The impact of mindfulness in improving insomnia symptoms is documented in different samples (e.g. anxiety disorders; insomnia samples) and mindfulness based programs for pregnancy refer the association between mindfulness development and the reduction of insomnia symptoms/improvement of sleep.

To explore differences in the Facets Mindfulness Questionnaire-10 (FMQ-10; Azevedo et at. 2015), between sleep groups, in Portuguese pregnant women.

Four hundred and nineteen pregnant women (mean age: 32.51 ± 4.759; weeks of gestation: 17.32 ± 4.803) answered the Facets Mindfulness Questionnaire-10 and the Insomnia Assessment Scale (IAS, Marques et al., 2015). Three sleep groups were created considering all the IAS items: good sleepers (no insomnia symptoms; no associated daily impairment); insomnia symptoms groups (one/more insomnia symptoms; no associated daily impairment; exclusion of other conditions/disorders explaining the symptoms); insomniacs (one/more insomnia symptoms; one/more daily associated impairment; exclusion of other conditions/disorders explaining the symptoms).

There were significant differences in the total FMQ-10 score, the F1/Nonjudging of inner experience and the F2/acting with awareness, between sleep groups [respectively, F (2.402) = 6,933; P = 0.001; F (2.406) = 10.243; P = 0.001; F (2.406) = 37.431; P = 0.002]. Tukey tests indicated that the mean total FMQ-10 and F1/Nonjudging of inner experience scores of good sleepers and insomnia symptoms group were significantly higher than of the insomniacs. The mean value of F2/acting with awareness in the good sleepers was significantly higher than of the insomniacs.

It seems important to develop mindfulness to improve sleep in pregnancy or reduce the impact of insomnia symptoms (common at pregnancy).

The authors have not supplied their declaration of competing interest.

To investigate the causes that postpartum women most mention for changes in sleep pattern and its associations with obstetric and sleep variables and depressive symptoms.

At three months postpartum 192 women fill in a booklet containing obstetric and sleep variables and the Postpartum Depression Screening Scale (PDSS; Pereira et al., 2010). If they experienced changes in their sleep pattern, they were asked about the perceived cause(s) (multiple choice). Chi-squared and Student t tests were applied as appropriate.

A total of 64.6% women referred to some cause(s); the most mentioned were feeding/baby care and older children care (32.3%) and worries (baby and life problems related) (29.5%). Women who mentioned feeding/baby and older children care as a cause did not significantly differ in relation to type of delivery, feeding method proportions and in PDSS mean scores. Women who identified worries as a cause vs. women who did not – presented significant differences in proportions of vaginal (20.0%) vs. assisted delivery (52.2%) (OR 4.444), caesarean-section (22.2%) vs. assisted delivery (52.6%) (OR 3.827), in breast-feeding (36.0%) vs. bottle-feeding (12.9%) (OR .263) and in “having trouble sleeping even when the baby is asleep” (28.0% vs. 2.9%) (OR 12.833) (all P<.05). PDSS mean scores were also significantly higher in women who mentioned worries as a cause (50.20 ± 20.622 vs. 58.640 ± 15.766, P < 0.05).

It is important to distinguish the causes for changes in sleep pattern in postpartum women. Worries as a perceived cause have a higher impact and clinical significance than causes related to baby care demands.

The authors have not supplied their declaration of competing interest.

The author has not supplied his/her declaration of competing interest.

Dialectical behavior therapy (DBT) is a comprehensive psycho-social treatment developed by Marsha Linehan and originally designed for persons meeting criteria for borderline personality disorder (BPD). DBT is considered as a standard evidence based treatment for suicidal BPD patients in most international guidelines. Although its effectiveness has been proved in multiple studies across different patient populations but almost all the research was conducted in North American or European countries. The current study was the first trial to apply DBT in Egypt with a different language and culture than where the treatment was originally developed.

Assessment of incidence of suicidal attempts and non-suicidal self-injury (NSSI) among a sample of Egyptian BPD patients enrolled in an outpatient DBT program.

