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Liaugaudaite V, Fineberg NA, Podlipskyte A, Gecaite J, Juskiene A, Mickuviene N, Burkauskas J. Neurocognitive markers of suicidal ideation in patients with anxiety and mood disorders. Int J Psychiatry Clin Pract 2020; 24:116-119. [PMID: 32162978 DOI: 10.1080/13651501.2019.1666148] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Objective: This study aims at identifying associations between cognitive function and suicidal ideation in the sample of patients with anxiety and mood disorders (AMD).Methods: In sum, 186 (age = 39 ± 12.3 years; 142 [76.3%] females) patients with AMD were enrolled in the study. Assessment included evaluation of socio-demographic information, medication use, anxiety and depression symptoms. Cognitive tests included measures of psychomotor performance and incidental learning using the Digit Symbol Test. Trail Making Tests respectively measured perceptual speed, task-switching and executive control. Additionally, 21 patients completed tests from the Cambridge Automated Neuropsychological Test Battery measuring set shifting (Interdimensional/extradimensional set-shift), executive planning (Stockings of Cambridge), and decision making (Cambridge Gamble Task [CGT]).Results: Almost half (45.0%, n = 86) of the study sample patients had experienced suicidal ideations. In multivariable regression analysis, suicidal ideation was associated with a greater overall proportion of bet and risk taking on the CGT task (β = 0.726, p = .010 and β = 0.634, p = .019), when controlling for socio-demographic characteristics, medication use, anxiety and depression symptoms.Conclusions: Outpatients with AMD and suicidal ideation could be distinguished by the presence of cognitive deficits in the executive function domain, particularly in impulse-control and risk taking.
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Affiliation(s)
- Vilma Liaugaudaite
- Laboratory of Behavioral Medicine, Neuroscience Institute, Lithuanian University of Health Sciences, Palanga, Lithuania
| | - Naomi A Fineberg
- National Obsessive Compulsive Disorders Specialist Service, Hertfordshire Partnership University NHS Foundation Trust, Welwyn Garden City, UK.,Highly Specialised Service for Obsessive Compulsive Disorders, University of Hertfordshire, Hatfield, UK
| | - Aurelija Podlipskyte
- Laboratory of Behavioral Medicine, Neuroscience Institute, Lithuanian University of Health Sciences, Palanga, Lithuania
| | - Julija Gecaite
- Laboratory of Behavioral Medicine, Neuroscience Institute, Lithuanian University of Health Sciences, Palanga, Lithuania
| | - Alicja Juskiene
- Laboratory of Behavioral Medicine, Neuroscience Institute, Lithuanian University of Health Sciences, Palanga, Lithuania
| | - Narseta Mickuviene
- Laboratory of Behavioral Medicine, Neuroscience Institute, Lithuanian University of Health Sciences, Palanga, Lithuania
| | - Julius Burkauskas
- Laboratory of Behavioral Medicine, Neuroscience Institute, Lithuanian University of Health Sciences, Palanga, Lithuania
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Malhi GS, Das P, Outhred T, Bryant RA, Calhoun V, Mann JJ. Default mode dysfunction underpins suicidal activity in mood disorders. Psychol Med 2020; 50:1214-1223. [PMID: 31144614 DOI: 10.1017/s0033291719001132] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
BACKGROUND Suicide is a serious and not uncommon consequence of mood disorders that occurs primarily when individuals are depressed. Understanding the neurobiology of suicidal activity (thoughts or behaviors) is likely to facilitate prevention. METHOD Seventy-nine adult depressed mood disorder patients (MDP), of which 25 had attempted suicide at least once, and 66 healthy controls (HC) participated in this study. Resting-state functional MRI was used to identify neural activity differences between suicide attempters (SA) and non-attempters (NA). Specifically, differences were examined in functional connectivity both within and between four large cognitive networks [Executive Control (ECN), Default Mode (DMN), Salience (SN), and Basal Ganglia (BGN)] and their respective associations with suicidal activity. RESULTS Compared to HCs, patients had greater posterior DMN activity, but less activity in the BGN, and less low-frequency spectral power in the dorso-medial DMN. Furthermore, increased posterior DMN activity in SA was associated with recent suicidal activity, whereas NA had reduced BGN activity and less dorso-medial DMN spectral power, the latter being associated with lifelong suicidal thinking. SA also had greater activity in midline circuitry compared to both HC and NA, and the pattern of BGN and DMN co-activity differed between SA and NA. CONCLUSIONS DMN engagement raises the possibility that suicidal activity in mood disorder patients may be a consequence of impaired self-referential thought processing. Furthermore, differential BGN and DMN co-activation according to suicide attempt status suggests that attempting suicide perhaps alters cognitive flexibility. These insights are potentially useful for understanding the neural basis of suicide activity.
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Affiliation(s)
- Gin S Malhi
- Academic Department of Psychiatry, Northern Sydney Local Health District, St Leonards, NSW2065, Australia
- ARCHI, Sydney Medical School Northern, The University of Sydney, NSW2006, Australia
- Sydney Medical School Northern, The University of Sydney, NSW2006, Australia
- CADE Clinic, Royal North Shore Hospital, Northern Sydney Local Health District, St Leonards, NSW2065, Australia
| | - Pritha Das
- Academic Department of Psychiatry, Northern Sydney Local Health District, St Leonards, NSW2065, Australia
- ARCHI, Sydney Medical School Northern, The University of Sydney, NSW2006, Australia
- Sydney Medical School Northern, The University of Sydney, NSW2006, Australia
- CADE Clinic, Royal North Shore Hospital, Northern Sydney Local Health District, St Leonards, NSW2065, Australia
| | - Tim Outhred
- Academic Department of Psychiatry, Northern Sydney Local Health District, St Leonards, NSW2065, Australia
- ARCHI, Sydney Medical School Northern, The University of Sydney, NSW2006, Australia
- Sydney Medical School Northern, The University of Sydney, NSW2006, Australia
- CADE Clinic, Royal North Shore Hospital, Northern Sydney Local Health District, St Leonards, NSW2065, Australia
| | - Richard A Bryant
- School of Psychology, University of New South Wales, Sydney, New South Wales, NSW2052, Australia
| | - Vince Calhoun
- The Mind Research Network, Albuquerque, NM, USA
- Department of Electrical and Computer Engineering, University of New Mexico, Albuquerque, NM, USA
| | - J John Mann
- Department of Psychiatry, Columbia University, New York, USA
- Molecular Imaging and the Neuropathology Division, New York State Psychiatric Institute, New York, USA
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53
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Kim SI, Kong KA. The Relationship between Performance of Attention Task and Suicidal Ideation in Korean Patients with Mood Disorders. Psychiatry Investig 2020; 17:374-381. [PMID: 32252509 PMCID: PMC7176557 DOI: 10.30773/pi.2020.0020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Accepted: 02/19/2020] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE We examined the performance of attention tests related to suicidal ideation in mood disorder patients and to explain the difference of attention test performance in relation to suicidal ideation after controlling clinical and psychological variables of mood disorder patients. METHODS Seventy-three in- and outpatients with major depressive disorder (n=41) or bipolar disorder (n=32) completed a self-rating questionnaire assessing socio-demographic characteristics, and clinical and psychological variables. Comprehensive Attention Test (CAT) also was conducted. RESULTS Thirty-three patients were the high-suicidal ideation (SI) group, and forty patients were the low-SI group. The errors of commission (CEs) of visual sustained attention in the high-SI group was 6.3 times higher on average than that of the low-SI group. After controlling for sex, age, and diagnosis, a higher number of CEs on visual sustained attention tasks predicted higher SI score. However, after controlling for sex, age, diagnosis, and depressive mood, this predictive ability was no longer observed. CONCLUSION This study showed that CE on the visual sustained attention task seems to influence suicidal ideation as a result of interaction with depressive symptoms.
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Affiliation(s)
- Soo In Kim
- Department of Psychiatry, Ewha Womans University College of Medicine, Seoul, Republic of Korea
| | - Kyoung Ae Kong
- Department of Preventive Medicine, Ewha Womans University College of Medicine, Seoul, Republic of Korea
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Orsolini L, Latini R, Pompili M, Serafini G, Volpe U, Vellante F, Fornaro M, Valchera A, Tomasetti C, Fraticelli S, Alessandrini M, La Rovere R, Trotta S, Martinotti G, Di Giannantonio M, De Berardis D. Understanding the Complex of Suicide in Depression: from Research to Clinics. Psychiatry Investig 2020; 17:207-221. [PMID: 32209966 PMCID: PMC7113180 DOI: 10.30773/pi.2019.0171] [Citation(s) in RCA: 162] [Impact Index Per Article: 40.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Accepted: 02/27/2020] [Indexed: 02/07/2023] Open
Abstract
OBJECTIVE Amongst psychiatric disorders, major depressive disorder (MDD) is the most prevalent, by affecting approximately 15-17% of the population and showing a high suicide risk rate equivalent to around 15%. The present comprehensive overview aims at evaluating main research studies in the field of MDD at suicide risk, by proposing as well as a schematic suicide risk stratification and useful flow-chart for planning suicide preventive and therapeutic interventions for clinicians. METHODS A broad and comprehensive overview has been here conducted by using PubMed/Medline, combining the search strategy of free text terms and exploded MESH headings for the topics of 'Major Depressive Disorder' and 'Suicide' as following: ((suicide [Title/Abstract]) AND (major depressive disorder [Title/Abstract])). All articles published in English through May 31, 2019 were summarized in a comprehensive way. RESULTS Despite possible pathophysiological factors which may explain the complexity of suicide in MDD, scientific evidence supposed the synergic role of genetics, exogenous and endogenous stressors (i.e., interpersonal, professional, financial, as well as psychiatric disorders), epigenetic, the hypothalamic-pituitary-adrenal stress-response system, the involvement of the monoaminergic neurotransmitter systems, particularly the serotonergic ones, the lipid profile, neuro-immunological biomarkers, the Brain-derived neurotrophic factor and other neuromodulators. CONCLUSION The present overview reported that suicide is a highly complex and multifaceted phenomenon in which a large plethora of mechanisms could be variable implicated, particularly amongst MDD subjects. Beyond these consideration, modern psychiatry needs a better interpretation of suicide risk with a more careful assessment of suicide risk stratification and planning of clinical and treatment interventions.
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Affiliation(s)
- Laura Orsolini
- Psychopharmacology, Drug Misuse and Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, UK.,Neomesia Mental Health, Villa Jolanda Hospital, Jesi, Italy.,Polyedra, Teramo, Italy
| | - Roberto Latini
- Neomesia Mental Health, Villa Jolanda Hospital, Jesi, Italy
| | - Maurizio Pompili
- Department of Neurosciences, Mental Health and Sensory Organs, Suicide Prevention Center, S. Andrea Hospital, Sapienza University, Rome, Italy
| | - Gianluca Serafini
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Umberto Volpe
- Department of Clinical Neurosciences/DIMSC, School of Medicine, Section of Psychiatry, Polytechnic University of Marche, Ancona, Italy
| | - Federica Vellante
- Department of Neuroscience, Imaging and Clinical Science, Chair of Psychiatry, University of "G. D'Annunzio", Chieti, Italy
| | - Michele Fornaro
- Polyedra, Teramo, Italy.,Department of Psychiatry, Federico II University, Naples, Italy
| | - Alessandro Valchera
- Polyedra, Teramo, Italy.,Villa S. Giuseppe Hospital, Hermanas Hospitalarias, Ascoli Piceno, Italy
| | - Carmine Tomasetti
- Department of Mental Health, National Health Service, Psychiatric Service of Diagnosis and Treatment, Hospital "SS. Annunziata" ASL 4, Giulianova, Italy
| | - Silvia Fraticelli
- Department of Neuroscience, Imaging and Clinical Science, Chair of Psychiatry, University of "G. D'Annunzio", Chieti, Italy
| | - Marco Alessandrini
- Department of Neuroscience, Imaging and Clinical Science, Chair of Psychiatry, University of "G. D'Annunzio", Chieti, Italy
| | - Raffaella La Rovere
- Department of Mental Health, National Health Service, Azienda Sanitaria Locale, Pescara, Italy
| | - Sabatino Trotta
- Department of Mental Health, National Health Service, Azienda Sanitaria Locale, Pescara, Italy
| | - Giovanni Martinotti
- Department of Neuroscience, Imaging and Clinical Science, Chair of Psychiatry, University of "G. D'Annunzio", Chieti, Italy
| | - Massimo Di Giannantonio
- Department of Neuroscience, Imaging and Clinical Science, Chair of Psychiatry, University of "G. D'Annunzio", Chieti, Italy
| | - Domenico De Berardis
- Department of Neuroscience, Imaging and Clinical Science, Chair of Psychiatry, University of "G. D'Annunzio", Chieti, Italy.,Department of Mental Health, National Health Service, Psychiatric Service of Diagnosis and Treatment, Hospital "G. Mazzini", ASL 4, Teramo, Italy
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Ozcan S, Gica S, Gulec H. Suicidal behavior in treatment resistant major depressive disorder patients treated with transmagnetic stimulation(TMS) and its relationship with cognitive functions. Psychiatry Res 2020; 286:112873. [PMID: 32114209 DOI: 10.1016/j.psychres.2020.112873] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Revised: 02/10/2020] [Accepted: 02/18/2020] [Indexed: 12/28/2022]
Abstract
The aim of this study is to investigate the effects of rTMS treatment on suicidal thoughts/behaviors and to determine the cognitive mechanisms underlying the effects of rTMS treatment on suicidal thoughts/behaviors in treatment-resistant depression(TRD). Thirty patients with TRD received rTMS 5 sessions per week for 4-6 weeks. Montgomery-Asberg Depression Rating Scale(MADRS), Columbia Suicide Severity Rating Scale(C-SSRS), Suicidal Ideation Scale(SIS), Beck Hopelessness Scale(BHS) and Cambridge Neuropsychological Test Automated Battery(CANTAB) were administered before and after treatment. After rTMS treatment, there was a significant decrease in depressive complaints and suicidal thoughts and improvement in emotional recognition. However, there was no significant change in cognitive functions such as cognitive flexibility, motor response inhibition and decision making. Pre-treatment decision-making and flexible thinking skills were related to the change in suicidal ideation. In TRD patients, rTMS has a positive effect on depressive symptoms and suicidal thoughts/behaviors and emotion recognition abilities. Although there is no negative effect on other cognitive functions, the positive effect of rTMS on cognitive functions is limited. At this point, we think that the TRD would be treated more effectively with treatments targeting specific symptom clusters such as other cognitive functions and suicidal thoughts.
