The impact of religiosity in suicidal behavior was evaluated in Brazil through a case-control study in which 110 subjects who had attempted suicide through the use of toxic substances were compared with 114 control subjects with no history of suicide attempts. Religiosity was measured in three aspects: organizational religious activities (ORAs), nonorganizational religious activities (NORAs), and intrinsic religiosity (IR). Multivariate logistic regression was used to evaluate the impact of religiosity on suicide attempts, controlling for sociodemographic variables, impulsivity, and mental illness. Religiosity, in its three dimensions, was shown to be an important protective factor against suicide attempts, even after controlling for relevant risk factors associated with suicidal behavior: ORA: odds ratio (OR), 0.63 (95% confidence interval [CI], 0.45-0.89); NORA: OR, 0.56 (95% CI, 0.42-0.75); and IR: OR, 0.59 (95% CI, 0.49-0.70). These data have important implications for understanding religiosity factors that might protect against suicide.

Objectives: To describe the onset pattern, frequency, and severity of the signs and symptoms of the prodrome of the first hypomanic/manic episode and first depressive episode of bipolar disorder (BD) and to investigate the influence of a history of childhood maltreatment on the expression of prodromal symptoms. Methods: Using a semi-structured interview, the Bipolar Prodrome Symptom Scale-Retrospective (BPSS-R), information regarding prodromal symptoms was assessed from patients with a DSM-IV diagnosis of BD. History of childhood maltreatment was evaluated using the Childhood Trauma Questionnaire (CTQ). Results: Forty-three individuals with stable BD were included. On average, the prodrome of mania lasted 35.8668.7 months and was predominantly subacute or insidious, with rare acute presentations. The prodrome of depression lasted 16.6623.3 months and was also predominantly subacute or insidious, with few acute presentations. The prodromal symptoms most frequently reported prior to the first hypomanic or manic episode were mood lability, depressive mood, and impatience. A history of childhood abuse and neglect was reported by 81.4% of participants. Presence of childhood maltreatment was positively associated with prodromal symptoms, including social withdrawal, decreased functioning, and anhedonia. Conclusions: This study provides evidence of a long-lasting, symptomatic prodrome prior to first hypomanic/manic and depressive episode in BD and suggests that a history of childhood maltreatment influences the manifestations of this prodrome.

Our aim is to evaluate the relationship between religiosity and impulsivity in patients with mental illness who had attempted suicide and in healthy individuals. This is a cross-sectional study that included 61 healthy individuals and 93 patients. The instruments used were a sociodemographic data questionnaire, the Mini International Neuropsychiatric Interview, the Barratt Impulsiveness Scale, and the Duke University Religion Index. The healthy individuals presented higher scores in the religiosity domains (organizational, p = 0.028; non-organizational, p = 0.000; intrinsic, p = 0.000). The patients presented higher scores in the impulsivity dimensions (attentional, p = 0.000; motor, p = 0.000; absence of planning, p = 0.000). In the patient group, intrinsic religiosity had a significant inverse relationship with total impulsivity (p = 0.023), attentional (p = 0.010), and absence of planning (p = 0.007), even after controlling for sociodemographic variables. Healthy individuals were more religious and less impulsive than patients. The relationship between religiosity, impulsiveness, and mental illness could be bidirectional; that is, just as mental illness might impair religious involvement, religiosity could diminish the expression of mental illness and impulsive behaviors.

BackgroundAttempted suicide is the main predictor of suicide constituting a major public health issue worldwide. It is estimated that for every completed suicide, 10 to 20 suicide attempts occur. Important part of the occurrences of suicide attempts in Brazil are registered in the hospital information system for coverage of more than 70 % allows to evaluate the extent of this problem in the country. The scope of this article is to analyse hospitalizations resulting from suicide attempts at public hospitals or services contracted out by the public health system (SUS) in Brazil from 1998 to 2014.MethodsThis is an ecological study of secondary morbidity data obtained from the Hospital Information System. The overall rate of suicide attempts per 100 000 (105) individuals and rates stratified by age group and sex were calculated. To measure trends, simple linear regression coefficients were calculated. The hospital mortality rate was calculated per 100 individuals.ResultsThe overall rate of hospitalization decreased from 1998 to 2014. The young and adult age groups had the highest hospitalization rates. Men were admitted more and the elderly had higher hospital mortality rates. The main cause of hospitalization was poisoning, accounting for 70.4 % of hospitalizations. Among the people who used poisoning by non-medical drugs as the method of attempted suicide, 58 178 (69.6 %) were men and 49 585 people who are poisoned by medical drugs (60.1 %) were women.ConclusionsAlthough hospitalization rates for attempted suicide have declined in Brazil, it remains a serious public health problem. Because a suicide attempt is the main predictor of suicide, studies to identify those most vulnerable to attempted suicide will help in the development of prevention strategies for mental health.

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Objective: To evaluate the association between personality disorders (PDs) and suicide attempts (SAs) in euthymic patients with type I bipolar disorder (BD). Methods: One-hundred twenty patients with type I BD, with and without history of SA, were evaluated during euthymia. The assessment included a clinical and sociodemographic questionnaire, the Hamilton Depression Rating Scale, the Young Mania Rating Scale, the Barratt Impulsiveness Scale, and Structured Clinical Interviews for DSM-IV Axis I and II Disorders. Logistic regression was employed to determine associations between history of SA and patient characteristics. Results: History of SA was significantly associated with comorbid axis I disorder, rapid cycling, high impulsivity (attentional, motor, non-planning, and total), having any PD, and cluster B and C PDs. Only cluster B PDs, high attentional impulsivity, and lack of paid occupation remained significant after multivariate analysis. Conclusions: Cluster B PDs were significantly associated with SA in patients with type I BD. High attentional impulsivity and lack of gainful employment were also associated with SA, which suggests that some cluster B clinical and social characteristics may exacerbate suicidal behavior in this population. This finding offers alternatives for new therapeutic interventions.

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