The aim of the current study was to estimate impact of comprehensive DBT on suicidal attempts and NSSI when applied to Egyptian BPD patients.

Twenty-five BPD patients, 4 males and 21 females, were included in a comprehensive outpatient DBT program for one year and incidence of suicidal attempts and NSSI were calculated.

Five patients only attempted suicide again with an incidence of 20% and a mean of one attempt/patient. Seven patients attempted NSSI with an incidence of 28%, an overall 22 incidents and a mean of 3 incidents/patient.

Although this was the first time to apply DBT in an Egyptian population, DBT proved to be an effective psycho-therapeutic intervention for suicidal BPD patients across regardless of different language or culture.

The authors have not supplied their declaration of competing interest.

The aim of the present study was to investigate various risk factors of suicidal behaviors, including the mixed features specifier, in Korean patients with bipolar disorder.

We retrospectively reviewed medical charts from 2005 to 2014. A total of 334 patients diagnosed with bipolar disorder using the DSM-IV TR were enrolled. Subjects were categorized into two groups according to their history of suicidal behavior and the demographic and clinical characteristics of the groups were compared, including the mixed features specifier. We re-evaluated the index episode using DSM-5 criteria and classified subjects into an index episode with mixed features group and an index episode without mixed features group. Logistic regression was performed to evaluate significant risk factors associated with suicidal behavior.

Suicidal behavior had an independent relationship with mixed features at the index episode using DSM-5 criteria (OR = 3.39; 95% CI: 1.57–7.34) and number of previous depressive episodes (OR = 1.62; 95% CI: 1.34–1.95) in Korean bipolar patients. The mixed feature specifier was the strongest risk factor for suicidal behavior in the present study. Limitations: this was a retrospective study and structured psychiatric interviews were not conducted.

This study may help clinicians understand potential risk factors and manage bipolar disorders with suicidal behaviors. Clinicians should carefully monitor patients with bipolar disorder who exhibit numerous depressive episodes or mixed features for suicidal behavior.

The authors have not supplied their declaration of competing interest.

Most suicide attempters are referred to community health professionals (CHP) after discharge from emergency department (ED). Thereafter, outpatient treatment engagement (OTE) is often poor. Strengthening it seems likely to reduce the risk of repeat suicidal behaviour.

To identify the predictive factors of OTE.

Multicentre prospective study in true life conducted in adult patients (≥18) in 4 EDs of the Southern Paris region. Patients were referred to CHP. OTE was assessed by telephone calls at 1 and 3 months. OTE at 1 month was defined as having booked 1 appointment; OTE at 3 months as having attended 2 appointments and booked another one.

One hundred and fifty-five patients were assessed at 1 month and 144 at 3 months. OTE at 1 and 3 months was observed in 58% and 51% respectively. A multivariate analysis showed factors significantly predictive of OTE at 1 month: a psychiatric follow-up before the suicide attempt (SA), ≥2 psychiatric interviews during the stay at ED, appointment with CHP booked before discharge from the ED; and at 3 months: college or university education, absence of alcohol intake during the SA, psychiatric follow-up before the SA, appointment with CHP booked before discharge from the ED.

This multicentre prospective study highlights the benefit of booking outpatient appointment before discharge from ED; of allowing patient to benefit from at least two psychiatric interviews; of being particularly cautious with patients who took alcohol concomitantly to their SA, patients with low level of academic achievement and patients without psychiatric follow-up.

The authors have not supplied their declaration of competing interest.

Suicide is a global public health problem. More than 800,000 people die due to suicide every year according to the WHOM. In Spain, about 9 people die due to suicide every day, and the rates increase every year. The presence of previous suicide attempts is one of the strongest risk factors for suicide consumption. Nevertheless, patients sometimes do not receive a correct assistance after a suicide attempt.

To study the follow-up of patients, without previous psychiatrichistory, who commit a first suicide attempt in the area of Huelva (Spain).

