This week we look deeper into gender’s role in adolescent suicidal behavior, reflect on 20 years of mental health care for women, and hear from readers about dietary and sexual behavior.

New Research Explores Role of Gender In Adolescent Suicide

Researchers have documented gender differences in suicidality among adolescents for years. Studies consistently point to higher rates of suicidal thoughts and behaviors in female adolescents compared to young men. 

Despite this, male adolescents are more likely to die by suicide. Multiple variables – such as sociodemographic variables, genetic predispositions, and gender norms – all play a role. Female adolescents often exhibit higher levels of guilt, hopelessness, and lower self-esteem, which can fuel suicidal thoughts. On the other hand, young men display more aggression and impulsivity, raising their risk of fatal suicide attempts. The psychopathological mechanisms driving these differences remain frustratingly unclear.

A study involving nearly 700 adolescents with depressive episodes at the Third People’s Hospital in Ganzhou, China, aimed to explore gender differences in SAs, risk factors, and the interplay between depression, rumination, and SAs. The findings showed:

There is a higher prevalence of attempts among women – 64.36% – compared to men – 49.47%. Female adolescents also exhibited more severe depressive symptoms and higher levels of rumination, particularly brooding. For younger men, depressive symptoms were the primary predictor of SAs, whereas for women, both depression and rumination significantly predicted SAs  In females, rumination mediated the relationship between depression and SAs, highlighting the role of cognitive patterns in suicidal behaviors.

These results suggest that interventions for suicidality in adolescents should be gender-specific. For men, strategies should focus on recognizing and addressing depressive symptoms and promoting help-seeking behaviors. For women, cognitive-behavioral approaches to reduce rumination might be more beneficial.

IN OTHER PSYCHIATRY AND NEUROLOGY NEWS On the anniversary of JCP’s Focus on Women’s Mental Health section, Marlene P. Freeman reflects on the past 20 years in women’s mental health care, including what’s changed and what hasn’t. A systematic review appearing in Primary Care Companion for CNS Disorders examines the literature on neurobiological mechanisms of obsessive-compulsive symptoms in people with dementia to shed light on the similarities and differences between these symptoms in dementia and OCD. Most cases of major depressive disorder (MDD) remain resistant to initial treatment, prompting exploration into novel treatments like esmethadone, which showed promise in phase 2 trials but failed to achieve its primary efficacy endpoint in a phase 3 trial despite some positive secondary outcomes. The authors shed light on many disturbed eating behaviors that defy existing nosological and taxonomic boundaries and demand further clarification. In this letter to the editor, the authors discuss 2 SSRI-related sexual dysfunction syndromes: post-SSRI sexual dysfunction and persistent genital arousal disorder.