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Mo L, Li H, Zhu T. Exploring the Suicide Mechanism Path of High-Suicide-Risk Adolescents-Based on Weibo Text Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11495. [PMID: 36141767 PMCID: PMC9517096 DOI: 10.3390/ijerph191811495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Revised: 09/06/2022] [Accepted: 09/09/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Adolescent suicide can have serious consequences for individuals, families and society, so we should pay attention to it. As social media becomes a platform for adolescents to share their daily lives and express their emotions, online identification and intervention of adolescent suicide problems become possible. In order to find the suicide mechanism path of high-suicide-risk adolescents, we explore the factors that influence is, especially the relations between psychological pain, hopelessness and suicide stages. METHODS We identified high-suicide-risk adolescents through machine learning model identification and manual identification, and used the Weibo text analysis method to explore the suicide mechanism path of high-suicide-risk adolescents. RESULTS Qualitative analysis showed that 36.2% of high-suicide-risk adolescents suffered from mental illness, and depression accounted for 76.3% of all mental illnesses. The mediating effect analysis showed that hopelessness played a complete mediating role between psychological pain and suicide stages. In addition, hopelessness was significantly negatively correlated with suicide stages. CONCLUSION mental illness (especially depression) in high-suicide-risk adolescents is closely related to suicide stages, the later the suicide stage, the higher the diagnosis rate of mental illness. The suicide mechanism path in high-suicide-risk adolescents is: psychological pain→ hopelessness → suicide stages, indicating that psychological pain mainly affects suicide risk through hopelessness. Adolescents who are later in the suicide stages have fewer expressions of hopelessness in the traditional sense.
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Affiliation(s)
- Liuling Mo
- Institute of Psychology, Chinese Academy of Sciences, Beijing 100101, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing 100049, China
| | - He Li
- Institute of Psychology, Chinese Academy of Sciences, Beijing 100101, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing 100049, China
| | - Tingshao Zhu
- Institute of Psychology, Chinese Academy of Sciences, Beijing 100101, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing 100049, China
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Niu GF, Shi XH, Yao LS, Yang WC, Jin SY, Xu L. Social Exclusion and Depression among undergraduate students: the mediating roles of rejection sensitivity and social self-efficacy. CURRENT PSYCHOLOGY 2022; 42:1-10. [PMID: 35935745 PMCID: PMC9345737 DOI: 10.1007/s12144-022-03318-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 04/22/2022] [Accepted: 06/05/2022] [Indexed: 12/30/2022]
Abstract
Nowadays, depression has been a prominent mental health problem throughout the world. A common but negative social experience, social exclusion (also known as ostracism) is a great risk factor for individuals' health and adaptation. Undergraduate students are in a development period of challenges and transitions, so they are vulnerable to suffering from depression and negative social experiences. Against this background, the present study aimed to examine the association between social exclusion and undergraduate students' depression as well as the underlying mechanism - the mediating roles of rejection sensitivity and social self-efficacy. Seven hundred sixty-two undergraduate students were recruited to participate in this study, who were asked to complete a set of questionnaires measuring social exclusion, depression, rejection sensitivity, and social self-efficacy. After controlling for gender, social exclusion was positively associated with undergraduate students' depression. And rejection sensitivity and social self-efficacy could significantly mediate this relation through three mediating paths - the separate mediating effects of rejection sensitivity and social self-efficacy, as well as the serial mediating effect of rejection sensitivity and social self-efficacy. These results could not only deepen our understanding of this theme, but also have several practical implications for the intervention of depression, for example, relevant social skill training and cognitive therapy could be adopted to intervene the rejection sensitivity and social self-efficacy.
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Affiliation(s)
- Geng-feng Niu
- School of Psychology, Central China Normal University, 430079 Wuhan, China
- Key Laboratory of Adolescent Cyberpsychology and Behavior (CCNU), Ministry of Education, 430079 Wuhan, China
- Center for Research on Internet Literacy and Behavior, Central China Normal University, 430079 Wuhan, China
- Collaborative Innovation Center of Assessment toward Basic Education Quality, Central China Normal University Branch, 430079 Wuhan, China
| | - Xiao-han Shi
- School of Psychology, Central China Normal University, 430079 Wuhan, China
- Key Laboratory of Adolescent Cyberpsychology and Behavior (CCNU), Ministry of Education, 430079 Wuhan, China
| | - Liang-shuang Yao
- School of Psychology, Central China Normal University, 430079 Wuhan, China
- Key Laboratory of Adolescent Cyberpsychology and Behavior (CCNU), Ministry of Education, 430079 Wuhan, China
| | - Wen-cheng Yang
- School of Psychology, Central China Normal University, 430079 Wuhan, China
- Key Laboratory of Adolescent Cyberpsychology and Behavior (CCNU), Ministry of Education, 430079 Wuhan, China
| | - Si-yu Jin
- School of Psychology, Central China Normal University, 430079 Wuhan, China
- Key Laboratory of Adolescent Cyberpsychology and Behavior (CCNU), Ministry of Education, 430079 Wuhan, China
| | - Lei Xu
- School of Education, Jianghan University, 430056 Wuhan, China
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53
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Üzer A, Kurtses Gürsoy B. The mediating roles of depression, anxiety, and psychological pain in the relationship between chronotype and suicide in patients with depressive disorder. Chronobiol Int 2022; 39:1352-1358. [PMID: 35920256 DOI: 10.1080/07420528.2022.2108438] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
The evening chronotype has been associated with depressive symptoms and suicidality; however, the underlying mechanisms are still under investigation. Research has shown that psychological pain, or feelings of suffering, is closely related to suicidality. Therefore, the aim of the study is to determine whether psychological pain, anxiety, and depressive symptoms mediate the association between chronotype and depressive symptoms in patients with depression and in healthy controls. A total of 118 patients with depressive disorder and 85 healthy controls completed the Morningness-Eveningness Questionnaire, the Hospital Anxiety and Depression Scale, the Suicide Probability Scale, and the Mee-Bunney Psychological Pain Assessment Scale. Mediation analysis revealed that the relationship between eveningness and suicidality was fully mediated by depression and psychological pain and not by anxiety. These findings highlight that psychological pain is an important psychological dimension in the relationship between eveningness and suicidality.
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Affiliation(s)
- Ahmet Üzer
- Faculty of Medicine, Department of Psychiatry, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey
| | - Betül Kurtses Gürsoy
- Faculty of Medicine, Department of Psychiatry, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey
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54
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shoib S, Hussaini SS, Chandradasa M, Saeed F, Khan T, Swed S, Lengvenyte A. Role of pets and animal assisted therapy in suicide prevention. Ann Med Surg (Lond) 2022; 80:104153. [PMID: 36045797 PMCID: PMC9422226 DOI: 10.1016/j.amsu.2022.104153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Revised: 07/03/2022] [Accepted: 07/06/2022] [Indexed: 12/01/2022] Open
Affiliation(s)
- Sheikh shoib
- Department of Psychiatry, Jawahar Lal Nehru Memorial Hospital, Srinagar, Kashmir, India
| | | | | | - Fahimeh Saeed
- Department of Psychiatry, Psychosis Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Tuba Khan
- Md, ziauddin university, Karachi, Pakistan
| | - Sarya Swed
- Faculty of Medicine, Aleppo University, Aleppo, Syria
- Corresponding author.
| | - Aiste Lengvenyte
- IGF, University of Montpellier, CNRS, INSERM, Montpellier, France
- Faculty of Medicine, Institute of Clinical Medicine, Psychiatric Clinic, Vilnius University, Vilnius, Lithuania
- Department of Urgent and Post Urgent Psychiatry, CHU Montpellier, Montpellier, France
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55
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Ihme H, Olié E, Courtet P, El-Hage W, Zendjidjian X, Mazzola-Pomietto P, Consoloni JL, Deruelle C, Belzeaux R. Childhood trauma increases vulnerability to attempt suicide in adulthood through avoidant attachment. Compr Psychiatry 2022; 117:152333. [PMID: 35714412 DOI: 10.1016/j.comppsych.2022.152333] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 05/14/2022] [Accepted: 06/02/2022] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Childhood trauma and affective disorders are known risk factors for adult suicidal behavior. Studies have shown a mediating effect of insecure attachment on the effect of childhood trauma and suicidal behavior but so far it is not clear whether this effect is related to an attachment dimension (anxiety, avoidance). AIM The present study sought to examine the mediating effect of attachment anxiety and avoidance on suicidal behavior. METHODS We analyzed data on childhood trauma, attachment style, depression severity, presence of prior suicide attempts and current suicide ideation from 96 patients diagnosed with an affective disorder. Two mediation analyses were conducted to assess the effect of childhood trauma on 1) prior suicide attempts and 2) current suicidal ideation through its effect on attachment. RESULTS We found that childhood trauma had a complete mediated effect on the presence of prior suicide attempts through its effect on avoidant attachment (a1b1 = 0.0120, 95%-CI [0.0031, 0.0276]). However, only emotional abuse had a direct influence on suicidal ideation (c' = 0.0273, p < 0.01) without any indirect effect of anxious or avoidant attachment. LIMITATIONS Variables were not assessed in a prospective way and sample size was small. CONCLUSIONS Our findings suggest that individuals with avoidant attachment and childhood trauma are likely to present a high suicide risk. Since avoidant attachment is associated with altered perceptions and eventual rejection of social support, we recommend to screen for attachment early and to engage patients in therapeutical approaches focusing on the client-therapist alliance.
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Affiliation(s)
- H Ihme
- Institut de Neurosciences de la Timone, UMR 7289, Aix Marseille Université, CNRS, Marseille, France
| | - E Olié
- IGF, Univ. Montpellier, CNRS, INSERM, Montpellier, France; Departement of Emergency Psychiatry and Acute Care, Lapeyronie Hospital, CHU Montpellier, Montpellier, France; FondaMental Foundation, Créteil, France
| | - P Courtet
- IGF, Univ. Montpellier, CNRS, INSERM, Montpellier, France; Departement of Emergency Psychiatry and Acute Care, Lapeyronie Hospital, CHU Montpellier, Montpellier, France; FondaMental Foundation, Créteil, France
| | - W El-Hage
- CIC 1415, CHRU de Tours, Inserm, Tours, France; UMR 1253, iBrain, Université de Tours, Inserm, Tours, France; CHRU de Tours, Centre Régional de Psychotraumatologie CVL, Tours, France
| | - X Zendjidjian
- Department of Psychiatry, Assistance Publique Hôpitaux de Marseille, Marseille, France; Aix-Marseille University, CEReSS-Health Service Research and Quality of Life Center, Marseille, France
| | - P Mazzola-Pomietto
- Institut de Neurosciences de la Timone, UMR 7289, Aix Marseille Université, CNRS, Marseille, France
| | - J-L Consoloni
- FondaMental Foundation, Créteil, France; Department of Psychiatry, Assistance Publique Hôpitaux de Marseille, Marseille, France
| | - C Deruelle
- Institut de Neurosciences de la Timone, UMR 7289, Aix Marseille Université, CNRS, Marseille, France
| | - R Belzeaux
- Institut de Neurosciences de la Timone, UMR 7289, Aix Marseille Université, CNRS, Marseille, France; FondaMental Foundation, Créteil, France; Department of Psychiatry, Assistance Publique Hôpitaux de Marseille, Marseille, France.
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Lai WD, Li DM, Yu J, Huang L, Zheng MZ, Jiang YP, Wang S, Wen JJ, Chen SJ, Wen CP, Jin Y. An Apriori Algorithm-Based Association Analysis of Analgesic Drugs in Chinese Medicine Prescriptions Recorded From Patients With Rheumatoid Arthritis Pain. FRONTIERS IN PAIN RESEARCH 2022; 3:937259. [PMID: 35959238 PMCID: PMC9358686 DOI: 10.3389/fpain.2022.937259] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 06/21/2022] [Indexed: 11/13/2022] Open
Abstract
Chronic pain, a common symptom of people with rheumatoid arthritis, usually behaves as persistent polyarthralgia pain and causes serious damage to patients' physical and mental health. Opioid analgesics can lead to a series of side effects like drug tolerance and addiction. Thus, seeking an alternative therapy and screening out the corresponding analgesic drugs is the key to solving the current dilemma. Traditional Chinese Medicine (TCM) therapy has been recognized internationally for its unique guiding theory and definite curative effect. In this study, we used the Apriori Algorithm to screen out potential analgesics from 311 cases that were treated with compounded medication prescription and collected from “Second Affiliated Hospital of Zhejiang Chinese Medical University” in Hangzhou, China. Data on 18 kinds of clinical symptoms and 16 kinds of Chinese herbs were extracted based on this data mining. We also found 17 association rules and screened out four potential analgesic drugs—“Jinyinhua,” “Wugong,” “Yiyiren,” and “Qingfengteng,” which were promised to help in the clinical treatment. Besides, combined with System Cluster Analysis, we provided several different herbal combinations for clinical references.