Retrospective review of the electronic clinical histories of patients attended in the Emergency service of Juan Ramón Jiménez Hospital after a first suicide attempt during the first six months of 2015.

From January to June of 2015 we collected a total of 159 patients who committed a firs suicide attempt in our area. A total of 69.18% were women and 30.82 were men. In both sex the mean age was 39 years. Out of the 159 attended after a first suicide attempt, only 54% were referred to the Psychiatry service to be followed up. Out of those referred, only 62% actually attended and only half of them really staying treatment.

An adequate psychiatric follow up after a suicide attempt is needed to reduce the risk of more suicide attempts or consumption. A minority (30.8%) of the patients attended in our area after a first suicide attempt received an adequate attention.

The authors have not supplied their declaration of competing interest.

It has been suggested that there is a relationship between BMI and suicide. Thus, BMI of subjects who commit suicide would be lower than the BMI of other unnatural deaths (Flaig 2013).

Explore the possible relationship between BMI and suicide.

A total of 1197 suicides and 473 unnatural deaths (not by suicide) were collected systematically for 60 months at the Institute of Legal Medicine of Seville. Age, sex, weight, height and cause of death were recorded. Statistical analysis was performed using SPSS v19.0.

(Figure 1)

In our study we found that suicide (of all age groups and both sexes) have a lower BMI than controls. However, the relationship between these two variables is complex and not all studies support it. Moreover, the relationships between depression, suicide and overweight point in different directions. More and more studies indicate the existence of a relationship between depression and overweight, suggesting that perhaps the “epidemic” of depression and overweight that we see in Western societies has some connection. In addition, depression is a risk factor for suicide well established. Our results indicate that suicide group tends to have lower BMI (less weight in relation to its size) than the controls.

The authors have not supplied their declaration of competing interest.

Psychological autopsy studies have constantly indicated a clear relation between mental disorders and suicide. This relation has been found in studies across the world, although the percentage of cases with at least one mental disorder diagnosed may vary between studies and specially, between countries and geographical regions.

Review of psychological autopsy studies of suicide completers which contained information on diagnostic distribution. Only studies carried out in Europe and North America were included.

A total of 14 studies, including 1519 suicides, were analyzed (Table 1).

Suicide risk is a multifactor phenomenon, however, it is strongly related to mental disorders. Mental health strategies should be directed to target clinical groups at high risk of suicide.

The authors have not supplied their declaration of competing interest.

Suicide is a major public health problem and one of the common causes of maternal mortality. Rates of suicide and self-harm are higher in British South Asian women compared to the majority white population. Suicidal Ideation (SI) is a significant risk factor associated with self-harm and suicide.

To explore the prevalence and risk factors of SI in British Pakistani women.

To identify risk factors associated with SI, in order to inform future preventive strategies.

This is a secondary analysis of a larger study which looked at depression during pregnancy and infant outcomes. Participants who consented (women aged 18 or over, in their third pregnancy trimester) were initially assessed for maternal depression using the Edinburgh Post-Natal Depression Scale (EPDS), with one of the questions on the EPDS being on SI. Participants who met the study criteria, were further assessed regarding socio-demographic factors, perceived social support, social adversity and isolation.

The rate of SI in this group of women was 8.1%, with baseline interview results suggesting that women with SI being significantly more likely to be aged 20 or less, have experience of severe life events and being less likely to have social support.

This area of research is key to understanding SI in British Pakistani women, to better develop culturally sensitive interventions for use within this group.

The authors have not supplied their declaration of competing interest.

The aim of this study was to analyze the clinical characteristics of individuals who used alcohol at the time of attempting suicide.

We divided 143 individuals who attempted suicide by consuming drugs into two groups on the basis of their blood alcohol concentration level: drinker group (n = 79) and non-drinker group (n = 64). We compared epidemiological characteristics and suicidal behavior between the groups by using the Suicidal Intent Scale (SIS) and the Risk Rescue Rating Scale (RRRS). In addition, we administered the Glasgow Coma Scale (GCS) and the Acute Physiology and Chronic Health Evaluation–II (APACHE–II) to evaluate the medical lethality of the individuals who attempted suicide. We used Student's t-test, Pearson's correlation analysis, and multiple linear regression to analyze the data.

