Nightmares mediate the association between traumatic event exposure and suicidal ideation in frontline medical workers exposed to COVID-19

Suicidal ideation and suicide attempts in healthcare professionals during the COVID-19 pandemic: A systematic review

“…Major factors associated with increased suicidality include higher rates of depression ( 27 , 32 , 33 , 36 , 37 , 39 , 40 , 55 ); anxiety ( 19 , 27 , 32 , 36 – 39 , 52 , 55 ); post-traumatic stress disorder ( 32 , 42 ); pre-pandemic lifetime mental disorders ( 24 ) or previous lifetime suicide attempt; insomnia severity; nightmare frequency; poorer subjective health ( 32 , 33 , 36 , 47 , 60 ); and burnout ( 32 ). In addition, other personal factors predisposing to suicidal thoughts include being female ( 58 ); having friends or family members infected with COVID-19 ( 24 , 32 , 56 ); living alone; having poor physical health ( 32 ); being single ( 27 , 39 ), divorced, legally separated, or widowed ( 24 ); higher alcohol consumption ( 32 , 34 ); psychotropic drug use ( 34 , 42 ); and change in vitamin D levels ( 45 ).…”

“…In this line, there are a number of factors associated with higher suicidality such as higher rates of depression ( 27 , 32 , 33 , 36 , 37 , 39 , 40 , 55 ); anxiety ( 19 , 27 , 32 , 36 – 39 , 52 , 55 ); post-traumatic stress disorder ( 32 , 42 ); pre-pandemic lifetime mental disorders ( 24 ) or previous lifetime suicide attempt; insomnia severity; nightmare frequency; a poorer self-perceived health ( 32 , 33 , 36 , 47 , 60 ); and burnout ( 32 ). In most cases, all these risk factors have increased in impact during the COVID-19 pandemic and, as Mamun and Ullah ( 65 ) estimate, approximately 90% of suicides are due to psychological distress in the face of continued exposure to highly stressful situations.…”

General Self-Efficacy in Association With Insomnia Symptoms and Suicidal Ideation Among Chinese Community-Based Population

“…Insomnia is becoming an increasingly prevalent, persistent, and disturbing concern worldwide, especially against the context of accelerated changes in modernized life styles and the threat of COVID-19 pandemic. 2,22 In view of such background, this study provides new insights into the importance of alleviating insomnia symptoms to reduce intentional or unintentional harms, though future research with appropriate prospective design to examine the potential causal relation- ship between insomnia and suicidal ideation is still warranted to further verify our findings. Furthermore, our study revealed the association of general self-efficacy with insomnia symptoms and suicidal ideation.…”

Psychological mediators of the associations between pandemic-related stressors and suicidal ideation across three periods of the COVID-19 pandemic in Canada

“…Finally, there is a need to examine psychological experiences that may account for the observed associations between demographic characteristics and SI, to illuminate why certain groups are vulnerable. So far, evidence has suggested that thwarted belongingness mediated the association between stay-at-home orders and suicide risk ( Gratz et al, 2020 ), insomnia mediated the association between COVID-19 worries and SI ( Killgore et al, 2020 ), nightmares fully mediated the association between trauma exposure and SI in healthcare workers ( Que et al, 2022 ), and depression mediated the association between stressful events and SI in adolescents ( Cheng et al, 2021 ). Further examination of the roles of depression, perceived burdensomeness, thwarted belongingness – three important risk factors for SI ( Joiner, 2005 ; Klonsky et al, 2021 ) – as well as the potential role of perceived discrimination given apparent concentration of SI in racialized groups, is warranted.…”