After a positive suicide screen, the follow-up that helped differed by age

The edition in brief

Today's psychiatry edition ends on a pragmatic US trial with a practical message for follow-up after a positive suicide screen. SPARC randomised 723 adolescents and 797 adults, identified in emergency departments and primary care, to instrumental support calls or two-way Caring Contacts texts added to usual care. At 6 months adults had lower suicidal ideation and behaviour scores with support calls; at 12 months adolescents had lower scores with caring texts. Both arms were active, so neither is shown to beat usual care. An umbrella review of 69 meta-analyses graded 221 risk and protective factors for psychotic disorders: six reached convincing evidence, including low birthweight and young paternal age, and the largest population attributable fractions were for childhood adversity, Toxoplasma seropositivity, near-daily cannabis use and the clinical high-risk state. These are associations from observational data. A Danish registry of 67,390 first-trimester abortions found small rises in first psychotropic prescriptions in the year after either method that did not survive correction for multiple testing, and lower rates beyond five years. The FDA recorded a supplement to a generic olanzapine application, which is administrative. The pearl covers what to set up before a patient leaves after a positive suicide screen.