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Affiliation(s)
- Selma Ozcan
- University of Health Sciences Antalya Training and Research Hospital, Department of Psychiatry, Antalya, Turkey
| | - Sakir Gica
- Necmettin Erbakan University, Meram Medical Faculty, Department of Psychiatry, Konya, Turkey.
| | - Huseyin Gulec
- University of Health Sciences Istanbul Erenkoy Mental Health and Neurological Disease Education and Research Hospital Psychiatry, Istanbul, Turkey
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Abstract
OBJECTIVES The objective of this study is to evaluate the relationship between suicidal ideation (SI), structural brain damage, and cognitive deficits in patients with penetrating traumatic brain injury (pTBI). METHODS Vietnam War veterans (n = 142) with pTBI to the prefrontal cortex (PFC) underwent combination of neuropsychological and psychiatric examinations and non-contrast CT brain scan. Patients were divided into SI positive (SI+) and SI negative (SI-) groups according to the SI item of the Beck Depression Inventory. RESULTS Lesions to the left rostrolateral PFC (rlPFC) were associated with a lower risk of SI independent of depression and global functioning. Left rlPFC lesion also reduced abstract reasoning skills, which mediated the lesion effects on suicide ideation. CONCLUSIONS The left rlPFC plays a crucial role in SI independently of depression and global functioning.
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57
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Goldman-Mellor S, Phillips D, Brown P, Gruenewald P, Cerdá M, Wiebe D. Emergency Department Use and Inpatient Admissions and Costs Among Adolescents With Deliberate Self-Harm: A Five-Year Follow-Up Study. Psychiatr Serv 2020; 71:136-143. [PMID: 31575352 PMCID: PMC7002213 DOI: 10.1176/appi.ps.201900153] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
OBJECTIVE Self-harm rates among U.S. adolescents have risen substantially. Health and social outcomes among contemporary self-harming youths are infrequently tracked and poorly understood. This study investigated long-term health service utilization (emergency department [ED] visits and inpatient admissions) and inpatient costs among a recent cohort of adolescents with deliberate self-harm. METHODS This retrospective cohort study used statewide, all-payer, longitudinally linked discharge data from California. All residents ages 10-19 presenting to EDs in 2010 with deliberate self-harm (N=5,396) were compared with two control groups: a random sample of adolescent ED patients with other complaints, matched on sex, age, residential zip code, and month of index visit (general control patients, N=14,921), and matched ED patients with psychiatric complaints but no self-harm (psychiatric control patients, N=15,835). Outcomes included 5-year rates of ED visits, inpatient admissions, and inpatient costs, overall and for psychiatric and nonpsychiatric complaints separately. RESULTS Self-harm patients' ED use, inpatient admissions, and inpatient costs were significantly higher than those of general control patients (by 39%, 81%, and 21%, respectively), when the analysis controlled for confounding demographic and utilization characteristics. Associations mostly persisted, although smaller in magnitude, in comparisons between self-harm and psychiatric control patients. Psychiatric and nonpsychiatric complaints contributed to self-harming adolescents' excess health service utilization and costs. CONCLUSIONS Deliberate self-harm among adolescents was found to be associated with long-lasting and costly patterns of health service utilization, often but not exclusively for psychiatric complaints. Future research should investigate the pathways underlying these associations and incorporate service utilization as a key patient outcome.
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Affiliation(s)
- Sidra Goldman-Mellor
- Department of Public Health (Goldman-Mellor, Phillips, Brown), Department of Psychology (Wiebe), School of Social Sciences, Humanities, and Arts, University of California, Merced; Prevention Research Center, Pacific Institute for Research and Evaluation; Oakland, California (Gruenewald); Department of Population Health, New York University; New York (Cerdá)
| | - Dwena Phillips
- Department of Public Health (Goldman-Mellor, Phillips, Brown), Department of Psychology (Wiebe), School of Social Sciences, Humanities, and Arts, University of California, Merced; Prevention Research Center, Pacific Institute for Research and Evaluation; Oakland, California (Gruenewald); Department of Population Health, New York University; New York (Cerdá)
| | - Paul Brown
- Department of Public Health (Goldman-Mellor, Phillips, Brown), Department of Psychology (Wiebe), School of Social Sciences, Humanities, and Arts, University of California, Merced; Prevention Research Center, Pacific Institute for Research and Evaluation; Oakland, California (Gruenewald); Department of Population Health, New York University; New York (Cerdá)
| | - Paul Gruenewald
- Department of Public Health (Goldman-Mellor, Phillips, Brown), Department of Psychology (Wiebe), School of Social Sciences, Humanities, and Arts, University of California, Merced; Prevention Research Center, Pacific Institute for Research and Evaluation; Oakland, California (Gruenewald); Department of Population Health, New York University; New York (Cerdá)
| | - Magdalena Cerdá
- Department of Public Health (Goldman-Mellor, Phillips, Brown), Department of Psychology (Wiebe), School of Social Sciences, Humanities, and Arts, University of California, Merced; Prevention Research Center, Pacific Institute for Research and Evaluation; Oakland, California (Gruenewald); Department of Population Health, New York University; New York (Cerdá)
| | - Deborah Wiebe
- Department of Public Health (Goldman-Mellor, Phillips, Brown), Department of Psychology (Wiebe), School of Social Sciences, Humanities, and Arts, University of California, Merced; Prevention Research Center, Pacific Institute for Research and Evaluation; Oakland, California (Gruenewald); Department of Population Health, New York University; New York (Cerdá)
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Ryan AT, Phalen P, Jahn DR, Wastler H, Bennett M, Ghahramanlou-Holloway M, Schwartz B. Cognitive impairment and depression symptoms are independently associated with suicidal ideation in US Veterans. Psychiatry Res 2020; 286:112833. [PMID: 32062520 DOI: 10.1016/j.psychres.2020.112833] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Revised: 01/29/2020] [Accepted: 01/29/2020] [Indexed: 10/25/2022]
Abstract
Depression is associated with cognitive impairment and suicidality. The independent association between cognitive impairment and suicidality is less clear. We examined the relationship between suicidal ideation and cognitive impairment in a sample of 50 veterans with depressive disorder diagnoses. Using zero-inflated Poisson regression, the severity of suicidal ideation was negatively associated with attention (incidence rate ratio [IRR] = 0.78, p < .001), memory (IRR = 0.87, p < .001), and total cognition (IRR = 0.90, p = .007) index scores as measured by the Dementia Rating Scale 2 (DRS-2). These three indices continued to significantly predict suicidal ideation severity once depression symptoms were controlled for.
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Affiliation(s)
- Arthur T Ryan
- Veterans Affairs VISN 5 Mental Illness Research, Education, and Clinical Center (MIRECC), Baltimore, MD, USA; Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA.
| | - Peter Phalen
- Veterans Affairs VISN 5 Mental Illness Research, Education, and Clinical Center (MIRECC), Baltimore, MD, USA; Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Danielle R Jahn
- Mental Health Center for Acute Recovery Empowerment, Orlando Veterans Affairs Medical Center, Orlando, FL, USA
| | - Heather Wastler
- Veterans Affairs VISN 5 Mental Illness Research, Education, and Clinical Center (MIRECC), Baltimore, MD, USA
| | - Melanie Bennett
- Veterans Affairs VISN 5 Mental Illness Research, Education, and Clinical Center (MIRECC), Baltimore, MD, USA; Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Marjan Ghahramanlou-Holloway
- Suicide Care, Prevention, and Research Initiative, Department of Medical & Clinical Psychology, Uniformed Services University, Bethesda, MD, USA
| | - Barbara Schwartz
- Mental Health Service, Washington DC Veterans Affairs Medical Center, Washington, DC, USA
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Abstract
Suicide is a global health issue accounting for at least 800,000 deaths per annum. Numerous models have been proposed that differ in their emphasis on the role of psychological, social, psychiatric and neurobiological factors in explaining suicide risk. Central to many models is a stress-diathesis component which states that suicidal behavior is the result of an interaction between acutely stressful events and a susceptibility to suicidal behavior (a diathesis). This article presents an overview of studies that demonstrate that stress and dysregulated hypothalamic-pituitary-adrenal (HPA) axis activity, as measured by cortisol levels, are important additional risk factors for suicide. Evidence for other putative stress-related suicide risk factors including childhood trauma, impaired executive function, impulsivity and disrupted sleep are considered together with the impact of family history of suicide, perinatal and epigenetic influences on suicide risk.
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60
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Qiao D, Zhang A, Sun N, Yang C, Li J, Zhao T, Wang Y, Xu Y, Wen Y, Zhang K, Liu Z. Altered Static and Dynamic Functional Connectivity of Habenula Associated With Suicidal Ideation in First-Episode, Drug-Naïve Patients With Major Depressive Disorder. Front Psychiatry 2020; 11:608197. [PMID: 33391057 PMCID: PMC7772142 DOI: 10.3389/fpsyt.2020.608197] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2020] [Accepted: 11/18/2020] [Indexed: 01/01/2023] Open
Abstract
Investigating the neurobiological mechanism of suicidal ideation (SI) in major depressive disorder (MDD) may be beneficial to prevent the suicidal behavior. Mounting evidence showed that habenula contributed to the etiology of MDD. The habenula is a key brain region that links the forebrain to midbrain, crucial for the processing of reward and aversion. The aim of the present study was to identify whether first-episode, drug-naive MDD patients with SI displayed altered habenula neural circuitry. Forty-three and 38 drug-naïve patients with first-episode MDD with or without SI (SI+/- group) and 35 healthy control subjects (HC) underwent resting-state functional magnetic resonance imaging. The whole-brain habenula static (sFC) and dynamic functional connectivity (dFC) were calculated to identify regions showing significant difference among these three groups followed by region of interest to region of interest post hoc analysis. For sFC, compared with SI- and HC groups, SI+ group showed decreased sFC from habenula to the precuneus and the inferior frontal gyrus. Patients with MDD displayed increased sFC from habenula to the putamen but decreased sFC to the precentral gyrus. For dFC, SI+ group showed increased dFC from habenula to the superior temporal gyrus, the precuneus, but decreased dFC to the lingual gyrus, the postcentral gyrus, when comparing with SI- and HC groups. Patients with MDD, regardless of SI, displayed decreased dFC from the habenula to the angular gyrus. These findings provide evidence that SI in first-episode, drug-naïve patients with MDD may be related to an abnormality in habenula neural circuitry, which may provide the theoretical basis of novel treatments.
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Affiliation(s)
- Dan Qiao
- Department of Psychiatry, The First Hospital of Shanxi Medical University, Taiyuan, China.,The First Clinical Medical College, Shanxi Medical University, Taiyuan, China
| | - Aixia Zhang
- Department of Psychiatry, The First Hospital of Shanxi Medical University, Taiyuan, China
| | - Ning Sun
- Department of Psychiatry, The First Hospital of Shanxi Medical University, Taiyuan, China
| | - Chunxia Yang
- Department of Psychiatry, The First Hospital of Shanxi Medical University, Taiyuan, China
| | - Jianying Li
- Department of Psychiatry, The First Hospital of Shanxi Medical University, Taiyuan, China
| | - Ting Zhao
- Department of Psychiatry, The First Hospital of Shanxi Medical University, Taiyuan, China
| | - Yuchen Wang
- Department of Psychiatry, The First Hospital of Shanxi Medical University, Taiyuan, China
| | - Yifan Xu
- Department of Psychiatry, The First Hospital of Shanxi Medical University, Taiyuan, China
| | - Yujiao Wen
- Department of Psychiatry, The First Hospital of Shanxi Medical University, Taiyuan, China
| | - Kerang Zhang
- Department of Psychiatry, The First Hospital of Shanxi Medical University, Taiyuan, China
| | - Zhifen Liu
- Department of Psychiatry, The First Hospital of Shanxi Medical University, Taiyuan, China
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Huber RS, Hodgson R, Yurgelun-Todd DA. A qualitative systematic review of suicide behavior using the cognitive systems domain of the research domain criteria (RDoC) framework. Psychiatry Res 2019; 282:112589. [PMID: 31703982 DOI: 10.1016/j.psychres.2019.112589] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Revised: 09/23/2019] [Accepted: 09/26/2019] [Indexed: 12/24/2022]
Abstract
Neurocognitive deficits are associated with both suicide behavior (SB) and psychiatric disorders. Application of a transdiagnostic framework to identify neurocognitive commonalities of SB may clarify important risk factors of SB across psychiatric disorders. The aim of this study was to conduct a qualitative systematic literature review of SB using the Research Domain Criteria (RDoC) Cognitive Systems framework to determine if cognitive deficits exist independently of psychiatric disorders in SB. The following six constructs that encompass the Cognitive Systems domain were assessed: 1) Attention, 2) Cognitive Control, 3) Declarative Memory, 4) Language, 5) Perception, and 6) Working Memory. A total of 1386 abstracts were identified and 74 studies met the inclusion criteria for this review. The majority of studies reviewed (65%) had significant differences in cognition between individuals with and without SB. Seventy-nine percent of studies with a patient control group showed significant cognitive deficits in SB groups. Deficits in cognitive control were associated with SB and had the greatest percentage of studies with significant main findings. Use of the RDoC cognitive systems framework to evaluate SB revealed that cognitive deficits may be a transdiagnostic risk factor for SB, especially alterations in cognitive control.
