The relationship between suicidality and the loudness dependence of auditory-evoked potentials (LDAEP) remains controversial. This article reviews the literature related to the LDAEP and suicide in patients with major depressive disorder, and suggests future research directions. Serotonergic dysfunction in suicidality seems to be more complicated than was originally thought. Studies of suicide based on the LDAEP have produced controversial results, but it is possible that these are due to differences in study designs and the smallness of samples. For example, some studies have evaluated suicide ideation and the LDAEP, while others have evaluated suicide attempts and the LDAEP. Furthermore, some of the latter studies enrolled acute suicide attempters, while others enrolled those with the history of previous suicide attempts, irrespective of whether these were acute or chronic. Thus, a more robust study design is needed in future studies, for example by evaluating the LDAEP immediately after a suicide attempt rather than in those with a history of suicide attempts and suicide ideation in order to reduce bias. Moreover, genuine suicide attempt, self-injurious behaviors, and faked suicide attempt need to be discriminated in the future.
Bias (Epidemiology) ; Depressive Disorder, Major* ; Humans ; Self-Injurious Behavior ; Suicide*

OBJECTIVE: To present an approach to phenotyping ACEs and explore the association between ACEs and adolescent health risky behaviors based on the social context of China. METHODS: Totally, 5,726 adolescents aged 12-18 years were investigated about their ACEs in the family, peer, school, and personal domains and the occurrence of six types of risky health behaviors (i.e., smoking, drinking, sexual intercourse, self-harm, and suicidal ideation and attempts). Latent class analysis (LCA) was used to explore the ACE patterns. RESULTS: Six latent classes of ACEs were identified, including low adversity, school adversity, school adversity and peer victimization, peer victimization, maltreatment and peer victimization, and high adversity, and associated with risky health behaviors in adolescents. Being physically punished by a teacher, experiencing sexual abuse, and experiencing family trauma most strongly differentiated from the six ACE classes and were correlated with an increased risk for risky adolescent health behaviors. CONCLUSION This study supports a positive association between ACEs and risky adolescent health behaviors. Peer victimization, school adversity and associated contexts need to be considered in future ACE studies.
Adverse Childhood Experiences ; Health Risk Behaviors ; Humans ; Phenotype ; Self-Injurious Behavior/epidemiology*

From September 2017 to February 2018, 650 disabled children and adolescents aged 6-to 17-year-old in Beijing were matched 1∶1 to those in normal physical condition with same age, gender and place of residence. All children and adolescents were investigated for self-injury status in the last year to understand the difference of self-injury incidence between groups. Multivariate unconditional logistic regression model was applied for exploring relevant factors of self-injury of children and adolescents. This study found that the disability, insufficient sleep, difficulty falling asleep, and sleeping late were associated with self-injury of children and adolescents.
Adolescent ; Beijing ; epidemiology ; Child ; Cross-Sectional Studies ; Disabled Children ; statistics & numerical data ; Humans ; Logistic Models ; Self-Injurious Behavior ; epidemiology ; Sleep

OBJECTIVETo investigate the prevalence of common psychosomatic symptoms among Chinese adolescents and the influence on 6 months later suicide and self-injurious behavior.

METHODSBased on the cluster sampling method, the participants who were recruited from 8 cities from 3 areas in China, including Eastern areas (Beijing, Shaoxing and Guangzhou), Middle areas (Ezhou, Harbin and Taiyuan) and Western areas (Guiyang and Chongqing), were administered by multidimensional sub-health questionnaire of adolescents (MSQA) in March 2008. Demographics, life style, psychosomatic symptoms, suicide and self-injurious behavior were also assessed. A total of 17 622 questionnaires were valid at baseline. Six months later, 14 407 questionnaires were eligible for two waves investigation. Analysis of Pearson chi-square and logistic model regression analysis were employed to compare the incidence of psychosomatic symptoms, suicide and self-injurious behaviors among different areas and to explore the possible risk factors of those symptoms and behaviors.