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Affiliation(s)
- Wei-dong Lai
- The Second Clinical Medical College of Zhejiang Chinese Medical University, Hangzhou, China
- College of Basic Medical Science, Zhejiang Chinese Medical University, Hangzhou, China
| | - Dian-ming Li
- College of Basic Medical Science, Zhejiang Chinese Medical University, Hangzhou, China
| | - Jie Yu
- College of Basic Medical Science, Zhejiang Chinese Medical University, Hangzhou, China
| | - Lin Huang
- College of Basic Medical Science, Zhejiang Chinese Medical University, Hangzhou, China
| | - Ming-zhi Zheng
- Hangzhou AI Center, China Academy of Information and Communications Technology, Hangzhou, China
| | - Yue-peng Jiang
- The Second Clinical Medical College of Zhejiang Chinese Medical University, Hangzhou, China
- College of Basic Medical Science, Zhejiang Chinese Medical University, Hangzhou, China
| | - Song Wang
- The Second Clinical Medical College of Zhejiang Chinese Medical University, Hangzhou, China
- College of Basic Medical Science, Zhejiang Chinese Medical University, Hangzhou, China
| | - Jun-jun Wen
- The Second Clinical Medical College of Zhejiang Chinese Medical University, Hangzhou, China
- College of Basic Medical Science, Zhejiang Chinese Medical University, Hangzhou, China
| | - Si-jia Chen
- The Second Clinical Medical College of Zhejiang Chinese Medical University, Hangzhou, China
- College of Basic Medical Science, Zhejiang Chinese Medical University, Hangzhou, China
| | - Cheng-ping Wen
- The Second Clinical Medical College of Zhejiang Chinese Medical University, Hangzhou, China
- College of Basic Medical Science, Zhejiang Chinese Medical University, Hangzhou, China
- *Correspondence: Cheng-ping Wen
| | - Yan Jin
- The Second Clinical Medical College of Zhejiang Chinese Medical University, Hangzhou, China
- College of Basic Medical Science, Zhejiang Chinese Medical University, Hangzhou, China
- Yan Jin
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Childhood maltreatment and depressive symptoms among Chinese college students: A moderated mediation model of adult attachment styles and physical activity. J Affect Disord 2022; 309:63-70. [PMID: 35461818 DOI: 10.1016/j.jad.2022.04.100] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 04/09/2022] [Accepted: 04/13/2022] [Indexed: 11/22/2022]
Abstract
BACKGROUND Previous research has investigated the independent effects of childhood maltreatment, adult attachment, and physical activity, on depressive symptoms. However, explanatory mechanisms linking childhood maltreatment to current depressive symptoms are poorly understood. This study investigated the mediating role of adult attachment between childhood maltreatment and depressive symptoms among college students and explored the moderating effect of physical activity in the mediating pathway. METHODS The data for the present study were gathered in three waves with 6-month lags. A total of 3662 Chinese college students completed anonymous questionnaires concerning demographic variables, childhood maltreatment, and depressive symptoms in Wave 1, adult attachment and physical activity in Wave 2, and depressive symptoms in Wave 3. RESULTS Childhood maltreatment and adult attachment were significantly associated with depressive symptoms, identifying a mediating role of adult attachment in the relationship between childhood maltreatment and depressive symptoms, and a moderating role of physical activity between attachment anxiety and depressive symptoms in the mediating pathway. LIMITATIONS This study utilized self-reported questionnaires for data collection purposes, which could constitute key study limitations. CONCLUSIONS These findings highlight the need to consider early stress factors (childhood maltreatment), social psychological factors (adult attachment), and potential protective factors (physical activity) simultaneously when evaluating the occurrence and development of depressive symptoms.
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58
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Peele M, Schnittker J. The Nexus of Physical and Psychological Pain: Consequences for Mortality and Implications for Medical Sociology. JOURNAL OF HEALTH AND SOCIAL BEHAVIOR 2022; 63:210-231. [PMID: 34964387 DOI: 10.1177/00221465211064533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Although physical pain lies at the intersection of biology and social conditions, a sociology of pain is still in its infancy. We seek to show how physical and psychological pain are jointly parts of a common expression of despair, particularly in relation to mortality. Using the 2002-2014 National Health Interview Survey Linked Mortality Files (N = 228,098), we explore sociodemographic differences in the intersection of physical and psychological pain (referred to as the "pain-distress nexus") and its relationship to mortality among adults ages 25 to 64. Results from regression and event history models reveal that differences are large for the combination of the two, pointing to an overlooked aspect of health disparities. The combination of both high distress and high pain is most prevalent and most strongly predictive of mortality among socioeconomically disadvantaged, non-Hispanic whites. These patterns have several implications that medical sociology is well positioned to address.
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Affiliation(s)
- Morgan Peele
- Population Studies Center, University of Pennsylvania, Philadelphia, PA, USA
| | - Jason Schnittker
- Sociology at the University of Pennsylvania, Philadelphia, PA, USA
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59
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Sun Z, Lin J, Zhang Y, Yao Y, Huang Z, Zhao Y, Zhang P, Fu S. Association between immunoglobulin A and depression in Chinese older adults: findings from a cross-sectional study. Immun Ageing 2022; 19:21. [PMID: 35606877 PMCID: PMC9125820 DOI: 10.1186/s12979-022-00283-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Accepted: 05/14/2022] [Indexed: 11/10/2022]
Abstract
BACKGROUND Depression is considered to be an immune-related disease; however, previous studies have focused on inflammatory factors, and there is no conclusive conclusion on the relationships between immunoglobulins and depression. Therefore, the objective of this cross-sectional study was to evaluate the associations between immunoglobulins and depressive symptoms in Chinese older adults. RESULTS The China Hainan Centenarian Cohort Study (CHCCS) provides a significant population-based sample of older adults in Hainan, China. A total of 1547 older adults were included in this study. A baseline survey was conducted using a structured questionnaire. Blood samples were obtained following standard procedures. The Geriatric Depression Scale (GDS-15) was used to evaluate depressive symptoms of the participants. This sample of older adults had a median age of 94.75 (range: 80-116) years, and the proportion of women was 72.07%. The prevalence of older adults with depressive symptoms was 20.36% (315 older adults). After adjusting for all covariates, we found that immunoglobulin A levels were positively associated with depression. The adjusted reliability of the association between immunoglobulin A and depression was 0.106 (beta) and 1.083 (odds ratio) (P < 0.05 for both). CONCLUSIONS The present study provides epidemiological evidence that depression has significant associations with immunoglobulin A levels in older adults. Further research should be conducted on the effects of regulating immunoglobulin A to improve depressive symptoms.
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Affiliation(s)
- Zhigao Sun
- Traditional Chinese Medicine Department, Hainan Hospital of Chinese People’s Liberation Army General Hospital, Sanya, China
| | - Jieqiong Lin
- Department of Pathology, Fujian Medical University Cancer Hospital, Fujian Cancer Hospital, Fuzhou, China
| | - Yujie Zhang
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, China
| | - Yao Yao
- Center for the Study of Aging and Human Development and Geriatrics Division, Medical School of Duke University, Durham, NC USA
- Center for Healthy Aging and Development Studies, National School of Development, Peking University, Beijing, China
| | - Zhenjun Huang
- Traditional Chinese Medicine Department, Hainan Hospital of Chinese People’s Liberation Army General Hospital, Sanya, China
| | - Yali Zhao
- Central Laboratory, Hainan Hospital of Chinese People’s Liberation Army General Hospital, Sanya, China
| | - Pei Zhang
- School of Life Science, Beijing Institute of Technology, Beijing, China
| | - Shihui Fu
- Department of Cardiology, Hainan Hospital of Chinese People’s Liberation Army General Hospital, Sanya, China
- Department of Geriatric Cardiology, Chinese People’s Liberation Army General Hospital, Beijing, China
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Muruthi JR, Spafford SG, Osa ML, DeLouize A, Kowal P, Biritwum R, Snodgrass JJ. Suicidal ideation in older Ghanaian women: The roles of bodily pain, functional limitation, and chronic health conditions. Int J Soc Psychiatry 2022; 68:555-563. [PMID: 33541175 DOI: 10.1177/0020764021991179] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Although approximately 79% of the world's suicides occur in low- and middle-income countries (LMICs), the limited research in these regions has primarily focused on the rates of suicide attempts (SA) and ideation among men and younger members of the population. AIM This study investigated the associations between bodily pain, functional limitation, chronic health conditions, and suicidal ideation among older Ghanaian women with a positive screen for depression. METHODS Data was obtained from the World Health Organization's Study on global AGEing and adult health (SAGE) Ghana Wave 1, a nationally representative sample. Based on the interpersonal theory of suicide, we used logistic regression analysis to investigate the associations between the variables. RESULTS Functional limitation, bodily pain, hopelessness, and hypertension were significantly associated with a higher risk of suicidal ideation after accounting for sociodemographic and other confounding factors. CONCLUSIONS Early interventions designed to decrease hopelessness, hypertension, and functional limitations may lead to reduced suicide ideation among older Ghanaian women who screen positive for depression.
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Affiliation(s)
- James R Muruthi
- Department of Counseling Psychology and Human Services, University of Oregon, Eugene, USA
| | - Sarah G Spafford
- Department of Counseling Psychology and Human Services, University of Oregon, Eugene, USA
| | - Maggie L Osa
- Department of Counseling Psychology and Human Services, University of Oregon, Eugene, USA
| | - Alicia DeLouize
- Department of Anthropology, University of Oregon, Eugene, USA
| | - Paul Kowal
- Department of Anthropology, University of Oregon, Eugene, USA
| | - Richard Biritwum
- Department of Community Health, University of Ghana, Legon, Greater Accra, Ghana
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Do tenants suffer from status syndrome? Homeownership, norms, and suicide in Belgium. DEMOGRAPHIC RESEARCH 2022. [DOI: 10.4054/demres.2022.46.16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Hinze V, Karl A, Ford T, Gjelsvik B. Pain and suicidality in children and adolescents: a longitudinal population-based study. Eur Child Adolesc Psychiatry 2022:10.1007/s00787-022-01963-2. [PMID: 35235043 PMCID: PMC10326152 DOI: 10.1007/s00787-022-01963-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Accepted: 02/16/2022] [Indexed: 11/30/2022]
Abstract
Suicidality is a common public health concern in young people. Previous research has highlighted pain as a key correlate of suicidality in young people. However, the long-term experience of pain may vary between individuals, and the relationship between distinct pain trajectories and suicidality is poorly understood. This study aims to describe the number and nature of distinct pain trajectories, their demographic and clinical correlates, including baseline suicidality, and whether identified pain trajectories may predict future suicidality. Secondary data analyses were performed, using longitudinal data from the British Child and Adolescent Mental Health Survey (N = 7977), collected at five timepoints between 2004 and 2007 on a population-based sample of UK youth (5-16 years). Data were collected from up to three respondents (parents, teachers, and 11 + year-olds). Latent Class Growth Analysis was used to identify distinct pain trajectories, explore predictors of these trajectories, and establish whether trajectories predicted future suicidality. We identified the following four pain trajectories: increasing (33.6%), decreasing (4.5%), persistent/recurrent probability of pain (15.7%), and no pain (46.2%). Pain trajectories were associated with unique demographic and clinical correlates. Only the persistent/recurrent (vs. no-pain) trajectory was predicted by baseline suicidality (aOR = 2.24; 95% bootstrap-CI = 1.59-3.26). Furthermore, the persistent/recurrent trajectory predicted future suicidality (aOR = 1.03, 95% bootstrap-CI = 1.01-1.06), after controlling for baseline suicidality, psychiatric disorder, age, and gender. Findings provide a better understanding of correlates associated with distinct pain trajectories and long-term risk of suicidality in young people, suggesting a bidirectional pain-suicidality association and emphasising the need of targeted support for young people with persistent/recurrent pain.
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Affiliation(s)
- Verena Hinze
- Department of Psychiatry, University of Oxford, Warneford Lane, Oxford, OX3 7JX, UK.
| | - Anke Karl
- Department of Psychology, University of Exeter, Exeter, UK
| | - Tamsin Ford
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - Bergljot Gjelsvik
- Department of Psychiatry, University of Oxford, Warneford Lane, Oxford, OX3 7JX, UK.,Department of Psychology, University of Oslo, Oslo, Norway
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Petrova N. The problem of suicide in depression in the modern world. Zh Nevrol Psikhiatr Im S S Korsakova 2022; 122:43-48. [DOI: 10.17116/jnevro202212206243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Kim DJ, Mirmina J, Narine S, Wachtel J, Carbajal JM, Fox H, Cáceda R. Altered physical pain processing in different psychiatric conditions. Neurosci Biobehav Rev 2021; 133:104510. [PMID: 34952034 DOI: 10.1016/j.neubiorev.2021.12.033] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 12/07/2021] [Accepted: 12/19/2021] [Indexed: 01/07/2023]
Abstract
Several reports indicate either increased or decreased pain sensitivity associated with psychiatric disorders. Chronic pain is highly prevalent in many of these conditions. We reviewed the literature regarding experimental pain sensitivity in patients with major depression, bipolar disorder, posttraumatic stress disorder (PTSD), generalized anxiety disorder, panic disorder, obsessive-compulsive disorder and schizophrenia. Electronic searches were performed to identify studies comparing experimental pain in patients with these conditions and controls. Across 31 depression studies, reduced pain threshold was noted except for ischemic stimuli, where increased pain tolerance and elevated sensitivity to ischemic pain was observed. A more pervasive pattern of low pain sensitivity was found across 20 schizophrenia studies. The majority of PTSD studies (n = 20) showed no significant differences compared with controls. The limited number of bipolar disorder (n = 4) and anxiety (n = 9) studies precluded identification of clear trends. Wide data variability was observed. Awareness of psychiatric patients' pain perception abnormalities is needed for active screening and addressing physical comorbidities, in order to enhance quality of life, life expectancy and mental health.