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Affiliation(s)
- Rebekah S Huber
- Department of Psychiatry, University of Utah School of Medicine, Salt Lake City, UT, United States; Diagnostic Neuroimaging Laboratory, University of Utah, Salt Lake City, UT, United States.
| | - Riley Hodgson
- Diagnostic Neuroimaging Laboratory, University of Utah, Salt Lake City, UT, United States
| | - Deborah A Yurgelun-Todd
- Department of Psychiatry, University of Utah School of Medicine, Salt Lake City, UT, United States; Diagnostic Neuroimaging Laboratory, University of Utah, Salt Lake City, UT, United States; U.S. Department of Veterans Affairs Rocky Mountain Mental Illness Research, Education and Clinical Center, Salt Lake City, UT, United States
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Bomyea J, Stout DM, Simmons AN. Attenuated prefrontal and temporal neural activity during working memory as a potential biomarker of suicidal ideation in veterans with PTSD. J Affect Disord 2019; 257:607-614. [PMID: 31349177 DOI: 10.1016/j.jad.2019.07.050] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2018] [Revised: 04/05/2019] [Accepted: 07/04/2019] [Indexed: 12/17/2022]
Abstract
BACKGROUND Suicide is a significant health concern among veterans, and suicidal ideation is a common and functionally debilitating condition that frequently precedes suicidal behavior. Characterizing neurobiological substrates associated with suicidal ideation in veterans may inform evaluation of risk for this population. Associations between suicidal ideation and functional abnormalities in prefrontal, temporal, and striatal regions supporting cognitive task performance have been documented in individuals with mood and psychotic disorders, suggesting a potential role for neurocognitive vulnerabilities in this condition. To date, however, relatively little research has explored neural correlates of suicidal ideation, particularly among individuals with posttraumatic stress disorder (PTSD). METHODS Twenty three combat veterans diagnosed with PTSD completed an adapted Reading Span (Rspan) working memory task during functional magnetic resonance imaging (fMRI). Participants were classified based on presence of current SI. We evaluated differences between these groups on neural activation in response to interference-based working memory demands within the task. Primary analyses were conducted using a voxel-wise between-group t-test. RESULTS Task-based activations were observed in regions including the cingulate, middle frontal, parietal, and occipital cortex, striatum, and cerebellum. Relative to individuals without SI, individuals with SI demonstrated less activation in a large region spanning the lateral prefrontal cortex and cingulate cortex, as well as the inferior temporal cortex, in response to interference demands. CONCLUSIONS Results are consistent with models proposing that prefrontal neural substrates involved in cognitive regulation are implicated in suicidal ideation. Involvement of temporal functioning may also exist based on current findings. Future research is needed to understand whether disturbances in prefrontal regulatory control reflect a specific profile subtype with distinct neural correlates, and how such neural patterns may be used to improve detection and treatment personalization.
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Affiliation(s)
- J Bomyea
- VA San Diego Healthcare System Center of Excellence for Stress and Mental Health, University of California, San Diego, United States.
| | - D M Stout
- VA San Diego Healthcare System Center of Excellence for Stress and Mental Health, University of California, San Diego, United States
| | - A N Simmons
- VA San Diego Healthcare System Center of Excellence for Stress and Mental Health, University of California, San Diego, United States
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63
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Song W, Li H, Guo T, Jiang S, Wang X. Effect of Affective Reward on Cognitive Event-related Potentials and its Relationship with Psychological Pain and Suicide Risk among Patients with Major Depressive Disorder. Suicide Life Threat Behav 2019; 49:1290-1306. [PMID: 30390328 DOI: 10.1111/sltb.12524] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2018] [Accepted: 07/18/2018] [Indexed: 11/27/2022]
Abstract
OBJECTIVE The present study aimed to explore the electrophysiological correlates involved in three-dimensional psychological pain and their relationship with suicide in patients with major depressive disorder. METHOD The sample comprised 23 and nine patients with major depressive disorder with high and low risk for suicide, respectively, and 24 healthy controls. All participants completed the measurements and performed an event-related potential-based analogue of the affective incentive delay task. The event-related potential components previously associated with motivationally salient cue (contingent negative variation, P2, and cue-P3), target (target-P3), and feedback (reward vs. punishment, feedback-related negativity, and feedback-P3) stimuli were examined. RESULTS All inventory scores differed significantly among the high-risk, low-risk, and healthy control groups. During the expectant phase, the main effect of group and interaction between group and condition was significant in the average amplitudes of the cue-P2 component. During the feedback phase, the feedback-P3 elicited by positive feedback had a significant main effect of group and of the interaction between group and condition. Specifically, the feedback-P3 elicited by negative feedback in the punitive condition showed significant positive correlations with the total and subscale scores on the Three-Dimensional Psychological Pain Scale. CONCLUSIONS Feedback-P3 may be an electrobiological component underlying the processing of psychological pain in suicidality.
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Affiliation(s)
- Wei Song
- Department of Psychology, Renmin University of China, Beijing, China
| | - Huanhuan Li
- Department of Psychology, Renmin University of China, Beijing, China
| | - Ting Guo
- Department of Psychology, Renmin University of China, Beijing, China
| | - Songyuan Jiang
- Department of Psychology, Renmin University of China, Beijing, China
| | - Xiang Wang
- Medical Psychological Institution of Second Xiangya Hospital, Central South University, Changsha, China
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Malhi GS. The Ethics of Suicide in Mental Illness: Novel Neuroscientific Perspectives. THE AMERICAN JOURNAL OF BIOETHICS : AJOB 2019; 19:94-96. [PMID: 31566491 DOI: 10.1080/15265161.2019.1654021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
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65
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Harfmann EJ, Rhyner KT, Ingram RE. Cognitive inhibition and attentional biases in the affective go/no-go performance of depressed, suicidal populations. J Affect Disord 2019; 256:228-233. [PMID: 31200162 DOI: 10.1016/j.jad.2019.05.022] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Revised: 05/09/2019] [Accepted: 05/12/2019] [Indexed: 12/23/2022]
Abstract
BACKGROUND Although cognitive inhibition deficits and attentional biases have been associated with suicidality, these findings have not been consistently reported across samples. The aim of the current study was to further investigate these variables among participants with differing suicidal risk. METHODS We compared affective go/no-go performance in 100 depressed individuals with both current suicidal ideation and a prior history of attempted suicide, 100 depressed individuals with current suicidal ideation, but no history of attempted suicide, 100 suicide attempters without current depression or suicidal ideation, and 100 healthy controls. RESULTS Suicide ideators with a history of attempted suicide committed more commission errors during negative word trials than any other group. Additionally, suicide ideators with no attempt history made more commission errors than did controls and previous attempters. An interaction for group status and emotional word valence revealed that suicide ideators with a history of attempted suicide responded fastest to negative words and slowest to positive words. Suicide ideators without an attempt history displayed a similar, but less pronounced pattern. Whereas, controls and previous attempters responded more quickly to positively valenced words. LIMITATIONS The use of cross-sectional self-report data and inclusion of only female participants limits generalizability. CONCLUSIONS Cognitive dysfunctions were apparent in all suicide vulnerable subjects, but significantly greater in suicide ideators with a history of attempted suicide. Suicidal ideation may be associated with a processing bias and inhibitory deficit for negative, mood-congruent information. These findings increase our knowledge of cognitive impairment in suicidality and may potentially help improve intervention strategies.
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Affiliation(s)
- Elisabeth J Harfmann
- Mental Health Department, Clement J. Zablocki Veterans Affairs Medical Center, 5000 W. National Ave, Milwaukee, WI, United States.
| | - Kathleen T Rhyner
- Canandaigua Veterans Affairs Medical Center, Canandaigua, NY, United States
| | - Rick E Ingram
- Department of Psychology, University of Kansas, Lawrence, KS, United States
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Roca M, del Amo ARL, Riera-Serra P, Pérez-Ara MA, Castro A, Roman Juan J, García-Toro M, García-Pazo P, Gili M. Suicidal risk and executive functions in major depressive disorder: a study protocol. BMC Psychiatry 2019; 19:253. [PMID: 31420027 PMCID: PMC6697936 DOI: 10.1186/s12888-019-2233-1] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Accepted: 08/07/2019] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Suicide is a serious public health concern. Depression is the main gateway to suicidal behavior. The already established relationship between depression and suicidal risk should now focus on the investigation of more specific factors: recent studies have suggested an association between vulnerability to suicidal behavior and neurocognitive alterations, a nuclear symptom of depression. This project aims to identify alterations in the Executive Functions (EF) of patients suffering a first depressive episode that might constitute a risk factor for suicidal ideation, suicidal attempts and suicide, to allow for more adequate suicide prevention. METHODS Prospective longitudinal design involving two groups (first depressive episodes with and without alterations in their EF) and four repeated measures (0, 6, 12 and 24 months). The estimated minimum sample size is 216 subjects. The variables and measurement instruments will include socio-demographic variables, clinical variables (age of illness onset, family and personal antecedents, psychopathological and medical comorbidity, suicidal ideation, suicide attempts and completed suicides, severity of depression, including melancholic or atypical, remission of the depressive episode), and neuropsychological variables (EF and decision-making processes evaluated through the Cambridge Neuropsychological Test Automated Battery (CANTAB)). DISCUSSION First and foremost, the identification of clinical and neuropsychological risk factors associated with suicidal behavior will open the possibility to prevent such behavior in patients with a first depressive episode in the context of clinical practice. Secondly, interventions aimed at cognitive impairment (in particular: EF) derived from the study may be incorporated into strategies for the prevention of suicidal behavior. Finally, impaired neurocognitive function (even in early stages) could become an identifiable endophenotype or "marker" in clinical and neurobiological studies about suicidal behavior in depressive patients.
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Affiliation(s)
- Miquel Roca
- Institut Universitari d’Investigació en Ciències de la Salut (IUNICS-IDISBA), University of Balearic Islands, Carretera de Valldemossa, km 7.5, 07122 Palma, Spain
| | | | | | - Mª. Angeles Pérez-Ara
- Institut Universitari d’Investigació en Ciències de la Salut (IUNICS-IDISBA), University of Balearic Islands, Carretera de Valldemossa, km 7.5, 07122 Palma, Spain
| | - Adoración Castro
- Institut Universitari d’Investigació en Ciències de la Salut (IUNICS-IDISBA), University of Balearic Islands, Carretera de Valldemossa, km 7.5, 07122 Palma, Spain
| | | | - Mauro García-Toro
- Institut Universitari d’Investigació en Ciències de la Salut (IUNICS-IDISBA), University of Balearic Islands, Carretera de Valldemossa, km 7.5, 07122 Palma, Spain
| | - Patricia García-Pazo
- Department of Nursing and Physiotherapy, University of the Balearic Islands, Palma, Spain
| | - Margalida Gili
- Institut Universitari d’Investigació en Ciències de la Salut (IUNICS-IDISBA), University of Balearic Islands, Carretera de Valldemossa, km 7.5, 07122 Palma, Spain
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Executive Dysfunction and Language Deficits in a Pediatric Patient with OCD and MDD with Suicidality. Case Rep Psychiatry 2019; 2019:6574304. [PMID: 31183239 PMCID: PMC6515185 DOI: 10.1155/2019/6574304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Accepted: 04/18/2019] [Indexed: 11/17/2022] Open
Abstract
The role of neuropsychiatric testing in psychiatric disorders is becoming more prominent. Neuropsychological measures that are similar across symptom domains and phenomena such as suicidality may help clinicians guide treatment and tailor therapies to the patient in the most effective way possible. We report the case of a 16-year-old girl who presented with bizarre, intrusive suicidal thoughts in the setting of OCD and MDD. This case is unusual in that we have accurate neuropsychological determination of our patient's language and executive function deficits, and we propose a link between them and her expression of suicidality in the context of OCD and MDD.
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68
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Tickell AM, Scott EM, Davenport T, Iorfino F, Ospina-Pinillos L, White D, Harel K, Parker L, Hickie IB, Hermens DF. Developing neurocognitive standard clinical care: A study of young adult inpatients. Psychiatry Res 2019; 276:232-238. [PMID: 31121529 DOI: 10.1016/j.psychres.2019.05.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Revised: 05/01/2019] [Accepted: 05/01/2019] [Indexed: 10/26/2022]
Abstract
Neuropsychological assessments have provided the field of psychiatry with important information about patients. As an assessment tool, a neuropsychological battery can be useful in a clinical setting; however, implementation as standard clinical care in an inpatient unit has not been extensively evaluated. A computerized cognitive battery was administered to 103 current young adult inpatients (19.2 ± 3.1 years; 72% female) with affective disorder. Neurocognitive tasks included Verbal Recognition Memory (VRM), Attention Switching (AST), Paired Association Learning (PAL), and Rapid Visual Processing (RVP). Patients also completed a computerized self-report questionnaire evaluating subjective impressions of their cognition. Hierarchical cluster analysis determined three neurocognitive subgroups: cluster 1 (n = 17) showed a more impaired neurocognitive profile on three of the four variables compared to their peers in cluster 2 (n = 59), and cluster 3 (n = 27), who had the most impaired attentional shifting. Two of the four neurocognitive variables were significantly different between all three cluster groups (verbal learning and sustained attention). Overall group results showed an association between poorer sustained attention and increased suicidal ideation. These findings strengthen the idea that neurocognitive profiles may play an important role in better understanding the severity of illness in young inpatients with major psychiatric disorders.