The drinker group scored lower on the SIS's planning subscale than the non-drinker group did (P = 0.022). The drinker group's blood alcohol concentration levels were negatively correlated with the rescue potential of their suicidal attempt (P = 0.031) and the APACHE-II score (P = 0.003). Higher blood alcohol concentration levels predicted poorer medical outcomes measured by the APACHE-II (P = 0.004).

Our findings support the notion that alcohol use increases suicidal impulsivity, decreases rescue potential, and worsens medical outcomes. Therefore, suicide prevention programs need to include education and counselling about the risks associated with alcohol use.

The authors have not supplied their declaration of competing interest.

Suicide is a major public-health problem in Canada. Data from ‘Statistics Canada’ suggests that there was a 10% increase in suicide rate between the years 1997 and 1999. Studies have found substantial differences in suicide rates (and patterns) amongst ethnic immigrants compared to Canadian-born individuals.

The aim of the study was to investigate whether ethnic-immigrant patients differed from Canadian-born patients in their social, demographic, psychiatric and historical associations.

All registered patients (n = 276) known to have completed suicide from 1966–1997 constituted the study sample. Data were extracted from the written case audits, autopsy and toxicology reports, and medical records.

Of the 276 known cases of suicide, 11 were Afro-Caribbean, 24 were Eastern European, 14 were Asian and 215 were Canadian-born patients. The ethnic-immigrant groups were broadly comparable to the Canadian-born group in terms of the social, demographic, psychiatric and background historical factors (except that the latter had a higher prevalence of alcohol and substance misuse). There were no significant differences between different ethnic immigrant groups themselves.

The most salient implication of the findings are that social, psychiatric and historical associations of mentally ill patients who complete suicide are common across different ethnic immigrant groups, and as such a universal approach to mental health promotion, early identification and treatment would be similarly applicable to patients belonging to all groups.

The authors have not supplied their declaration of competing interest.

Acute suicidality or a condition after attempted suicide frequently leads patients to both voluntary or involuntary inpatient admission. Emergency room psychiatrists decide whether such patients can be treated on an outpatient basis.

To identify if immigration status is associated with the decision whether a patient needs a hospital admission.

To detect social determinants of hospital-based health resource uses.

A cross-sectional study including data from 323 patients treated in a general hospital's emergency room after a suicidal attempt during year 2014.

Seventy-six patients were admitted to the hospital (23.5%). Hospitalization frequencies for immigrant and non-immigrant individuals were 6.3% and 26.5% (P = 0.002). No significant association was found between psychiatric admission and history of a diagnosed psychiatric disorder, previous suicidal attempts, previous emergency room care use, family support or current drug use. A subgroup of patients (n = 37; 9%) answered Beck's suicidal intent scale (SIS), a measure of risk in suicidal attempters. Mean SIS was found to be higher among hospitalized than discharged patients (8.5 vs. 16.5; P = 0.01). No significant difference was found in mean SIS between immigrant and non-immigrant patients (9.3 vs. 9.1; P = 0.3).

These preliminary results call for consideration. The highly significant lower rate of psychiatric admission among immigrant patients, without significant differences in mean SIS score in regard to non-immigrants, needs further study.

The authors have not supplied their declaration of competing interest.

Suicide is a leading cause of death worldwide and is largely preventable. The social media site Twitter is used by individuals to express suicidal intentions. It is not yet feasible to contact each Twitter user to confirm risk. Instead, it may be possible to validate risk by linguistic analysis. Psychological linguistic theory suggests that language is a reliable way of measuring people's internal thoughts and emotions; however, the linguistics of suicidality on Twitter is yet to be fully explored.

The aim of this study is to characterise the linguistic styles of suicide-related posts on Twitter for the purposes of predicting suicide risk.

