2f:I[703058,["/_next/static/immutable/chunks/3bhq_5eh1d760.js","/_next/static/immutable/chunks/1855-ogyi8eh4.js","/_next/static/immutable/chunks/2pfsjpn6k6zlg.js","/_next/static/immutable/chunks/26c7v3_3uwnwu.js","/_next/static/immutable/chunks/25a3ozcrvi1ff.js","/_next/static/immutable/chunks/2r4wx50nvjh_4.js","/_next/static/immutable/chunks/23fsw06hsi5b1.js","/_next/static/immutable/chunks/06_yt270h41rg.js","/_next/static/immutable/chunks/3ezsiz-7shkna.js","/_next/static/immutable/chunks/20x2y96ldu5wx.js","/_next/static/immutable/chunks/2lxntcm3pd1_h.js","/_next/static/immutable/chunks/00dgco8irq3jw.js","/_next/static/immutable/chunks/00nwe-kq0rboc.js","/_next/static/immutable/chunks/2051ffx3xzio9.js"],"PaperListPageClient"] 30:T7bf,Providing lethal means counseling to caregivers is an underutilized component of emergency department (ED)-based suicide prevention. We assessed the feasibility and acceptability of Lock and Protect, a web-based lethal means counseling decision aid, among caregivers of adolescents who presented to the ED for self-injurious and/or suicidal thoughts and behaviors. We conducted a pilot feasibility study of caregiver-adolescent dyads in a pediatric ED. Adolescents were 13-17 years old with current suicidal ideation, suicide attempt, or non-suicidal self-injury. Caregivers received the Lock and Protect intervention plus usual care while their child was in the ED. Feasibility was measured via enrollment rates, duration of time caregivers interacted with Lock and Protect, and tool completion rates. Caregiver acceptability was measured with the Ottawa Acceptability Scale. Follow-up assessments measured changes in home storage at 2- and 4-weeks after enrollment. Of 47 caregivers screened and eligible, 40 enrolled (85.1%), of whom 39/40 and 1/40 reported home access to medications and firearms, respectively. Caregivers found Lock and Protect respectful of their family values about medications (100%) and firearms (97.5%). Almost all caregivers (95.0%) reported the length was "just right" and 92.5% reported the amount of information was "just right". All caregivers completed the tool in the ED, using it for a mean of 8 min (SD = 3.4 min). All would recommend the tool to others. Ottawa Acceptability Scale scores demonstrated that 95.0% of caregivers found the options in Lock and Protect realistic, and 97.5% found the tool useful for changing home medication access. Follow-up was completed for 77.5% of caregivers, with 20/31 (64.5%) reporting safer home storage of medications. Lock and Protect, a web-based lethal means counseling decision aid, was feasible to administer in the pediatric ED and acceptable to caregivers of adolescents at risk for suicide.31:Ta5c,ABSTRACT Background Providing lethal means counseling to caregivers is an underutilized component of emergency department (ED)‐based suicide prevention. We assessed the feasibility and acceptability of Lock and Protect, a web‐based lethal means counseling decision aid, among caregivers of adolescents who presented to the ED for self‐injurious and/or suicidal thoughts and behaviors. Methods We conducted a pilot feasibility study of caregiver‐adolescent dyads in a pediatric ED. Adolescents were 13–17 years old with current suicidal ideation, suicide attempt, or non‐suicidal self‐injury. Caregivers received the Lock and Protect intervention plus usual care while their child was in the ED. Feasibility was measured via enrollment rates, duration of time caregivers interacted with Lock and Protect, and tool completion rates. Caregiver acceptability was measured with the Ottawa Acceptability Scale. Follow‐up assessments measured changes in home storage at 2‐ and 4‐weeks after enrollment. Results Of 47 caregivers screened and eligible, 40 enrolled (85.1%), of whom 39/40 and 1/40 reported home access to medications and firearms, respectively. Caregivers found Lock and Protect respectful of their family values about medications (100%) and firearms (97.5%). Almost all caregivers (95.0%) reported the length was “just right” and 92.5% reported the amount of information was “just right”. All caregivers completed the tool in the ED, using it for a mean of 8 min (SD = 3.4 min). All would recommend the tool to others. Ottawa Acceptability Scale scores demonstrated that 95.0% of caregivers found the options in Lock and Protect realistic, and 97.5% found the tool useful for changing home medication access. Follow‐up was completed for 77.5% of caregivers, with 20/31 (64.5%) reporting safer home storage of medications. Conclusions Lock and Protect, a web‐based lethal means counseling decision aid, was feasible to administer in the pediatric ED and acceptable to caregivers of adolescents at risk for suicide. 32:T6ba,Suicidal ideation and behavior represent a serious public health concern, particularly during adolescence, and are closely linked to symptoms of depression and anxiety. Although previous studies have examined the network structure of suicidality and emotional symptoms, gaps remain regarding how different stages of suicidal ideation and behavior relate to internalizing symptoms. This study aimed to estimate the lifetime prevalence of suicidal ideation and behavior, examine the associations between depressive and anxiety symptoms and distinct forms of suicidal behavior, and compare symptom networks between adolescents who had or had not reported such experiences. A total of 4160 Spanish adolescents participated in this nationwide study, completing the Paykel Suicide Scale and the Assessment System of Children and Adolescents. 