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Affiliation(s)
- Ashleigh M Tickell
- Clinical Research Unit, Brain and Mind Centre, University of Sydney, 100 Mallett Street, Camperdown, NSW 2050, Australia.
| | - Elizabeth M Scott
- Young Adult Mental Health Unit, Uspace, St Vincent's Private Hospital, Australia
| | - Tracey Davenport
- Clinical Research Unit, Brain and Mind Centre, University of Sydney, 100 Mallett Street, Camperdown, NSW 2050, Australia
| | - Frank Iorfino
- Clinical Research Unit, Brain and Mind Centre, University of Sydney, 100 Mallett Street, Camperdown, NSW 2050, Australia
| | - Laura Ospina-Pinillos
- Clinical Research Unit, Brain and Mind Centre, University of Sydney, 100 Mallett Street, Camperdown, NSW 2050, Australia
| | - Django White
- Clinical Research Unit, Brain and Mind Centre, University of Sydney, 100 Mallett Street, Camperdown, NSW 2050, Australia
| | - Kate Harel
- Young Adult Mental Health Unit, Uspace, St Vincent's Private Hospital, Australia
| | - Lisa Parker
- Young Adult Mental Health Unit, Uspace, St Vincent's Private Hospital, Australia
| | - Ian B Hickie
- Clinical Research Unit, Brain and Mind Centre, University of Sydney, 100 Mallett Street, Camperdown, NSW 2050, Australia
| | - Daniel F Hermens
- Clinical Research Unit, Brain and Mind Centre, University of Sydney, 100 Mallett Street, Camperdown, NSW 2050, Australia; Sunshine Coast Mind and Neuroscience Thompson Institute, University of the Sunshine Coast, Birtinya, QLD, Australia
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69
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Boldrini M, Galfalvy H, Dwork AJ, Rosoklija GB, Trencevska-Ivanovska I, Pavlovski G, Hen R, Arango V, Mann JJ. Resilience Is Associated With Larger Dentate Gyrus, While Suicide Decedents With Major Depressive Disorder Have Fewer Granule Neurons. Biol Psychiatry 2019; 85:850-862. [PMID: 30819514 PMCID: PMC6830307 DOI: 10.1016/j.biopsych.2018.12.022] [Citation(s) in RCA: 67] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2018] [Revised: 12/28/2018] [Accepted: 12/28/2018] [Indexed: 01/04/2023]
Abstract
BACKGROUND Early life adversity (ELA) increases major depressive disorder (MDD) and suicide risk and potentially affects dentate gyrus (DG) plasticity. We reported smaller DG and fewer granular neurons (GNs) in MDD. ELA effects on DG plasticity in suicide decedents with MDD (MDDSui) and resilient subjects (ELA history without MDD or suicide) are unknown. METHODS We quantified neural progenitor cells (NPCs), GNs, glia, and DG volume in whole hippocampus postmortem in four groups of drug-free, neuropathology-free subjects (N = 52 total): psychological autopsy-defined MDDSui and control subjects with and without ELA (before 15 years of age). RESULTS ELA was associated with larger DG (p < .0001) and trending fewer NPCs (p = .0190) only in control subjects in whole DG, showing no effect on NPCs and DG volume in MDDSui. ELA exposure was associated with more GNs (p = .0003) and a trend for more glia (p = .0160) in whole DG in MDDSui and control subjects. MDDSui without ELA had fewer anterior and mid DG GNs (p < .0001), fewer anterior DG NPCs (p < .0001), and smaller whole DG volume (p = .0005) compared with control subjects without ELA. In MDDSui, lower Global Assessment Scale score correlated with fewer GNs and smaller DG. CONCLUSIONS Resilience to ELA involves a larger DG, perhaps related to more neurogenesis depleting NPCs, and because mature GNs and glia numbers do not differ in the resilient group, perhaps there are effects on process extension and synaptic load that can be examined in future studies. In MDDSui without ELA, smaller DG volume, with fewer GNs and NPCs, suggests less neurogenesis and/or more apoptosis and dendrite changes.
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Affiliation(s)
- Maura Boldrini
- Department of Psychiatry, Columbia University, New York State Psychiatric Institute, New York, New York; Division of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, New York, New York.
| | - Hanga Galfalvy
- Department of Psychiatry, New York State Psychiatric Institute, New York, New York; Department of Biostatistics, New York State Psychiatric Institute, New York
| | - Andrew J. Dwork
- Department of Psychiatry, New York State Psychiatric Institute, New York, New York; Department of Pathology and Cell Biology, New York State Psychiatric Institute, New York, New York; Columbia University, Division of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, New York, New York; Division of Integrative Neuroscience, New York State Psychiatric Institute, New York, New York
| | - Gorazd B. Rosoklija
- Department of Psychiatry, New York State Psychiatric Institute, New York, New York; Columbia University, Division of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, New York, New York; Division of Integrative Neuroscience, New York State Psychiatric Institute, New York, New York; Macedonian Academy of Sciences and Arts, Ss. Cyril and Methodius University, Skopje, Macedonia
| | | | - Goran Pavlovski
- Institute for Forensic Medicine, Ss. Cyril and Methodius University, Skopje, Macedonia
| | - René Hen
- Department of Psychiatry, New York State Psychiatric Institute, New York, New York; Department of Neuroscience, New York State Psychiatric Institute, New York, New York; Department of Pharmacology, New York State Psychiatric Institute, New York, New York; Division of Integrative Neuroscience, New York State Psychiatric Institute, New York, New York
| | - Victoria Arango
- Department of Psychiatry, New York State Psychiatric Institute, New York, New York; Columbia University, Division of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, New York, New York
| | - J. John Mann
- Department of Psychiatry, New York State Psychiatric Institute, New York, New York; Columbia University, Division of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, New York, New York
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70
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Malhi GS, Das P, Outhred T, Gessler D, John Mann J, Bryant R. Cognitive and emotional impairments underpinning suicidal activity in patients with mood disorders: an fMRI study. Acta Psychiatr Scand 2019; 139:454-463. [PMID: 30865285 DOI: 10.1111/acps.13022] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/07/2019] [Indexed: 12/18/2022]
Abstract
OBJECTIVE Mood disorders are strongly associated with suicide, the prevention of which is predicated on timely detection of suicidal activity (ideation, behaviour). Building on our previous work, we sought to determine the nature of neural responses to an emotional-cognitive task in patients with varying degrees of suicidal activity. METHOD Seventy-nine patients with mood disorders were assessed clinically and scanned using fMRI. Neural responses to an Emotional Face-Word Stroop task were compared with 66 healthy controls. We identified regions of interest from seven key networks and examined responses to incongruent stimuli (Happy face-'Sad' word; Sad face-'Happy' word). RESULTS In comparison with healthy controls, patients had differential activity during both incongruent conditions. When examining for associations with suicidal activity within the patient group, those with higher scores had decreased default mode network activity for Happy face-'Sad' word manipulation, and increased basal ganglia network activity for Sad face-'Happy' word manipulation, after controlling for patient characteristics. CONCLUSION The fMRI findings suggest that suicidal activity in patients with mood disorders may be underpinned by cognitive-emotional deficits. These findings have implications for future suicide research and for achieving a deeper understanding of suicidal activity that may ultimately inform clinical detection and management.
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Affiliation(s)
- G S Malhi
- Department of Academic Psychiatry, Northern Sydney Local Health District, St Leonards, NSW, Australia.,ARCHI, Sydney Medical School Northern, The University of Sydney, Sydney, NSW, Australia.,Discipline of Psychiatry, Northern Clinical School, University of Sydney, Sydney, NSW, Australia.,CADE Clinic, Royal North Shore Hospital, Northern Sydney Local Health District, St Leonards, NSW, Australia
| | - P Das
- Department of Academic Psychiatry, Northern Sydney Local Health District, St Leonards, NSW, Australia.,ARCHI, Sydney Medical School Northern, The University of Sydney, Sydney, NSW, Australia.,Discipline of Psychiatry, Northern Clinical School, University of Sydney, Sydney, NSW, Australia.,CADE Clinic, Royal North Shore Hospital, Northern Sydney Local Health District, St Leonards, NSW, Australia
| | - T Outhred
- Department of Academic Psychiatry, Northern Sydney Local Health District, St Leonards, NSW, Australia.,ARCHI, Sydney Medical School Northern, The University of Sydney, Sydney, NSW, Australia.,Discipline of Psychiatry, Northern Clinical School, University of Sydney, Sydney, NSW, Australia.,CADE Clinic, Royal North Shore Hospital, Northern Sydney Local Health District, St Leonards, NSW, Australia
| | - D Gessler
- Department of Academic Psychiatry, Northern Sydney Local Health District, St Leonards, NSW, Australia.,ARCHI, Sydney Medical School Northern, The University of Sydney, Sydney, NSW, Australia.,Discipline of Psychiatry, Northern Clinical School, University of Sydney, Sydney, NSW, Australia.,CADE Clinic, Royal North Shore Hospital, Northern Sydney Local Health District, St Leonards, NSW, Australia
| | - J John Mann
- Department of Psychiatry, Columbia University, New York, NY, USA.,Molecular Imaging and Neuropathology Division, New York State Psychiatric Institute, New York, NY, USA
| | - R Bryant
- School of Medical Sciences, University of New South Wales, Sydney, NSW, Australia
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Schuck A, Calati R, Barzilay S, Bloch-Elkouby S, Galynker I. Suicide Crisis Syndrome: A review of supporting evidence for a new suicide-specific diagnosis. BEHAVIORAL SCIENCES & THE LAW 2019; 37:223-239. [PMID: 30900347 DOI: 10.1002/bsl.2397] [Citation(s) in RCA: 64] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/26/2018] [Revised: 12/21/2018] [Accepted: 12/22/2018] [Indexed: 06/09/2023]
Abstract
Suicide is a major public health problem, and suicide rates are still on the rise. Current strategies for identifying individuals at risk for suicide, such as the use of a patient's self-reported suicidal ideation or evidence of past suicide attempts, have not been sufficient in reducing suicide rates. Recently, research groups have been focused on determining the acute mental state preceding a suicide attempt. The development of an acute suicidal diagnosis, the Suicide Crisis Syndrome (SCS), is aimed at capturing this state to better treat individuals. The SCS has five main evidence-based components-entrapment, affective disturbance, loss of cognitive control, hyperarousal, and social withdrawal. The SCS may provide clinicians with the ability to identify individuals who are experiencing an acute pre-suicidal mental state, regardless of their self-reported suicidal ideation. Future research leading to the incorporation of this diagnosis into clinical practice could improve the quality of care and reduce the personal, societal, and legal burden of suicide.
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Affiliation(s)
- Allison Schuck
- Department of Psychiatry, Mount Sinai Beth Israel, New York, NY, USA
| | - Raffaella Calati
- Department of Psychiatry, Mount Sinai Beth Israel, New York, NY, USA
| | - Shira Barzilay
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | | | - Igor Galynker
- Department of Psychiatry, Mount Sinai Beth Israel, New York, NY, USA
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
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Weiner L, Flin A, Causin JB, Weibel S, Bertschy G. A case study of suicidality presenting as a restricted interest in autism Spectrum disorder. BMC Psychiatry 2019; 19:126. [PMID: 31029170 PMCID: PMC6487006 DOI: 10.1186/s12888-019-2122-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Accepted: 04/16/2019] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Suicidality has been under-researched in autism spectrum disorders (ASD). Most studies have linked increased suicidality in ASD to psychiatric comorbidities such as depression. Here we investigated, from a neuropsychological and clinical standpoint, the relationship between core ASD symptoms, i.e., restricted behaviors and social and communication impairments, and the suicidal behaviors in an adult male individual with ASD, with no psychiatric comorbidities. CASE PRESENTATION We report the case of a 21-year-old male with ASD who attempted suicide twice, in the absence of other psychiatric diagnoses. His behavior and communication skills were rigid. His suicidality was characterized by a rigid, detailed, and pervasive thinking pattern, akin to restricted interests. Consistently, from a neuropsychological standpoint, we found below-average planning and attention skills, and mind-reading skills were rigid and lacked spontaneity. CONCLUSIONS Our case-study suggests that specific clinical and neuropsychological dimensions might be related to suicidal behaviors in ASD. Clinically, the repetitive and rigid suicide-oriented thinking of our patient was not part of a depressive episode. Instead, it followed a purely logical, inflexible, and pervasive reasoning pattern focused on a topic that fascinated him - i.e., suicide --, akin to restricted behaviors. From a neuropsychological standpoint, restrictive suicide-oriented thinking in our patient seems to be related to attention and executive anomalies that have been linked to repetitive and restricted behaviors in ASD. New tools need to be developed to assess persistent suicidal thoughts in this population, as they might be related to intrinsic features of ASD.
