Berta Moreno-Küstner

Suicide risk among university students continues to rise globally, underscoring the need for preventive strategies that cultivate resilience. Gratitude and

Suicide is the fourth leading cause of death worldwide among people aged 15-29 years. These data show the urgent need to address this problem, and literacy is fundamental to doing so. The objective of this study is to determine the level of literacy about suicide and examine differences in literacy scores among students from different subject areas, as well as differences in literacy levels in the presence of psychological problems or suicidal behaviour in personal or family history in an incidental sample of students from the University of Malaga. An incidental sample of 443 students (364 women) was obtained and completed the Literacy of Suicide Scale, short form. It was answered before attending a lecture about suicide (attendance was voluntary). The scores obtained were compared according to the field of study and the presence or absence of a history of psychological problems and suicidal behaviour, both personally and in the family. An exploratory cross-sectional and ex post facto exploratory analysis was applied using Student's test, analysis of variance, Eta squared, and Cohen's d. Analyses performed showed that participants had a high knowledge of suicidal behaviour. By studying the dimensions that make up suicidal behaviour literacy through exploratory cross-sectional and ex post facto analysis, Differences were found in the literacy dimensions, with causes/triggers and signs being the weakest. Students with the highest literacy levels were those in the arts and humanities. Students with psychological problem histories showed higher total literacy, but no differences were found for those with or without suicidal behaviour histories. From the results obtained, it can be concluded that more emphasis should be placed on educating students about the causes and warning signs of suicidal behavior. Likewise, university suicide prevention programs should be designed to reach out to science students in particular. Knowing who to target and what aspects to teach will help practitioners and researchers to design programs that will actually have a positive impact on suicidal behavior literacy in the university population.

Symptoms of depression and anxiety are common among Spanish university students. Minimally guided online interventions have shown promise in reducing symptomatology and preventing increased mental distress. Here we describe the protocol of a controlled study which aims to evaluate the effectiveness of a guided preventive mental health intervention for depression and anxiety in Spanish university students. Ongoing two-arm multicenter randomized controlled trial (RCT) targeting undergraduate students from 6 public universities with symptoms of depression and/or anxiety. Students are evaluated (between February and November 2024) through a web-based survey assessing mental health problems, use of mental health services, self-perceived health, childhood and adolescent adversities, recent stressful events, social networks, university experiences, as well as sociodemographic variables. A total of 428 students, fulfilling the inclusion criteria, are randomly assigned to: intervention group (minimally guided mhealth prevention intervention) or control group (treatment as usual plus self-monitoring including periodic evaluations on mood and stress). The intervention is based on cognitive behavioral therapy principles, such as relaxation and cognitive restructuring, and includes weekly asynchronous feedback from a psychologist based on content and participation, along with self-monitoring. Participants are assessed at baseline, and 3, 6 and 12 months after randomization. The primary outcome consists of the reduction of depressive and/or anxiety symptoms post-intervention, assessed with the Patient Health Questionnaire-9, the Generalized Anxiety Disorder-7 and the Patient Health Questionnaire-Anxiety and Depression Scale. Secondary outcomes of the RCT will be symptoms of other mental health conditions, psychological wellbeing, academic stress, acceptability and adherence. Primary analyses will be conducted on an intention-to-treat basis. The results of the PROMES-U RCT will provide valuable information on the effectiveness of a minimally guided preventive mental health intervention to reduce symptoms of depression and anxiety among university students that could be delivered in the campus context. Results will also provide information on the potential impact of the intervention on other relevant factors involved in mental health among university students and on the acceptability and adherence of this intervention. Trial registration number: NCT06078007.

El II de Prevención de la Conducta Suicida de la Universidad de Málaga 2025-2025 tiene como objetivo general establecer un procedimiento de actuación integral para abordar la problemática del suicidio dentro de la comunidad universitaria desde la sensibilización y formación académica, detección de riesgo de suicidio en grupos vulnerables e intervención en conducta suicida. Y para ello se proponen 8 líneas estratégicas distribuidas en los niveles de prevención universal, selectiva e indicada. Por lo tanto, este nuevo Plan supone la consolidación de lo realizado anteriormente en el I Plan de Prevención de la Conducta Suicida de la Universidad de Málaga 2022-2024 ampliando su actuación en 15 acciones las cuales se irán desarrollando de forma sucesiva, a lo largo del periodo de implementación del mismo. Este plan ha sido aprobado en Consejo de Gobierno de la Universidad de Málaga el 22 de julio de 2025 y cuenta con el apoyo institucional del Vicerrectorado de Igualdad, Política Social y Bienestar Educativo y la Facultad de Psicología y Logopedia de la Universidad de Málaga.

Early readmission to psychiatric units poses a significant challenge for both patients and healthcare institutions. It hampers patient progress and prognosis, and the professional approach taken during discharge can greatly influence the recovery process. This paper proposes a multicomponent discharge transition intervention to mitigate the risk of early readmission to a mental health hospitalization unit (MHHU). The present proposal consists of two distinct phases with two clearly differentiated main objectives. On the one hand, following an observational design, the development of a measurement instrument to assess patients’ risk of early readmission, allowing for stratification into the high-, medium-, and low-risk categories. On the other hand, according to a quasi-experimental design, the implementation and evaluation of the intervention program, with a focus on tailored interventions to ensure adherence and continuity of care post-discharge, with a more intensive approach for high-risk patients. A post-discharge psychotherapeutic group will also be introduced for high-risk cases to support recovery. The program’s effectiveness will be evaluated by comparing the early readmission rates at the Regional Hospital of Malaga’s MHHU to those of the previous year. Two other hospitals in the province, where the intervention is not applied, will serve as control groups. Success will also be measured through pre- and post-assessments of the recovery, functionality, subjective well-being, social support, and treatment satisfaction of those participating in the psychotherapeutic group. This proposal aims to address the issue of early readmission by enhancing predictability and understanding intervention strategies to reduce readmission rates.

