Suicide is a major public health concern affecting both the society and family life. There are data indicating that higher level lithium intake with drinking water is associated with lower suicide rate. This pilot study examined the relationship between lithium levels in drinking water and suicide rates in Lithuania. Twenty-two samples from public drinking water systems were taken in 9 cities of Lithuania. The lithium concentration in these samples was determined by inductively coupled plasma mass spectrometry (ICP-MS). The suicide data were obtained from the Lithuania Database of Health Indicators, and comprised all registered suicides across all ages and gender within the 5-year period from 2009 to 2013. The study demonstrated an inverse correlation between levels of lithium (log natural transformed), number of women for 1000 men and standardized mortality rate for suicide among total study population. After adjusting for confounder (the number of women for 1000 men), the lithium level remained statistically significant in men, but not in women. Our study suggested that higher levels of lithium in public drinking water are associated with lower suicide rates in men. It might have a protective effect on the risk of suicide in men.

Background: Problematic internet use (PIU) is a serious global mental health issue that especially manifested during the Coronavirus disease (COVID-19) pandemic. Engagement in PIU as an impulsive coping with mental distress may pose a long-lasting threat to develop anxiety and depressive disorders. The first aim of our study was to investigate the prevalence of PIU and mental distress symptoms during the COVID-19 pandemic among university students in Lithuania. The second aim was to test the hypothesis that PIU affects anxiety and depressive symptoms through the mediating role of impulsivity.Methods: The cross-sectional study was comprised of 619 university students (92.9% females and 7.1% males) with a mean age of 22 ± 3 years who participated in an online survey from May to November, 2020. Participants completed the following scales: the Problematic Internet Use Questionnaire-9, the Generalized Anxiety Disorder Questionnaire-7, the Patient Health Questionnaire-9, and the Barratt Impulsiveness Scale-11. K-means cluster analysis and one-way multivariate analysis of variance were used for group comparison in terms of internet use time and habit change during COVID-19 pandemic. Structural equation modeling was applied to examine the mediating effect of impulsivity in association between PIU and mental distress, while controlling for age.Results: In sum, 45.1% of the participants reported PIU and 38.1% had markedly expressed symptoms of anxiety while 43.6% of the students reported moderate to severe depressive symptoms. During the COVID-19 pandemic 76% of the students reported at least moderate increase in their internet use time. Anxiety and depressive symptoms were significantly higher in the group of frequent internet users. The results of the structural equational modeling analysis showed a statistically significant effect of PIU on subjective anxiety symptoms and the statistically significant effect of PIU on subjective depression symptoms, both mediated via impulsivity.Conclusions: During COVID-19 pandemic, PIU, anxiety and depression symptoms are highly prevalent among students. Findings also suggest that relationships between PIU, anxiety and depressive symptoms are mediated via impulsivity. These results underscore the importance of the inclusion of impulsivity factor in the studies analyzing longitudinal effects of PIU on mental distress during COVID-19 pandemic.

Objective. The aim of this study was to establish prevalence, recognition, and risk factors for mental disorders and suicidal ideation in PC patients. Design. A cross-sectional survey based on standard mental health evaluation. Setting. Lithuanian primary care. Subjects. 998 patients from four urban PC clinics. Main outcome measures. Current mental disorders and suicidal ideation assessed using the Mini International Neuropsychiatric Interview (MINI). Results. According to the MINI, 27% of patients were diagnosed with at least one current mental disorder. The most common mental disorders were generalized anxiety disorder (18%) and major depressive episode (MDE) (15%), followed by social phobia (3%), panic disorder (3%), and post-traumatic stress disorder (2%). Some 6% of patients reported suicidal ideation. About 70% of patients with current mental disorder had no documented psychiatric diagnosis and about 60% received no psychiatric treatment. Greater adjusted odds for current MDE were associated with being widowed or divorced patients (odds ratio, OR = 1.8, 95% CI 1.2–2.8) and with lower education (OR = 1.6, 95% CI 1.1–2.3), while greater adjusted odds for any current anxiety disorder were found for women (OR = 1.9, 95% CI 1.3–2.8) and for patients with documented insomnia (OR = 2.2, 95% CI 1.2–4.2). Suicidal ideation was independently associated with use of antidepressants (OR = 5.4, 95% CI 1.7–16.9), with current MDE (OR = 2.9, 95% CI 1.5–5.8), and with excessive alcohol consumption (OR = 2.0, 95% CI 1.1–3.8). Conclusions. Depression, anxiety disorders, and suicidal ideation are prevalent but poorly recognized among PC patients. The presence of current MDE is independently associated with marital status and with lower education, while current anxiety disorder is associated with female gender and insomnia. Suicidal ideation is associated with current MDE, and with antidepressants and alcohol use.

