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      Characteristics and predictors of suicidal ideation severity among callers to a telephone helpline in Spain Translated title: Características y predictores de la gravedad de la ideación suicida entre las personas que llaman a una línea telefónica de ayuda en España

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          Abstract

          ABSTRACT Teléfono de la Esperanza (TE) is the main Spanish helpline providing telephone listening and support for callers in crisis. Crisis helplines can facilitate the identification of persons at risk for suicide. The main goals of this cross-sectional study were to identify severe suicidal ideation and to explore the differential characteristics between callers with severe and low-moderate suicidal ideation. A sample of 26,032 callers to TE was assessed; 544 callers with suicidal ideation were evaluated through ATENSIS, an assessment tool designed to collect information related to suicidal ideation. Comparisons between severe and low-moderate suicidal ideators in sociodemographics, telephone call timing, risk factors, and suicidality variables were conducted. Sixty-four (11.8%) of the suicidal ideators presented with severe suicidal ideation and 480 (88.2%) with low-moderate severity. Significant differences in several sociodemographic characteristics, risk factors, and suicidality variables between both levels of suicidal ideation severity were found. In the regression analysis, the main variables related to the presence of high suicidal ideation severity were preparatory acts, previous suicide attempts, non-suicidal self-injuries, lack of life sense, age, and hopelessness. It is concluded that helplines can be used to identify suicidal ideation among callers and to provide rapid crisis interventions according to the risk of suicide.

          Translated abstract

          RESUMEN El Teléfono de la Esperanza (TE) es la principal línea telefónica de ayuda en España que brinda apoyo a las personas en situaciones de crisis. Las líneas telefónicas de ayuda pueden facilitar la identificación de personas en riesgo de suicidio. Los objetivos principales de este estudio transversal fueron identificar la ideación suicida grave y explorar las características diferenciales con respecto a la ideación suicida moderada. Se revisaron las llamadas al TE de 26,032 personas y se evaluó una muestra de 544 personas que presentaban ideación suicida a través de ATENSIS, una herramienta diseñada para recopilar información sobre la ideación suicida. Se comparó a las personas con ideación suicida grave y moderada en características sociodemográficas, momento de la llamada, factores de riesgo y variables de suicidio. Sesenta y cuatro (11.8%) de las personas presentaban ideación suicida grave y 480 (88.2%) ideación baja-moderada. Se encontraron diferencias significativas en las distintas variables estudiadas. En el análisis de regresión, las principales variables relacionadas con la presencia de alta gravedad de la ideación suicida fueron la existencia de actos preparatorios, los intentos previos de suicidio, las autolesiones no suicidas, la falta de sentido de la vida, la edad y la desesperanza. Las líneas de ayuda pueden identificar la ideación suicida en las personas que llaman y proporcionar una intervención rápida en situaciones de crisis de acuerdo con el riesgo de suicidio presentado.

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          Most cited references45

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          The Columbia-Suicide Severity Rating Scale: initial validity and internal consistency findings from three multisite studies with adolescents and adults.

          Research on suicide prevention and interventions requires a standard method for assessing both suicidal ideation and behavior to identify those at risk and to track treatment response. The Columbia-Suicide Severity Rating Scale (C-SSRS) was designed to quantify the severity of suicidal ideation and behavior. The authors examined the psychometric properties of the scale. The C-SSRS's validity relative to other measures of suicidal ideation and behavior and the internal consistency of its intensity of ideation subscale were analyzed in three multisite studies: a treatment study of adolescent suicide attempters (N=124); a medication efficacy trial with depressed adolescents (N=312); and a study of adults presenting to an emergency department for psychiatric reasons (N=237). The C-SSRS demonstrated good convergent and divergent validity with other multi-informant suicidal ideation and behavior scales and had high sensitivity and specificity for suicidal behavior classifications compared with another behavior scale and an independent suicide evaluation board. Both the ideation and behavior subscales were sensitive to change over time. The intensity of ideation subscale demonstrated moderate to strong internal consistency. In the adolescent suicide attempters study, worst-point lifetime suicidal ideation on the C-SSRS predicted suicide attempts during the study, whereas the Scale for Suicide Ideation did not. Participants with the two highest levels of ideation severity (intent or intent with plan) at baseline had higher odds for attempting suicide during the study. These findings suggest that the C-SSRS is suitable for assessment of suicidal ideation and behavior in clinical and research settings.
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            The Three-Step Theory (3ST): A New Theory of Suicide Rooted in the “Ideation-to-Action” Framework

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              Risk factors for suicidality in Europe: results from the ESEMED study.

              Precise knowledge of the epidemiology of suicidality provides necessary information for designing prevention programs. The aims of the present study were to investigate the prevalence and correlates of suicidal ideas and attempts in the general population of Europe. The European Study on the Epidemiology of Mental Disorders (ESEMED) is a cross-sectional household survey carried out in a probability representative sample of non-institutionalised adults (aged 18 years or older) of six European countries (Belgium, France, Germany, Italy, the Netherlands and Spain). The Composite International Diagnostic Interview (CIDI 3.0) was administered to 21,425 individuals. Lifetime prevalence of suicidal ideation was 7.8% and of suicidal attempts 1.3%. Being women, younger and divorced or widowed were associated with a higher prevalence of suicide ideation and attempts. Psychiatric diagnoses were strongly related to suicidality. Among them, major depressive episode (Rate ratio 2.9 for lifetime ideas and 4.8 for lifetime attempts), dysthymia (RR 2.0 and 1.6), GAD (RR 1.8 and 2.3 for lifetime), PTSD (RR 1.9 and 2.0) and alcohol dependence (RR 1.7 and 2.5) were the most important. Population attributable risks for lifetime suicidal attempt was 28% for major depression. Information about suicidal ideas and attempts was self reported, psychiatric diagnoses were made using fully structured lay interviews rather than clinician-administered interviews. In spite of meaningful country variation in prevalence, risk factors for suicidality are consistent in the European countries. Population prevention programmes should focus on early diagnosis and treatment of major depression and alcohol abuse and in those individuals with recent appearance of suicidal ideas.
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                Author and article information

                Journal
                inter
                Psychosocial Intervention
                Psychosocial Intervention
                Colegio Oficial de la Psicología de Madrid (Madrid, Madrid, Spain )
                1132-0559
                2173-4712
                2021
                : 30
                : 3
                : 174-181
                Affiliations
                [02] Pamplona orgnameInstituto de Investigación Sanitaria de Navarra Spain
                [01] Pamplona Navarra orgnameUniversidad Pública de Navarra Spain
                [03] Pamplona orgnameTeléfono de la Esperanza de Navarra Spain
                Article
                S1132-05592021000300006 S1132-0559(21)03000300006
                10.5093/pi2021a7
                3f4a60d4-3595-4cdd-912d-2d6611ca20d1

                This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

                History
                : 23 March 2021
                : 08 July 2021
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 45, Pages: 8
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                SciELO Spain

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                Factores de riesgo,Risk factors,Telephone helplines,Severity,Suicidal ideation,Evaluación,Líneas teléfonicas de ayuda,Gravedad,Ideación suicida,Assessment

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