One of the most relevant risk factors for suicide is the presence of previous attempts. The symptomatic profile of people who reattempt suicide deserves attention. Network analysis is a promising tool to study this field.

To analyze the symptomatic network of patients who have attempted suicide recently and compare networks of people with several attempts and people with just one at baseline.

1043 adult participants from the Spanish cohort “SURVIVE” were part of this study. Participants were classified into two groups: single attempt group (n = 390) and reattempt group (n = 653). Different network analyses were carried out to study the relationships between suicidal ideation, behavior, psychiatric symptoms, diagnoses, childhood trauma, and impulsivity. A general network and one for each subgroup were estimated.

People with several suicide attempts at baseline scored significantly higher across all clinical scales. The symptomatic networks were equivalent in both groups of patients (p > .05). Although there were no overall differences between the networks, some nodes were more relevant according to group belonging.

People with a history of previous attempts have greater psychiatric symptom severity but the relationships between risk factors show the same structure when compared with the single attempt group. All risk factors deserve attention regardless of the number of attempts, but assessments can be adjusted to better monitor the occurrence of reattempts.

To assess the post-earthquake trauma and hopelessness levels of nursing students due to the earthquakes that occurred on February 6, 2023.

This study was conducted between April and May 2023 in the Nursing Department in a province located in Southeastern Türkiye using the face-to-face interview technique. The study was completed with 276 students in line with the power analysis. The data were collected using a questionnaire, the Scale that Determines the Level of Post-Earthquake Trauma (SDLPET), and the Beck Hopelessness Scale (BHS).

The mean SDLPET and BHS scores of the students were 55.45±13.58 and 9.38±4.53, respectively. Some 12.3% of the nursing students lost their friends due to the earthquake, 80.4% did not receive any earthquake training, 46% needed psychological support, 48.6% needed financial support, 49.6% needed social support, 37% had sleep problems, 72.8% experienced hopelessness, and the quality of life of 67.8% of the students was negatively affected due to the hopelessness they experienced.

It was found that the level of post-earthquake trauma and hopelessness of the students was moderate, and a positive and significant correlation was found between trauma and hopelessness scores.

Fifteen years ago, we published an article in Social Science and Medicine seeking to resolve the contentious debate between advocates of two very different frameworks for understanding and addressing the mental health needs of conflict-affected populations. The two approaches, which we labelled trauma-focused and psychosocial, reflect deeply held beliefs about the causes and nature of distress in war-affected communities. Drawing on the burgeoning literature on armed conflict and mental health, the reports of mental health and psychosocial support (MHPSS) staff in the field, and on research on the psychology and psychophysiology of stress, we proposed an integrative model that drew on the strengths of both frameworks and underscored their essential complementarity. Our model includes two primary pathways by which armed conflict impacts mental health: directly, through exposure to war-related violence and loss, and indirectly, through the harsh conditions of everyday life caused or exacerbated by armed conflict. The mediated model we proposed draws attention to the effects of stressors both past (prior exposure to war-related violence and loss) and present (ongoing conflict, daily stressors), at all levels of the social ecology; for that reason, we have termed it an ecological model for understanding the mental health needs of conflict-affected populations.

In the ensuing 15 years, the model has been rigorously tested in diverse populations and has found robust support. In this paper, we first summarize the development and key tenets of the model and briefly review recent empirical support for it. We then discuss the implications of an ecological framework for interventions aimed at strengthening mental health in conflict-affected populations.

We present preliminary evidence suggesting there has been a gradual shift towards more ecological (i.e., multilevel, multimodal) programming in MHPSS interventions, along the lines suggested by our model as well as other conceptually related frameworks, particularly public health.

We reflect on several gaps in the model, most notably the absence of adverse childhood experiences. We suggest the importance of examining early adversity as both a direct influence on mental health and as a potential moderator of the impact of potentially traumatic war-related experiences of violence and loss.

Migraine and post-traumatic stress disorder (PTSD) are both twice as common in women as men. Cross-sectional studies have shown associations between migraine and several psychiatric conditions, including PTSD. PTSD is disproportionally common among patients in headache clinics, and individuals with migraine and PTSD report greater disability from migraines and more frequent medication use. To further clarify the nature of the relationship between PTSD and migraine, we conducted bidirectional analyses of the association between (1) migraine and incident PTSD and (2) PTSD and incident migraine.

We used longitudinal data from 1989–2020 among the 33,327 Nurses’ Health Study II respondents to the 2018 stress questionnaire. We used log-binomial models to estimate the relative risk of developing PTSD among women with migraine and the relative risk of developing migraine among individuals with PTSD, trauma-exposed individuals without PTSD, and individuals unexposed to trauma, adjusting for race, education, marital status, high blood pressure, high cholesterol, alcohol intake, smoking, and body mass index.

Overall, 48% of respondents reported ever experiencing migraine, 82% reported experiencing trauma and 9% met the Diagnostic and Statistical Manual of Mental Disorders-5 criteria for PTSD. Of those reporting migraine and trauma, 67% reported trauma before migraine onset, 2% reported trauma and migraine onset in the same year and 31% reported trauma after migraine onset. We found that migraine was associated with incident PTSD (adjusted relative risk [RR]: 1.26, 95% confidence interval [CI]: 1.14–1.39). PTSD, but not trauma without PTSD, was associated with incident migraine (adjusted RR: 1.20, 95% CI: 1.14–1.27). Findings were consistently stronger in both directions among those experiencing migraine with aura.

Our study provides further evidence that migraine and PTSD are strongly comorbid and found associations of similar magnitude between migraine and incident PTSD and PTSD and incident migraine.

There is a strong link between trauma exposure and serious mental health conditions (SMHCs), such as schizophrenia and bipolar disorder. The majority of research in the field has focused on childhood trauma as a risk factor for developing an SMHC and on samples from high-income countries. There is less research on having an SMHC as a risk factor for exposure to traumatic events, and particularly on populations in low- and middle-income countries (LMICs).

This scoping review aimed to synthesize the nature and extent of research on traumatic events that adults with SMHCs face in LMICs. It was conducted across five databases: PubMed, Embase, PsycINFO, Web of Science Core Collection and Africa-Wide Information/NiPad in December 2023 and by hand searching citation lists.

The database search returned 4,111 articles. After removing duplicates and following a rigorous screening process, 51 articles met criteria for inclusion. There was one case study, one mixed methods study, 12 qualitative studies and 37 quantitative studies. Ten countries were represented, with the most studies from India (n = 19), Ethiopia (n = 9) and China (n = 6). Schizophrenia was the most studied type of SMHC. Of the trauma exposures, more than 76% were on interpersonal violence, such as sexual and physical violence. Of the studies on interpersonal violence, more than 23% were on physical restraint (e.g., shackling) in the community or in hospital settings. There were no studies on man-made or natural disasters.

Much of our data in this population are informed by a small subset of countries and by certain types of interpersonal violence. Future research should aim to expand to additional countries in LMICs. Additional qualitative research would likely identify and contextualize other trauma types among adults with SMHCs in LMICs.