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Affiliation(s)
- Diane J Kim
- Department of Psychiatry and Behavioral Sciences, Stony Brook University, Stony Brook, New York, USA
| | - Julianne Mirmina
- Department of Psychiatry and Behavioral Sciences, Stony Brook University, Stony Brook, New York, USA
| | - Serah Narine
- Department of Psychiatry and Behavioral Sciences, Stony Brook University, Stony Brook, New York, USA
| | - Jonathan Wachtel
- Department of Psychiatry and Behavioral Sciences, Stony Brook University, Stony Brook, New York, USA
| | - Jessica M Carbajal
- Department of Psychiatry and Behavioral Sciences, Stony Brook University, Stony Brook, New York, USA
| | - Helen Fox
- Department of Psychiatry and Behavioral Sciences, Stony Brook University, Stony Brook, New York, USA
| | - Ricardo Cáceda
- Department of Psychiatry and Behavioral Sciences, Stony Brook University, Stony Brook, New York, USA; Psychiatry Service, Northport Veterans Affairs Medical Center, Northport, New York, USA.
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DASentimental: Detecting Depression, Anxiety, and Stress in Texts via Emotional Recall, Cognitive Networks, and Machine Learning. BIG DATA AND COGNITIVE COMPUTING 2021. [DOI: 10.3390/bdcc5040077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Most current affect scales and sentiment analysis on written text focus on quantifying valence/sentiment, the primary dimension of emotion. Distinguishing broader, more complex negative emotions of similar valence is key to evaluating mental health. We propose a semi-supervised machine learning model, DASentimental, to extract depression, anxiety, and stress from written text. We trained DASentimental to identify how N = 200 sequences of recalled emotional words correlate with recallers’ depression, anxiety, and stress from the Depression Anxiety Stress Scale (DASS-21). Using cognitive network science, we modeled every recall list as a bag-of-words (BOW) vector and as a walk over a network representation of semantic memory—in this case, free associations. This weights BOW entries according to their centrality (degree) in semantic memory and informs recalls using semantic network distances, thus embedding recalls in a cognitive representation. This embedding translated into state-of-the-art, cross-validated predictions for depression (R = 0.7), anxiety (R = 0.44), and stress (R = 0.52), equivalent to previous results employing additional human data. Powered by a multilayer perceptron neural network, DASentimental opens the door to probing the semantic organizations of emotional distress. We found that semantic distances between recalls (i.e., walk coverage), was key for estimating depression levels but redundant for anxiety and stress levels. Semantic distances from “fear” boosted anxiety predictions but were redundant when the “sad–happy” dyad was considered. We applied DASentimental to a clinical dataset of 142 suicide notes and found that the predicted depression and anxiety levels (high/low) corresponded to differences in valence and arousal as expected from a circumplex model of affect. We discuss key directions for future research enabled by artificial intelligence detecting stress, anxiety, and depression in texts.
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Chen Y, Ye X, Wu H, Huang X, Ke C, Chen Y, Wu H, Wu X. Association of Postpartum Pain Sensitivity and Postpartum Depression: A Prospective Observational Study. Pain Ther 2021; 10:1619-1633. [PMID: 34580805 PMCID: PMC8586323 DOI: 10.1007/s40122-021-00325-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Accepted: 09/08/2021] [Indexed: 12/29/2022] Open
Abstract
INTRODUCTION Postpartum depression (PPD) is a severe psychiatric disorder that negatively affects postnatal mothers worldwide. The aim of the study is to investigate the association between postpartum pain sensitivity and PPD as well as to identify the other potential risk factors for PPD and their interconnections. METHODS The current study was a prospective observational clinical study that enrolled 210 singleton pregnant women in a tertiary referral hospital from January to December 2020. Postpartum pain sensitivity was assessed by the Mandarin Chinese version of the Pain Sensitivity Questionnaire (PSQ), and PSQ-C-total and PSQ-C-minor scores were collected. PPD was screened by self-reporting Edinburgh Postnatal Depression Scale (EPDS), and EPDS total score was recorded. The association between postpartum pain sensitivity and PPD, as well as the risk factors and their interconnections, was analyzed by using a combination of stratified, bivariate, correlation, receiver-operating characteristic (ROC) curve, multivariate logistic regression, and path analysis. RESULTS Overall, 87 of 210 mothers (41.4%) screened positive for PPD. A positive correlation between PSQ-C-total (r = 0.67) or PSQ-C-minor (r = 0.62) and EPDS scores was identified. PSQ-C-total [area under curve (AUC) 0.89, 95% CI 0.84-0.93; P < 0.0001] showed significantly higher diagnostic accuracy compared with PSQ-C-minor (AUC 0.85, 95% CI 0.80-0.90; P < 0.0001) in predicting EPDS scores ≥ 10 points. Multivariate logistic regression indicated that a high PSQ-C-total score [adjusted odds ratio (OR) 1.12, 95% CI 1.08-1.51; P < 0.001] and gestational diabetes (adjusted OR 2.68, 95% CI 0.96-7.47; P = 0.045) were independent risk factors, while breastfeeding (adjusted OR: 0.34, 95% CI 0.15-0.78; P = 0.007) and normal birth weight (adjusted OR 0.17, 95% CI 0.05-0.61; P = 0.0047) were independently associated with decreasing adjusted ORs for EPDS scores ≥ 10 points. The path analysis model indicated that PSQ-C-total scores and gestational diabetes showed bidirectional effects, while birth weight and breastfeeding only had a direct impact on EPDS scores ≥ 10 points. CONCLUSION Increased postpartum pain sensitivity was closely associated with EPDS scores ≥ 10 points, and PSQ-C scores could be a reliable predictor. Moreover, gestational diabetes, low occurrence of breastfeeding, and low birth weight were the risk factors for EPDS scores ≥ 10 points. TRIAL REGISTRATION ChiCTR.org.cn identifier, ChiCTR-2000033091.
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Affiliation(s)
- Yu Chen
- grid.415108.90000 0004 1757 9178Department of Anesthesiology, Jinshan Branch of Fujian Provincial Hospital, No. 516, South of Jinrong Rd, Fuzhou, 350028 China ,grid.256112.30000 0004 1797 9307Department of Anesthesiology, Fujian Provincial Clinical Medical College, Fujian Medical University, Fuzhou, 350001 China
| | - Xin Ye
- grid.256112.30000 0004 1797 9307Department of Anesthesiology, Fujian Provincial Clinical Medical College, Fujian Medical University, Fuzhou, 350001 China ,grid.415108.90000 0004 1757 9178Department of Anesthesiology, Fujian Provincial Hospital, Fuzhou, 350001 China
| | - Han Wu
- grid.415108.90000 0004 1757 9178Department of Anesthesiology, Jinshan Branch of Fujian Provincial Hospital, No. 516, South of Jinrong Rd, Fuzhou, 350028 China
| | - Xinlei Huang
- grid.256112.30000 0004 1797 9307Department of Anesthesiology, Fujian Provincial Clinical Medical College, Fujian Medical University, Fuzhou, 350001 China ,grid.415108.90000 0004 1757 9178Department of Anesthesiology, Fujian Provincial Hospital, Fuzhou, 350001 China
| | - Congrong Ke
- grid.415108.90000 0004 1757 9178Department of Obstetrics and Gynecology, Jinshan Branch of Fujian Provincial Hospital, Fuzhou, 350028 China
| | - Yanqing Chen
- grid.415108.90000 0004 1757 9178Department of Anesthesiology, Jinshan Branch of Fujian Provincial Hospital, No. 516, South of Jinrong Rd, Fuzhou, 350028 China ,grid.256112.30000 0004 1797 9307Department of Anesthesiology, Fujian Provincial Clinical Medical College, Fujian Medical University, Fuzhou, 350001 China
| | - Huanghui Wu
- Department of Anesthesiology, Xiang'an Hospital of Xiamen University, School of Medicine, Xiamen University, No. 2000, East of Xiang'an Rd, Xiamen, 361102, China. .,Department of Anesthesiology and Perioperative Medicine, 900 Hospital of the Joint Logistics Team of the PLA, Fuzhou, 350025, China.
| | - Xiaodan Wu
- Department of Anesthesiology, Jinshan Branch of Fujian Provincial Hospital, No. 516, South of Jinrong Rd, Fuzhou, 350028, China. .,Department of Anesthesiology, Fujian Provincial Clinical Medical College, Fujian Medical University, Fuzhou, 350001, China.
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Uğur K, Polat H. The relationship of suicidal ideation with psychological pain and anger rumination in patients with major depressive disorder. Arch Psychiatr Nurs 2021; 35:479-485. [PMID: 34561062 DOI: 10.1016/j.apnu.2021.06.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 06/14/2021] [Accepted: 06/20/2021] [Indexed: 12/25/2022]
Abstract
UNLABELLED OBJECTıVE: The study was conducted to determine the association between ruminating anger and mental pain with suicidal ideation in patients diagnosed with major depression disorder. METHODS The study with 156 patients diagnosed with major depressive disorder was carried out in a cross-sectional study design. Personal Information Form, Reflection on Anger Scale, Psychological Pain Scale and Beck Depression Scale were used. RESULTS It was concluded that there was a statistically equal directional and linear relationship between the Meebunney and Beck depression scores of all patients diagnosed with a major depressive disorder and the total reflective anger score and its sub-dimensions. Suicidal attempts and psychological pain and depression levels were found to be effective in the increase in suicidal ideation in the patients with major depressive disorder. CONCLUSIONS Studies with larger samples are recommended to determine the factors that may pose a risk of suicidal ideation in patients diagnosed with majör depressive disorder.
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Affiliation(s)
- Kerim Uğur
- Department of Psychiatry, Faculty of Medicine, Malatya Turgut Özal University, 44000 Malatya, Turkey
| | - Hatice Polat
- Malatya Training and Research Hospital, Psychiatry Clinic, 44000 Malatya, Turkey.
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Mental Pain in Eating Disorders: An Exploratory Controlled Study. J Clin Med 2021; 10:jcm10163584. [PMID: 34441880 PMCID: PMC8397208 DOI: 10.3390/jcm10163584] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 08/11/2021] [Accepted: 08/12/2021] [Indexed: 12/12/2022] Open
Abstract
Mental pain (MP) is a transdiagnostic feature characterized by depression, suicidal ideation, emotion dysregulation, and associated with worse levels of distress. The study explores the presence and the discriminating role of MP in EDs in detecting patients with higher depressive and ED-related symptoms. Seventy-one ED patients and 90 matched controls completed a Clinical Assessment Scale for MP (CASMP) and the Mental Pain Questionnaire (MPQ). ED patients also completed the Beck Depression Inventory-II (BDI-II), Clinical Interview for Depression (CID-20), and Eating Attitudes Test (EAT-40). ED patients exhibited significantly greater severity and higher number of cases of MP than controls. Moreover, MP resulted the most important cluster predictor followed by BDI-II, CID-20, and EAT-40 in discriminating between patients with different ED and depression severity in a two-step cluster analysis encompassing 87.3% (n = 62) of the total ED sample. Significant positive associations have been found between MP and bulimic symptoms, cognitive and somatic-affective depressive symptoms, suicidal tendencies, and anxiety-related symptoms. In particular, those presenting MP reported significantly higher levels of depressive and anxiety-related symptoms than those without. MP represents a clinical aspect that can help to detect more severe cases of EDs and to better understand the complex interplay between ED and mood symptomatology.