12.7 % of participants reported suicidal ideation and 3.6 % had attempted suicide, with higher rates among girls and older adolescents. Network analyses revealed that worthlessness, anhedonia, sadness, crying, panic attacks, and intrusive thoughts were consistently associated with both passive and active suicidal ideation and attempts. Moreover, adolescents who had experienced suicidal ideation or attempts displayed stronger interconnections among depressive symptoms and between depressive and anxiety symptoms. The sample was partially based on convenience sampling, and the large amount of network comparisons limited power. These findings provide a comprehensive view of the psychopathological structure underlying suicidality in adolescence and contribute to the identification of key emotional symptoms that may be targets for early intervention and prevention strategies.33:T449,A total of 81 713 cases of SA (50 512 [61.8%] female; mean [SD] age, 32.3 [14.9] years), with 408 490 age-matched controls (252 525 [61.8%] female; mean [SD] age, 32.3 [14.9] years), and 9362 cases of suicide (2360 [25.2%] female; mean [SD] age, 45.1 [14.6] years), along with 46 749 matched controls (11 796 [25.2%] female; mean [SD] age, 45.1 [14.6] years) who were alive at the date of the case's death, were included in the health conditions analysis. The PGS analysis included 8221 cases of SA (5944 [72.3%] female; mean [SD] age, 19.7 [4.4] years) and 225 cases of suicide (80 [35.6%] female; mean [SD] age, 24.6 [5.0] years). Chronic diseases (eg, dyslipidemia or hearing problems) showed stronger associations with SA, while severe conditions (eg, cancer) were more strongly associated with suicide. Suicide was influenced only by PGSs for mental disorders, whereas SA was associated with both psychiatric and broader health-related genetic risk factors. Notably, dose-response associations were observed for most health conditions and PGSs in relation to cumulative SA burden.34:Ta95,Not all individuals who die by suicide have a history of nonfatal suicide attempt (SA); however, little is known about the extent to which the genetic and environmental etiologies of SA and suicide are shared or distinct. To examine shared and distinct risk factors for SA and suicide, focusing on clinically diagnosed health conditions and genetic factors. For health conditions, a nested case-control study was performed using data from the Danish registers. For genetic factors, a case-control analysis framework was used, with individual genotypes retrieved from the iPSYCH2015 dataset, which was nested within the entire Danish population. Individuals older than 10 years were included to minimize the risk of misclassification for SA and suicide. Data were analyzed from January 2024 to April 2025. Twenty-eight health conditions and 35 polygenic scores (PGSs) for complex traits. The primary outcomes were SA, suicide, and cumulative SA burden. Associations between health conditions and the risk of SA and suicide were assessed using conditional logistic regression. PGSs for complex traits were calculated using LDpred2-auto, and their associations with SA and suicide were evaluated via logistic regression. To assess whether effect sizes differed significantly between SA and suicide, bayesian model-based classification and Cochran Q test were applied. A total of 81 713 cases of SA (50 512 [61.8%] female; mean [SD] age, 32.3 [14.9] years), with 408 490 age-matched controls (252 525 [61.8%] female; mean [SD] age, 32.3 [14.9] years), and 9362 cases of suicide (2360 [25.2%] female; mean [SD] age, 45.1 [14.6] years), along with 46 749 matched controls (11 796 [25.2%] female; mean [SD] age, 45.1 [14.6] years) who were alive at the date of the case's death, were included in the health conditions analysis. The PGS analysis included 8221 cases of SA (5944 [72.3%] female; mean [SD] age, 19.7 [4.4] years) and 225 cases of suicide (80 [35.6%] female; mean [SD] age, 24.6 [5.0] years). Chronic diseases (eg, dyslipidemia or hearing problems) showed stronger associations with SA, while severe conditions (eg, cancer) were more strongly associated with suicide. Suicide was influenced only by PGSs for mental disorders, whereas SA was associated with both psychiatric and broader health-related genetic risk factors. Notably, dose-response associations were observed for most health conditions and PGSs in relation to cumulative SA burden. A broad range of health conditions and genetic factors were associated with increased risk of both outcomes; however, their shared and distinct risk factors suggest that SA and death by suicide are not solely differentiated by liability severity.35:Tfeb, Importance Not all individuals who die by suicide have a history of nonfatal suicide attempt (SA); however, little is known about the extent to which the genetic and environmental etiologies of SA and suicide are shared or distinct. Objective To examine shared and distinct risk factors for SA and suicide, focusing on clinically diagnosed health conditions and genetic factors. Design, Setting, and Participants For health conditions, a nested case-control study was performed using data from the Danish registers. For genetic factors, a case-control analysis framework was used, with individual genotypes retrieved from the iPSYCH2015 dataset, which was nested within the entire Danish population. Individuals older than 10 years were included to minimize the risk of misclassification for SA and suicide. Data were analyzed from January 2024 to April 2025. Exposures Twenty-eight health conditions and 35 polygenic scores (PGSs) for complex traits. Main Outcomes and Measures The primary outcomes were SA, suicide, and cumulative SA burden. Associations between health conditions and the risk of SA and suicide were assessed using conditional logistic regression. PGSs for complex traits were calculated using LDpred2-auto, and their associations with SA and suicide were evaluated via logistic regression. To assess whether effect sizes differed significantly between SA and suicide, bayesian model-based classification and Cochran Q test were applied. Results A total of 81 713 cases of SA (50 512 [61.8%] female; mean [SD] age, 32.3 [14.9] years), with 408 490 age-matched controls (252 525 [61.8%] female; mean [SD] age, 32.3 [14.9] years), and 9362 cases of suicide (2360 [25.2%] female; mean [SD] age, 45.1 [14.6] years), along with 46 749 matched controls (11 796 [25.2%] female; mean [SD] age, 45.1 [14.6] years) who were alive at the date of the case’s death, were included in the health conditions analysis. The PGS analysis included 8221 cases of SA (5944 [72.3%] female; mean [SD] age, 19.7 [4.4] years) and 225 cases of suicide (80 [35.6%] female; mean [SD] age, 24.6 [5.0] years). Chronic diseases (eg, dyslipidemia or hearing problems) showed stronger associations with SA, while severe conditions (eg, cancer) were more strongly associated with suicide. Suicide was influenced only by PGSs for mental disorders, whereas SA was associated with both psychiatric and broader health-related genetic risk factors. Notably, dose-response associations were observed for most health conditions and PGSs in relation to cumulative SA burden. Conclusions and Relevance A broad range of health conditions and genetic factors were associated with increased risk of both outcomes; however, their shared and distinct risk factors suggest that SA and death by suicide are not solely differentiated by liability severity. 