The Linguistic Inquiry and Word Count (LIWC) program was used to compare the linguistic features of suicide-related tweets previously coded for suicide risk by humans with a set of matched controls. Logistic regression was then used for predictive modelling.

The suicide-related tweets had significantly different linguistic profiles to the control tweets. The “strongly concerning” suicide tweets were found to have fewer words than all other tweets and not surprisingly, references to ‘death’ were significantly higher in this group. A number of other results were found. The final model which distinguished “strongly concerning” suicide risk from the controls was found to have 97.7% sensitivity and 99.8% specificity.

This study confirms that the linguistic features of suicide-related Twitter posts are different from general Twitter posts and that these linguistic profiles may be used to predict suicide risk in Twitter users.

The authors have not supplied their declaration of competing interest.

The social and economic impact of mood disorders and suicide is extremely high. In depression, suicide is included among the cognitive disturbances, together with guilt, paranoid and obsessive-compulsive symptoms, depersonalization/derealization and agitation [1,2]. The aim of this report is to study a sample of depressed patients with bipolar disorder or major depressive disorder, to evaluate the level of impulsivity and dissociation in a context of a suicidal plan.

Twenty inpatients with suicidal plan were assessed with: the SCID-P for Axis I diagnosis, SCI-DER, DSS, HRSD, HAS, YMRS, GSR. We conducted a systematic literature review (PubMed, Embase, PsychInfo) using the key terms “depression”, “suicide”, “suicidal plan”, “depersonalization”, “derealization” AND “dissociation”.

An independent sample T-Test analysis suggested that the patient with high sucidal plan present significant highter score at SCI-DER TOT (P = 0.015), DSS TOT (P = 0.037), BIS-11 motor perseveration factor (P = 0.023) and inversely significant HAS TOT (P = .029).

It's suggestive that when are lost the boundaries of the self, the clarity of suicidal's purpose reduces the levels of anxiety and suicide appears the only way to achieve the liberation of the suffering of depression. Methodological limitations, clinical implications and suggestions for future research directions are considered.

The authors have not supplied their declaration of competing interest.

Epidemiological studies revealed that 21 to 34 percent of women around the world have been victim of physical assault by their spouse and spouse abuse have been more prevalent in developing countries.

The most common form of violence against women is spousal abuse which is a dangerous factor and leads to serious psychological damages while it is one of the most important causes of suicide in married women.

The study of factors related to spousal abuse in the population where they attempt to suicide is important for recognizing it and preventing spousal abuse, consequently, preventing suicide.

The study was conducted cross-sectional on 360 married women who attempted suicide and referred to Shoshtari Hospital in Shiraz. Instruments for data collection comprised of about spousal abuse questionnaire and demographic cases questionnaire which were filled through interview.

A total of 43.9% of domestic violence prevalence, 61.7% of economic violence, 45.3% of psychological violence, 38.1% of social violence, 38.1% physical violence, 35.9% of sexual violence was reported. There was a relation between spousal abuse and some factors such as: age difference between spouses, wife and husband's education, husband's substance abuse, husband's medical illness, wife's psychiatry disorder, spouses’ obligatory marriage, polygamy and husband's job.

Considering relatively high prevalence of spousal abuse in people who attempted suicide and the relation between some demographic factors with violence, besides regarding spousal abuse as one causes of suicide, the women's screening, particularly those who attempt suicide in regard to spousal abuse and its related factors seems necessary.

The authors have not supplied their declaration of competing interest.

The authors have not supplied their declaration of competing interest.

Physical illness has been recognized as a major risk factor for suicidal behaviours, especially among females. A higher number of physical comorbidities has been associated with higher suicide- risk, thus having a greater burden among the elderly.

investigate this evidence to be able to estimate the load of physical illness on suicidality among psychiatric females of different age.

Evaluate the association between suicidal ideation, age, depression and physical comorbidities in a sample of acute females psychiatric in-patients.