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Affiliation(s)
- Luisa Weiner
- Department of Psychiatry and Addictology, University Hospital of Strasbourg, Strasbourg, France
- INSERM 1114, Department of Psychiatry, 1 place de l’hôpital, 67000 Strasbourg, France
| | - Amandine Flin
- Department of Psychiatry and Addictology, University Hospital of Strasbourg, Strasbourg, France
- INSERM 1114, Department of Psychiatry, 1 place de l’hôpital, 67000 Strasbourg, France
| | - Jean-Baptiste Causin
- Department of Psychiatry and Addictology, University Hospital of Strasbourg, Strasbourg, France
- INSERM 1114, Department of Psychiatry, 1 place de l’hôpital, 67000 Strasbourg, France
| | - Sébastien Weibel
- Department of Psychiatry and Addictology, University Hospital of Strasbourg, Strasbourg, France
- INSERM 1114, Department of Psychiatry, 1 place de l’hôpital, 67000 Strasbourg, France
| | - Gilles Bertschy
- Department of Psychiatry and Addictology, University Hospital of Strasbourg, Strasbourg, France
- INSERM 1114, Department of Psychiatry, 1 place de l’hôpital, 67000 Strasbourg, France
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73
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Li J, Duan X, Cui Q, Chen H, Liao W. More than just statics: temporal dynamics of intrinsic brain activity predicts the suicidal ideation in depressed patients. Psychol Med 2019; 49:852-860. [PMID: 29909788 DOI: 10.1017/s0033291718001502] [Citation(s) in RCA: 128] [Impact Index Per Article: 25.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
BACKGROUND Major depressive disorder (MDD) is associated with high risk of suicide. Conventional neuroimaging works showed abnormalities of static brain activity and connectivity in MDD with suicidal ideation (SI). However, little is known regarding alterations of brain dynamics. More broadly, it remains unclear whether temporal dynamics of the brain activity could predict the prognosis of SI. METHODS We included MDD patients (n = 48) with and without SI and age-, gender-, and education-matched healthy controls (n = 30) who underwent resting-state functional magnetic resonance imaging. We first assessed dynamic amplitude of low-frequency fluctuation (dALFF) - a proxy for intrinsic brain activity (iBA) - using sliding-window analysis. Furthermore, the temporal variability (dynamics) of iBA was quantified as the variance of dALFF over time. In addition, the prediction of the severity of SI from temporal variability was conducted using a general linear model. RESULTS Compared with MDD without SI, the SI group showed decreased brain dynamics (less temporal variability) in the dorsal anterior cingulate cortex, the left orbital frontal cortex, the left inferior temporal gyrus, and the left hippocampus. Importantly, these temporal variabilities could be used to predict the severity of SI (r = 0.43, p = 0.03), whereas static ALFF could not in the current data set. CONCLUSIONS These findings suggest that alterations of temporal variability in regions involved in executive and emotional processing are associated with SI in MDD patients. This novel predictive model using the dynamics of iBA could be useful in developing neuromarkers for clinical applications.
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Affiliation(s)
- Jiao Li
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, University of Electronic Science and Technology of China,Chengdu 610054,P.R. China
| | - Xujun Duan
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, University of Electronic Science and Technology of China,Chengdu 610054,P.R. China
| | - Qian Cui
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, University of Electronic Science and Technology of China,Chengdu 610054,P.R. China
| | - Huafu Chen
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, University of Electronic Science and Technology of China,Chengdu 610054,P.R. China
| | - Wei Liao
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, University of Electronic Science and Technology of China,Chengdu 610054,P.R. China
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74
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Lidón-Moyano C, Wiebe D, Gruenewald P, Cerdá M, Brown P, Goldman-Mellor S. Associations between self-harm and chronic disease among adolescents: Cohort study using statewide emergency department data. J Adolesc 2019; 72:132-140. [PMID: 30903930 DOI: 10.1016/j.adolescence.2019.03.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2018] [Revised: 03/11/2019] [Accepted: 03/12/2019] [Indexed: 11/19/2022]
Abstract
INTRODUCTION We sought to understand the association between youthful self-harm and subsequent chronic disease-related healthcare utilization and whether self-harm reflects unique vulnerability in comparison with severe psychiatric disorders. METHODS We used a retrospective matched cohort design with statewide, all-payer, individually linked emergency department (ED) data from California, USA. Risk of future ED visits for common chronic conditions in adolescence (headaches, asthma, epilepsy, diabetes, and gastrointestinal disorders, assessed using ICD-9 diagnoses) were compared between three adolescent study groups presenting to an ED in 2010: self-harm patients (n = 5,484), patients with psychiatric complaints but no self-harm (n = 14,235), and patients with other complaints (n = 16,452). Cohort follow-up ended on Sept. 30, 2015. Analyses were adjusted for patients' prior histories of ED utilization for chronic conditions as well as patient- and area-level sociodemographic characteristics. RESULTS Risk of subsequent ED visits was higher among self-harm patients compared to non-psychiatric control patients for subsequent epilepsy- (aRR = 1.77, 95% CI [1.42, 2.21]). Risk of subsequent ED visits was higher among psychiatric patients compared to non-psychiatric control patients for subsequent headache- (aRR = 1.31, 95% CI [1.21, 1.42]), and epilepsy-related problems (aRR = 1.85, 95% CI [1.55, 2.21]). Self-harm patients were at higher risk than psychiatric patients for subsequent gastrointestinal disorder (aRR = 1.76, 95% CI [1.03, 3.01]). CONCLUSIONS Findings suggest that self-harm behavior and psychiatric disorders are associated with increased ED utilization for subsequent chronic disease-related ED utilization. Chronic disease among adolescent psychiatric patients should be attended to, potentially involving new models of clinical follow-up care.
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Affiliation(s)
- Cristina Lidón-Moyano
- Department of Public Health, School of Social Sciences, Humanities, and Arts, University of California, Merced, Merced CA 95343, USA.
| | - Deborah Wiebe
- Department of Psychology, School of Social Sciences, Humanities, and Arts, University of California, Merced, Merced CA 95343, USA.
| | - Paul Gruenewald
- Prevention Research Center, Pacific Institute for Research and Evaluation, Oakland, CA 94612, USA.
| | - Magdalena Cerdá
- Violence Prevention Research Program, University of California, Davis, Sacramento, CA 95817, USA.
| | - Paul Brown
- Department of Public Health, School of Social Sciences, Humanities, and Arts, University of California, Merced, Merced CA 95343, USA.
| | - Sidra Goldman-Mellor
- Department of Public Health, School of Social Sciences, Humanities, and Arts, University of California, Merced, Merced CA 95343, USA.
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75
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Segreti AM, Chase HW, Just M, Brent D, Pan L. Cortical thickness and volume reductions in young adults with current suicidal ideation. J Affect Disord 2019; 245:126-129. [PMID: 30388554 DOI: 10.1016/j.jad.2018.10.081] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2018] [Revised: 08/09/2018] [Accepted: 10/04/2018] [Indexed: 01/23/2023]
Abstract
The extent to which observed differences in emotion processing and regulation neural circuitry in young adults with current suicidal ideation are paralleled by structural differences is unknown. We measured brain cortical thickness and gray and white matter volumes in 78 young adults aged 18-35: 35 with current suicidal ideation (SI) and 43 healthy controls (HC). The SI group, compared to HC, showed reduction in cortical thickness in the bilateral precentral gyri and diminished cortical volume in the left middle frontal gyrus. These regions are implicated in executive function, stress regulation, and emotion processing. We propose that these structural differences among the SI group could be contributing to suicidal thought patterns.
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Affiliation(s)
- Anna Maria Segreti
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA
| | - Henry W Chase
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA
| | - Marcel Just
- Center for Cognitive Brain Imaging, Department of Psychology, Carnegie Mellon University, Pittsburgh, PA 15213, USA
| | - David Brent
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA
| | - Lisa Pan
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA.
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76
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Duffy A, Dawson DL, Moghaddam NG, das Nair R. Do thinking styles play a role in whether people pathologise their pornography use? SEXUAL AND RELATIONSHIP THERAPY 2019. [DOI: 10.1080/14681994.2017.1412417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Athena Duffy
- Trent Doctorate in Clinical Psychology, Division of Psychiatry & Applied Psychology, University of Nottingham, Nottingham, UK
| | - David L Dawson
- Trent Doctorate in Clinical Psychology, University of Lincoln, Lincoln, UK
| | - Nima G Moghaddam
- Trent Doctorate in Clinical Psychology, University of Lincoln, Lincoln, UK
| | - Roshan das Nair
- Trent Doctorate in Clinical Psychology, Division of Psychiatry & Applied Psychology, University of Nottingham, Nottingham, UK
- Institute of Mental Health, Triumph Road, Jubilee Campus, Nottingham, UK
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77
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Liao SJ, Wu BJ, Liu TT, Chou CP, Rong JR. Prevalence and characteristics of suicidal ideation among 2199 elderly inpatients with surgical or medical conditions in Taiwan. BMC Psychiatry 2018; 18:397. [PMID: 30577782 PMCID: PMC6303983 DOI: 10.1186/s12888-018-1981-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2017] [Accepted: 12/11/2018] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Worldwide, the elderly are at a greater risk of suicide than other age groups. There is a paucity of research exploring risk factors for suicide in hospitalized elderly patients. Therefore, a study designed to explore the prevalence and characteristic of suicidal ideation (SI), such as QOL (quality of life), a wish to die (WTD), and other factors in elderly inpatients with medical or surgical conditions in Taiwan was warranted. METHODS A total of 2199 hospitalized elderly patients over age 65 were enrolled. Demographic data, 5-item Brief Symptom Rating Scale (BSRS-5), and the World Health Organization Quality of Life-BREF (WHOQOL-BREF) data were collected. Logistic regression models were used to find the SI-related factors for all participants and to investigate the covariates correlated with WTD in patients with SI. Receiver operating characteristic (ROC) curve analysis was used to find the most important items of the BSRS-5 predictive of SI in this population. RESULTS SI was found in 3.1% (68/2199) of the elderly. The statistically significantly factors associated with SI were: BSRS-5 item 2 (depression) (odds ratio [OR] = 2.15, 95% confidence interval [CI] = 1.56-2.98), item 4 (inferiority) (OR = 1.62, 1.23-2.13), item 5 (insomnia) (OR = 1.52, 1.13-2.05), and physical domain of WHOQOL (OR = 0.84, 0.72-0.99). QOL15 (mobility) (OR = 0.64, 0.46-0.90) and QOL 16 (satisfaction with sleep) (OR = 0.62, 0.44-0.88) were also significantly associated with SI. The status of living alone (OR = 4.44, 1.24-15.87), QOL 26 (absence of negative feeling) (OR = 0.38, 0.15-0.98), and QOL 27 (being respected/accepted) (OR = 0.43, 0.20-0.92) were significantly associated with WTD among inpatients with SI. The ROC curve analysis revealed that depression, inferiority, and insomnia were the most important items in the BSRS-5 significantly associated with SI among the elderly inpatients. CONCLUSION To provide physical recovery and maintain mental health for physically ill elderly inpatients, setting up a multi-faceted approach targeting the aforementioned determinants of SI and WTD for reducing the risk of suicide attempt, and exploring other factors correlated with suicidal behaviors, are important topics and directions for clinical practice and further research.
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Affiliation(s)
- Su-Jung Liao
- grid.490600.bDepartment of Nursing, Ministry of Health and Welfare, Yuli Hospital, 448 Chung-Hua Road, Yuli Township, Hualien County 981 Taiwan, Republic of China ,Department of Nursing, National Taipei University of Nursing Health Science, No.365, Mingde Rd., Beitou Dist., Taipei City, 112 Taiwan, Republic of China
| | - Bo-Jian Wu
- grid.490600.bDepartment of Psychiatry, Ministry of Health and Welfare, Yuli Hospital, 448 Chung-Hua Road, Yuli Township, Hualien County 981 Taiwan, Republic of China
| | - Tse-Tsung Liu
- 0000 0004 0639 3300grid.415323.2Department of Geriatrics, Mennonite Christian Hospital, 44, Minquan Rd., Hualien City, Hualien County 970 Taiwan, Republic of China
| | - Chao-Ping Chou
- 0000 0004 0639 3300grid.415323.2Department of Psychiatry, Mennonite Christian Hospital, 44, Minquan Rd., Hualien City, Hualien County 970 Taiwan, Republic of China
| | - Jiin-Ru Rong
- Department of Nursing, National Taipei University of Nursing Health Science, No.365, Mingde Rd., Beitou Dist., Taipei City, 112, Taiwan, Republic of China.
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78
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Ai H, van Tol MJ, Marsman JBC, Veltman DJ, Ruhé HG, van der Wee NJA, Opmeer EM, Aleman A. Differential relations of suicidality in depression to brain activation during emotional and executive processing. J Psychiatr Res 2018; 105:78-85. [PMID: 30212727 DOI: 10.1016/j.jpsychires.2018.08.018] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Revised: 07/02/2018] [Accepted: 08/13/2018] [Indexed: 10/28/2022]
Abstract
Suicidal behavior is highly prevalent in major depressive disorder (MDD), though not present in all patients. It is unclear whether the tendency for suicidal behavior is associated with a unique functional neuroanatomical signature identifiable through neuroimaging. In this study, we investigated brain activation in suicidal and non-suicidal patients with MDD during facial emotion processing and executive control. Functional magnetic resonance imaging (fMRI) data from the NESDA-fMRI study (MDD patients N = 103, healthy controls N = 26, HC) were analyzed. Patients were divided in a group of suicide attempters (N = 18, SA), suicide ideators (N = 31, SI) and a patient-control group (N = 73, PC). A gender discrimination task with emotional faces and the Tower of London executive planning task were investigated. An ANOVA was performed to compare brain activation among suicidal patients (SA + SI), PC and HC first and then among SI, SA, PC and HC. Significance was determined as meeting p < .05 family wise error (FWE) corrected at the voxel-level. We observed that SA patients showed lower activation in the bilateral fusiform gyri during emotional faces processing compared to SI, PC and HC. No group differences were found during executive planning. Results were independent of childhood emotional maltreatment, depression severity, anxiety severity, use of psychotherapy and SSRI-use. Results suggest that a propensity for suicidal behavior in MDD is associated with abnormal emotional processing but not executive functioning, represented by altered face processing compared to non-suicidal patients and controls. While in need of replication, these results indicate that altered fusiform gyrus activation during emotion processing may serve as a marker for suicidality.