PREVENSAP es el protocolo de actuación del SAP de la UMA ante la conducta suicida. Este protocolo está dirigido a psicólogos sanitarios (profesionales del servicio y alumnado en formación) y especialistas en psicología clínica del SAP de la UMA con el propósito de aportarles un marco de actuación ante personas del colectivo universitario (Personal de Administración y Servicio- PAS, Personal Docente e Investigador-PDI o estudiantado) en riesgo y/o con conducta suicida. Los terapeutas del SAP han de entrenarse mediante la revisión de este protocolo, la participación en reuniones clínicas y la supervisión/consulta con otros profesionales de cara a ofrecer un óptimo acompañamiento. Así, su propósito se sitúa tanto en el nivel de prevención secundaria o selectiva (dirigido a personas de la comunidad universitaria en situación de riesgo de conducta suicida) como de prevención terciaria o indicada (al delimitar también pautas de actuación ante personas de la comunidad universitaria con alto riesgo de realizar un intento de suicidio). En línea con lo anterior, PREVENSAP persigue los siguientes objetivos: a) Establecer pautas comunes de actuación ante situaciones de riesgo de conducta suicida en el contexto universitario para poder ofrecer una detección precoz, una atención efectiva y seguimiento proactivo de las personas que lo requieran. b) Orientar la toma de decisiones y la evaluación de las intervenciones enmarcadas en el protocolo. c) Promover una adecuada valoración, abordaje y seguimiento de las personas con conducta suicida atendidas en el SAP de la UMA. d) Facilitar y orientar la coordinación del SAP con otros servicios asistenciales, a fin de optimizar la integración de los recursos disponibles y poder dotar a las personas de un adecuado acompañamiento, asegurando la continuidad asistencial en el abordaje. e) Optimizar la calidad asistencial del SAP de la UMA a personas con conducta suicida.

Background: The aims of this study were to describe the use of health services by patients attended for suicidal behavior by out-of-hospital emergency services and to identify the variables associated with the repetition of this behavior in Spain.Methods: An analytical, observational, retrospective study was carried out. A total of 554 patients attended by the mobile teams of the Primary Care Emergency (mt-PCES) of the Malaga Health District (Spain), after being coordinated by the 061 Emergency Coordination Center (ECC) were analyzed.Results: Of the total, 61.9% of the patients were women and the mean age was 43.5 years. Ninety-six percent (N = 532) of the patients attended by mt-PCES were transferred to hospital emergency services. Regarding clinical decision, of those transferred 436 persons (82%) were discharged home. Of the total sample 25.5% (N = 141) were referred to primary care, while 69% (N = 382) were referred to outpatient mental health care. Regarding follow up in the 6 months after being seen by emergency services, among those referred to a mental health facility, 64.4% (N = 246) attended the follow-up appointment while out of the total sample only 50.5% (N = 280) attended a follow-up appointment with an outpatient mental health service. Finally, it should be noted that 23.3% presented a relapse of suicidal behavior in the 6 months following index episode. The variables associated with repetition of suicidal behavior were older age, greater number of previous suicide attempts and having any contact with mental health services in the following 6 months.Conclusion: We believe that selective suicide prevention initiatives should be designed to target the population at risk of suicide, especially those receiving both out-of-hospital and in-hospital emergency services.

Background: The aim of this systematic review was to examine the classification of calls for suicidal behavior in emergency medical services (EMS). Methods: A search strategy was carried out in four electronic databases on calls for suicidal behavior in EMS published between 2010 and 2020 in Spanish and English. The outcome variables analyzed were the moment of call classification, the professional assigning the classification, the type of classification, and the suicide codes. Results: Twenty-five studies were included in the systematic review. The EMS classified the calls at two moments during the service process. In 28% of the studies, classification was performed during the emergency telephone call and in 36% when the professional attended the patient at the scene. The calls were classified by physicians in 40% of the studies and by the telephone operator answering the call in 32% of the studies. In 52% of the studies, classifications were used to categorize the calls, while in 48%, this information was not provided. Eighteen studies (72%) described codes used to classify suicidal behavior calls: a) codes for suicidal behavior and self-injury, and b) codes related to intoxication, poisoning or drug abuse, psychiatric problems, or other methods of harm. Conclusion: Despite the existence of international disease classifications and standardized suicide identification systems and codes in EMS, there is no consensus on their use, making it difficult to correctly identify calls for suicidal behavior.

This study investigates, for the first time, clinical, cognitive, social cognitive and metacognitive differences in people diagnosed with first-episode of psychosis (FEP) with and without a family history of mental disorder split by maternal and paternal antecedents. A total of 186 individuals with FEP between 18 and 45 years old were recruited in community mental-health services. A transversal, descriptive, observational design was chosen for this study. Results suggest that there is a higher prevalence of maternal history of psychosis rather than paternal, and furthermore, these individuals exhibit a specific clinical, social and metacognitive profile. Individuals with a maternal history of mental disorder scored higher in delusional experiences, inhibition of the response to a stimulus and higher emotional irresponsibility while presenting a poorer overall functioning as compared to individuals without maternal history. Individuals with paternal history of mental disorder score higher in externalizing attributional bias, irrational beliefs of need for external validation and high expectations. This study elucidates different profiles of persons with FEP and the influence of the maternal and paternal family history on clinical, cognitive, social and metacognitive variables, which should be taken into account when offering individualized early treatment.