25:[[["$","script","0",{"type":"application/ld+json","dangerouslySetInnerHTML":{"__html":"{\"@context\":\"https://schema.org\",\"@type\":\"CollectionPage\",\"name\":\"Suicide Attempt: condition Research & Clinical Takeaways\",\"description\":\"Explore peer-reviewed papers on Suicide Attempt (condition). Clinician-written summaries and actionable practice insights. 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Suicide prevalence was meaningfully elevated only in the top 5% of PHAs by predicted risk (sensitivity 18.6%); SA risk was elevated only in the top 10% (sensitivity 46.5%). Overall, 11.9% of PHAs flagged soldiers at elevated risk of either outcome, and 3.1% were elevated for both.","limitations":"- Suicide and SA predictors were distinct, limiting a single unified screening approach.\n- SA data only captured soldiers still in active service, requiring loss-to-follow-up weighting that may not fully correct for bias.\n- Suicide model AUROC had a very wide SE (0.17), reflecting rarity of the outcome and uncertainty in performance estimates.","practice_takeaway":"Routine PHAs can be used with ML models to flag the roughly 12% of soldiers at elevated suicide-related risk for targeted DBT-skills interventions — but suicide and SA require separate risk scores, and the low sensitivity for suicide (18.6%) means most future suicides will not be flagged."}},{"doi":"10.1016/j.jadohealth.2026.06.005","pmid":"42550120","title":"A Socioecological Approach to Adolescent Suicide Risk: The Roles of Social Bonds and Recognition","journal_title":"Journal of Adolescent Health","journal_issn":"1054-139X","published_at":"2026-08-04T00:00:00.000Z","url":"https://doi.org/10.1016/j.jadohealth.2026.06.005","source_score":18,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-08-07T13:22:59.210Z","updated_at":"2026-08-07T13:22:59.210Z","tags":[{"paper_doi":"10.1016/j.jadohealth.2026.06.005","tag_type":"age_group","value":"adolescent","value_numeric":null},{"paper_doi":"10.1016/j.jadohealth.2026.06.005","tag_type":"category","value":"Pediatrics","value_numeric":null},{"paper_doi":"10.1016/j.jadohealth.2026.06.005","tag_type":"condition","value":"Adolescent Mental Health","value_numeric":null},{"paper_doi":"10.1016/j.jadohealth.2026.06.005","tag_type":"condition","value":"Suicidal Ideation","value_numeric":null},{"paper_doi":"10.1016/j.jadohealth.2026.06.005","tag_type":"condition","value":"Suicide Attempt","value_numeric":null},{"paper_doi":"10.1016/j.jadohealth.2026.06.005","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1016/j.jadohealth.2026.06.005","tag_type":"level_of_evidence","value":"3","value_numeric":null},{"paper_doi":"10.1016/j.jadohealth.2026.06.005","tag_type":"modality","value":"Psychosocial Intervention","value_numeric":null},{"paper_doi":"10.1016/j.jadohealth.2026.06.005","tag_type":"sample_size","value":"n=190151","value_numeric":190151},{"paper_doi":"10.1016/j.jadohealth.2026.06.005","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1016/j.jadohealth.2026.06.005","tag_type":"study_design","value":"Cross-Sectional Study","value_numeric":null},{"paper_doi":"10.1016/j.jadohealth.2026.06.005","tag_type":"warning","value":"Structural equation modeling pathways are described directionally (e.g., 'associated with lower risk'), but the observational design does not confirm mediation in a causal sense.","value_numeric":null},{"paper_doi":"10.1016/j.jadohealth.2026.06.005","tag_type":"warning","value":"The 'impact_flag' of practice_changing reflects the large sample size and multi-domain findings, but causal claims cannot be made due to the cross-sectional design.","value_numeric":null},{"paper_doi":"10.1016/j.jadohealth.2026.06.005","tag_type":"warning","value":"The study is limited to Pennsylvania public school students; findings may not generalize to other states, private schools, or out-of-school youth.","value_numeric":null}],"summaries":{"what_studied":"Using the 2023 Pennsylvania Youth Survey (n=190,151 students), this cross-sectional study examined whether stronger social bonds and recognition across family, school, and community domains were associated with lower adolescent suicide risk (ideation, plan, attempt, injury), both directly and indirectly through individual/interpersonal risk factors (substance use, depression, bullying victimization), with rurality included as a covariate.","key_result":"Suicidal ideation was reported by 16%, plan by 13%, attempt by 5%, and injury by attempt by 1%. Family attachment had the largest direct protective association with suicide risk; school commitment had the largest indirect protective association via reduced individual/interpersonal risk factors. Community recognition showed the largest direct protective association among social recognition domains; family recognition had the largest indirect effect through social bonds and lower risk factors. Rurality, substance use, depression, and bullying victimization were each associated with higher suicide risk.","limitations":"Cross-sectional design limits causal inference. The sample is geographically restricted to Pennsylvania, which may limit generalizability. All measures were self-reported and dichotomous for suicide outcomes, which may reduce precision.","practice_takeaway":"Clinicians and school health teams should assess family attachment, school connectedness, and community recognition as protective factors—not just individual risk—when screening adolescents for suicide risk. Coordinated, multisector prevention efforts (family, school, community) are especially important for rural youth."