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Affiliation(s)
- Hui Ai
- College of Psychology and Sociology, Shenzhen University, PR China; University of Groningen, University Medical Center Groningen, Department of Neuroscience, Groningen, the Netherlands.
| | - Marie-José van Tol
- University of Groningen, University Medical Center Groningen, Department of Neuroscience, Groningen, the Netherlands
| | - Jan-Bernard C Marsman
- University of Groningen, University Medical Center Groningen, Department of Neuroscience, Groningen, the Netherlands
| | - Dick J Veltman
- VU University Medical Center Amsterdam, Department of Psychiatry, the Netherlands; VU University, Amsterdam Neuroscience, Amsterdam, the Netherlands
| | - Henricus G Ruhé
- University of Groningen, University Medical Center Groningen, Department of Psychiatry, Groningen, the Netherlands; University of Amsterdam, Academic Medical Center, Department of Psychiatry, Amsterdam, the Netherlands
| | - Nic J A van der Wee
- Leiden University Medical Center, Department of Psychiatry, the Netherlands; Leiden University, Leiden Institute for Brain and Cognition, Leiden, the Netherlands
| | - Esther M Opmeer
- University of Groningen, University Medical Center Groningen, Department of Neuroscience, Groningen, the Netherlands
| | - André Aleman
- College of Psychology and Sociology, Shenzhen University, PR China; University of Groningen, University Medical Center Groningen, Department of Neuroscience, Groningen, the Netherlands; University of Groningen, Department of Psychology, the Netherlands.
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79
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Adolph D, Teismann T, Forkmann T, Wannemüller A, Margraf J. High frequency heart rate variability: Evidence for a transdiagnostic association with suicide ideation. Biol Psychol 2018; 138:165-171. [PMID: 30253232 DOI: 10.1016/j.biopsycho.2018.09.006] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Revised: 09/12/2018] [Accepted: 09/15/2018] [Indexed: 10/28/2022]
Abstract
Low levels of high frequency heart rate variability (HF-HRV) have been shown to be associated with suicidal ideation and behavior in students and depressed patients. The goal of the present study was to examine associations between suicide ideation and resting HF-HRV as well as HF-HRV reactivity in a diagnostically heterogeneous sample of adult outpatients with or without concurrent suicide ideation. Participants were N = 85 outpatients (67.1% female; age: M = 38.8, SD = 13.72). HF-HRV reactivity was assessed using a sad film induction method. Associations between resting HF-HRV, HF-HRV reactivity and suicide ideation were analyzed using linear regression modeling - controlling for depression, anxiety and stress. HF-HRV reactivity towards the sad film, but not low resting HF-HRV baseline, was predictive of higher scores on suicidal ideation within the whole sample. In women, lower resting as well as perturbed HF-HRV reactivity was associated with higher scores on suicidal ideation. Results suggest that suicide ideators have a reduced capacity to regulate their response to stress.
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Affiliation(s)
- Dirk Adolph
- Mental Health Research and Treatment Center, Ruhr-Universität, Bochum, Germany.
| | - Tobias Teismann
- Mental Health Research and Treatment Center, Ruhr-Universität, Bochum, Germany
| | - Thomas Forkmann
- Institute of Medical Psychology and Medical Sociology, University Hospital of RWTH Aachen University, Germany
| | - Andre Wannemüller
- Mental Health Research and Treatment Center, Ruhr-Universität, Bochum, Germany
| | - Jürgen Margraf
- Mental Health Research and Treatment Center, Ruhr-Universität, Bochum, Germany
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80
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Abstract
Suicidal behavior in older adults (65 years old and over) is a major public health issue in many countries. Suicide rates increase during the life course and are as high as 48.7/100,000 among older white men in the USA. Specific health conditions and stress factors increase the complexity of the explanatory model for suicide in older adults. A PubMed literature search was performed to identify most recent and representative studies on suicide risk factors in older adults. The aim of our narrative review was to provide a critical evaluation of recent findings concerning specific risk factors for suicidal thoughts and behaviors among older people: psychiatric and neurocognitive disorders, social exclusion, bereavement, cognitive impairment, decision making and cognitive inhibition, physical illnesses, and physical and psychological pain. We also aimed to approach the problem of euthanasia or physician-assisted suicide in older adults. Our main findings emphasize the need to integrate specific stress factors, such as feelings of social disconnectedness, neurocognitive impairment or decision making, as well as chronic physical illnesses and disability in suicide models and in suicide prevention programs in older adults. Furthermore, the chronic care model should be adapted for the treatment of older people with long-term conditions in order to improve the treatment of depressive disorders and the prevention of suicidal thoughts and acts.
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Affiliation(s)
- Ismael Conejero
- Institut National de la Santé Et de la Recherche Médicale (INSERM), University of Montpellier, Neuropsychiatry: Epidemiological and Clinical Research, Montpellier, France.,Department of Emergency Psychiatry and Post-Acute Care, Lapeyronie Hospital, Center Hospitalier Universitairere (CHU) Montpellier, Montpellier, France
| | - Emilie Olié
- Institut National de la Santé Et de la Recherche Médicale (INSERM), University of Montpellier, Neuropsychiatry: Epidemiological and Clinical Research, Montpellier, France.,Department of Emergency Psychiatry and Post-Acute Care, Lapeyronie Hospital, Center Hospitalier Universitairere (CHU) Montpellier, Montpellier, France.,FondaMental Foundation, Créteil, France
| | - Philippe Courtet
- Institut National de la Santé Et de la Recherche Médicale (INSERM), University of Montpellier, Neuropsychiatry: Epidemiological and Clinical Research, Montpellier, France.,Department of Emergency Psychiatry and Post-Acute Care, Lapeyronie Hospital, Center Hospitalier Universitairere (CHU) Montpellier, Montpellier, France.,FondaMental Foundation, Créteil, France
| | - Raffaella Calati
- Institut National de la Santé Et de la Recherche Médicale (INSERM), University of Montpellier, Neuropsychiatry: Epidemiological and Clinical Research, Montpellier, France.,Department of Emergency Psychiatry and Post-Acute Care, Lapeyronie Hospital, Center Hospitalier Universitairere (CHU) Montpellier, Montpellier, France.,FondaMental Foundation, Créteil, France
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81
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Abstract
BACKGROUND Increased inflammation is linked to suicide risk. However, it is unclear whether increased inflammation drives suicidal crises or is a trait associated with lifetime suicidal behavior. Limited data exist on the sources of increased inflammation observed in suicidal patients and on its downstream effects. AIMS To examine factors associated with inflammation and with suicidal ideation severity in acutely suicidal depressed patients. METHODS Fifty-two adult depressed patients of both sexes hospitalized for severe suicidal ideation were characterized for suicidality, depression, anxiety, medical comorbidity, psychological and physical pain, impulsivity, verbal fluency, C-reactive protein (CRP) and interleukin (IL) 6. Two generalized linear models were performed with either CRP or suicidal ideation severity as dependent variables. RESULTS CRP levels were positively associated with age, body mass index (BMI), IL6, current physical pain and number of lifetime suicide attempts. Suicidal ideation severity was not significantly correlated with either CRP or IL6. Suicidal ideation severity was positively associated with female sex, presence of an anxiety disorder, current physical pain, number of lifetime suicide attempts and with delay discounting for medium and large losses. CONCLUSIONS Increased inflammation is not associated with acute suicidal risk, but seems to represent a trait associated with lifetime suicidal behavior.
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Affiliation(s)
- Ricardo Cáceda
- Department of Psychiatry, Stony Brook University, New York, USA
| | - W Sue T Griffin
- Donald W. Reynolds Department of Geriatrics and Institute on Aging, University of Arkansas for Medical Sciences, Geriatric Research, Education and Clinical Center, VAMC/CAVHS, Little Rock, USA
| | - Pedro L Delgado
- Psychiatric Research Institute, University of Arkansas for Medical Sciences, Little Rock, USA
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82
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Tavakoli P, Boafo A, Dale A, Robillard R, Greenham SL, Campbell K. Event-Related Potential Measures of Attention Capture in Adolescent Inpatients With Acute Suicidal Behavior. Front Psychiatry 2018; 9:85. [PMID: 29615936 PMCID: PMC5868137 DOI: 10.3389/fpsyt.2018.00085] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2017] [Accepted: 03/02/2018] [Indexed: 01/08/2023] Open
Abstract
Impaired executive functions, modulated by the frontal lobes, have been suggested to be associated with suicidal behavior. The present study examines one of these executive functions, attentional control, maintaining attention to the task-at-hand. A group of inpatient adolescents with acute suicidal behavior and healthy controls were studied using a passively presented auditory optimal paradigm. This "optimal" paradigm consisted of a series of frequently presented homogenous pure tone "standards" and different "deviants," constructed by changing one or more features of the standard. The optimal paradigm has been shown to be a more time-efficient replacement to the traditional oddball paradigm, which makes it suitable for use in clinical populations. The extent of processing of these "to-be-ignored" auditory stimuli was measured by recording event-related potentials (ERPs). The P3a ERP component is thought to reflect processes associated with the capturing of attention. Rare and novel stimuli may result in an executive decision to switch attention away from the current cognitive task and toward a probe of the potentially more relevant "interrupting" auditory input. On the other hand, stimuli that are quite similar to the standard should not elicit P3a. The P3a has been shown to be larger in immature brains in early compared to later adolescence. An overall enhanced P3a was observed in the suicidal group. The P3a was larger in this group for both the environmental sound and white noise deviants, although only the environmental sound P3a attained significance. Other deviants representing only a small change from the standard did not elicit a P3a in healthy controls. They did elicit a small P3a in the suicidal group. These findings suggest a lowered threshold for the triggering of the involuntary switch of attention in these patients, which may play a role in their reported distractibility. The enhanced P3a is also suggestive of an immature frontal central executive and may provide a promising marker for early identification of some of the risk factors for some of the cognitive difficulties linked to suicidality.
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Affiliation(s)
- Paniz Tavakoli
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada
| | - Addo Boafo
- Department of Psychiatry, University of Ottawa, Ottawa, ON, Canada.,Children's Hospital of Eastern Ontario, Ottawa, ON, Canada
| | - Allyson Dale
- School of Psychology, University of Ottawa, Ottawa, ON, Canada
| | - Rebecca Robillard
- School of Psychology, University of Ottawa, Ottawa, ON, Canada.,University of Ottawa Institute of Mental Health Research, Ottawa, ON, Canada
| | - Stephanie L Greenham
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada.,Children's Hospital of Eastern Ontario, Ottawa, ON, Canada.,School of Psychology, University of Ottawa, Ottawa, ON, Canada
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83
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Homaifar BY, Shura RD, Miskey HM, Yoash-Gantz RE, Rowland JA. The Relationship of Suicidal Ideation to Objective and Subjective Executive Functioning. MILITARY PSYCHOLOGY 2017. [DOI: 10.1037/mil0000111] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Beeta Y. Homaifar
- Rocky Mountain Mental Illness Research, Education and Clinical Center, Denver, Colorado, and Departments of Psychiatry and Physical Medicine & Rehabilitation, Anschutz Medical Campus, University of Colorado School of Medicine
| | - Robert D. Shura
- Mid-Atlantic Mental Illness Research, Education and Clinical Center, Salisbury, North Carolina, and Mental Health & Behavioral Sciences Service Line, W.G. “Bill” Hefner Veterans Affairs Medical Center, Salisbury, North Carolina
| | - Holly M. Miskey
- Mid-Atlantic Mental Illness Research, Education and Clinical Center, Salisbury, North Carolina, and Mental Health & Behavioral Sciences Service Line, W.G. “Bill” Hefner Veterans Affairs Medical Center, Salisbury, North Carolina
| | - Ruth E. Yoash-Gantz
- Mid-Atlantic Mental Illness Research, Education and Clinical Center, Salisbury, North Carolina, and Mental Health & Behavioral Sciences Service Line, W.G. “Bill” Hefner Veterans Affairs Medical Center, Salisbury, North Carolina
| | - Jared A. Rowland
- Mid-Atlantic Mental Illness Research, Education and Clinical Center, Salisbury, North Carolina, and Mental Health & Behavioral Sciences Service Line, W.G. “Bill” Hefner Veterans Affairs Medical Center, Salisbury, North Carolina
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84
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Chang CC, Tzeng NS, Kao YC, Yeh CB, Chang HA. The relationships of current suicidal ideation with inflammatory markers and heart rate variability in unmedicated patients with major depressive disorder. Psychiatry Res 2017; 258:449-456. [PMID: 28886903 DOI: 10.1016/j.psychres.2017.08.076] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2016] [Revised: 07/11/2017] [Accepted: 08/27/2017] [Indexed: 10/19/2022]
Abstract
Studies investigating inflammatory status and autonomic functioning simultaneously in depressed patients with current suicidal ideation (SI) are lacking. We recruited 58 unmedicated depressed patients with current SI but without lifetime history of suicidal behavior, as well as 61 equally depressed patients without lifetime history of SI or suicidal behavior. We measured serum cortisol, high-sensitivity C-reactive protein (hs-CRP), erythrocyte sedimentation rate (ESR), and autonomic functioning evaluated by frequency-domain measures of heart rate variability (HRV). The intensity of current SI was rated with the Columbia Suicide Severity Rating Scale. Chronic psychological stress was assessed using the Chinese version of the Perceived Stress Scale (PSS). Patients with current SI showed higher hs-CRP and ESR but lower variance (total HRV), low frequency (LF), and high frequency (HF) HRV than those without lifetime history of SI. We found no differences in cortisol levels and PSS scores. The intensity of current SI was negatively correlated with variance, LF, and HF but positively correlated with hs-CRP. Our results help improve the understanding of the relationships among current SI, inflammation, and autonomic functioning in depressed patients. The combined use of inflammatory markers and HRV indices may one day be applied in predicting and monitoring patients' suicide risk.