RESULTSAt baseline, rates of total common physiological and psychological symptoms were 24.1% (4255/17622) and 30.9% (5447/17622), respectively, with the highest being eating and drinking too much (6.4%, 1130/17622) and hardly feel ease to learn at home (11.8%, 2087/17 622). In males, the rate of common psychological symptoms (30.7%, 2637/8599) was higher than physiological symptoms (24.0%, 2061/8599) (P < 0.05); in females, the rate of common psychological symptoms (31.1%, 2810/9023) was higher than physiological symptoms (24.3%, 2194/9023) (P<0.05). The rate of the common psychosomatic symptoms in senior high school students (46.8%, 2905/6208) were significantly higher than those in middle high school students (37.3%, 2337/6262) and college students (33.2%, 1711/5152) (all P values <0.05). Students from Western areas had the highest incidences of the common physiological and psychological symptoms (30.2%, 1471/4871; 40.6%, 1979/4871), higher than students from Middle areas (22.4%, 1443/6453; 27.0%, 1743/6453) and Eastern areas (21.3%, 1341/6298; 27.4%, 1725/6298) (all P values <0. 05). Results from multiple logistic regression showed that physical symptoms > or = 2 at baseline were shared risk factors for suicidal ideation (RR = 1.44, 95% CI:1.16 - 1.79), attempted suicide (RR = 1.79, 95% CI: 1.22 - 2.61) and self-injurious behaviors (RR = 1.39, 95% CI: 1.17 - 1.66) 6 months later. Psychopathological symptoms > or = 4 at baseline was the shared risk factors for suicide ideation (RR = 1.74, 95% CI: 1.39 -2.17), attempted suicide (RR = 2.08, 95%CI: 1.39 - 3.11) and self-injurious (RR = 1.90, 95%CI: 1.59 - 2.28) 6 months later.

CONCLUSIONIt is common in Chinese adolescents who have multiple psychosomatic symptoms simultaneously. What's important is that those common psychosomatic symptoms are shared risk factors of later suicidal and self-injurious behaviors.

Adolescent ; China ; epidemiology ; Female ; Humans ; Male ; Psychophysiologic Disorders ; epidemiology ; Self-Injurious Behavior ; epidemiology ; psychology ; Suicidal Ideation ; Suicide ; psychology ; statistics & numerical data ; Surveys and Questionnaires

OBJECTIVETo explore the relationships between quality of life, negative life events, social support and suicide ideation among undergraduates in colleges.

METHODS3517 undergraduates in colleges were recruited by multistage stratified random clustered sampling method. Factors associated with suicide ideation were analyzed with logistic regression by scores of Beck Scale for Suicide Ideation(BSSI), Generic Quality of Life Inventory (GQOLI), Adolescent Self-rate Life Events Checklist (ASLEC), Social Support Rating Scale (SSRS) and a questionnaire on background information.

RESULTSThe rate of suicide ideation within 7 days was 14.1%, especially in females (15.96%), with single parent (23.79%) and disabled undergraduates (25.00%). The primary risk factors for suicide ideation were with low psychological function, material life, family/social support, lower availability of support and more negative life events.

CONCLUSIONThe prevalence of suicide ideation among these undergraduates was high, appropriate measures focusing on these risk factors should be implemented.

China ; epidemiology ; Cluster Analysis ; Female ; Humans ; Logistic Models ; Male ; Risk Factors ; Self-Injurious Behavior ; epidemiology ; Students ; psychology ; Suicide ; psychology ; Surveys and Questionnaires

Adolescent ; Child ; China ; epidemiology ; Female ; Humans ; Male ; Puberty ; Self-Injurious Behavior ; epidemiology ; Sex Characteristics ; Sex Factors ; Students ; statistics & numerical data ; Violence ; statistics & numerical data

OBJECTIVETo understand the characteristics of self-inflicted injury/suicide cases that were seen from the clinic or the emergency rooms, to provide basis for suicide prevention strategies development.

METHODSData from the National Injury Surveillance System, from 2006 to 2013 were used to analyze the trend of self-inflicted injury/suicide proportion in injuries as well as the socio-demographic characteristics of the cases with related basic and clinic information related to self-inflicted injury/suicide.

RESULTSThe proportion of self-inflicted injury/suicide cases decreased during the past 8 years. 58.6% of the self-inflicted injury/suicide cases were females in 2013 and 42.1% received junior secondary school education. Self-inflicted injury/suicide were mostly taken place at home (76.2% ). Poisoning (56.1% ) and sharp injury were the major ways causing self-inflicted injury or suicide.

CONCLUSIONInterventions on self-inflicted injury/suicide should be strengthened including control programs on pesticide/psychotropic drugs. Prevention on future attempts and suicide should include the full use during the in-hospital time of those suicide attempters.

Asian Continental Ancestry Group ; China ; epidemiology ; Emergency Service, Hospital ; statistics & numerical data ; Female ; Humans ; Self-Injurious Behavior ; Suicide ; statistics & numerical data ; Suicide, Attempted ; statistics & numerical data

INTRODUCTIONDeliberate self-harm (DSH) is frequently seen in adolescents with a range of mental health problems. The prevalence and features of DSH vary among different countries and settings. This study examines the prevalence of self-harm in a sample of adolescents seen at a psychiatric outpatient clinic in Singapore.