}},{"doi":"10.1097/pec.0000000000003644","pmid":"42374744","title":"Pediatric Behavioral Health Emergencies Before, During, and After the COVID-19 Pandemic","journal_title":"Pediatric Emergency Care","journal_issn":"0749-5161","published_at":"2026-06-30T00:00:00.000Z","url":"https://doi.org/10.1097/pec.0000000000003644","source_score":1,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-07-09T13:36:10.120Z","updated_at":"2026-07-09T13:36:10.120Z","tags":[{"paper_doi":"10.1097/pec.0000000000003644","tag_type":"age_group","value":"adolescent","value_numeric":null},{"paper_doi":"10.1097/pec.0000000000003644","tag_type":"age_group","value":"child","value_numeric":null},{"paper_doi":"10.1097/pec.0000000000003644","tag_type":"category","value":"Emergency Medicine","value_numeric":null},{"paper_doi":"10.1097/pec.0000000000003644","tag_type":"condition","value":"Pediatric Behavioral Health Emergency","value_numeric":null},{"paper_doi":"10.1097/pec.0000000000003644","tag_type":"condition","value":"Suicidal Ideation","value_numeric":null},{"paper_doi":"10.1097/pec.0000000000003644","tag_type":"condition","value":"Suicide Attempt","value_numeric":null},{"paper_doi":"10.1097/pec.0000000000003644","tag_type":"impact_flag","value":"safety_signal","value_numeric":null},{"paper_doi":"10.1097/pec.0000000000003644","tag_type":"level_of_evidence","value":"3","value_numeric":null},{"paper_doi":"10.1097/pec.0000000000003644","tag_type":"sample_size","value":"n=5228930","value_numeric":5228930},{"paper_doi":"10.1097/pec.0000000000003644","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1097/pec.0000000000003644","tag_type":"study_design","value":"Repeated Cross-Sectional Study","value_numeric":null},{"paper_doi":"10.1097/pec.0000000000003644","tag_type":"warning","value":"BH diagnoses are based on administrative codes; under-coding of behavioral health conditions in ED records is a known limitation of this data source.","value_numeric":null},{"paper_doi":"10.1097/pec.0000000000003644","tag_type":"warning","value":"Logistic regression associations (e.g., race/ethnicity, insurance) are reported as odds ratios from observational data — confounding is possible.","value_numeric":null},{"paper_doi":"10.1097/pec.0000000000003644","tag_type":"warning","value":"The study period ends December 2022; 'postpandemic' is the authors' label for a specific defined window and may not reflect the current landscape as of mid-2026.","value_numeric":null}],"summaries":{"what_studied":"This repeated cross-sectional study examined rates and characteristics of pediatric behavioral health (BH) ED visits and hospitalizations in California (ages 6–17) across three periods: prepandemic (from Sept 2018), pandemic, and postpandemic (through Dec 2022), using 5,228,930 total ED visits.","key_result":"Of 5,228,930 ED visits, 215,460 (4.1%) had a primary BH diagnosis. BH visits and admissions/transfers rose during the pandemic vs. prepandemic; postpandemic rates largely returned to prepandemic levels, but suicide attempt/ideation remained elevated. Racial/ethnic minorities had lower odds of BH visits yet similar or higher admission/transfer rates vs. white patients. Postpandemic, children with public insurance or living farther from a hospital had higher BH visit severity.","limitations":"- Observational cross-sectional design limits causal inference.\n- California-only data may not generalize to other states or regions.\n- Analysis relies on administrative discharge codes, which may misclassify or undercount BH diagnoses.","practice_takeaway":"Clinicians should remain alert to elevated suicide attempt/ideation presentations in pediatric patients, even as overall BH ED volumes stabilize post-COVID. Pay extra attention to children on public insurance or in geographically remote areas, who show higher illness severity at presentation and may face greater access barriers."}},{"doi":"10.1007/s10802-026-01477-4","pmid":"42377692","title":"Low Self-Esteem Predicts Persistent Suicidal Ideation Across Adolescence and Young Adulthood: A 14-year Longitudinal Study","journal_title":"Research on Child and Adolescent Psychopathology","journal_issn":"2730-7166","published_at":"2026-06-30T00:00:00.000Z","url":"https://doi.org/10.1007/s10802-026-01477-4","source_score":5,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-07-05T13:38:31.086Z","updated_at":"2026-07-05T13:38:31.086Z","tags":[{"paper_doi":"10.1007/s10802-026-01477-4","tag_type":"age_group","value":"adolescent","value_numeric":null},{"paper_doi":"10.1007/s10802-026-01477-4","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1007/s10802-026-01477-4","tag_type":"category","value":"Psychology, Clinical","value_numeric":null},{"paper_doi":"10.1007/s10802-026-01477-4","tag_type":"condition","value":"Low Self-Esteem","value_numeric":null},{"paper_doi":"10.1007/s10802-026-01477-4","tag_type":"condition","value":"Suicidal Ideation","value_numeric":null},{"paper_doi":"10.1007/s10802-026-01477-4","tag_type":"condition","value":"Suicide Attempt","value_numeric":null},{"paper_doi":"10.1007/s10802-026-01477-4","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1007/s10802-026-01477-4","tag_type":"level_of_evidence","value":"2","value_numeric":null},{"paper_doi":"10.1007/s10802-026-01477-4","tag_type":"modality","value":"Psychosocial Risk Factor Assessment","value_numeric":null},{"paper_doi":"10.1007/s10802-026-01477-4","tag_type":"sample_size","value":"n=6504","value_numeric":6504},{"paper_doi":"10.1007/s10802-026-01477-4","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1007/s10802-026-01477-4","tag_type":"study_design","value":"Longitudinal Cohort Study","value_numeric":null},{"paper_doi":"10.1007/s10802-026-01477-4","tag_type":"warning","value":"Full text was not accessible; key quantitative results (odds