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Functional alterations of the suicidal brain: a coordinate-based meta-analysis of functional imaging studies. Brain Imaging Behav 2021; 16:291-304. [PMID: 34351557 DOI: 10.1007/s11682-021-00503-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/05/2021] [Indexed: 01/22/2023]
Abstract
Altered brain activities in suicidal subjects have been reported in a number of neuroimaging studies. However, the activity aberrances were inconsistent in previous investigations. Thus, we aimed to address activity abnormalities in suicidal individuals. Databases were searched to perform a meta-analysis of whole-brain functional MRI studies of suicidal individuals through January 14, 2020. Meta-analyses were conducted using Seed-based d Mapping software. Based on a meta-analysis of 17 studies comprising 381 suicidal individuals and 642 controls, we mainly found that increased activity in the bilateral superior temporal gyrus, left middle temporal gyrus, and bilateral middle occipital gyrus, along with decreased activity in the right putamen and left insula, were detected in suicidal individuals compared with nonsuicidal subjects. To reduce methodological heterogeneity between the included studies, subanalyses of behavioral domains were conducted, and the right superior temporal gyrus was found to increase in all subanalyses of domains. In subanalyses of suicidal attempters and ideators, suicide attempters displayed hyperactivation in the bilateral superior temporal gyrus and left middle temporal gyrus and blunted responses in the left insula relative to controls. Suicidal ideators demonstrated elevated activation in the right middle occipital gyrus and reduced activity in the right putamen relative to controls. The bilateral superior temporal gyrus was the most robust finding, replicable in all data sets in the jackknife sensitive analysis. Moreover, increased activity in the right superior temporal gyrus, left middle temporal gyrus, and right middle occipital gyrus was found to be involved with higher suicide ideation scores. This study revealed several brain regions associated with suicidality. These findings may contribute to our understanding of the pathophysiology of suicide and have important implications for suicide prevention and interventions.
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Cameron CM, Nieto S, Bosler L, Wong M, Bishop I, Mooney L, Cahill CM. Mechanisms Underlying the Anti-Suicidal Treatment Potential of Buprenorphine. ADVANCES IN DRUG AND ALCOHOL RESEARCH 2021; 1. [PMID: 35265942 PMCID: PMC8903193 DOI: 10.3389/adar.2021.10009] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Death by suicide is a global epidemic with over 800 K suicidal deaths worlwide in 2012. Suicide is the 10th leading cause of death among Americans and more than 44 K people died by suicide in 2019 in the United States. Patients with chronic pain, including, but not limited to, those with substance use disorders, are particularly vulnerable. Chronic pain patients have twice the risk of death by suicide compared to those without pain, and 50% of chronic pain patients report that they have considered suicide at some point due to their pain. The kappa opioid system is implicated in negative mood states including dysphoria, depression, and anxiety, and recent evidence shows that chronic pain increases the function of this system in limbic brain regions important for affect and motivation. Additionally, dynorphin, the endogenous ligand that activates the kappa opioid receptor is increased in the caudate putamen of human suicide victims. A potential treatment for reducing suicidal ideation and suicidal attempts is buprenorphine. Buprenorphine, a partial mu opioid agonist with kappa opioid antagonist properties, reduced suicidal ideation in chronic pain patients with and without an opioid use disorder. This review will highlight the clinical and preclinical evidence to support the use of buprenorphine in mitigating pain-induced negative affective states and suicidal thoughts, where these effects are at least partially mediated via its kappa antagonist properties.
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Affiliation(s)
- Courtney M. Cameron
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, United States
- Shirley and Stefan Hatos Center for Neuropharmacology, University of California, Los Angeles, Los Angeles, CA, United States
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, United States
- David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
| | - Steven Nieto
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA, United States
| | - Lucienne Bosler
- Shirley and Stefan Hatos Center for Neuropharmacology, University of California, Los Angeles, Los Angeles, CA, United States
| | - Megan Wong
- Shirley and Stefan Hatos Center for Neuropharmacology, University of California, Los Angeles, Los Angeles, CA, United States
| | - Isabel Bishop
- Shirley and Stefan Hatos Center for Neuropharmacology, University of California, Los Angeles, Los Angeles, CA, United States
| | - Larissa Mooney
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, United States
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, United States
- David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
| | - Catherine M. Cahill
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, United States
- Shirley and Stefan Hatos Center for Neuropharmacology, University of California, Los Angeles, Los Angeles, CA, United States
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, United States
- David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
- Correspondence: Catherine M. Cahill,
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Facco E. Pain, the uknown: epistemological issues and related clinical implications. Minerva Anestesiol 2021; 87:1255-1267. [PMID: 34263590 DOI: 10.23736/s0375-9393.21.15920-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Despite the huge development of pain management in the past decades, pain remains elusive and many patients still remain in the middle of the ford struggling between low drug efficacy and their overuse. A reason for pain elusiveness is its nature of subjective phenomenon, escaping the meshes of the objectivist, mechanist-reductionist net prevailing in medicine. Actually, pain is not only a symptom but an essential aspect of life, consciousness and contact with the world and its noetic and autonoetic components play a key role in the development of the concepts of pleasure-unpleasure and good-evil. The intensity and tolerability of pain and suffering also depends on what the pain means to the patient. The outstanding effects of placebo and nocebo, behavioral and non-pharmacological techniques warrant the need for a shift from the traditional positivist idea of patient as passive carrier of disease to the patient as active player of recovery and move toward a patient's centered approach exploiting individual resources for recovery. Among the mentioned techniques, hypnosis has proved to increase pain threshold up to the level of surgical analgesia, improve acute and chronic pain as well as coping and resilience, helping to decrease both drug overuse and the costs of pharmacological therapy. The wealth of available data suggest the need for a holistic approach, aiming to take care of the individual as an inseparable mind-body unit in its interplay with the environment, where patient's inner world, his/her experience and cognition are taken into due account as powerful resources for recovery through a phenomenological-existential approach.
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Affiliation(s)
- Enrico Facco
- Studium Patavinum, Department of Neurosciences, University of Padua, Padua, Italy - .,Institute F. Granone, Italian Center of Clinical and Experimental Hypnosis (CIICS), Turin, Italy -
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Leone C, Galosi S, Mollica C, Fortunato M, Possidente C, Milone V, Misuraca S, Berillo L, Truini A, Cruccu G, Ferrara M, Terrinoni A. Dissecting pain processing in adolescents with Non-Suicidal Self Injury: Could suicide risk lurk among the electrodes? Eur J Pain 2021; 25:1815-1828. [PMID: 33982830 PMCID: PMC8453562 DOI: 10.1002/ejp.1793] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Revised: 02/01/2021] [Accepted: 05/02/2021] [Indexed: 12/13/2022]
Abstract
Background Although non‐suicidal self‐injury (NSSI) disorder is highly prevalent in adolescents, its relationship with pain system function and suicidality is still controversial. The present study was designed to assess the function of the nociceptive afferent pathways and the endogenous pain modulation in adolescent patients with NSSI and to longitudinally register any suicide attempt, describe its frequency and find a possible association between suicide, neurophysiological measures and psychological measures. Methods We enrolled 30 adolescents suffering from NSSI and 20 age‐ and gender‐matched healthy controls. Patients underwent a comprehensive psychological evaluation. Each participant underwent thermal pain thresholds of the quantitative sensory testing, laser‐evoked potential recording to study the ascending nociceptive pathway and the conditioned pain modulation testing to test the endogenous pain modulation. Results We found that patients with NSSI had a reduced amplitude of the N2 component of laser‐evoked potentials and an abnormal conditioned pain modulation. The amplitude of the N2 was associated with suicidal risk. Conclusions The deficit of the endogenous pain modulation likely depends on a saturation due to continuous pain solicitation. The strong association of a reduced amplitude of the N2 component with suicide suggests that it may serve as a possible biomarker in self‐harming adolescents. Significance The present study identifies the N2 component of laser‐evoked potentials as a possible neurophysiological biomarker of suicidal risk in patients with non‐suicidal self‐injury, therefore, raising the possibility for a non‐invasive test to identify subjects at higher risk of suicide among self‐harming patients.
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Affiliation(s)
- Caterina Leone
- Department of Human Neuroscience, Sapienza University, Rome, Italy
| | - Serena Galosi
- Department of Human Neuroscience, Sapienza University, Rome, Italy
| | - Cristina Mollica
- Department of Methods and Models for Economics, Territory and Finance, Sapienza University, Rome, Italy
| | - Mattia Fortunato
- Department of Human Neuroscience, Sapienza University, Rome, Italy
| | | | - Valeria Milone
- Department of Human Neuroscience, Sapienza University, Rome, Italy
| | - Sofia Misuraca
- Department of Human Neuroscience, Sapienza University, Rome, Italy
| | - Luana Berillo
- Department of Human Neuroscience, Sapienza University, Rome, Italy
| | - Andrea Truini
- Department of Human Neuroscience, Sapienza University, Rome, Italy
| | - Giorgio Cruccu
- Department of Human Neuroscience, Sapienza University, Rome, Italy
| | - Mauro Ferrara
- Department of Human Neuroscience, Sapienza University, Rome, Italy
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Cabeza L, Ramadan B, Giustiniani J, Houdayer C, Pellequer Y, Gabriel D, Fauconnet S, Haffen E, Risold PY, Fellmann D, Belin D, Peterschmitt Y. Chronic exposure to glucocorticoids induces suboptimal decision-making in mice. Eur Neuropsychopharmacol 2021; 46:56-67. [PMID: 33531260 DOI: 10.1016/j.euroneuro.2021.01.094] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Revised: 01/12/2021] [Accepted: 01/18/2021] [Indexed: 12/11/2022]
Abstract
Anxio-depressive symptoms as well as severe cognitive dysfunction including aberrant decision-making (DM) are documented in neuropsychiatric patients with hypercortisolaemia. Yet, the influence of the hypothalamo-pituitary-adrenal (HPA) axis on DM processes remains poorly understood. As a tractable mean to approach this human condition, adult male C57BL/6JRj mice were chronically treated with corticosterone (CORT) prior to behavioural, physiological and neurobiological evaluation. The behavioural data indicate that chronic CORT delays the acquisition of contingencies required to orient responding towards optimal DM performance in a mouse Gambling Task (mGT). Specifically, CORT-treated animals show a longer exploration and a delayed onset of the optimal DM performance. Remarkably, the proportion of individuals performing suboptimally in the mGT is increased in the CORT condition. This variability seems to be better accounted for by variations in sensitivity to negative rather than to positive outcome. Besides, CORT-treated animals perform worse than control animals in a spatial working memory (WM) paradigm and in a motor learning task. Finally, Western blotting neurobiological analyses show that chronic CORT downregulates glucocorticoid receptor expression in the medial Prefrontal Cortex (mPFC). Besides, corticotropin-releasing factor signalling in the mPFC of CORT individuals negatively correlates with their DM performance. Collectively, this study describes how chronic exposure to glucocorticoids induces suboptimal DM under uncertainty in a mGT, hampers WM and motor learning processes, thus affecting specific emotional, motor, cognitive and neurobiological endophenotypic dimensions relevant for precision medicine in biological psychiatry.
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Affiliation(s)
- Lidia Cabeza
- Laboratoire de Neurosciences Intégratives et Cliniques EA-481, Université de Bourgogne - Franche-Comté, Besançon, France.
| | - Bahrie Ramadan
- Laboratoire de Neurosciences Intégratives et Cliniques EA-481, Université de Bourgogne - Franche-Comté, Besançon, France
| | - Julie Giustiniani
- Laboratoire de Neurosciences Intégratives et Cliniques EA-481, Université de Bourgogne - Franche-Comté, Besançon, France; Clinical Psychiatry, Hôpital Universitaire CHRU, Besançon, France; Hôpital Universitaire CHRU, CIC-INSERM-1431, Besançon, France
| | - Christophe Houdayer
- Laboratoire de Neurosciences Intégratives et Cliniques EA-481, Université de Bourgogne - Franche-Comté, Besançon, France
| | - Yann Pellequer
- PEPITE EA-4267, Université de Bourgogne - Franche-Comté, Besançon, France
| | - Damien Gabriel
- Laboratoire de Neurosciences Intégratives et Cliniques EA-481, Université de Bourgogne - Franche-Comté, Besançon, France; Hôpital Universitaire CHRU, CIC-INSERM-1431, Besançon, France
| | - Sylvie Fauconnet
- Hôpital Universitaire CHRU, CIC-INSERM-1431, Besançon, France; Laboratoire de Carcinogenèse associée aux HPV EA-3181, Université de Bourgogne - Franche-Comté, Besançon, France; Urologie, andrologie et transplantation rénale, Hôpital Universitaire CHRU, Besançon, France
| | - Emmanuel Haffen
- Laboratoire de Neurosciences Intégratives et Cliniques EA-481, Université de Bourgogne - Franche-Comté, Besançon, France; Clinical Psychiatry, Hôpital Universitaire CHRU, Besançon, France; Hôpital Universitaire CHRU, CIC-INSERM-1431, Besançon, France
| | - Pierre-Yves Risold
- Laboratoire de Neurosciences Intégratives et Cliniques EA-481, Université de Bourgogne - Franche-Comté, Besançon, France
| | - Dominique Fellmann
- Laboratoire de Neurosciences Intégratives et Cliniques EA-481, Université de Bourgogne - Franche-Comté, Besançon, France
| | - David Belin
- Department of Psychology, University of Cambridge, Cambridge, United Kingdom
| | - Yvan Peterschmitt
- Laboratoire de Neurosciences Intégratives et Cliniques EA-481, Université de Bourgogne - Franche-Comté, Besançon, France.
