Background: Every year, more than 800,000 people die by suicide, three‐quarters of which are males. Economic factors influence suicide rates, but a worldwide perspective of their impact according to age and sex is lacking.Method: We queried publicly available datasets on economic factors and on suicide rates stratified according to sex and age, from 1991 to 2017, for 175 countries. Thus, we analyzed approximately 21 million deaths by suicide using a multivariable regression model approach.Results: Every 1% increase in global unemployment rates is associated with a 1% upsurge in male deaths by suicide (Relative risk (RR) = 1.01 [CI 95% 1.00–1.01] with respect to females) or 5000 excess male deaths. A 1% higher unemployment rate also exerts age‐specific effects on suicide rates, since, among adults aged 30–59, the suicide rate is increased by 2–3%. Lastly, for every 1000 US dollar increase in the GDP per capita, suicide rates are reduced by 2% (RR = 0.98 [0.98–0.98]), corresponding to a reduction of 14,000–15,000 suicide deaths per year globally.Conclusions: Males who have lost their jobs in adulthood are those at higher risk of suicide and to whom financial support measures should be delivered in a timely manner.

Aims: Prospective studies on the mental health of university students highlighted a major concern. Specifically, young adults in academia are affected by markedly worse mental health status than their peers or adults in other vocations. This situation predisposes to exacerbated disability-adjusted life-years. Methods: We enroled 1,388 students at the baseline, 557 of whom completed follow-up after 6 months, incorporating their demographic information and self-report questionnaires on depressive, anxiety and obsessive–compulsive symptoms. We applied multiple regression modelling to determine associations – at baseline – between demographic factors and self-reported mental health measures and supervised machine learning algorithms to predict the risk of poorer mental health at follow-up, by leveraging the demographic and clinical information collected at baseline. Results: Approximately one out of five students reported severe depressive symptoms and/or suicidal ideation. An association of economic worry with depression was evidenced both at baseline (when high-frequency worry odds ratio = 3.11 [1.88–5.15]) and during follow-up. The random forest algorithm exhibited high accuracy in predicting the students who maintained well-being (balanced accuracy = 0.85) or absence of suicidal ideation but low accuracy for those whose symptoms worsened (balanced accuracy = 0.49). The most important features used for prediction were the cognitive and somatic symptoms of depression. However, while the negative predictive value of worsened symptoms after 6 months of enrolment was 0.89, the positive predictive value is basically null. Conclusions: Students’ severe mental health problems reached worrying levels, and demographic factors were poor predictors of mental health outcomes. Further research including people with lived experience will be crucial to better assess students’ mental health needs and improve the predictive outcome for those most at risk of worsening symptoms.

Objectives: A third of people suffering from major depressive disorder do not experience a significant improvement in their symptoms even after adequate treatment with two different antidepressant medications. This common condition, termed treatment‐resistant depression (TRD), severely affects the quality of life of millions of people worldwide, causing long‐lasting interpersonal problems and social costs. Given its epidemiological and clinical relevance and the little consensus on whether the neurobiological underpinnings of TRD differ from treatment‐sensitive depression (TSD), we sought to highlight the convergent morphometric and functional neuroimaging correlates of TRD.Methods: We systematically reviewed the published literature on structural and resting‐state functional neuroimaging of TRD compared to TSD and healthy controls (HC) and performed exploratory coordinate‐based meta‐analyses (CBMA) of significant results separately for each modality and multimodally (“all‐effects”). CBMAs were also performed for each direction and combining both directions of group contrasts.Results: Out of the initial 1929 studies, only eight involving 555 participants (189 patients with TRD, 156 with TSD, and 210 HC) were included. In all‐effects CBMA, precentral/superior frontal gyrus showed a significant difference between TRD and HC. Functional and structural imaging meta‐analyses did not yield statistically significant results. A marginally significant cluster of altered intrinsic activity was found between TRD and HC in the cerebellum/pons.Conclusions: Frontal, cerebellar, and brainstem functions can be involved in the pathophysiology of TRD. However, the design and heterogeneity of the (scarce) published literature hinder the generalizability of the findings.

During recent decades, model organisms such as Drosophila melanogaster have made it possible to study the effects of different environmental oxygen conditions on lifespan and oxidative stress. However, many studies have often yielded controversial results usually assigned to variations in Drosophila genetic background and differences in study design. In this study, we compared longevity and ROS levels in young, unmated males of three laboratory wild-type lines (Canton-S, Oregon-R and Berlin-K) and one mutant line (Sod1n1) as a positive control of redox imbalance, under both normoxic and hypoxic (2% oxygen for 24 h) conditions. Lifespan was used to detect the effects of hypoxic treatment and differences were analysed by means of Kaplan–Meier survival curves and log-rank tests. Electron paramagnetic resonance spectroscopy was used to measure ROS levels and analysis of variance was used to estimate the effects of hypoxic treatment and to assess ROS differences between strains. We observed that the genetic background is a relevant factor involved in D. melanogaster longevity and ROS levels. Indeed, as expected, in normoxia Sod1n1 are the shortest-lived, while the wild-type strains, despite a longer lifespan, show some differences, with the Canton-S line displaying the lowest mortality rate. After hypoxic stress these variances are amplified, with Berlin-K flies showing the highest mortality rate and most evident reduction of lifespan. Moreover, our analysis highlighted differential effects of hypoxia on redox balance/unbalance. Canton-S flies had the lowest increase of ROS level compared to all the other strains, confirming it to be the less sensitive to hypoxic stress. Sod1n1 flies displayed the highest ROS levels in normoxia and after hypoxia. These results should be used to further standardize future Drosophila research models designed to investigate genes and pathways that may be involved in lifespan and/or ROS, as well as comparative studies on specific mutant strains.

A growing number of studies support a bidirectional relationship between inflammation and bipolar disorders. Tumor necrosis factor‐α (TNF‐α) inhibitors have recently attracted interest as potential therapeutic compounds for treating depressive symptoms, but the risk for triggering mood switches in patients with or without bipolar disorders remains controversial. Thus, we conducted a systematic review to study the anti‐TNF‐α medication‐induced manic or hypomanic episodes. PubMed, Scopus, Medline, and Embase databases were screened for a comprehensive literature search from inception until November 2020, using The Preferred Reporting Items for Systematic Reviews and Meta‐Analyses guidelines. Out of the initial 75 references, the screening resulted in the inclusion of four case reports (each describing one patient) and a cohort study (in which 40 patients out of 7600–0.53% – experienced elated mood episodes after infliximab administration). Of these 44 patients, 97.7% experienced a manic episode and 2.3% hypomania. 93.2% of patients had no history of psychiatric disorder or psychotropic treatment. Only 6.8% had a history of psychiatric disorders with the affective spectrum (4.6% dysthymia and 2.3% bipolar disorder). The time of onset of manic or hypomanic symptoms varied across TNF‐α inhibitors with an early onset for Infliximab and a later onset for Adalimumab and Etanercept. These findings suggest that medications targeting the TNF‐α pathway may trigger a manic episode in patients with or without affective disorders. However, prospective studies are needed to evaluate the relative risk of such side effects and identify the population susceptible to secondary mania.