ratios, effect sizes, absolute event rates) could not be verified or reported.","value_numeric":null},{"paper_doi":"10.1007/s10802-026-01477-4","tag_type":"warning","value":"Study data originates from 1994–2008, which may limit generalizability to today's adolescents given major sociocultural changes (e.g., social media).","value_numeric":null},{"paper_doi":"10.1007/s10802-026-01477-4","tag_type":"warning","value":"The 'practice_changing' impact flag reflects the long follow-up and nationally representative sample, but should be interpreted cautiously without full-text access to confirm effect magnitude.","value_numeric":null}],"summaries":{"what_studied":"This 14-year longitudinal study (Add Health, n=6,504 U.S. adolescents) examined whether baseline self-esteem predicted suicidal ideation (SI) and suicide attempts (SA) at 1, 7, and 14 years of follow-up, adjusting for demographics, concurrent risk factors (depression, substance use, victimization, maltreatment, exposure to SA), and prior suicidality.","key_result":"Low adolescent self-esteem independently predicted SI at all three follow-up waves — even after controlling for concurrent risk factors and prior suicidality. SA, by contrast, was more consistently predicted by concurrent risk factors (e.g., depressive symptoms, substance use) rather than baseline self-esteem.","limitations":"- Full-text access was unavailable; effect sizes, odds ratios, and absolute event rates could not be extracted.\n- Data collection began in 1994–1995, so findings may not fully reflect the current adolescent landscape (e.g., social media era).\n- Self-esteem and several covariates relied on self-report, raising potential measurement bias.","practice_takeaway":"Screening for low self-esteem in adolescents may help identify youth at risk for persistent suicidal ideation well into adulthood — not just at the time of assessment. 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Enrollment, tool completion, acceptability (Ottawa Acceptability Scale), and changes in home storage were assessed at 2- and 4-week follow-up.","key_result":"Of 47 eligible caregivers, 40 enrolled (85.1%); 100% completed the tool in the ED (mean use: 8 min). At follow-up (77.5% completion), 20/31 (64.5%) reported safer home storage of medications. Acceptability was high: 97.5% found the tool useful for changing home medication access and all caregivers would recommend it.","limitations":"Small pilot sample (n=40) limits generalizability; only 1/40 caregivers reported home firearm access, so firearm-specific outcomes could not be meaningfully assessed; follow-up was completed by only 77.5% of enrollees.","practice_takeaway":"A brief (~8-min) web-based lethal means counseling tool is feasible to deploy in the pediatric ED during an adolescent's visit and is highly acceptable to caregivers. Over 60% of caregivers reported safer medication storage at follow-up, supporting its routine use as part of ED-based suicide prevention."}},{"doi":"10.1037/pha0000857","pmid":"42095851","title":"Short-term lithium treatment modulates excitation/inhibition balance in resting-state electroencephalography (EEG) among survivors of medically severe suicide attempts.","journal_title":"Experimental and Clinical Psychopharmacology","journal_issn":"1936-2293","published_at":"2026-05-07T00:00:00.000Z","url":"https://doi.org/10.1037/pha0000857","source_score":26,"is_retracted":false,"is_open_access":false,"raw_metadata":{"ooir":{"day":"2026-05-09","doi":"10.1037/pha0000857","days":"7","issn":"1064-1297","rank":"4","field":"Clinical Medicine","score":"26","category":"Psychology, Clinical","categories":["Psychology, Clinical"],"_categories":["Psychology, Clinical"]},"pubmed":{"doi":"10.1037/pha0000857","title":"Short-term lithium treatment modulates excitation/inhibition balance in resting-state electroencephalography (EEG) among survivors of medically severe suicide attempts.","journal":"Experimental and clinical psychopharmacology","methods":"","results":"","abstract":"Short-term lithium treatment may reduce impulsivity and suicide risk by stabilizing cortical signaling in high-risk individuals. The present double-blind, placebo-controlled, crossover study enrolled survivors of medically severe suicide attempts and recorded 2-min eyes-open resting-state electroencephalography at baseline (drug-naïve), after 4 weeks of lithium carbonate, and after 4 weeks of placebo (","keywords":[],"pubmed_id":"42095851","conclusions":"","publication_date":"2026-05-07T00:00:00"},"crossref":{"DOI":"10.1037/pha0000857","URL":"https://doi.org/10.1037/pha0000857","ISSN":["1936-2293","1064-1297"],"link":[{"URL":"https://psycnet.apa.org/psycarticles/2027-65735-001.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"page":null,"type":"journal-article","issue":null,"score":1,"title":["Short-term lithium treatment modulates excitation/inhibition balance in resting-state electroencephalography (EEG) among survivors of medically severe suicide attempts."],"author":[{"given":"Nicholas","family":"Murphy","sequence":"first","affiliation":[]},{"given":"Ynhi T.","family":"Thomas","sequence":"additional","affiliation":[]},{"given":"Ioana","family":"Murgulet","sequence":"additional","affiliation":[]},{"given":"Krisha","family":"Shah","sequence":"additional","affiliation":[]},{"given":"Julia","family":"Engelhardt","sequence":"additional","affiliation":[]},{"given":"Nidal J.","family":"Moukaddam","sequence":"additional","affiliation":[]},{"given":"Thomas R.","family":"Kosten","sequence":"additional","affiliation":[]},{"given":"Sanjay J.","family":"Mathew","sequence":"additional","affiliation":[]},{"given":"Alan C.","family":"Swann","sequence":"additional","affiliation":[]}],"funder":[{"id":[{"id":"10.13039/100001455","id-type":"DOI","asserted-by":"publisher"}],"DOI":"10.13039/100001455","name":"American Foundation for Suicide 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(APA)","reference":null,"short-title":[],"update-policy":"https://doi.org/10.1037/pha0000857","alternative-id":["2027-65735-001"],"content-domain":{"domain":[],"crossmark-restriction":false},"original-title":[],"container-title":["Experimental