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Background/Objectives: Schizophrenia (SZ) is a severe psychiatric disorder characterized by a complex interplay of genetic, developmental, and environmental factors that significantly increase the risk of suicidal ideation (SI) and suicide attempts (SAs). This systematic review synthesizes current research on the developmental predictors of SI in individuals with SZ, aiming to delineate the multifactorial etiology of suicide within this population. Methods: A comprehensive search across Medline, PsycINFO, and EMBASE databases identified 23 eligible studies, emphasizing the varied methodological approaches and the global distribution of research efforts. Results: These studies demonstrate a robust association between early life adversities, particularly childhood trauma such as physical neglect, emotional abuse, and sexual abuse, and the increased prevalence of SI and SAs in SZ. This review also highlights the significant genetic factors associated with the development of suicidality in SZ, raising the possibility that polymorphisms in inflammation-related genes and neurodevelopmental abnormalities may influence susceptibility to SI. Notably, family history of psychiatric conditions may exacerbate the risk of SI through both hereditary and environmental mechanisms. Environmental factors, including socioeconomic status and social support, are also implicated, underscoring the role of broader socio-environmental conditions influencing outcomes. Conclusions: This review supports the integration of biopsychosocial models in understanding SI in SZ, advocating for interventions addressing the complex interplay of risk factors and the need for longitudinal studies to elucidate the dynamic interactions between risk factors over time. This comprehensive understanding is crucial for developing targeted preventive strategies and enhancing the clinical management of SZ, aiming to reduce suicidality in this vulnerable population.

OBJECTIVE: To investigate the effect of 10 Hz repetitive transcranial magnetic stimulation (rTMS) and intermittent theta-burst stimulation (iTBS) on suicidality in patients with treatment-resistant depression (TRD). METHODS: We used data from a three-site randomized clinical trial comparing 10 Hz rTMS and iTBS applied to the left dorsolateral prefrontal cortex (DLPFC) in patients with TRD. We compared the effect of 10Hz rTMS and iTBS on suicidality as measured by the suicide item of the Hamilton Depression Rating Scale 17-item (HDRS-17). RESULTS: Suicidality remitted in 71 (43.7%) participants randomized to 10Hz stimulation and 91 (49.1%) participants randomized to iTBS, without a significant difference between the proportions in the two groups (Χ2  = 0.674, df = 1, p = 0.4117). There was a significant correlation between change in suicidality and change in depression severity for both modalities (10 Hz, Pearsons r = 0.564; iTBS, Pearsons r = 0.502), with a significantly larger decrease in depression severity for those in whom suicidality remitted compared to those in whom it did not (t = 10.912, df = 276.8, p

[This corrects the article DOI: 10.1021/acsptsci.1c00024.].

The effects of common antidepressants on suicidal ideation (SI) is unclear. In the landmark STAR*D trial antidepressants were effective for Major Depressive Disorder (MDD) in early treatment phases, but less effective in later phases. The effects of antidepressants on SI across the entire sample of the STAR*D trial has never been investigated. We performed a secondary analysis of the STAR*D data with the primary outcome of change in score on the suicide item (item three) of the Hamilton Rating Scale for Depression (HRSD17) across all four study levels. We used descriptive statistics and logistic regression analyses. Pearson correlation was used for change in SI versus change in depression (HRSD16). Reduction in mean (SD) SI was greater in levels one: 0.29 (±0.78) (p

Background: There is growing interest in the potential of neuromodulation options in treatment‐resistant obsessive–compulsive disorder (OCD). Magnetic seizure therapy (MST), is a new treatment intervention in which generalized seizures are induced with transcranial magnetic stimulation. We conducted a pilot study to assess the efficacy and cognitive effects of MST in patients with treatment‐resistant OCD. Methods: In an open‐label pilot study, participants with treatment‐resistant OCD and a baseline Yale‐Brown Obsessive–Compulsive Scale (Y‐BOCS) scores of ≥16 were treated with up to 24 acute treatments. The primary clinical outcomes were clinical response (Y‐BOCS score reduction ≥30%) and remission (final Y‐BOCS score ≤8). A neurocognitive battery, the Quick Inventory for Depressive Symptoms–Self Report (QIDS‐SR), the Beck Scale for Suicidal Ideation (SSI), and the Quality of Life Enjoyment and Satisfaction Questionnaire‐Short Form (Q‐LES‐Q‐SF) were also completed as secondary measures. Results: Ten participants with OCD who had not responded to medications or psychotherapy enrolled in the study and seven completed an adequate trial (defined as ≥8 treatments). MST was associated with minimal cognitive effects except for some decrease in autobiographical memory and no serious adverse effects. Only one participant met the predefined criteria for response, and none for remission. The baseline and endpoint Y‐BOCS scores were not statistically different. Conclusion: Overall, MST was not beneficial in a small group of patients with treatment‐resistant OCD. At this time, other studies of MST for OCD are not warranted until different coil placements targeting other brain circuits can be proposed. [ABSTRACT FROM AUTHOR]

