Effects of media stories featuring coping with suicidal crises on psychiatric patients: Randomized controlled trial

BACKGROUND

Accumulating evidence suggests beneficial effects of media stories featuring individuals mastering their suicidal crises, but effects have not been assessed for psychiatric patients.

METHODS

We randomized n = 172 adult psychiatric patients (n = 172, 97.1% inpatients) to read an educative article featuring a person mastering a suicidal crisis (n = 92) or an unrelated article (n = 80) in a single-blind randomized controlled trial. Questionnaire data were collected before (T1) and after exposure (T2) as well as 1 week later (study end-point, T3). The primary outcome was suicidal ideation as assessed with the Reasons for Living Inventory; secondary outcomes were help-seeking intentions, mood, hopelessness, and stigmatization. Differences between patients with affective versus other diagnoses were explored based on interaction tests.

RESULTS

We found that patients with affective disorders (n = 99) experienced a small-sized reduction of suicidal ideation at 1-week follow up (mean difference to control group [MD] at T3 = -0.17 [95% CI -0.33, -0.03], d = -0.15), whereas patients with nonaffective diagnoses (n = 73) experienced a small-sized increase (T2: MD = 0.24 [95% CI 0.06, 0.42], d = 0.19). Intervention group participants further experienced a nonsustained increase of help-seeking intentions (T2: MD = 0.53 [95% CI 0.11, 0.95], d = 0.19) and a nonsustained deterioration of mood (T2: MD = -0.14 [95% CI -0.27, -0.02], d = -0.17).

CONCLUSIONS

This study suggests that patients with affective disorders appear to benefit from media materials featuring mastery of suicidal crises. More research is needed to better understand which patient groups are at possible risk of unintended effects.

Effects of ‘It Gets Better’ suicide prevention videos on LGBTQ youth: randomised controlled trial

Background

The ‘It Gets Better' suicide prevention project (IGBP) features video narratives of LBTQ+ persons telling their stories of overcoming difficulties related to coming-out. Research on the effects of the videos is scarce.

Methods

We conducted a double-blind randomised controlled trial between January and November 2020. LGBTQ youth aged 14-22 years (n = 483) were randomized to an IGBP (n = 242) or unrelated video (n = 241). Suicidality (primary outcome), depressive symptoms, help-seeking intentions, hopelessness, mood and sexual identity were assessed at baseline (T1), immediately after exposure (T2) and at 4-week follow-up (T3). Identification was assessed at T2. Data were analysed with linear mixed models, and a mediation analysis was used to explore effects of identification on suicidality.

Results

No significant effect was identified for the entire intervention group with regard to suicidal ideation but nonbinary/transgender individuals experienced a short-term improvement in suicidality (T2: mean change from baseline [MC]=-0.20 (95% CI -0.39 to -0.02); P = 0.01, mean difference [MD] compared with control group MD=-0.54 (95% CI -1.01 to -0.08); P = 0.02; d=-0.10). The effect was most pronounced among nonbinary/transgender individuals with depressive symptoms. The effect on suicidal ideation was mediated through identification. Intentions to seek help from personal contacts showed a short-term improvement in the overall intervention group (T2: MC = 0.25 (95% CI 0.15 to 0.35); P < 0.001, MD = 0.28 (95% CI 0.01 to 0.54); P < 0.05; d = 0.09).

Conclusions

Personal narratives of coping with adversity have beneficial effects on LGBTQ youth, particularly nonbinary/transgender youth including those with depressive symptoms. Identification with the featured characters is relevant for suicide preventive effects.

News media representations of women who kill their newly born children

This paper presents a first quantitative analysis of language in media reports of neonaticide and a comparative examination of language use within the reports. One thousand twenty-seven Austrian print media reports from 2004 to 2014 were retrieved; after exclusion, 331 were analysed using the Linguistic Inquiry and Word Count (LIWC) software. After a preliminary analysis, a comparative analysis was carried out between reports on the Graz case and all other cases. The preliminary analysis revealed that a majority of media reports were related to one repeat neonaticide case (Graz) despite not being clinically different from other cases identified for the same period. The comparative linguistic analysis shows some statistically significant differences relating to the domains of emotional words (less words of anxiety, sadness) and family and in the category of insight and certainty (more words). The unexpected media attention on the Graz case and the ensuing verdict, which was in contradiction with the Austrian infanticide act, might have been influenced by the way language was used by journalists and the media. The authors suggest guidelines on sensitive media reporting are required.