and Clinical Psychopharmacology"],"reference-count":0,"published-online":{"date-time":null,"timestamp":null,"date-parts":[[2026,5,7]]},"references-count":0,"short-container-title":["Experimental and Clinical Psychopharmacology"],"is-referenced-by-count":0},"unpaywall":{"doi":"10.1037/pha0000857","is_oa":false,"title":"Short-term lithium treatment modulates excitation/inhibition balance in resting-state electroencephalography (EEG) among survivors of medically severe suicide attempts.","updated":"2026-05-08T16:02:47+00:00","published_date":"2026-05-07","best_oa_location":null}},"created_at":"2026-05-11T13:20:56.681Z","updated_at":"2026-05-14T15:13:26.918Z","tags":[{"paper_doi":"10.1037/pha0000857","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1037/pha0000857","tag_type":"category","value":"Psychology, Clinical","value_numeric":null},{"paper_doi":"10.1037/pha0000857","tag_type":"condition","value":"Suicidal Behavior","value_numeric":null},{"paper_doi":"10.1037/pha0000857","tag_type":"condition","value":"Suicide Attempt","value_numeric":null},{"paper_doi":"10.1037/pha0000857","tag_type":"generic","value":"lithium carbonate","value_numeric":null},{"paper_doi":"10.1037/pha0000857","tag_type":"impact_flag","value":"limited_evidence","value_numeric":null},{"paper_doi":"10.1037/pha0000857","tag_type":"level_of_evidence","value":"2","value_numeric":null},{"paper_doi":"10.1037/pha0000857","tag_type":"modality","value":"Mood Stabilizer","value_numeric":null},{"paper_doi":"10.1037/pha0000857","tag_type":"sample_size","value":"n=10","value_numeric":10},{"paper_doi":"10.1037/pha0000857","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1037/pha0000857","tag_type":"study_design","value":"Randomized Controlled Trial","value_numeric":null},{"paper_doi":"10.1037/pha0000857","tag_type":"warning","value":"Age group tagged as 'adult' but specific age range is not confirmed in the abstract.","value_numeric":null},{"paper_doi":"10.1037/pha0000857","tag_type":"warning","value":"Crossover design introduces potential carryover effects that are not discussed in the available abstract text.","value_numeric":null},{"paper_doi":"10.1037/pha0000857","tag_type":"warning","value":"Sample size of n=10 completers is very small; level of evidence set to 2 based on double-blind crossover RCT design, but the tiny N substantially limits reliability of findings.","value_numeric":null},{"paper_doi":"10.1037/pha0000857","tag_type":"warning","value":"Sex breakdown of participants is not reported in the abstract; 'mixed' sex tag is an assumption.","value_numeric":null}],"summaries":{"what_studied":"A double-blind, placebo-controlled crossover trial evaluated short-term lithium carbonate (4 weeks) vs. placebo (4 weeks) in 10 survivors of medically severe suicide attempts, measuring resting-state EEG spectral power and the aperiodic slope (a marker of excitation/inhibition balance) at baseline, post-lithium, and post-placebo.","key_result":"Lithium significantly increased gamma-band power vs. both baseline and placebo, and flattened the aperiodic EEG slope vs. baseline (p < .001), suggesting a shift toward restored excitation/inhibition balance and enhanced neural synchrony; beta and alpha band changes lacked consistent post hoc support.","limitations":"Very small sample (n = 10 completers) limits generalizability; no behavioral or neurochemical outcomes were integrated; crossover design carries carryover risk and the study was not powered to detect clinical endpoints such as suicidal behavior.","practice_takeaway":"These preliminary findings are hypothesis-generating only and are not yet sufficient to change lithium prescribing practice; EEG-based aperiodic slope and gamma power may be worth tracking as objective biomarkers in future large-scale lithium trials for high-suicide-risk patients."}},{"doi":"10.1007/s10608-026-10748-9","pmid":null,"title":"The Efficacy of Online Cognitive Behavioral Therapy on Suicidal Ideation, Cognitive Flexibility, and Hopelessness in Persons Diagnosed with Depression who Attempted Suicide: Randomized Controlled Trial","journal_title":"Cognitive Therapy and Research","journal_issn":"0147-5916","published_at":"2026-05-06T00:00:00.000Z","url":"https://doi.org/10.1007/s10608-026-10748-9","source_score":8,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":false,"crossref":true,"unpaywall":true},"created_at":"2026-05-08T13:23:42.639Z","updated_at":"2026-05-08T13:23:42.639Z","tags":[{"paper_doi":"10.1007/s10608-026-10748-9","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1007/s10608-026-10748-9","tag_type":"category","value":"Psychology, Clinical","value_numeric":null},{"paper_doi":"10.1007/s10608-026-10748-9","tag_type":"condition","value":"Major Depressive Disorder","value_numeric":null},{"paper_doi":"10.1007/s10608-026-10748-9","tag_type":"condition","value":"Suicidal Ideation","value_numeric":null},{"paper_doi":"10.1007/s10608-026-10748-9","tag_type":"condition","value":"Suicide Attempt","value_numeric":null},{"paper_doi":"10.1007/s10608-026-10748-9","tag_type":"generic","value":"cognitive behavioral therapy","value_numeric":null},{"paper_doi":"10.1007/s10608-026-10748-9","tag_type":"impact_flag","value":"limited_evidence","value_numeric":null},{"paper_doi":"10.1007/s10608-026-10748-9","tag_type":"level_of_evidence","value":"2","value_numeric":null},{"paper_doi":"10.1007/s10608-026-10748-9","tag_type":"modality","value":"Cognitive Behavioral Therapy","value_numeric":null},{"paper_doi":"10.1007/s10608-026-10748-9","tag_type":"modality","value":"Online Psychotherapy","value_numeric":null},{"paper_doi":"10.1007/s10608-026-10748-9","tag_type":"sample_size","value":"n=50","value_numeric":50},{"paper_doi":"10.1007/s10608-026-10748-9","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1007/s10608-026-10748-9","tag_type":"study_design","value":"Randomized Controlled Trial","value_numeric":null},{"paper_doi":"10.1007/s10608-026-10748-9","tag_type":"warning","value":"Age range and sex breakdown of participants are not reported in the abstract; age_group tagged as 'adult' based