This article includes an argument for the importance of academic electives in undergraduate medical education, along with a description of an academic elective that I took during the summer of 2012. The elective was a one-week course in evolutionary medicine, which is a growing field that is guiding exciting new medical advances. The key theme of the elective was the application of evolutionary theory to research and clinical practice in the fields of infectious disease and oncology. The elective took place in the beautiful setting of Mount Desert Island, in Maine, with a small group of learners of various ages and academic backgrounds. Leaders in the field were present to discuss the bright future of this young discipline. Through this elective I was able to develop new perspectives on my approach to medicine, which I will carry throughout my career. Academic electives of all types are an effective way for medical students to widen their knowledge base, which helps in both understanding disease and in patient communication. [ABSTRACT FROM AUTHOR]

Objective: This study investigated spaced transcranial direct current stimulation for major depressive disorder, focusing on feasibility., Methods: In a prospective open-label study, 30 participants with major depressive disorder were enrolled to receive a 50-session transcranial direct current stimulation (tDCS) treatment over 2 weeks. The feasibility, safety, tolerability, and preliminary therapeutic effects of this tDCS protocol were assessed using the 17-item Hamilton Depression Rating Scale (HAM-D-17) and the Montgomery-Åsberg Depression Rating Scale (MADRS) at baseline and 1-week and 4-week follow-ups, as well as with the 6-item HAM-D (HAM-D-6) daily during treatment., Results: The protocol demonstrated good feasibility, with a retention rate of 93.3% and an adherence rate of 99.7%. There were no serious adverse events. The most common side effect was a mild tingling and itching sensation during stimulation (100%) and temporary skin redness following stimulation (100%). Additionally, 64.3% of participants presented with mild irritative contact dermatitis, which had disappeared by the 1-week follow-up for most participants and completely resolved by the 4-week follow-up for the remaining cases; this was not treatment limiting and did not require specific treatment. HAM-D-17 scores decreased from a mean of 21.3 (SD=3.0) at baseline to 15.3 (SD=6.3) at 1 week and 13.2 (SD=7.1) at 4 weeks. Depressive symptom severity, as measured by the HAM-D-17, showed significant reductions over time, with similar trends observed on the MADRS. HAM-D-6 scores highlighted important differences between response groups, particularly during the later stages of treatment, suggesting a potential for differential response patterns between the 1-week and 4-week follow-ups., Conclusions: The protocol was feasible, safe, and well-tolerated and led to significant reductions in depressive symptoms. These results will need to be validated in a sham-controlled randomized trial. The inclusion of neurophysiological measures in future trials for purposes of biological target engagement might also contribute to our understanding of underlying mechanisms and biomarker discovery., Competing Interests: Dr. Nitsche has served on scientific advisory boards for Neuroelectrics and Precisis, and he has received travel funds from NeuroDevice. Dr. Blumberger has received research support from Brain Canada, the Canadian Institutes of Health Research, NIMH, and the Temerty Family through the CAMH Foundation and the Campbell Family Research Institute; he has received research support and in-kind equipment support for an investigator-initiated study from BrainsWay, and he was the site principal investigator for three sponsor-initiated studies for BrainsWay; he has received in-kind equipment support from MagVenture for two investigator-initiated studies; he has received medication supplies for an investigator-initiated trial from Indivior; he has served as a scientific adviser for Sooma Medical; and he is co-chair of the Clinical Standards Committee of the Clinical TMS Society (unpaid). Dr. Weissman has served as a consultant for GoodCap Pharmaceuticals, and he has received support from the Brain and Behavior Research Foundation, NIMH, and Wellcome Leap. Dr. Daskalakis has received research and in-kind equipment support for an investigator-initiated study through BrainsWay and MagVenture, and he has served on the scientific advisory board for BrainsWay. The other authors report no financial relationships with commercial interests.

Objective: Psychiatric inpatients represent an acutely vulnerable population with high rates of suicidality (ie, suicidal ideation, attempts, and completed suicide). This systematic review aimed to evaluate treatments for suicidality delivered within inpatient settings., Data Sources: MEDLINE, Embase, APA PsycInfo, CINAHL, and The Cochrane Library were systematically searched using 3 concepts: suicidality, inpatient population/setting, and treatment/ interventions. Searches were limited to years 2001-2024, with no language restrictions., Study Selection: Of 19,921 articles identified, 11,519 were screened, and 179 underwent full-text review. We included clinical trials on pharmacologic and nonpharmacologic interventions for suicidality in psychiatric inpatients aged 18-65 with moderate to high levels of suicidality that measured changes in suicidality., Data Extraction and Synthesis: Studies were organized into tables by study design, treatments, participants, suicide measure, outcomes, and key findings. Due to heterogeneity, a meta-analysis was not conducted; instead, a narrative synthesis was used for qualitative analysis., Results: Forty-nine studies were included. Of 14 pharmacologic trials, intravenous ketamine showed most consistent rapid reduction in suicidality. Thirty-five nonpharmacologic trials, covering a broad spectrum of treatments including chronotherapy, neurostimulations, and psychotherapies, were reviewed. The results were mixed, with some interventions showing potential in reducing suicidality, particularly in the mood, personality, and trauma-related disorders. Many studies had methodological concerns including nonrandomized designs, lack of control arms, and retrospective assessments., Conclusion: A range of interventions for treating suicidality in inpatient settings have been evaluated, with mixed results. The current review underscores the need for larger, well-designed trials to assess the effectiveness of these treatments in inpatient settings., (© Copyright 2025 Physicians Postgraduate Press, Inc.)