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Borelli E, Bigi S, Potenza L, Artioli F, Eliardo S, Mucciarini C, Cagossi K, Razzini G, Pasqualini A, Lui F, Ferlazzo F, Cruciani M, Bruera E, Efficace F, Luppi M, Cacciari C, Porro CA, Bandieri E. Different semantic and affective meaning of the words associated to physical and social pain in cancer patients on early palliative/supportive care and in healthy, pain-free individuals. PLoS One 2021; 16:e0248755. [PMID: 33788893 PMCID: PMC8011738 DOI: 10.1371/journal.pone.0248755] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Accepted: 03/04/2021] [Indexed: 12/25/2022] Open
Abstract
Early palliative/supportive care (ePSC) is a medical intervention focused on patient's needs, that integrates standard oncological treatment, shortly after a diagnosis of advanced/metastatic cancer. ePSC improves the appropriate management of cancer pain. Understanding the semantic and emotional impact of the words used by patients to describe their pain may further improve its assessment in the ePSC setting. Psycholinguistics assumes that the semantic and affective properties of words affect the ease by which they are processed and comprehended. Therefore, in this cross-sectional survey study we collected normative data about the semantic and affective properties of words associated to physical and social pain, in order to investigate how patients with cancer pain on ePSC process them compared to healthy, pain-free individuals. One hundred ninety patients and 124 matched controls rated the Familiarity, Valence, Arousal, Pain-relatedness, Intensity, and Unpleasantness of 94 words expressing physical and social pain. Descriptive and inferential statistics were performed on ratings in order to unveil patients' semantic and affective representation of pain and compare it with those from controls. Possible effects of variables associated to the illness experience were also tested. Both groups perceived the words conveying social pain as more negative and pain-related than those expressing physical pain, confirming previous evidence of social pain described as worse than physical pain. Patients rated pain words as less negative, less pain-related, and conveying a lower intense and unpleasant pain than controls, suggesting either an adaptation to the pain experience or the role played by ePSC in improving patients' ability to cope with it. This exploratory study suggests that a chronic pain experience as the one experienced by cancer patients on ePSC affects the semantic and affective representation of pain words.
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Affiliation(s)
- Eleonora Borelli
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
- Center for Neuroscience and Neurotechnology, University of Modena and Reggio Emilia, Modena, Italy
| | - Sarah Bigi
- Department of Linguistic Sciences and Foreign Literatures, Catholic University of the Sacred Heart, Milan, Italy
| | - Leonardo Potenza
- Hematology Unit and Chair, Azienda Ospedaliera Universitaria di Modena, Modena, Italy
- Department of Medical and Surgical Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Fabrizio Artioli
- Oncology and Palliative Care Units, Civil Hospital Carpi, USL, Carpi, Italy
| | - Sonia Eliardo
- Oncology and Palliative Care Units, Civil Hospital Carpi, USL, Carpi, Italy
| | - Claudia Mucciarini
- Oncology and Palliative Care Units, Civil Hospital Carpi, USL, Carpi, Italy
| | - Katia Cagossi
- Oncology and Palliative Care Units, Civil Hospital Carpi, USL, Carpi, Italy
| | - Giorgia Razzini
- Oncology and Palliative Care Units, Civil Hospital Carpi, USL, Carpi, Italy
| | | | - Fausta Lui
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
- Center for Neuroscience and Neurotechnology, University of Modena and Reggio Emilia, Modena, Italy
| | - Fabio Ferlazzo
- Department of Psychology, Sapienza University, Rome, Italy
| | | | - Eduardo Bruera
- Palliative Care & Rehabilitation Medicine, UT MD Anderson Cancer Center, Houston, Texas, United States of America
| | - Fabio Efficace
- Health Outcomes Research Unit, Italian Group for Adult Hematologic Diseases (GIMEMA), Rome, Italy
| | - Mario Luppi
- Hematology Unit and Chair, Azienda Ospedaliera Universitaria di Modena, Modena, Italy
- Department of Medical and Surgical Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Cristina Cacciari
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
- Center for Neuroscience and Neurotechnology, University of Modena and Reggio Emilia, Modena, Italy
| | - Carlo Adolfo Porro
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
- Center for Neuroscience and Neurotechnology, University of Modena and Reggio Emilia, Modena, Italy
| | - Elena Bandieri
- Oncology and Palliative Care Units, Civil Hospital Carpi, USL, Carpi, Italy
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Tian S, Zhu R, Chattun MR, Wang H, Chen Z, Zhang S, Shao J, Wang X, Yao Z, Lu Q. Temporal dynamics alterations of spontaneous neuronal activity in anterior cingulate cortex predict suicidal risk in bipolar II patients. Brain Imaging Behav 2021; 15:2481-2491. [PMID: 33656698 DOI: 10.1007/s11682-020-00448-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2020] [Revised: 11/25/2020] [Accepted: 12/29/2020] [Indexed: 12/17/2022]
Abstract
Bipolar disorder type II (BD-II) is linked to an increased suicidal risk. Since a prior suicide attempt (SA) is the single most important risk factor for sequent suicide, the elucidation of involved neural substrates is critical for its prevention. Therefore, we examined the spontaneous brain activity and its temporal variabilities in suicide attempters with bipolar II during a major depressive episode. In this cross-sectional study, 101 patients with BD-II, including 44 suicidal attempters and 57 non-attempters, and 60 non-psychiatric controls underwent a resting-state functional magnetic resonance imaging (fMRI). Participants were assessed with Hamilton Rating Scale for Depression (HAMD) and Nurses, Global Assessment of Suicide Risk (NGASR). The dynamics of low-frequency fluctuation (dALFF) was measured using sliding-window analysis and its correlation with suicidal risk was conducted using Pearson correlation. Compared to non-attempters, suicidal attempters showed an increase in brain activity and temporal dynamics in the anterior cingulate cortex (ACC). In addition, the temporal variabilities of ACC activity positively correlated with suicidal risk (R = 0.45, p = 0.004), while static ACC activity failed to (R = 0.08, p > 0.05). Our findings showed that an aberrant static ALFF and temporal variability could affect suicidal behavior in BD-II patients. However, temporal variability of neuronal activity was more sensitive than static amplitude in reflecting diathesis for suicide in BD-II. Dynamics of brain activity could be considered in developing neuromarkers for suicide prevention.
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Affiliation(s)
- Shui Tian
- School of Biological Sciences & Medical Engineering, Southeast University, No. 2 Sipailou, Jiangsu Province, Nanjing, 210096, China
- Child Development and Learning Science, Key Laboratory of Ministry of Education, Nanjing, 210096, China
| | - Rongxin Zhu
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, 210029, China
| | - Mohammad Ridwan Chattun
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, 210029, China
| | - Huan Wang
- School of Biological Sciences & Medical Engineering, Southeast University, No. 2 Sipailou, Jiangsu Province, Nanjing, 210096, China
- Child Development and Learning Science, Key Laboratory of Ministry of Education, Nanjing, 210096, China
| | - Zhilu Chen
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, 210029, China
| | - Siqi Zhang
- School of Biological Sciences & Medical Engineering, Southeast University, No. 2 Sipailou, Jiangsu Province, Nanjing, 210096, China
- Child Development and Learning Science, Key Laboratory of Ministry of Education, Nanjing, 210096, China
| | - Junneng Shao
- School of Biological Sciences & Medical Engineering, Southeast University, No. 2 Sipailou, Jiangsu Province, Nanjing, 210096, China
- Child Development and Learning Science, Key Laboratory of Ministry of Education, Nanjing, 210096, China
| | - Xinyi Wang
- School of Biological Sciences & Medical Engineering, Southeast University, No. 2 Sipailou, Jiangsu Province, Nanjing, 210096, China
- Child Development and Learning Science, Key Laboratory of Ministry of Education, Nanjing, 210096, China
| | - Zhijian Yao
- School of Biological Sciences & Medical Engineering, Southeast University, No. 2 Sipailou, Jiangsu Province, Nanjing, 210096, China.
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, 210029, China.
- Nanjing Brain Hospital, Medical School of Nanjing University, Nanjing, 210093, China.
| | - Qing Lu
- School of Biological Sciences & Medical Engineering, Southeast University, No. 2 Sipailou, Jiangsu Province, Nanjing, 210096, China.
- Child Development and Learning Science, Key Laboratory of Ministry of Education, Nanjing, 210096, China.
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76
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Kim DJ, Bartlett EA, DeLorenzo C, Parsey RV, Kilts C, Cáceda R. Examination of structural brain changes in recent suicidal behavior. Psychiatry Res Neuroimaging 2021; 307:111216. [PMID: 33129637 PMCID: PMC9227957 DOI: 10.1016/j.pscychresns.2020.111216] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2020] [Revised: 10/21/2020] [Accepted: 10/23/2020] [Indexed: 11/17/2022]
Abstract
We aimed to identify brain structural changes in cortical and subcortical regions linked to recent suicidal behavior. We performed secondary analyses of structural MRI data of two independent studies, namely the Establishing Moderators/Biosignatures of Antidepressant Response - Clinical Care (EMBARC) study and a Little Rock study on acute suicidal behavior. Study 1 (EMBARC, N = 187), compared individuals with remote suicide attempts (Remote-SA), individuals with lifetime suicide ideation but no attempts (Lifetime-SI only), and depressed individuals without lifetime suicide ideation or attempts (non-suicidal depressed). Study 2 (Little Rock data, N = 34) included patients recently hospitalized for suicide ideation or attempt constituted by: patients who recently attempted suicide (Recent-SA), individuals with remote suicide attempts (Remote-SA), and Lifetime-SI only. Study 3 combined the EMBARC and Little Rock datasets including Recent-SA, Remote-SA, Lifetime-SI only and non-suicidal depressed individuals. In Study 1 and Study 2, no significant differences were observed between groups. In Study 3, significantly lower middle temporal gyrus thickness, insular surface area, and thalamic volume and higher volume in the nucleus accumbens were observed in Recent-SA. This pattern of structural abnormalities may underlie pain and emotion dysregulation, which have been linked to the transition from suicidal thoughts to action.
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Affiliation(s)
- Diane J Kim
- Renaissance School of Medicine at Stony Brook University, Department of Psychiatry and Behavioral Health, Stony Brook, New York, United States.
| | - Elizabeth A Bartlett
- Columbia University College of Physicians and Surgeons, Department of Psychiatry, New York, NY, United States; New York State Psychiatric Institute, Division of Molecular Imaging and Neuropathology, New York, New York, United States
| | - Christine DeLorenzo
- Renaissance School of Medicine at Stony Brook University, Department of Psychiatry and Behavioral Health, Stony Brook, New York, United States; Stony Brook University, Department of Biomedical Engineering, Stony Brook, New York, United States
| | - Ramin V Parsey
- Renaissance School of Medicine at Stony Brook University, Department of Psychiatry and Behavioral Health, Stony Brook, New York, United States
| | - Clinton Kilts
- University of Arkansas for Medical Sciences, Psychiatric Research Institute, Little Rock, Arkansas, United States
| | - Ricardo Cáceda
- Renaissance School of Medicine at Stony Brook University, Department of Psychiatry and Behavioral Health, Stony Brook, New York, United States
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77
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Casanova MP, Nelson MC, Pickering MA, Appleby KM, Grindley EJ, Larkins LW, Baker RT. Measuring psychological pain: psychometric analysis of the Orbach and Mikulincer Mental Pain Scale. MEASUREMENT INSTRUMENTS FOR THE SOCIAL SCIENCES 2021; 3:7. [PMCID: PMC8127506 DOI: 10.1186/s42409-021-00025-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
Background Suicide is a public health concern, with an estimated 1 million individuals dying each year worldwide. Individual psychological pain is believed to be a contributing motivating factor. Therefore, establishing a psychometrically sound tool to adequately measure psychological pain is important. The Orbach and Mikulincer Mental Pain Scale (OMMP) has been proposed; however, previous psychometric analysis on the OMMP has not yielded a consistent scale structure, and the internal consistency of the subscales has not met recommended values. Therefore, the primary purpose of this study was to assess the psychometric properties of the OMMP in a diverse sample. Methods A confirmatory factor analysis (CFA) on the 9-factor, 44-item OMMP was conducted on the full sample (n = 1151). Because model fit indices were not met, an exploratory factor analysis (EFA) was conducted on a random subset of the data (n = 576) to identify a more parsimonious structure. The EFA structure was then tested in a covariance model in the remaining subset of participants (n = 575). Multigroup invariance testing was subsequently performed to examine psychometric properties of the refined scale. Results The CFA of the original 9-factor, 44-item OMMP did not meet recommended model fit recommendations. The EFA analysis results revealed a 3-factor, 9-item scale (i.e., OMMP-9). The covariance model of the OMMP-9 indicated further refinement was necessary. Multigroup invariance testing conducted on the final 3-factor, 8-item scale (i.e., OMMP-8) across mental health diagnoses, sex, injury status, age, activity level, and athlete classification met all criteria for invariance. Conclusions The 9-factor, 44-item OMMP does not meet recommended measurement criteria and should not be recommended for use in research and clinical practice in its current form. The refined OMMP-8 may be a more viable option to use; however, more research should be completed prior to adoption. Supplementary Information The online version contains supplementary material available at 10.1186/s42409-021-00025-8.