on outpatient psychiatry context.","value_numeric":null},{"paper_doi":"10.1007/s10608-026-10748-9","tag_type":"warning","value":"No brand or proprietary drug names are reported; pharmacological co-treatments are unspecified.","value_numeric":null},{"paper_doi":"10.1007/s10608-026-10748-9","tag_type":"warning","value":"Sample is small (n=50) and from a single state hospital clinic in one country — demographic details and generalizability are not fully described in the abstract.","value_numeric":null},{"paper_doi":"10.1007/s10608-026-10748-9","tag_type":"warning","value":"The study was published in May 2026; today's date is May 8, 2026 — findings are very recent and have not yet been independently replicated.","value_numeric":null}],"summaries":{"what_studied":"A 20-session individual online CBT (OCBT) program vs. standard psychiatric care (both with pharmacotherapy) was tested in 50 adults with depression who had attempted suicide in the prior 6 months, with outcomes assessed at baseline, 1, 3, and 6 months.","key_result":"OCBT produced significantly lower suicidal ideation (ηp²=0.602), greater cognitive flexibility (ηp²=0.823), and lower hopelessness (ηp²=0.293) vs. controls (all p<.001); however, the suicidal ideation benefit attenuated by 6 months (p=.067), while cognitive flexibility and hopelessness gains were sustained.","limitations":"- Very small sample (n=50 total) from a single outpatient psychiatry clinic limits generalizability.\n- Suicidal ideation effect lost significance by 6-month follow-up, raising durability concerns.\n- No active psychotherapy comparator — control group received standard care only, which may inflate effect sizes.","practice_takeaway":"For patients with depression and recent suicide attempts, adding online CBT to pharmacotherapy can meaningfully reduce suicidal ideation, hopelessness, and improve cognitive flexibility — but consider scheduling maintenance sessions beyond the initial 20, as suicidal ideation benefits may fade by 6 months."}},{"doi":"10.1016/j.brat.2026.105049","pmid":"42019098","title":"The association of short-term variability in suicidal ideation with subsequent suicidal thoughts and behaviours: Longitudinal cohort study","journal_title":"Behaviour Research and Therapy","journal_issn":"0005-7967","published_at":"2026-04-20T00:00:00.000Z","url":"https://doi.org/10.1016/j.brat.2026.105049","source_score":8,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-05-08T13:23:44.842Z","updated_at":"2026-05-08T13:23:44.842Z","tags":[{"paper_doi":"10.1016/j.brat.2026.105049","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1016/j.brat.2026.105049","tag_type":"category","value":"Psychology, Clinical","value_numeric":null},{"paper_doi":"10.1016/j.brat.2026.105049","tag_type":"condition","value":"Self-Harm","value_numeric":null},{"paper_doi":"10.1016/j.brat.2026.105049","tag_type":"condition","value":"Suicidal Ideation","value_numeric":null},{"paper_doi":"10.1016/j.brat.2026.105049","tag_type":"condition","value":"Suicide Attempt","value_numeric":null},{"paper_doi":"10.1016/j.brat.2026.105049","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1016/j.brat.2026.105049","tag_type":"level_of_evidence","value":"2","value_numeric":null},{"paper_doi":"10.1016/j.brat.2026.105049","tag_type":"sample_size","value":"n=831","value_numeric":831},{"paper_doi":"10.1016/j.brat.2026.105049","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1016/j.brat.2026.105049","tag_type":"study_design","value":"Prospective Longitudinal Cohort Study","value_numeric":null},{"paper_doi":"10.1016/j.brat.2026.105049","tag_type":"warning","value":"Level of evidence is assigned as 2 (prospective cohort), but no randomised intervention was tested; this reflects the observational prognostic design.","value_numeric":null},{"paper_doi":"10.1016/j.brat.2026.105049","tag_type":"warning","value":"The impact flag 'practice_changing' is applied cautiously — the study challenges the clinical utility of frequent SI monitoring, but this is a single cohort study and replication in acute/clinical settings is needed before changing monitoring protocols.","value_numeric":null},{"paper_doi":"10.1016/j.brat.2026.105049","tag_type":"warning","value":"The paper is dated April 2026 and references a 3-year prospective cohort (LifeTrack); only 12-month outcome data are reported here — longer-term predictive analyses may follow.","value_numeric":null}],"summaries":{"what_studied":"This prospective longitudinal cohort study (LifeTrack, n=831 adults with suicidal ideation, 66% women) examined whether short-term intraindividual variability in suicidal ideation — measured via daily assessments over 7 days — predicted suicide attempt, self-harm, and suicidal ideation severity over 12 months.","key_result":"Four SI trajectories were identified: low stable (55%), low increasing (7%), high stable (27%), and high decreasing (11%). Trajectories did not significantly predict suicide attempts (p=0.51); variability showed only a modest association with subsequent attempts (p=0.03) but explained minimal variance beyond baseline ideation severity, with no consistent link to self-harm or SI at 12 months.","limitations":"- Study relied on 7-day daily assessments to capture variability, which may not reflect longer-term fluctuation patterns.\n- The association between variability and suicide attempts, while statistically significant (p=0.03), explained minimal additional variance, limiting clinical interpretability.\n- The sample was drawn from a population-based cohort and may not generalise to acute clinical or inpatient settings.","practice_takeaway":"Frequent repeated measurement of suicidal ideation variability appears to add little predictive value beyond baseline ideation severity, suggesting intensive monitoring protocols may not improve risk stratification. Clinicians should instead prioritise addressing depression, distress, perceived burdensomeness, and social connection in patients with suicidal thoughts."