METHODSInformation regarding self-harm, as well as its associated demographic and clinical risk factors, was extracted from the clinical records of 542 consecutive, new patients, aged 12-19 years, who presented between 2006 and 2010.

RESULTSDSH was reported in 23.6% of patients, and was positively associated with the female gender (odds ratio [OR] 4.54), mood disorders (OR 4.58), adjustment disorders (OR 3.41) and regular alcohol use (OR 4.80). However, there was no association with parental marital status, anxiety disorder, habitual smoking or family history of psychiatric illness.

CONCLUSIONDSH is a significant clinical problem that may be influenced by biological and clinical factors. Adolescents presenting with DSH should be examined for mood and alcohol use disorders.

Adolescent ; Child ; Female ; Humans ; Male ; Mental Health ; Odds Ratio ; Outpatients ; psychology ; statistics & numerical data ; Prevalence ; Retrospective Studies ; Risk Assessment ; Risk Factors ; Self-Injurious Behavior ; epidemiology ; psychology ; Singapore ; epidemiology ; Surveys and Questionnaires ; Young Adult

INTRODUCTIONThe prevalence rate of anorexia nervosa is lower in Asia than in the West, although studies have found that it is on the rise in Asia. This study aims to present the clinical profile of patients presenting with anorexia nervosa in Singapore.

METHODSThe present study used archival data from the Eating Disorder Programme registry of the Department of Psychiatry, Singapore General Hospital, Singapore. Patient records from 2003 to 2010 were collected and analysed. Presenting characteristics of the patients were also compared with those of another local study conducted eight years earlier.

RESULTSFrom 2003 to 2010, a total of 271 patients were diagnosed with anorexia nervosa by a psychiatrist in our hospital. Of these, 251 (92.6%) were female and 238 (87.8%) were Chinese. Our patients had a lower mean weight (36.83 kg, p < 0.001) and a lower mean body mass index (BMI) (14.43 kg/m(2), p < 0.001) than patients from the previous local study. Almost half of all our patients (n = 135, 49.8%) were diagnosed with at least one psychiatric comorbidity and 50 (18.5%) had a history of self-harm.

CONCLUSIONThe presenting characteristics of our study cohort were similar to those of the Western population. However, the lower presenting weight and BMI in our cohort indicates that cases seen today are more severe than those seen eight years ago. Therefore, it is important to put in place prevention programmes to help adolescents cultivate a healthy body image as well as early intervention programmes to improve detection rates and treatment outcomes.

Adolescent ; Adult ; Anorexia Nervosa ; diagnosis ; epidemiology ; ethnology ; therapy ; Asian Continental Ancestry Group ; Body Image ; Body Mass Index ; Body Weight ; Child ; Comorbidity ; Female ; Follow-Up Studies ; Humans ; Male ; Prevalence ; Retrospective Studies ; Self-Injurious Behavior ; complications ; Singapore ; Treatment Outcome ; Young Adult

During visits to emergency medical facilities, the primary care of and risk identification for individuals who have attempted suicide is considered an important element in suicide prevention. With the ultimate goal of helping to prevent suicide, the aim of the present study was to determine the characteristics of patients with self-inflicted injuries who presented in the emergency department. Patients with self-inflicted injuries who visited 1 of 3 sentinel emergency medical centers from 2007 through 2009 were included in the study. The characteristics, methods, and reasons for suicide attempts were evaluated. Moreover, predictors of severe outcomes were evaluated. A total of 2,996 patients with self-inflicted injuries visited the three centers during a period of 3 yr. The male-to-female suicide ratio was 1:1.38 (P < 0.001). The mean age was 41 yr. Poisoning was the most common method of self-inflicted injury (68.7%) among all age groups. Medication was the primary means of injury in the < 50 age group, and the use of agricultural chemicals was the primary means in the > or = 50 age group. The reasons for attempting suicide varied among the age groups. The predictors of severe outcome are male gender, older age, and not having consumed alcohol.
Adolescent ; Adult ; Age Factors ; Aged ; Child ; Cross-Sectional Studies ; Emergency Service, Hospital ; Female ; Humans ; Male ; Middle Aged ; Poisoning/epidemiology ; Republic of Korea/epidemiology ; Retrospective Studies ; Risk Factors ; Self-Injurious Behavior/*epidemiology ; Sex Factors ; Suicide/prevention & control ; Suicide, Attempted/*statistics & numerical data ; Young Adult