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Affiliation(s)
- Madeline P. Casanova
- Medical Education, University of Idaho, 875 Perimeter Drive, Moscow, ID 83844 USA
| | - Megan C. Nelson
- Medical Education, University of Idaho, 875 Perimeter Drive, Moscow, ID 83844 USA
| | | | - Karen M. Appleby
- Idaho State University, 921 South 8th Ave, Pocatello, ID 83209 USA
| | | | | | - Russell T. Baker
- Medical Education, University of Idaho, 875 Perimeter Drive, Moscow, ID 83844 USA
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Carrillo P, Petit AC, Gaillard R, Vinckier F. The next psychoactive drugs: From imipramine to ketamine. BULLETIN DE L'ACADEMIE NATIONALE DE MEDECINE 2020; 204:e169-e177. [PMID: 36879561 PMCID: PMC9977542 DOI: 10.1016/j.banm.2020.09.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Since the 1950s, the therapeutic arsenal against depression has grown considerably. From the discovery of mono-amine oxidase inhibitors (MAOIs) to the antidepressant effect of ketamine, several pharmacological breakthroughs made the history of psychiatry. These discoveries oriented the research about the pathophysiology of depression, which is one of the most disabling diseases worldwide affecting 10 to 20% of general population. In this article, we offer a short historical review of the various therapeutic options developed over the past century and the consequences of these innovations. We then review the discovery of the antidepressant effects of ketamine (and its S-enantiomer, esketamine), the lastest development in depression treatment. Ketamine's effects are spectacular both in terms of their very short onset time, and because they are observed even in treatment-resistant depression. Just as MAOIs and tricyclic antidepressants allowed the "monoaminergic hypothesis of depression" to emerge, unravelling the mechanisms of ketamine's antidepressant effects should highlight the role of glutamatergic system and neuro-inflammation in the neurobiology of depression. Ketamine might also help to refine our understanding of the cognitive pathophysiology of depression and to deeply transform the clinical representations of depressive disorder.
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Affiliation(s)
- Pablo Carrillo
- Département de Psychiatrie, centre hospitalier le-Vinatier, 69678 Bron, France
| | - Anne-Cécile Petit
- Université de Paris, 75006 Paris, France.,Service hospitalo-universitaire, GHU de Paris psychiatrie & neurosciences, 75014 Paris, France.,Unité de neuropathologie expérimentale, département santé globale, institut Pasteur, 75015 Paris, France
| | - Raphaël Gaillard
- Université de Paris, 75006 Paris, France.,Service hospitalo-universitaire, GHU de Paris psychiatrie & neurosciences, 75014 Paris, France.,Unité de neuropathologie expérimentale, département santé globale, institut Pasteur, 75015 Paris, France
| | - Fabien Vinckier
- Université de Paris, 75006 Paris, France.,Service hospitalo-universitaire, GHU de Paris psychiatrie & neurosciences, 75014 Paris, France
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Morgiève M, Genty C, Azé J, Dubois J, Leboyer M, Vaiva G, Berrouiguet S, Courtet P. A Digital Companion, the Emma App, for Ecological Momentary Assessment and Prevention of Suicide: Quantitative Case Series Study. JMIR Mhealth Uhealth 2020; 8:e15741. [PMID: 33034567 PMCID: PMC7584985 DOI: 10.2196/15741] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Revised: 04/08/2020] [Accepted: 06/03/2020] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Many suicide risk factors have been identified, but traditional clinical methods do not allow for the accurate prediction of suicide behaviors. To face this challenge, emma, an app for ecological momentary assessment (EMA), ecological momentary intervention (EMI), and prediction of suicide risk in high-risk patients, was developed. OBJECTIVE The aim of this case report study was to describe how subjects at high risk of suicide use the emma app in real-world conditions. METHODS The Ecological Mental Momentary Assessment (EMMA) study is an ongoing, longitudinal, interventional, multicenter trial in which patients at high risk for suicide are recruited to test emma, an app designed to be used as a self-help tool for suicidal crisis management. Participants undergo clinical assessment at months 0, 1, 3, and 6 after inclusion, mainly to assess and characterize the presence of mental disorders and suicidal thoughts and behaviors. Patient recruitment is still ongoing. Some data from the first 14 participants who already completed the 6-month follow-up were selected for this case report study, which evaluated the following: (1) data collected by emma (ie, responses to EMAs), (2) metadata on emma use, (3) clinical data, and (4) qualitative assessment of the participants' experiences. RESULTS EMA completion rates were extremely heterogeneous with a sharp decrease over time. The completion rates of the weekly EMAs (25%-87%) were higher than those of the daily EMAs (0%-53%). Most patients (10/14, 71%) answered the EMA questionnaires spontaneously. Similarly, the use of the Safety Plan Modules was very heterogeneous (2-75 times). Specifically, 11 patients out of 14 (79%) used the Call Module (1-29 times), which was designed by our team to help them get in touch with health care professionals and/or relatives during a crisis. The diversity of patient profiles and use of the EMA and EMI modules proposed by emma were highlighted by three case reports. CONCLUSIONS These preliminary results indicate that patients have different clinical and digital profiles and needs that require a highly scalable, interactive, and customizable app. They also suggest that it is possible and acceptable to collect longitudinal, fine-grained, contextualized data (ie, EMA) and to offer personalized intervention (ie, EMI) in real time to people at high risk of suicide. To become a complementary tool for suicide prevention, emma should be integrated into existing emergency procedures. TRIAL REGISTRATION ClinicalTrials.gov NCT03410381; https://clinicaltrials.gov/ct2/show/NCT03410381.
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Affiliation(s)
- Margot Morgiève
- Department of Emergency Psychiatry and Acute Care, Lapeyronie Hospital, CHU Montpellier, INSERM, Univ Montpellier, Neuropsychiatry: Epidemiological and Clinical Research, Montpellier, France.,ICM - Brain and Spine Institute, hôpital de la Pitié-Salpêtrière, Paris, France.,GEPS - Groupement d'Étude et de Prévention du Suicide, Paris, France
| | - Catherine Genty
- Department of Emergency Psychiatry and Acute Care, Lapeyronie Hospital, CHU Montpellier, INSERM, Univ Montpellier, Neuropsychiatry: Epidemiological and Clinical Research, Montpellier, France
| | - Jérôme Azé
- LIRMM, UMR 5506, Montpellier University/CNRS, Montpellier, France
| | - Jonathan Dubois
- Department of Emergency Psychiatry and Acute Care, Lapeyronie Hospital, CHU Montpellier, INSERM, Univ Montpellier, Neuropsychiatry: Epidemiological and Clinical Research, Montpellier, France
| | - Marion Leboyer
- Fondation Fondamental, hôpital Albert-Chenevier, Créteil, France
| | - Guillaume Vaiva
- GEPS - Groupement d'Étude et de Prévention du Suicide, Paris, France.,CHU Lille, Hôpital Fontan, Department of Psychiatry, Lille, France.,Centre National de Ressources & Résilience pour les psychotraumatismes, Lille, France.,Université de Lille, CNRS UMR-9193, SCALab - Sciences Cognitives et Sciences Affectives, Lille, France
| | - Sofian Berrouiguet
- GEPS - Groupement d'Étude et de Prévention du Suicide, Paris, France.,EA 7479 SPURBO, Université de Bretagne Occidentale, Brest, France.,IMT Atlantique, Lab-STICC, Brest, France
| | - Philippe Courtet
- Department of Emergency Psychiatry and Acute Care, Lapeyronie Hospital, CHU Montpellier, INSERM, Univ Montpellier, Neuropsychiatry: Epidemiological and Clinical Research, Montpellier, France.,Fondation Fondamental, hôpital Albert-Chenevier, Créteil, France
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80
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[The next psychoactive drugs: From imipramine to ketamine]. BULLETIN DE L ACADEMIE NATIONALE DE MEDECINE 2020; 204:1034-1042. [PMID: 32963409 PMCID: PMC7494514 DOI: 10.1016/j.banm.2020.09.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/15/2020] [Accepted: 09/10/2020] [Indexed: 12/02/2022]
Abstract
Depuis les années 1950, l’arsenal thérapeutique permettant de lutter contre la dépression s’est considérablement enrichi. De la découverte des inhibiteurs de la monoamine oxydase (IMAO) à celle de la kétamine, ces percées pharmacologiques ont marqué l’histoire de la psychiatrie et guidé la recherche sur la physiopathologie de la dépression, cette pathologie dévastatrice affectant entre 10 et 20 % de la population mondiale. Nous proposons dans cet article une courte revue historique des différentes options thérapeutiques développées au cours du siècle passé et des conséquences qu’ont eu ces innovations. Nous réalisons ensuite un état des lieux de la plus récente de ces découvertes, celle des effets antidépresseurs de la kétamine (et de son énantiomère S, l’eskétamine), spectaculaires de par leur délai d’apparition et leur efficacité même dans les formes les plus résistantes de dépression. De même que la découverte des IMAO et des tricycliques a permis de concevoir une théorie monoaminergique de la dépression, l’étude des mécanismes d’actions de la kétamine pourrait permettre de comprendre le rôle de la transmission glutamatergique ou de la neuro-inflammation dans la neurobiologie de cette pathologie, d’affiner nos connaissances sur sa physiopathologie cognitive ou encore de transformer en profondeur les représentations des cliniciens sur cette maladie.
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81
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Yang Y, Wang S, Hu B, Hao J, Hu R, Zhou Y, Mao Z. Do Older Adults with Parent(s) Alive Experience Higher Psychological Pain and Suicidal Ideation? A Cross-Sectional Study in China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E6399. [PMID: 32887427 PMCID: PMC7504437 DOI: 10.3390/ijerph17176399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 08/27/2020] [Accepted: 08/31/2020] [Indexed: 11/16/2022]
Abstract
Elderly mental health promotion is an important task in the current "Healthy China Action". This study aims to (a) clarify the psychological pain and suicidal ideation of the Chinese elderly with different parental states, (b) examine the associated factors of psychological pain and suicidal ideation, and (c) examine the relationship between psychological pain and suicidal ideation. A sample of 4622 adults aged 60 years and older were included in this study, from the China's Health-related Quality of Life Survey for Older Adults 2018. Participants with both parents alive demonstrated the heaviest psychological pain, and those with one parent alive observed significantly lowest psychological pain and suicidal ideation. Participants who were single, divorced, or widowed, live in rural areas, had higher education level, had lower family income, suffered from two or more chronic diseases, and had no self-care ability were more likely to experience psychological pain and suicidal ideation. In addition, higher psychological pain significantly associated with the occurrence of suicidal ideation. In China, much more attention should be paid to the mental health condition of the elderly, especially for those with both parents alive. Moreover, the associated factors above should be considered to develop targeted health interventions.
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Affiliation(s)
- Ying Yang
- School of Health Sciences, Wuhan University, Wuhan 430071, China; (Y.Y.); (S.W.); (B.H.); (J.H.); (R.H.)
- Global Health Institute, Wuhan University, Wuhan 430071, China
| | - Shizhen Wang
- School of Health Sciences, Wuhan University, Wuhan 430071, China; (Y.Y.); (S.W.); (B.H.); (J.H.); (R.H.)
| | - Borui Hu
- School of Health Sciences, Wuhan University, Wuhan 430071, China; (Y.Y.); (S.W.); (B.H.); (J.H.); (R.H.)
| | - Jinwei Hao
- School of Health Sciences, Wuhan University, Wuhan 430071, China; (Y.Y.); (S.W.); (B.H.); (J.H.); (R.H.)
| | - Runhu Hu
- School of Health Sciences, Wuhan University, Wuhan 430071, China; (Y.Y.); (S.W.); (B.H.); (J.H.); (R.H.)
| | - Yinling Zhou
- School of Health Sciences, Wuhan University, Wuhan 430071, China; (Y.Y.); (S.W.); (B.H.); (J.H.); (R.H.)
- Global Health Institute, Wuhan University, Wuhan 430071, China
| | - Zongfu Mao
- School of Health Sciences, Wuhan University, Wuhan 430071, China; (Y.Y.); (S.W.); (B.H.); (J.H.); (R.H.)