Predictors of psychological improvement on non-professional suicide message boards: content analysis

BACKGROUND

Suicide message boards have been at the core of debates about negative influences of the Internet on suicidality. Nothing is currently known about communication styles that may help users to psychologically improve in these settings.

METHOD

In all, 1182 archival threads with 20 499 individual postings from seven non-professional suicide message boards supporting an 'against-suicide', 'neutral' or 'pro-suicide' attitude were randomly selected and subject to content analysis. Initial needs of primary posters (i.e. individual who open a thread), their psychological improvement by the end of the thread, their responses received and indicators of suicidality were coded. Differences between 'pro-suicide', 'neutral' and 'against suicide' boards, and correlations between primary posters and respondents in terms of suicidality were assessed. Logistic regression was used to test associations with psychological improvement.

RESULTS

'Pro-suicide' boards (n = 4) differed from 'neutral' (n = 1) and 'against-suicide' (n = 2) boards in terms of communicated contents. Indicators of suicidality correlated moderately to strongly between primary posters and respondents on 'pro-suicide' message boards, but less on other boards. Several communicative strategies were associated with psychological improvement in primary posters, including the provision of constructive advice [adjusted odds ratio (aOR) 4.10, 95% confidence interval (CI) 2.40-7.03], active listening (aOR 1.60, 95% CI 1.12-2.27), sympathy towards the poster (aOR 2.22, 95% CI 1.68-2.95) and provision of alternatives to suicide (aOR 2.30, 95% CI 1.67-3.18).

CONCLUSIONS

Respondents resemble primary posters with regard to suicidality in 'pro-suicide' boards, which may hinder psychological improvement. Still, opportunities to intervene in these settings using simple communication techniques exist and need to be taken and evaluated.

CRS1 is a novel group II intron splicing factor that was derived from a domain of ancient origin

Protein-dependent group II intron splicing provides a forum for exploring the roles of proteins in facilitating RNA-catalyzed reactions. The maize nuclear gene crs1 is required for the splicing of the group II intron in the chloroplast atpF gene. Here we report the molecular cloning of the crs1 gene and an initial biochemical characterization of its gene product. Several observations support the notion that CRS1 is a bona fide group II intron splicing factor. First, CRS1 is found in a ribonucleoprotein complex in the chloroplast, and cofractionation data provide evidence that this complex includes atpF intron RNA. Second, CRS1 is highly basic and includes a repeated domain with features suggestive of a novel RNA-binding domain. This domain is related to a conserved free-standing open reading frame of unknown function found in both the eubacteria and archaea. crs1 is the founding member of a gene family in plants that was derived by duplication and divergence of this primitive gene. In addition to its previously established role in atpF intron splicing, new genetic data implicate crs1 in chloroplast translation. The chloroplast splicing and translation functions of crs1 may be mediated by the distinct protein products of two crs1 mRNA forms that result from alternative splicing of the crs1 pre-mRNA.

A survey of inpatient antibiotic use in a teaching hospital

To assess the appropriateness of inpatient antibiotic use, a 4-week prospective survey in medical, surgical and gynaecological wards was undertaken at Groote Schuur Hospital. A total of 224 prescriptions comprising 680 antibiotics were analysed. Of all patients in the medical, gynaecology and surgery wards, 27%, 26.5% and 32%, respectively, were prescribed antibiotics. The greatest number of inappropriate prescriptions--54%--were found in the gynaecology ward. Prophylactic antibiotic use was highest in the surgical ward at 41% where a very satisfactory 91% was considered appropriate, whereas 66% of gynaecological prophylaxis was inappropriate. Therapeutic use was highest and more often appropriate in the medical wards. Antibiotics classified as restricted according to the hospital antibiotic policy were generally used appropriately, whereas inappropriate choice, dose, frequency of administration, duration, and unnecessary antibiotic use were encountered in 22-100% of cases with unrestricted antibiotics. Particular problems pinpointed in this survey included excessive dosages of penicillin G and amoxycillin, an irrational protocol for the treatment of pelvic sepsis in gynaecology, and frequent inappropriate selection of erythromycin. The greatest expenditure was on amikacin, the only aminoglycoside allowed according to the existing antibiotic policy.