}},{"doi":"10.1016/j.jad.2025.120978","pmid":"41443311","title":"A network analysis of symptom-level associations between suicidality, depression and anxiety in Spanish adolescents","journal_title":"Journal of Affective Disorders","journal_issn":"0165-0327","published_at":"2025-12-25T00:00:00.000Z","url":"https://doi.org/10.1016/j.jad.2025.120978","source_score":161,"is_retracted":false,"is_open_access":true,"raw_metadata":{"ooir":{"day":"2025-12-26","doi":"10.1016/j.jad.2025.120978","days":"30","issn":"0165-0327","rank":"9","field":"Clinical Medicine","score":"161","category":"Psychiatry","categories":["Psychiatry"],"_categories":["Psychiatry"]},"pubmed":{"doi":"10.1016/j.jad.2025.120978","title":"A network analysis of symptom-level associations between suicidality, depression and anxiety in Spanish adolescents.","journal":"Journal of affective disorders","methods":"","results":"12.7 % of participants reported suicidal ideation and 3.6 % had attempted suicide, with higher rates among girls and older adolescents. Network analyses revealed that worthlessness, anhedonia, sadness, crying, panic attacks, and intrusive thoughts were consistently associated with both passive and active suicidal ideation and attempts. Moreover, adolescents who had experienced suicidal ideation or attempts displayed stronger interconnections among depressive symptoms and between depressive and anxiety symptoms.","abstract":"$32","keywords":["Adolescents","Anxiety","Depression","Network analysis","Passive and active suicidal ideation","Suicide"],"pubmed_id":"41443311","conclusions":"These findings provide a comprehensive view of the psychopathological structure underlying suicidality in adolescence and contribute to the identification of key emotional symptoms that may be targets for early intervention and prevention strategies.","publication_date":"2025-12-25T00:00:00"},"crossref":{"DOI":"10.1016/j.jad.2025.120978","URL":"https://doi.org/10.1016/j.jad.2025.120978","ISSN":["0165-0327"],"link":[{"URL":"https://api.elsevier.com/content/article/PII:S0165032725024206?httpAccept=text/xml","content-type":"text/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https://api.elsevier.com/content/article/PII:S0165032725024206?httpAccept=text/plain","content-type":"text/plain","content-version":"vor","intended-application":"text-mining"}],"page":"120978","type":"journal-article","issue":null,"score":1,"title":["A network analysis of symptom-level associations between suicidality, depression and anxiety in Spanish adolescents"],"author":[{"given":"Mireia","family":"Orgilés","sequence":"first","affiliation":[]},{"given":"Víctor","family":"Amorós-Reche","sequence":"additional","affiliation":[]},{"given":"Jose P.","family":"Espada","sequence":"additional","affiliation":[]}],"funder":[{"id":[{"id":"10.13039/501100003359","id-type":"DOI","asserted-by":"publisher"}],"DOI":"10.13039/501100003359","name":"Generalitat Valenciana","doi-asserted-by":"publisher"}],"issued":{"date-parts":[[2025,12]]},"member":"78","prefix":"10.1016","source":"Crossref","volume":null,"created":{"date-time":"2025-12-22T16:53:31Z","timestamp":1766422411000,"date-parts":[[2025,12,22]]},"indexed":{"date-time":"2026-01-15T19:41:04Z","timestamp":1768506064624,"date-parts":[[2026,1,15]]},"license":[{"URL":"https://www.elsevier.com/tdm/userlicense/1.0/","start":{"date-time":"2025-12-01T00:00:00Z","timestamp":1764547200000,"date-parts":[[2025,12,1]]},"delay-in-days":0,"content-version":"tdm"},{"URL":"https://www.elsevier.com/legal/tdmrep-license","start":{"date-time":"2025-12-01T00:00:00Z","timestamp":1764547200000,"date-parts":[[2025,12,1]]},"delay-in-days":0,"content-version":"tdm"},{"URL":"http://creativecommons.org/licenses/by/4.0/","start":{"date-time":"2025-12-21T00:00:00Z","timestamp":1766275200000,"date-parts":[[2025,12,21]]},"delay-in-days":20,"content-version":"vor"}],"subject":[],"abstract":null,"language":"en","relation":{},"resource":{"primary":{"URL":"https://linkinghub.elsevier.com/retrieve/pii/S0165032725024206"}},"subtitle":[],"assertion":[{"name":"publisher","label":"This article is maintained by","value":"Elsevier"},{"name":"articletitle","label":"Article Title","value":"A network analysis of symptom-level associations between suicidality, depression and anxiety in Spanish adolescents"},{"name":"journaltitle","label":"Journal Title","value":"Journal of Affective Disorders"},{"name":"articlelink","label":"CrossRef DOI link to publisher maintained version","value":"https://doi.org/10.1016/j.jad.2025.120978"},{"name":"content_type","label":"Content Type","value":"article"},{"name":"copyright","label":"Copyright","value":"© 2025 The Author(s). 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The health-condition analysis included 81,713 suicide attempt cases with 408,490 controls and 9,362 suicide cases with 46,749 controls; the genetic analysis included 8,221 attempt cases and 225 suicide cases.","key_result":"Chronic diseases (e.g., dyslipidemia, hearing problems) showed stronger associations with suicide attempt, while severe conditions (e.g., cancer) were more strongly associated with suicide. Suicide related only to polygenic scores for mental disorders, whereas attempts related to both psychiatric and broader health-related genetic risk; dose-response patterns were observed for most health conditions and polygenic scores with cumulative attempt burden.","practice_takeaway":"Do not equate suicide attempt and suicide as the same risk state: chronic diseases tracked more with attempts, while severe illnesses like cancer tracked more with suicide in this Danish analysis. When stratifying risk, weigh psychiatric genetic load for suicide and a broader health and genetic profile for attempts, and consider cumulative attempt burden."}}],"initialOffset":10,"fetchConfig":{"kind":"tags","tags":[{"tag_type":"condition","value":"Suicide Attempt"}]},"breadcrumbItems":[{"name":"Home","href":"/"},{"name":"Research Hub","href":"/hub"},{"name":"Conditions","href":"/hub/tag/condition"},{"name":"Suicide Attempt"}],"hrefConfig":{"basePath":"/hub/papers","webViewQueryParams":{"hub_ctx":"tag","hub_tag_type":"condition","hub_tag_value":"Suicide Attempt"}}}]]

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