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Affiliation(s)
- Chuan-Chia Chang
- Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Nian-Sheng Tzeng
- Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan; Student Counseling Center, National Defense Medical Center, Taipei, Taiwan
| | - Yu-Chen Kao
- Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan; Department of Psychiatry, Tri-Service General Hospital Songshan Branch, Taipei, Taiwan
| | - Chin-Bin Yeh
- Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Hsin-An Chang
- Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
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85
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Moniz M, de Jesus SN, Pacheco A, Gonçalves E, Viseu J, Brás M, Silva D, Batista S. The Influence of Planning and Response Inhibition on Cognitive Functioning of Non-Psychotic Unipolar Depressed Suicide Attempters. EUROPES JOURNAL OF PSYCHOLOGY 2017; 13:717-732. [PMID: 29358984 PMCID: PMC5763459 DOI: 10.5964/ejop.v13i4.1385] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2017] [Accepted: 06/23/2017] [Indexed: 11/20/2022]
Abstract
Depression is one of the main risk factors for suicide. However, little is known about the intricate relationships among depressive symptomatology in unipolar depression, suicide risk, and the characteristics of executive dysfunction in depressed patients. We compared 20 non-psychotic unipolar depressed suicide attempters to 20 matching depressed non-attempters and to 20 healthy controls to further investigate the possible differences in neuropsychological performance. Depressed subjects were controlled for current suicidal ideation, and their neuropsychological profile was assessed using a range of measures of executive functioning, attention, verbal memory, processing speed, and psychomotor speed. Depressed groups were outperformed by healthy controls. Depressed attempters presented more cognitive impairment than depressed non-attempters on a simple Go/No-go response inhibition task and performed better than non-attempters on the Tower of London planning task. Depressed attempters were clearly distinguished by a deficit in response inhibition (Go/No-go commission errors). The normative planning performance (Tower of London extra moves) of the suicide attempters was unexpected, and this unanticipated finding calls for further research. Normative planning may indicate an increased risk of suicidal behavior.
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Affiliation(s)
- Marco Moniz
- Department of Psychiatry and Mental Health, Hospital Center of Algarve, Faro, Portugal.,Faculty of Human and Social Sciences, University of Algarve, Faro, Portugal.,Research Centre for Spatial and Organizational Dynamics (CIEO), Faro, Portugal.,Algarve Biomedical Center (ABC), Faro, Portugal
| | - Saul Neves de Jesus
- Research Centre for Spatial and Organizational Dynamics (CIEO), Faro, Portugal.,Algarve Biomedical Center (ABC), Faro, Portugal
| | - Andreia Pacheco
- Department of Psychiatry and Mental Health, Hospital Center of Algarve, Faro, Portugal.,Research Centre for Spatial and Organizational Dynamics (CIEO), Faro, Portugal
| | - Eduardo Gonçalves
- Department of Psychiatry and Mental Health, Hospital Center of Algarve, Faro, Portugal.,Research Centre for Spatial and Organizational Dynamics (CIEO), Faro, Portugal
| | - João Viseu
- Research Centre for Spatial and Organizational Dynamics (CIEO), Faro, Portugal.,Algarve Biomedical Center (ABC), Faro, Portugal
| | - Marta Brás
- Research Centre for Spatial and Organizational Dynamics (CIEO), Faro, Portugal.,Algarve Biomedical Center (ABC), Faro, Portugal
| | - Dina Silva
- Research Centre for Spatial and Organizational Dynamics (CIEO), Faro, Portugal.,Algarve Biomedical Center (ABC), Faro, Portugal
| | - Sílvia Batista
- Department of Psychiatry and Mental Health, Hospital Center of Algarve, Faro, Portugal.,Research Centre for Spatial and Organizational Dynamics (CIEO), Faro, Portugal
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86
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Kim K, Kim SW, Myung W, Han CE, Fava M, Mischoulon D, Papakostas GI, Seo SW, Cho H, Seong JK, Jeon HJ. Reduced orbitofrontal-thalamic functional connectivity related to suicidal ideation in patients with major depressive disorder. Sci Rep 2017; 7:15772. [PMID: 29150619 PMCID: PMC5693996 DOI: 10.1038/s41598-017-15926-0] [Citation(s) in RCA: 56] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2017] [Accepted: 11/04/2017] [Indexed: 11/25/2022] Open
Abstract
Despite recent developments in neuroimaging, alterations of brain functional connectivity in major depressive disorder (MDD) patients with suicidal ideation are poorly understood. This study investigated specific changes of suicidal ideation in functional connectivity of MDD patients. Whole brain functional connectivity in 46 patients with MDD (23 with suicidal ideation and 23 without) and 36 age- and gender- matched healthy controls were compared using resting-state functional Magnetic Resonance Imaging (fMRI) analyzed with network-based statistics (NBS) and graph-theoretical methods. Decreased functional connectivity in a characterized sub-network was observed in patients with MDD and suicidal ideation (FDR-adjusted p < 0.05). The sub-network included the regions of the fronto-thalamic circuits in the left hemisphere. The network measures of the left superior frontal gyrus, pars orbitalis (r = -0.40, p = 0.009), left thalamus (r = -0.41, p = 0.009), and right thalamus (r = -0.51, p = -0.002) were shown, through graph theoretical analysis, to be significantly negatively correlated with severity of suicidal ideation. The reduced functional connectivity in left orbitofrontal-both thalamic regions with suicidal ideation in MDD were inversely proportional to the severity of suicidality independent from depression severity. These findings suggest problems with decision-making and information integration in MDD patients with suicidal ideation.
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Affiliation(s)
- Kiwon Kim
- Department of Psychiatry, Depression Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, South Korea
- National Institute of Dementia, Seongnam, South Korea
| | - Sung-Woo Kim
- School of Biomedical Engineering, College of Health Science, Korea University, Seoul, South Korea
| | - Woojae Myung
- Department of Psychiatry, CHA Bundang Medical Center, CHA University, Seongnam, South Korea
| | - Cheol E Han
- Department of Electronics and Information Engineering, College of Science & Technology, Korea University, Sejong, South Korea
| | - Maurizio Fava
- Depression Clinical and Research Program, Massachusetts General Hospital, Harvard Medical School, Boston, USA
| | - David Mischoulon
- Depression Clinical and Research Program, Massachusetts General Hospital, Harvard Medical School, Boston, USA
| | - George I Papakostas
- Depression Clinical and Research Program, Massachusetts General Hospital, Harvard Medical School, Boston, USA
| | - Sang Won Seo
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Hana Cho
- Department of Physiology, Sungkyunkwan University School of Medicine, Samsung Biomedical Research Institute, Suwon, South Korea
| | - Joon-Kyung Seong
- School of Biomedical Engineering, College of Health Science, Korea University, Seoul, South Korea.
| | - Hong Jin Jeon
- Department of Psychiatry, Depression Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
- Depression Clinical and Research Program, Massachusetts General Hospital, Harvard Medical School, Boston, USA.
- Department of Health Sciences & Technology, Department of Medical Device Management & Research, and Department of Clinical Research Design & Evaluation, Samsung Advanced Institute for Health Sciences & Technology (SAIHST), Sungkyunkwan University, Seoul, South Korea.
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87
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Bauer BW, Gustafsson HC, Nigg J, Karalunas SL. Working memory mediates increased negative affect and suicidal ideation in childhood attention-deficit/hyperactivity disorder. JOURNAL OF PSYCHOPATHOLOGY AND BEHAVIORAL ASSESSMENT 2017; 40:180-193. [PMID: 30386005 DOI: 10.1007/s10862-017-9635-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Objective Children with attention-deficit/hyperactivity disorder (ADHD) are at greater risk for suicidal ideation and suicide attempts compared to those without ADHD. Increased risk is at least partially attributable to a subset of children with ADHD and comorbid depression or disruptive behavior disorders; however, the early predictors and mechanisms driving increased risk are not well understood. Here, we investigate the contributions of two candidate mechanisms for increased suicidal ideation in children with ADHD: executive function and negative affect. Methods 623 clinically well-characterized, community-recruited children classified by research criteria as ADHD (n=388) or typically-developing controls (n=253) participated. Parent-report on the Temperament in Middle Childhood Questionnaire provided a measure of negative affectivity. Children completed laboratory tasks to measure response inhibition and working memory. Suicidal ideation was evaluated by parent report during a semi-structured interview and child responses on the Children's Depression Inventory. Results Compared to typically developing controls, children with ADHD had higher rates of suicidal ideation, more negative affect, slower stop signal reaction times, and weaker working memory. Statistical path-model analyses confirmed the hypothesis that weaker working memory in ADHD statistically mediated increased negative affect. Weaker working memory also mediated and increased suicidal ideation in these cross sectional data. Findings were not attributable to comorbid disruptive behavioral disorders. Poor response inhibition did not reliably mediate negative affect or suicidal ideation. Conclusion Impairment in working memory is an important early risk factor for suicidal ideation in children with ADHD, and may help in identifying children for prevention and early intervention efforts.
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Affiliation(s)
- Brian W Bauer
- University of Southern Mississippi, 118 College Drive #5025, Hattiesburg, MS 39406
| | - Hanna C Gustafsson
- Oregon Health and Science University, 3181 SW Sam Jackson Park Road, Multnomah Pavilion, Suite 1505, Mail Code: UHN-80R1 Portland, OR 97239
| | - Joel Nigg
- Oregon Health and Science University, 3181 SW Sam Jackson Park Road, Multnomah Pavilion, Suite 1513, Mail Code: UHN-80R1 Portland, OR 97239
| | - Sarah L Karalunas
- Oregon Health and Science University, 3181 SW Sam Jackson Park Road, Multnomah Pavilion, Suite 1513, Mail Code: UHN-80R1, Portland, OR 97239
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88
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Naifeh JA, Nock MK, Ursano RJ, Vegella PL, Aliaga PA, Fullerton CS, Kessler RC, Wryter CL, Heeringa SG, Stein MB. Neurocognitive Function and Suicide in U.S. Army Soldiers. Suicide Life Threat Behav 2017; 47:589-602. [PMID: 27801502 PMCID: PMC5411316 DOI: 10.1111/sltb.12307] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2016] [Accepted: 08/18/2016] [Indexed: 11/29/2022]
Abstract
This prospective cohort study used administrative data from the Army Study to Assess Risk and Resilience in Servicemembers to examine associations between neurocognitive functioning and subsequent suicidal events among Regular Army enlisted soldiers during the years 2004-2009. Cases were all soldiers who completed the Army's Automated Neuropsychological Assessment Metrics (ANAM) computerized testing battery prior to documented suicide attempt (n = 607), ideation (n = 955), or death (n = 57). Controls were an equal-probability sample of 9,893 person-months from other soldiers. Exploratory factor analysis of five ANAM tests identified a general neurocognitive factor that excluded the mathematic processing test (MTH). When examined separately in logistic regression analyses that controlled for sociodemographics and prior mental health diagnosis, both the general neurocognitive factor (logit [β] = -.197 to -.521; p < .01) and MTH (β = -.024 to -.064; p < .05) were associated with all outcomes. When both predictors were examined simultaneously, the general neurocognitive factor continued to be associated with all outcomes (β = -.164 to -.417; p < .05) and MTH continued to be associated with suicide attempt (β = -.015; p = .046) and ideation (β = -.014; p = .018). These small but robust associations suggest that future research must continue to examine the extent to which objective neurocognitive tests may enhance understanding and prediction of suicide risk.
