lara J. Cox, Barbara H. Stanley, Nadine M.
Melhem, Maria A. Oquendo, Boris Birmaher, Ainsley Burke, David J.
Kolko, Jamie M. Zelazny, J. John Mann, Giovanna Porta, and David A.
Brent
J Clin Psychiatry 2012;73(6):821–828
Inflammation and Suicidality
5 Inflammatory Markers and the Pathogenesis of Pediatric Depression and Suicide: A Systematic Review of the Literature
Jae-Won Kim, Eva M. Szigethy, Nadine M. Melhem, Ester M. Saghafi, and David A. Brent
J Clin Psychiatry 2014;75(11):1242–1253
Sleep Disturbance and Suicidality
6 Objectively Assessed Sleep
Variability as an Acute Warning Sign of Suicidal Ideation in a
Longitudinal Evaluation of Young Adults at High Suicide Risk
Rebecca A. Bernert, Melanie A. Hom, Naomi G. Iwata, and Thomas E. Joiner
J Clin Psychiatry 2017;78(6):e678–e687
Internet Addiction Among Adolescents Increases Suicidal Risk
7 Internet Addiction and Its Relationship With Suicidal Behaviors: A Meta-Analysis of Multinational Observational Studies
Yu-Shian Cheng, Ping-Tao Tseng, Pao-Yen
Lin, Tien-Yu Chen, Brendon Stubbs, Andre F. Carvalho, Ching-Kuan Wu,
Yen-Wen Chen, and Ming-Kung Wu
J Clin Psychiatry 2018;79(x):17r11761
Risk Factors During College
8 Characteristics and Risk Factors
for Suicide and Deaths Among College Students: A 23-Year Serial
Prevalence Study of Data From 8.2 Million Japanese College Students
Chiyoko Uchida and Mai Uchida
J Clin Psychiatry 2017;78(4):e404–e412
Thought Patterns May Determine Level of Urgency
9 Cognitive Control Deficits Differentiate Adolescent Suicide Ideators From Attempters
Jeremy G. Stewart, Catherine R. Glenn, Erika C. Esposito, Christine B. Cha, Matthew K. Nock, and Randy P. Auerbach
J Clin Psychiatry 2017;78(6):e614–e621
Coping Strategies Play a Role
10 Responses to Depressed Mood and Suicide Attempt in Young Adults With a History of Childhood-Onset Mood Disorder**
Xianchen Liu, Amy L. Gentzler, Charles J. George, and Maria Kovacs
J Clin Psychiatry 2009;70(5):644–652
Suicidality in First-Episode Psychoses
11 Predictors of Suicide Attempt in Early-Onset, First-Episode Psychoses: A Longitudinal 24-Month Follow-Up Study
Vanessa Sanchez-Gistau, Inmaculada Baeza,
Celso Arango, Ana González-Pinto, Elena de la Serna, Mara Parellada,
Motserrat Graell, Beatriz Paya, Cloe Llorente, and Josefina
Castro-Fornieles
J Clin Psychiatry 2013;74(1):59–66
Suicidality During Treatment for Depression
12 Suicidal Events in the Treatment for Adolescents With Depression Study (TADS)
Benedetto Vitiello, Susan G. Silva, Paul
Rohde, Christopher J. Kratochvil, Betsy D. Kennard, Mark A. Reinecke,
Taryn L. Mayes, Kelly Posner, Diane E. May, and John S. March
J Clin Psychiatry 2009;70(5):741–747
Active Screening
13 Patient Health Questionnaire
Depression Scale as a Suicide Screening Instrument in Depressed Primary
Care Patients: A Cross-Sectional Study
Lisa A. Uebelacker, Nicole M. German, Brandon A. Gaudiano, and Ivan W. Miller
Prim Care Companion CNS Disord 2011;13(1):e1–e6
14 A Risk Algorithm for the Persistence of Suicidal Thoughts and Behaviors During College
Philippe Mortier, Glenn Kiekens, Randy P.
Auerbach, Pim Cuijpers, Koen Demyttenaere, Jennifer G. Green, Ronald C.
Kessler, Matthew K. Nock, Alan M. Zaslavsky, and Ronny Bruffaerts
J Clin Psychiatry 2017;78(7):e828–e836
Prevention Strategies
15 Student Evaluation of the Yellow Ribbon Suicide Prevention Program in Midwest Schools**
Alexandra Flynn, Rosalee Zackula, Nicole M. Klaus, Liz McGinness, Susan Carr, and Matthew Macaluso
Prim Care Companion CNS Disord 2016;18(3):doi:10.4088/PCC.15m01852
16 Guns and Suicide: Are They Related?
Simrat Kaur Sarai, Bilal Abaid, and Steven Lippmann
Prim Care Companion CNS Disord 2017;19(6):17br02116
**Although this CME activity is expired, the posttest and answers are provided for your benefit.