- Global Health Institute, Wuhan University, Wuhan 430071, China
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82
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Lengvenyte A, Strumila R, Courtet P, Kim SYH, Olié E. "Nothing Hurts Less Than Being Dead": Psychological Pain in Case Descriptions of Psychiatric Euthanasia and Assisted Suicide from the Netherlands: « Rien ne fait moins mal qu'être mort »: La douleur psychologique dans les descriptions de cas d'euthanasie et de suicide assisté psychiatrique aux Pays-Bas. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2020; 65:612-620. [PMID: 32501108 PMCID: PMC7485035 DOI: 10.1177/0706743720931237] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVES Euthanasia and assisted suicide (EAS) of individuals with mental disorders is a growing practice in several countries, including the Netherlands. Here, we aimed to identify the most frequent dimensions of and associated factors to psychological pain, which has been associated with suicidality, in individuals undergoing psychiatric EAS. METHODS An exploratory retrospective content analysis of the English translation of 66 digital case records of individuals who died by EAS in the Netherlands between 2011 and 2014 was performed. Nine standard psychological pain dimensions (irreversibility, loss of control, emptiness, emotional flooding, freezing, social distancing, narcissistic wounds, confusion, and self-estrangement), illness, and sociodemographic variables were evaluated by 2 independent raters using a premade data abstraction form (Kohen κ > 0.8 in all cases). RESULTS The mean number of dimensions was 4.64 ± 1.20 (median = 5), out of 9. The most frequent dimensions were irreversibility, loss of control, emptiness, and emotional flooding, in decreasing order. Past treatment refusal and the mention of social connections in case descriptions were related to the higher number of psychological pain dimensions (4.89 ± 1.24 vs. 4.31 ± 1.07, P = 0.03 and 5.05 ± 1.17 vs. 4.43 ± 1.17, P = 0.03, respectively). Emotional flooding was the only dimension specifically associated with specific psychiatric conditions, namely posttraumatic phenomena and personality disorders. CONCLUSIONS Numerous psychological pain dimensions were detected in case descriptions of individuals who underwent EAS before the procedure. Subjective nature of the study precludes definite conclusions but suggest that future studies should explore psychological pain and the role of interventions targeting it in patients requesting EAS.
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Affiliation(s)
- Aiste Lengvenyte
- Department of Psychiatric Emergency and Acute Care, Lapeyronie Hospital, CHRU Montpellier, France.,Faculty of Medicine, Institute of Clinical Medicine, Psychiatric Clinic, Vilnius University, Lithuania
| | - Robertas Strumila
- Department of Psychiatric Emergency and Acute Care, Lapeyronie Hospital, CHRU Montpellier, France.,Faculty of Medicine, Institute of Clinical Medicine, Psychiatric Clinic, Vilnius University, Lithuania
| | - Philippe Courtet
- Faculty of Medicine, Institute of Clinical Medicine, Psychiatric Clinic, Vilnius University, Lithuania.,PSNREC, University of Montpellier, INSERM, CHU de Montpellier, Montpellier, France
| | - Scott Y H Kim
- Department of Bioethics, National Institutes of Health Clinical Center, Bethesda, Maryland, USA
| | - Emilie Olié
- Department of Psychiatric Emergency and Acute Care, Lapeyronie Hospital, CHRU Montpellier, France.,PSNREC, University of Montpellier, INSERM, CHU de Montpellier, Montpellier, France
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83
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[Suicidal behavior in light of COVID-19 outbreak: Clinical challenges and treatment perspectives]. Encephale 2020; 46:S66-S72. [PMID: 32471707 PMCID: PMC7205618 DOI: 10.1016/j.encep.2020.05.001] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Accepted: 05/04/2020] [Indexed: 12/29/2022]
Abstract
OBJECTIVE The COVID-19 pandemic affected today more than 3,000,000 worldwide, and more than half of humanity has been placed in quarantine. The scientific community and the political authorities fear an epidemic of suicide secondary to this crisis. The aim of this review is to analyze the impact of the COVID-19 pandemic on the dimensions of the suicidal process and its interaction with the various risk factors. We also propose innovative strategies to manage suicidal behavior in the context of pandemic. METHODS We carried out a narrative review of international publications dealing with major pandemics (COVID-19, SARS) and their influence on suicidal vulnerability. RESULTS Many factors are likely to increase the emergence of suicidal ideation and suicide attempts during this crisis. Social distancing and quarantine could increase the feeling of disconnection and the perception of social pain in vulnerable individuals. Some populations at high suicidal risk could be further impacted by the current pandemic: the elderly, medical staff and individuals exposed to economic insecurity. Several innovative tools adapted to the constraints of social distancing and quarantine may prevent suicide risk: e-health, VigilanS, buddhist-derived practices and art engagement. CONCLUSIONS This unprecedented crisis may interact with certain dimensions of the suicidal process. However, it is time to innovate. Several suicide prevention tools all have their place in new modes of care and should be tested on a large scale.
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Mento C, Silvestri MC, Muscatello MRA, Rizzo A, Celebre L, Bruno A, Zoccali AR. Psychological pain and risk of suicide in adolescence. Int J Adolesc Med Health 2020; 34:/j/ijamh.ahead-of-print/ijamh-2019-0270/ijamh-2019-0270.xml. [PMID: 32304305 DOI: 10.1515/ijamh-2019-0270] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2019] [Accepted: 01/30/2020] [Indexed: 11/15/2022]
Abstract
Psychological pain or psychache is intolerable and unacceptable mental pain. This construct plays a key role in the risk of suicide in adolescence. This is a frequent condition in adolescents with depression; a variety of studies propose a bidirectional relationship between these two circumstances. Adolescents with psychological pain are exposed to the risk of suicidal ideation, and behavior. This review aimed to explore psychological pain in adolescents, and the correlation to the risk of suicide. We have conducted, following PRISMA guidelines, a systematic review for the literature on PubMed. Search terms were "Suicide risk in adolescents" AND "Mental Pain in adolescence" OR "Psychological Pain in adolescence". An initial search identified publications 1189. A total of 15 studies met the predefined inclusion criteria and were analyzed. Mental pain is a stronger factor of vulnerability of suicidal ideation and behavior. Intense negative emotions, such as guilt, shame, hopelessness, may become a psychological pain in adolescence, and many studies showed a relation between psychological pain and capability for suicide.
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Affiliation(s)
- Carmela Mento
- Department of Biomedical and Dental Sciences, Morphofunctional Imaging, University of Messina, Consolare Valeria 1, 98125 Messina, Italy, Phone: +390903489.,University of Messina, BIOMORF, via Consolare Valeria 1 Messina, Italy.,Policlinico Hospital, Psychiatric Unit, Messina, Italy
| | | | - Maria Rosaria Anna Muscatello
- Policlinico Hospital, Psychiatric Unit, Messina, Italy.,University of Messina, BIOMORF, Messina, Italy.,Department of Biomedical and Dental Sciences, Morphofunctional Imaging, University of Messina, Consolare Valeria 1, 98125 Messina, Italy
| | - Amelia Rizzo
- Policlinico Hospital, Psychiatric Unit, Messina, Italy.,University of Messina, Messina, Italy
| | - Laura Celebre
- Policlinico Hospital, Psychiatric Unit, Messina, Italy.,University of Messina, Messina, Italy
| | - Antonio Bruno
- Policlinico Hospital, Psychiatric Unit, Messina, Italy.,University of Messina, BIOMORF, Messina, Italy.,Department of Biomedical and Dental Sciences, Morphofunctional Imaging, University of Messina, Consolare Valeria 1, 98125 Messina, Italy
| | - Antonio Rocco Zoccali
- Policlinico Hospital, Psychiatric Unit, Messina, Italy.,University of Messina, BIOMORF, Messina, Italy.,Department of Biomedical and Dental Sciences, Morphofunctional Imaging, University of Messina, Consolare Valeria 1, 98125 Messina, Italy
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85
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Wang S, Li C, Jia X, Lyu J, Wang Y, Sun H. From depressive symptoms to suicide risk: Roles of sense of belongingness and acquired capability for suicide in patients with mental disorders. Psych J 2020; 9:185-198. [PMID: 31945807 DOI: 10.1002/pchj.334] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Revised: 10/31/2019] [Accepted: 11/14/2019] [Indexed: 11/12/2022]
Abstract
In order to prevent suicides in patients with mental disorders, it was critical to recognize the risk factors and explore the mechanism. Based on depressive symptoms, which were common in patients with mental disorders in consolidation period in China, we constructed a moderated mediating model under the framework of Integrated Motivational-Volitional Model of suicidal behaviour, and examined the mechanism of how depressive symptoms, thwarted belongingness, and acquired capability for suicide influenced suicide risk. In this study, data were collected from 164 patients through four questionnaires, and analyzed with PROCESS macro for SPSS (Hayes, 2008). The result showed that in the predictive effects of depressive symptoms on suicide risk, thwarted belongingness was a partial mediating variable, while acquired capability for suicide played a moderating role in the partial mediating model. Specifically, the predictive effects of depressive symptoms and thwarted belongingness, both as motivation variables, on suicide risk both occurred in the case of the high acquired capability of suicide, which was a volition variable. The research pointed out the interdependence of depressive symptoms and a sense of belongingness, and clarified the critical role of acquired capability for suicide. The integrated perspective could enhance the interpretation of reality, and enlightened those carrying out the practice of suicide intervention to patients with mental disorders.
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Affiliation(s)
- Shengnan Wang
- Department of Psychology, Weifang Medical University, Weifang, China.,School of Public Health and Management, Weifang Medical University, Weifang, China
| | - Congcong Li
- Department of Psychology, Weifang Medical University, Weifang, China.,Weifang New Epoch School, Weifang, China
| | - Xuji Jia
- Institute of Psychology and Behavior, Tianjin Normal University, Tianjin, China
| | - Juncheng Lyu
- School of Public Health and Management, Weifang Medical University, Weifang, China
| | - Yanyu Wang
- Department of Psychology, Weifang Medical University, Weifang, China
| | - Hongwei Sun
- Department of Psychology, Weifang Medical University, Weifang, China
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86
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Zhang G, Xu S, Zhang Z, Zhang Y, Wu Y, An J, Lin J, Yuan Z, Shen L, Si T. Identification of Key Genes and the Pathophysiology Associated With Major Depressive Disorder Patients Based on Integrated Bioinformatics Analysis. Front Psychiatry 2020; 11:192. [PMID: 32317989 PMCID: PMC7146847 DOI: 10.3389/fpsyt.2020.00192] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Accepted: 02/27/2020] [Indexed: 12/11/2022] Open
Abstract
Background: At present, laboratory blood tests to support major depressive disorder (MDD) diagnosis are not available. This study aimed to screen potential mRNAs for peripheral blood biomarkers and novel pathophysiology of MDD. Methods: The present study utilized public data from two mRNA microarray datasets to analyze the hub genes changes related to MDD. Gene Ontology (GO) analysis and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis of differentially expressed genes (DEGs) were performed. Finally, some potential mRNA quality biomarkers for hub gene expression in blood were identified. Results: A total of 25 significantly co-upregulated DEGs and 98 co-downregulated DEGs were obtained from two datasets. The pathway enrichment analyses showed that co-upregulated genes were significantly enriched in the regulation of cell-matrix adhesion and mitochondrial membrane permeability which were involved in the apoptotic process. Co-downregulated genes were mainly involved in the neutrophil activation which in turn was involved in the immune response, degranulation and cell-mediated immunity, positive regulation of immune response, the Toll-like receptor signaling pathway, and the NOD-like receptor signaling pathway. From the PPI network, 14 hub genes were obtained. Among them, the subnetworks of PLCG1, BCL2A1, TLR8, FADD, and TLR4 screened out from our study have been shown to play a role in immune and inflammation responses. Discussion: The potential molecular mechanisms that have been identified simultaneously include innate immunity, neuroinflammation, and neurotrophic factors for synapse function and development.
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Affiliation(s)
- Guangyin Zhang
- Department of Psychosomatic Medicine, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China.,Key Laboratory of Mental Health, Ministry of Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Peking University Sixth Hospital and Peking University Institute of Mental Health, Beijing, China
| | - Shixin Xu
- Tianjin Key Laboratory of Traditional Research of TCM Prescription and Syndrome, Medical Experiment Center, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | | | - Yu Zhang
- Hebei North University, Hebei, China
| | - Yankun Wu
- Key Laboratory of Mental Health, Ministry of Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Peking University Sixth Hospital and Peking University Institute of Mental Health, Beijing, China
| | - Jing An
- Key Laboratory of Mental Health, Ministry of Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Peking University Sixth Hospital and Peking University Institute of Mental Health, Beijing, China
| | - Jinyu Lin
- Key Laboratory of Mental Health, Ministry of Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Peking University Sixth Hospital and Peking University Institute of Mental Health, Beijing, China
| | - Zhuo Yuan
- Department of Psychosomatic Medicine, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Li Shen
- Department of Psychosomatic Medicine, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Tianmei Si
- Key Laboratory of Mental Health, Ministry of Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Peking University Sixth Hospital and Peking University Institute of Mental Health, Beijing, China
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87
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Nobile B, Lutz PE, Olie E, Courtet P. The Role of Opiates in Social Pain and Suicidal Behavior. Curr Top Behav Neurosci 2020; 46:197-210. [PMID: 32865762 DOI: 10.1007/7854_2020_167] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
With more than 800,000 deaths by suicide each year and 20 to 30 times more suicide attempts worldwide, suicide is a major public health problem. Current treatments of SB are mainly based on pharmacological treatments that are not specific of SB (e.g. antidepressants), and new therapeutic targets are urgently needed. Recent data strengthen the ancient conception pain (social, psychic, physical) that is at the core of the suicidal process and should be incorporated in the clinical assessment of suicide risk. Then, the mechanisms involved in the regulation of pain may open new avenues regarding therapeutic perspectives. Opiates appear to be a promising candidate in treatment of SB. Indeed, since the last two decades, growing evidences suggest an implication of the opioid system in the pathophysiology of SB, this conduct to the elaboration of randomized controlled trials (RCTs) using opiates in patients with SB. Results suggesting an anti-suicidal effect of buprenorphine and the potential opioidergic-related anti-suicidal effect of ketamine both contribute to the growing interest in opiates use in SB. In this review, we will summarize a large part of the evidence that leads researchers and clinicians to be interested in the use of opiates for SB treatment and discuss on new opioid pharmacological options for suicidal patients.