Background The Patient Health Questionnaire—9 (PHQ-9) and the Generalized Anxiety Disorder Questionnaire– 7 (GAD-7) are short screening instruments used for detection of depression and anxiety symptoms in various settings, including general and mental health care as well as the general population. The aim of this study is to evaluate psychometric properties and factorial structure of the PHQ-9 and the GAD-7 in a sample of Lithuanian university students. Methods 1368 students (mean age 22.5±4.8) completed the PHQ-9 and the GAD-7 questionnaires online; after the completion of the survey, students were asked to provide phone contact for an additional interview. Eligible students were approached later by trained interviewers and completed The Clinical Interview Schedule-Revised for assessment of depressive and anxiety disorders. Results Results showed that the PHQ-9 and the GAD-7 are reliable screening tools for depression and anxiety (Cronbach alpha 0.86 and 0.91, respectively). The one-factor structure of the PHQ-9 and the GAD-7 was confirmed by the Confirmatory Factor Analysis. A cut-off of ≥10 for the PHQ-9 resulted in 71% sensitivity and 66% specificity recognizing students with increased risk for mood or anxiety disorder. For the GAD-7, a cut-off ≥9 resulted in 73% sensitivity and 70% specificity recognizing students at risk. The PHQ-9 was sensitive but not specific in recognizing students with depressive disorders. The sensitivity and specificity of the GAD-7 in differentiating students with generalized anxiety disorders were low. Conclusions The PHQ-9 and the GAD-7 have sufficient formal psychometric properties, but their clinical utility as diagnostic tools for recognition of depressive and anxiety disorders in students is limited. Due to low specificity and high false positive rates, both scales are recommended only as an initial screening tool for recognition of subjects with increased risk of mental disorders, however positive cases should be later assessed using more comprehensive instruments.

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Objective: This study aims at identifying associations between cognitive function and suicidal ideation in the sample of patients with anxiety and mood disorders (AMD). Methods: In sum, 186 (age = 39 ± 12.3 years; 142 [76.3 %] females) patients with AMD were enrolled in the study. Assessment included evaluation of socio-demographic information, medication use, anxiety and depression symptoms. Cognitive tests included measures of psychomotor performance and incidental learning using the Digit Symbol Test. Trail Making Tests respectively measured perceptual speed, task-switching and executive control. Additionally, 21 patients completed tests from the Cambridge Automated Neuropsychological Test Battery measuring set shifting (Interdimensional/extradimensional set-shift), executive planning (Stockings of Cambridge), and decision making (Cambridge Gamble Task [CGT]).Results: Almost half (45.0%, n = 86) of the study sample patients had experienced suicidal ideations. In multivariable regression analysis, suicidal ideation was associated with a greater overall proportion of bet and risk taking on the CGT task (β = .726, p = .010 and β = .634, p = .019), when controlling for socio-demographic characteristics, medication use, anxiety and depression symptoms. Conclusions:Outpatients with AMD and suicidal ideation could be distinguished by the presence of cognitive deficits in the executive function domain, particularly in impulse-control and risk taking.

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Conducting a psychosocial autopsy after a suicide is a well-known method in the world for a deeper understanding of suicide, but it still raises a lot of debates over how this method could be applied better to avoid questionable reliability of the research. This study represents methodological insights from a psychosocial autopsy study of adult suicide. 145 people, who lost a close relative or friend due to a suicide, participated in the study. The results revealed that it is particularly important to complete a pilot study and a test of the protocol in a specific sample. Insights to organize face to face meetings due to the sensitivity of the experience, the ability to observe and respond to the risk of suicide of respondents, and to require researchers with practical experience in suicide prevention and psychological assistance is emphasized. This study is an attempt to give methodological insights for future research of suicide and facilitate significant progress in our understanding of suicide.