81 psychiatric female in-patients were evaluated during their first day of hospitalization through MADRS, SSI and the presence of organic comorbidity has been collected together with demographic data. All the evaluations were carried out at the Psychiatric Clinic, University of Genova, Italy.

Mean age 48 (age–range value: 74, high variability). Pearson's Chi-squared test showed: significant association between SSI and MADRS (P = 0,027; α = 0,05); no association between SSI and age (P = 0,194; α=0,05); no association between SSI and presence medical illness (P = 0,132; α = 0,05); no association between SSI and number of medical illness (P = 0,186; α = 0,05).

Our results show that the levels of suicidal ideation in psychiatric females are independent from age, presence and number of physical comorbidities. Suicidal ideation appears to be associated only with levels of depression. Our results challenge evidence from a large number of current studies and, if confirmed by further research, would lead to reconsider major suicide risk factors. Further research to investigate these associations on larger samples is needed.

The authors have not supplied their declaration of competing interest.

Older adults with depression resist accepting depression screening and seeking treatment due to stigmatization of mental disorders and little knowledge about depression. This study was undertaken to develop and determine the psychometrics of an instrument for assessing triggers of suicidal ideation among older outpatients.

Participants were recruited from older outpatients of two hospitals in northern Taiwan. An initial 32-item Triggers of Suicidal Ideation Inventory (TSII) was developed, and its items were validated by experts in two runs of Delphi technique survey. After this TSII was pre-tested in 200 elderly outpatients, 12 items were retained. The 12-item TSII was examined by criterion validity, construct validity, internal consistency reliability, and test-retest reliability.

TSII scores were significantly and positively correlated with the Beck Scale for Suicide Ideation (r = 0.45, P < 0.01), and UCLA Loneliness scores (r = 0.55, P < 0.01), indicating satisfied criterion validity. Participants with depressive tendency tended to have higher TSII scores than participants with no depressive tendency (t = 8.62, P < 0.01), indicating good construct validity. Cronbach's α and the intraclass correlation coefficient for the TSII were 0.70 and 0.99 respectively, indicating acceptable internal consistency reliability and excellent test-retest reliability. Receiver operating characteristic analysis revealed that the area under the curve was 0.83, indicating excellent ability to detect triggers of suicidal ideation. With a cutoff point of 2, the sensitivity and specify were 0.86 and 0.67, respectively.

The TSII can be completed in 5 minutes and is perceived as easy to complete. Moreover, the inventory yielded highly acceptable parameters of validity and reliability.

The authors have not supplied their declaration of competing interest.

The long-term associations between posttraumatic stress disorder (PTSD) and suicidal ideation (SI) among ex-prisoners of war (ex-POWs) has recently been exemplified. Several studies have revealed the toll of war captivity on secondary traumatization’ (ST) of ex-POWs’ wives. However, a question remains regarding the possible SI among ex-POWs’ wives.

Understanding of SI phenomena among wives of severely traumatized ex-POWs in a longitudinal dyadic designed study.

Assessment of SI among ex-POWs’ wives and the longitudinal associations with their husbands’ PTSD. We also aim to assess the moderating role of the couple's dyadic adjustment in these associations.

A sample of 233 Israeli couples (142 ex-POWs couples and a comparison group of 91 veteran couples) completed self-report measures at two time points: T1 30 (2003-4) and T2 37 (2010) years after the ‘Yom Kipur’ 1973 war.

Surprisingly, no significant differences were found between ex-POWs wives and veterans’ wives, with and without husbands’ PTSD, in SI at T1 and T2. Only among ex-POW couples, an increase in the husband's level of PTSD and SI was related to a more moderate increase in their wives’ SI between T1 and T2. Interestingly, the more a wife reported positive dyadic adjustment, the more moderate the increase in her SI between T1 to T2, regardless of the study group.

Suicidal ideation among ex-POWs’ wives is closely related to their husbands’ PTSD and is moderated by their perception of marital adjustment.

The authors have not supplied their declaration of competing interest.