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Affiliation(s)
- Benedicte Nobile
- Department of Emergency Psychiatry and Acute Care, CHU, Montpellier, France
- PSNREC, Univ Montpellier, INSERM, CHU de Montpellier, Montpellier, France
- University Montpellier, Montpellier, France
| | - Pierre-Eric Lutz
- Centre National de la Recherche Scientifique, Université de Strasbourg, Institut des Neurosciences Cellulaires et Intégratives, Strasbourg, France
- Fédération de Médecine Translationnelle de Strasbourg (FMTS), Strasbourg, France
| | - Emilie Olie
- Department of Emergency Psychiatry and Acute Care, CHU, Montpellier, France
- PSNREC, Univ Montpellier, INSERM, CHU de Montpellier, Montpellier, France
- University Montpellier, Montpellier, France
| | - Philippe Courtet
- Department of Emergency Psychiatry and Acute Care, CHU, Montpellier, France.
- PSNREC, Univ Montpellier, INSERM, CHU de Montpellier, Montpellier, France.
- University Montpellier, Montpellier, France.
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88
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Pachkowski MC, May AM, Tsai M, Klonsky ED. A Brief Measure of Unbearable Psychache. Suicide Life Threat Behav 2019; 49:1721-1734. [PMID: 31074006 DOI: 10.1111/sltb.12556] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Accepted: 02/08/2019] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Psychache has been proposed to cause suicide when it becomes unbearable. However, existing measures of psychache do not directly target unbearable psychache. Thus, the purpose of the current study was to provide initial validation for a brief measure of unbearable psychache. METHOD Three items were selected to create the Unbearable Psychache Scale (UP3). Psychometric properties were assessed in two populations: (1) an online sample composed of 1,006 adults (53% male) from various locations in the United States and (2) a sample of 190 psychiatric inpatient adults (47% male) from a hospital in Western Canada. RESULTS In both samples, the UP3 demonstrated excellent internal reliability, and strong convergent and predictive validity. Additionally, the UP3 predicted significant variance in suicidal ideation over and above documented correlates of suicidal ideation including general psychache, hopelessness, perceived burdensomeness, and low belongingness. CONCLUSIONS The UP3 is a brief, psychometrically sound measure of unbearable psychache that may be well-suited for use in research protocols and clinical assessments.
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Affiliation(s)
| | - Alexis M May
- Department of Psychology, Wesleyan University, Middletown, CT, USA
| | - Michelle Tsai
- Surrey Mental Health & Substance Use Services, Fraser Health Authority, Surrey, BC, Canada
| | - E David Klonsky
- Department of Psychology, University of British Columbia, Vancouver, BC, Canada
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89
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Attenuation of antidepressant and antisuicidal effects of ketamine by opioid receptor antagonism. Mol Psychiatry 2019; 24:1779-1786. [PMID: 31467392 DOI: 10.1038/s41380-019-0503-4] [Citation(s) in RCA: 88] [Impact Index Per Article: 17.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2018] [Revised: 04/30/2019] [Accepted: 05/17/2019] [Indexed: 12/12/2022]
Abstract
We recently reported that naltrexone blocks antidepressant effects of ketamine in humans, indicating that antidepressant effects of ketamine require opioid receptor activation. However, it is unknown if opioid receptors are also involved in ketamine's antisuicidality effects. Here, in a secondary analysis of our recent clinical trial, we test whether naltrexone attenuates antisuicidality effects of ketamine. Participants were pretreated with naltrexone or placebo prior to intravenous ketamine in a double-blinded crossover design. Suicidality was measured with the Hamilton Depression Rating Scale item 3, Montgomery-Åsberg Depression Rating Scale item 10, and Columbia Suicide Severity Rating Scale. In the 12 participants who completed naltrexone and placebo conditions, naltrexone attenuated the antisuicidality effects of ketamine on all three suicidality scales/subscales (linear mixed model, fixed pretreatment effect, p < 0.01). Results indicate that opioid receptor activation plays a significant role in the antisuicidality effects of ketamine.
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90
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Calati R, Nemeroff CB, Lopez-Castroman J, Cohen LJ, Galynker I. Candidate Biomarkers of Suicide Crisis Syndrome: What to Test Next? A Concept Paper. Int J Neuropsychopharmacol 2019; 23:192-205. [PMID: 31781761 PMCID: PMC7171927 DOI: 10.1093/ijnp/pyz063] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Revised: 11/25/2019] [Accepted: 11/27/2019] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND There has been increasing interest in both suicide-specific diagnoses within the psychiatric nomenclature and related biomarkers. Because the Suicide Crisis Syndrome-an emotional crescendo of several interrelated symptoms-seems to be promising for the identification of individuals at risk of suicide, the aim of the present paper is to review the putative biological underpinnings of the Suicide Crisis Syndrome symptoms (entrapment, affective disturbance, loss of cognitive control, hyperarousal, social withdrawal). METHODS A PubMed literature search was performed to identify studies reporting a link between each of the 5 Suicide Crisis Syndrome symptoms and biomarkers previously reported to be associated with suicidal outcomes. RESULTS Disturbances in the hypothalamic-pituitary-adrenal axis, with dysregulated corticotropin-releasing hormone and cortisol levels, may be linked to a sense of entrapment. Affective disturbance is likely mediated by alterations in dopaminergic circuits involved in reward and antireward systems as well as endogenous opioids. Loss of cognitive control is linked to altered neurocognitive function in the areas of executive function, attention, and decision-making. Hyperarousal is linked to autonomic dysregulation, which may be characterized by a reduction in both heart rate variability and electrodermal activity. Social withdrawal has been associated with oxytocin availability. There is also evidence that inflammatory processes may contribute to individual Suicide Crisis Syndrome symptoms. CONCLUSION The Suicide Crisis Syndrome is a complex syndrome that is likely the consequence of distinct changes in interconnected neural, neuroendocrine, and autonomic systems. Available clinical and research data allow for development of empirically testable hypotheses and experimental paradigms to scrutinize the biological substrates of the Suicide Crisis Syndrome.
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Affiliation(s)
- Raffaella Calati
- Department of Psychiatry, Mount Sinai Beth Israel, New York, New York,Icahn School of Medicine at Mount Sinai, New York, New York,Department of Psychology, University of Milan-Bicocca, Milan, Italy,Department of Adult Psychiatry, Nîmes University Hospital, Nîmes, France,Correspondence: Raffaella Calati, PsyD, PhD, Department of Psychology, University of Milan-Bicocca, Piazza dell’Ateneo Nuovo 1, 20126, Milan, Italy ()
| | - Charles B Nemeroff
- Department of Psychiatry, University of Texas Dell Medical School, Austin, Texas
| | - Jorge Lopez-Castroman
- Department of Adult Psychiatry, Nîmes University Hospital, Nîmes, France,INSERM, University of Montpellier, Neuropsychiatry: Epidemiological and Clinical Research, Montpellier, France
| | - Lisa J Cohen
- Department of Psychiatry, Mount Sinai Beth Israel, New York, New York,Icahn School of Medicine at Mount Sinai, New York, New York
| | - Igor Galynker
- Department of Psychiatry, Mount Sinai Beth Israel, New York, New York,Icahn School of Medicine at Mount Sinai, New York, New York
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91
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A study of psychological pain in substance use disorder and its relationship to treatment outcome. PLoS One 2019; 14:e0216266. [PMID: 31697679 PMCID: PMC6837512 DOI: 10.1371/journal.pone.0216266] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Accepted: 10/23/2019] [Indexed: 12/02/2022] Open
Abstract
Substance Use Disorder (SUD) is a major public health concern affecting an estimated 22.5 million individuals in the United States. The primary aim of this study was to characterize psychological pain in a cohort of patients participating in outpatient treatment for SUD. A secondary aim was to determine the relationships between pre-treatment assessments of psychological pain, depression, anxiety and hopelessness with treatment retention time and completion rates. Data was analyzed from 289 patients enrolled in an outpatient community drug treatment clinic in Southern California, U.S. A previously determined threshold score on the Mee-Bunney Psychological Pain Assessment Scale (MBP) was utilized to group patients into high and low-moderate scoring subgroups. The higher pain group scored higher on measures of anxiety, hopelessness and depression compared to those in the low-moderate pain group. Additionally, patients scoring in the higher psychological pain group exhibited reduced retention times in treatment and more than two-fold increased odds of dropout relative to patients with lower pre-treatment levels of psychological pain. Among all assessments, the correlation between psychological pain and treatment retention time was strongest. To our knowledge, this is the first study to demonstrate that psychological pain is an important construct which correlates with relevant clinical outcomes in SUD. Furthermore, pre-treatment screening for psychological pain may help target higher-risk patients for clinical interventions aimed at improving treatment retention and completion rates.
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[An example of post-discharge monitoring after a suicide attempt: VigilanS]. Encephale 2018; 45 Suppl 1:S13-S21. [PMID: 30477899 DOI: 10.1016/j.encep.2018.09.009] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2018] [Revised: 09/04/2018] [Accepted: 09/08/2018] [Indexed: 11/21/2022]
Abstract
BACKGROUND Attempted suicide is a major risk factor of further re-attempts and death. Self-harm behaviors are related to multiple causes explaining why it is ineffective to have a single and simple strategy to offer after the clinical assessment in reducing morbidity and mortality. Furthermore, treatment adherence is known to be especially poor in a context where social connection seems compromised and a source of pain. Effective interventions can be divided into two categories: intensive intervention programs (care at home, supported by a series of brief psychotherapy interventions) and case management programs that rely on a "stay in contact" dimension. These programs, initiated by Jerome Motto and its short letters may consist of: (1) sending letters or postcards after discharge of the ER; (2) giving a crisis card that offers a crisis telephone line and a crisis unit for hospitalization if needed, and; (3) placing a phone call at some time distance after the discharge. The aim is to enhance a "connectedness feeling" with the patient. These different strategies have proven to be even more effective in some specific subgroups, highlighting the heterogeneity of this population. Each modality of contact was well accepted and generated a positive involvement of the patients. METHOD It led to the idea of combining these different strategies in an algorithm built on the specificity of identified subgroups. A randomized controlled trial, named ALGOS was carried out in France to test this algorithm in 2011. The algorithm consisted of: (1) delivering a crisis card for first attempters; (2) giving a phone call for re-attempters to re-assess their situation between the 10th and 21st day after their discharge, and to propose a new intervention if needed, and; (3) in case of an unsuccessful call or a refusal of proposed care, sending personalized postcards for 6 months. All of this was supported with shared information to the general practitioner of the patient. This study was further adapted to routine care in 2015 in the northern departments of France, Nord and Pas-de-Calais (4.3 million people), taking the name of VigilanS. The inclusion consists of sending a form for every patient assessed after a suicide attempt in the two departments to the medical staff of VigilanS in order to provide information about the patient and the context of his suicide attempt. The algorithm has been modified in giving the crisis card to all the patients whether it is a first attempt or not. An information letter, explaining the aim of the monitoring is also given to the patient, and to his general practitioner. The calling staff is composed of 4 nurses and 4 psychologists, all trained in suicidal crisis management. They use a phone platform located in the Emergency Medical Assistance Service (SAMU) of the Nord department on a halftime basis and manage the incoming calls from the patients as well as the outgoing calls towards the patients, their relatives and their medical contacts. A set of 4 postcards (1 per month) can be sent if needed in case of an inconclusive or a failed phone call. CONCLUSION Built on a monitoring philosophy, VigilanS has further developed a real crisis case management dimension requiring enough time to insure an effective medical supervision and strong networking abilities. A specific time is also needed to take care of all the technical aspects of the organization. This program expertise, designed by Northern departments to prevent suicide, can be shared with other French or even foreign territories.
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