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Affiliation(s)
- James A. Naifeh
- Department of Psychiatry; Center for the Study of Traumatic Stress; Uniformed Services University of the Health Sciences; Bethesda MD USA
| | - Matthew K. Nock
- Department of Psychology; Harvard University; Cambridge MA USA
| | - Robert J. Ursano
- Department of Psychiatry; Center for the Study of Traumatic Stress; Uniformed Services University of the Health Sciences; Bethesda MD USA
| | - Patti L. Vegella
- Department of Psychiatry; Center for the Study of Traumatic Stress; Uniformed Services University of the Health Sciences; Bethesda MD USA
| | - Pablo A. Aliaga
- Department of Psychiatry; Center for the Study of Traumatic Stress; Uniformed Services University of the Health Sciences; Bethesda MD USA
| | - Carol S. Fullerton
- Department of Psychiatry; Center for the Study of Traumatic Stress; Uniformed Services University of the Health Sciences; Bethesda MD USA
| | - Ronald C. Kessler
- Department of Health Care Policy; Harvard Medical School; Boston MA USA
| | - Christina L. Wryter
- Department of Psychiatry; Center for the Study of Traumatic Stress; Uniformed Services University of the Health Sciences; Bethesda MD USA
| | | | - Murray B. Stein
- Department of Psychiatry; University of California San Diego; La Jolla CA USA
- Department of Family Medicine and Public Health; University of California San Diego; La Jolla CA USA
- VA San Diego Healthcare System; La Jolla CA USA
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89
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Pu S, Setoyama S, Noda T. Association between cognitive deficits and suicidal ideation in patients with major depressive disorder. Sci Rep 2017; 7:11637. [PMID: 28912439 PMCID: PMC5599636 DOI: 10.1038/s41598-017-12142-8] [Citation(s) in RCA: 63] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2017] [Accepted: 09/05/2017] [Indexed: 11/12/2022] Open
Abstract
The role of cognitive function in suicidal ideation in patients with major depressive disorder (MDD) has not been adequately explored. This research sought to measure the relationship between suicidal ideation and cognitive function. Therefore, in this study, the association between cognitive function and suicidal ideation in patients with MDD was assessed. Cognitive function was evaluated in 233 patients with MDD using the Japanese version of the Brief Assessment of Cognition in Schizophrenia (BACS). Suicidal ideation was assessed using item 3 of the Hamilton Depression Rating Scale. Approximately 59.2% of the patients (138/233) expressed suicidal ideation. Among the BACS subtests, only the executive function scores were significantly lower in patients with MDD with than in those without (p < 0.005). In addition, the executive function, motor speed function, and composite scores correlated negatively with the severity of suicidal ideation in these patients. These results suggest that executive function, motor speed function, and global neuropsychological function are associated with suicidal ideation in patients with MDD and that the BACS neuropsychological battery is an efficient instrument for monitoring these characteristics. Moreover, specific BACS scores can potentially serve as cognitive biomarkers of suicide risk in patients with MDD.
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Affiliation(s)
- Shenghong Pu
- Integrative Brain Imaging Center, National Center Hospital, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-Higashi, Kodaira, Tokyo, 187-8551, Japan.
- Division of Neuropsychiatry, Department of Brain and Neuroscience, Tottori University Faculty of Medicine, 36-1 Nishi-cho, Yonago, Tottori, 683-8504, Japan.
| | - Shiori Setoyama
- Department of Psychiatry, National Center Hospital, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-Higashi, Kodaira, Tokyo, 187-8551, Japan
| | - Takamasa Noda
- Integrative Brain Imaging Center, National Center Hospital, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-Higashi, Kodaira, Tokyo, 187-8551, Japan
- Department of Psychiatry, National Center Hospital, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-Higashi, Kodaira, Tokyo, 187-8551, Japan
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90
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Baek K, Kwon J, Chae JH, Chung YA, Kralik JD, Min JA, Huh H, Choi KM, Jang KI, Lee NB, Kim S, Peterson BS, Jeong J. Heightened aversion to risk and loss in depressed patients with a suicide attempt history. Sci Rep 2017; 7:11228. [PMID: 28894106 PMCID: PMC5593974 DOI: 10.1038/s41598-017-10541-5] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2016] [Accepted: 08/10/2017] [Indexed: 01/19/2023] Open
Abstract
Suicide attempters have been found to be impaired in decision-making; however, their specific biases in evaluating uncertain outcomes remain unclear. Here we tested the hypothesis that suicidal behavior is associated with heightened aversion to risk and loss, which might produce negative predictions about uncertain future events. Forty-five depressed patients with a suicide attempt history, 47 nonsuicidal depressed patients, and 75 healthy controls participated in monetary decision-making tasks assessing risk and loss aversion. Suicide attempters compared with the other groups exhibited greater aversion to both risk and loss during gambles involving potential loss. Risk and loss aversion correlated with each other in the depressed patients, suggesting that a common pathophysiological mechanism underlies these biases. In addition, emotion regulation via suppression, a detrimental emotional control strategy, was positively correlated with loss aversion in the depressed patients, also implicating impairment in regulatory processes. A preliminary fMRI study also found disrupted neural responses to potential gains and losses in the subgenual anterior cingulate cortex, insula cortex, and left amygdala, brain regions involved in valuation, emotion reactivity, and emotion regulation. The findings thus implicate heightened negative valuation in decision-making under risk, and impaired emotion regulation in depressed patients with a history of suicide attempts.
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Affiliation(s)
- Kwangyeol Baek
- Department of Bio and Brain Engineering, Korea Advanced Institute of Science and Technology (KAIST), Daejeon, 34141, Republic of Korea.,Department of Psychiatry, University of Cambridge, Addenbrooke's Hospital, Cambridge, CB2 0QQ, United Kingdom
| | - JaeHyung Kwon
- Department of Bio and Brain Engineering, Korea Advanced Institute of Science and Technology (KAIST), Daejeon, 34141, Republic of Korea
| | - Jeong-Ho Chae
- Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul, 06591, Republic of Korea.
| | - Yong An Chung
- Department of Radiology, College of Medicine, The Catholic University of Korea, Seoul, 06591, Republic of Korea
| | - Jerald D Kralik
- Department of Bio and Brain Engineering, Korea Advanced Institute of Science and Technology (KAIST), Daejeon, 34141, Republic of Korea
| | - Jung-Ah Min
- Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul, 06591, Republic of Korea
| | - HyuJung Huh
- Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul, 06591, Republic of Korea
| | - Kyung Mook Choi
- Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul, 06591, Republic of Korea
| | - Kuk-In Jang
- Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul, 06591, Republic of Korea
| | - Na-Bin Lee
- Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul, 06591, Republic of Korea
| | - Sunyoung Kim
- Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul, 06591, Republic of Korea
| | - Bradley S Peterson
- Institute for the Developing Mind, Children's Hospital Los Angeles and the Keck School of Medicine at the University of Southern California, Los Angeles, CA 90033, United States
| | - Jaeseung Jeong
- Department of Bio and Brain Engineering, Korea Advanced Institute of Science and Technology (KAIST), Daejeon, 34141, Republic of Korea.
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91
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Granek L, Nakash O, Ben-David M, Shapira S, Ariad S. Oncologists', nurses', and social workers' strategies and barriers to identifying suicide risk in cancer patients. Psychooncology 2017. [DOI: 10.1002/pon.4481] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Leeat Granek
- Department of Public Health, Faculty of Health Sciences; Ben-Gurion University of the Negev; Beer Sheva Israel
| | - Ora Nakash
- Baruch Ivcher School of Psychology; Interdisciplinary Center; Herzliya Israel
| | - Merav Ben-David
- Radiation Oncology; Sheba Medical Center; Ramat-Gan Israel
- The Sackler School of Medicine; Tel-Aviv University; Tel-Aviv Israel
| | - Shahar Shapira
- Department of Gender Studies; Ben-Gurion University of the Negev; Beer Sheva Israel
| | - Samuel Ariad
- Department of Oncology; Soroka University Medical Center, Ben-Gurion University of the Negev; Beer Sheva Israel
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92
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Du L, Zeng J, Liu H, Tang D, Meng H, Li Y, Fu Y. Fronto-limbic disconnection in depressed patients with suicidal ideation: A resting-state functional connectivity study. J Affect Disord 2017; 215:213-217. [PMID: 28340447 DOI: 10.1016/j.jad.2017.02.027] [Citation(s) in RCA: 76] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2016] [Revised: 01/22/2017] [Accepted: 02/05/2017] [Indexed: 01/26/2023]
Abstract
BACKGROUND Suicidal ideation (SI) is highly prevalent and a known symptom of Major Depressive Disorder (MDD), but its underlying biological mechanisms are relatively unknown. Several studies linked suicidal ideation to dysfunctional brain circuits, specifically fronto-limbic connections. The purpose of this work was to investigate fronto-limbic disconnection in MDD patients with or without SI. METHODS MDD patients with SI (SI, n=28) or without SI (NSI, n=20), identified by the Scale for Suicide Ideation and healthy controls (HCs, n=30) underwent resting-state functional MRI scanning. The functional properties of correlations in neural activity (intrinsic functional connectivity, iFC) of the rostral anterior cingulate cortex (rACC) were analyzed among the three groups. Furthermore, correlation analyses between iFC, SI severity and depression severity were performed. RESULTS We found that the SI group exhibited decreased iFC between the rACC, the orbitomedial prefrontal cortex and the right middle temporal pole compared to HCs and NSI groups. The NSI group showed decreased iFC between the rACC and the orbitomedial prefrontal cortex compared to HCs. In the SI group, iFC strength between the right rACC and the middle temporal pole positively correlated with SI severity. CONCLUSION Transdiagnostic and diagnosis-specific alterations of fronto-limbic iFC were found in MDD patients with or without SI. Disrupted fronto-limbic circuits may impact decision-making and emotional processing in SI. These results provide useful information about the pathophysiological mechanisms of MDD patients with SI.
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Affiliation(s)
- Lian Du
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, PR China
| | - Jinkun Zeng
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, PR China
| | - Huan Liu
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, PR China
| | - Dejian Tang
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, PR China
| | - Huaqing Meng
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, PR China
| | - Yongmei Li
- Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, PR China.
| | - Yixiao Fu
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, PR China.
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93
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Fazakas-DeHoog LL, Rnic K, Dozois DJA. A Cognitive Distortions and Deficits Model of Suicide Ideation. EUROPES JOURNAL OF PSYCHOLOGY 2017; 13:178-193. [PMID: 28580021 PMCID: PMC5450979 DOI: 10.5964/ejop.v13i2.1238] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2016] [Accepted: 01/21/2017] [Indexed: 12/22/2022]
Abstract
Although cognitive distortions and deficits are known risk factors for the development and escalation of suicide ideation and behaviour, no empirical work has examined how these variables interact to predict suicide ideation. The current study proposes an integrative model of cognitive distortions (hopelessness and negative evaluations of self and future) and deficits (problem solving deficits, problem solving avoidance, and cognitive rigidity). To test the integrity of this model, a sample of 397 undergraduate students completed measures of deficits, distortions, and current suicide ideation. A structural equation model demonstrated excellent fit, and findings indicated that only distortions have a direct effect on suicidal thinking, whereas cognitive deficits may exert their effects on suicide ideation via their reciprocal relation with distortions. Findings underscore the importance of both cognitive distortions and deficits for understanding suicidality, which may have implications for preventative efforts and treatment.
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Affiliation(s)
- Laura L Fazakas-DeHoog
- St. Joseph's Health Care - Regional Mental Health Care St. Thomas, St. Thomas, Ontario, Canada.,Department of Psychology, The University of Western Ontario, London, Ontario, Canada
| | - Katerina Rnic
- Department of Psychology, The University of Western Ontario, London, Ontario, Canada
| | - David J A Dozois
- Department of Psychology, The University of Western Ontario, London, Ontario, Canada
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94
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Majer JM, Beasley C, Jason LA. Suicide Attempts and Personal Need for Structure Among Ex-Offenders. INTERNATIONAL JOURNAL OF OFFENDER THERAPY AND COMPARATIVE CRIMINOLOGY 2017; 61:334-346. [PMID: 26175545 PMCID: PMC4713382 DOI: 10.1177/0306624x15595981] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Suicide attempts were examined in relation to sociodemographic (age, gender, ethnicity), psychopathological (prior psychiatric hospitalizations, physical and sexual abuse histories), and cognitive (personal need for structure) variables among a sample of ex-offenders with substance use disorders ( N = 270). Hierarchical logistic regression was conducted to determine whether personal need for structure would significantly predict whether participants reported past suicide attempts beyond sociodemographic and psychopathological predictors. Personal need for structure and prior psychiatric hospitalizations were the only significant predictors, with higher values of these predictors increasing the likelihood of suicide attempts. Findings are consistent with a cognitive model for understanding suicide behavior, suggesting that persons with a high need for cognitive structures operate with persistent and rigid thought processes that contribute to their risk of suicide.
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95
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Cohen GH, Fink DS, Sampson L, Tamburrino M, Liberzon I, Calabrese JR, Galea S. Coincident alcohol dependence and depression increases risk of suicidal ideation among Army National Guard soldiers. Ann Epidemiol 2016; 27:157-163.e1. [PMID: 28139369 DOI: 10.1016/j.annepidem.2016.12.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2016] [Revised: 11/26/2016] [Accepted: 12/04/2016] [Indexed: 10/20/2022]
Abstract
PURPOSE Suicide rates among military service members have risen dramatically, while drivers remain poorly understood. We examined the relationship between coincident alcohol dependence and depression in shaping risk of suicidal ideation among National Guard forces. METHODS We performed a longitudinal analysis using a randomly selected, population-based sample of Ohio Army National Guard soldiers. Telephone-based surveys of 1582 soldiers who participated in both wave 1 (2008-2009) and wave 2 (2009-2010) were analyzed. RESULTS Odds ratios (ORs) for suicidal ideation among those with versus without alcohol dependence were similar among nondepressed (OR = 3.85 [95% confidence intervals (CIs) = 1.18-12.52]) and depressed individuals (OR = 3.13 [95% CI = 0.88-11.14]); multiplicative interaction was not observed. In contrast, the risk differences (RDs) among those with versus without alcohol dependence diverged for those without depression (RD = 0.04 [95% CI = 0.02-0.07]) compared with those with depression (RD = 0.11 [95% CI = 0.06-0.18]); strong evidence of additive interaction was observed. CONCLUSIONS We found that alcohol dependence and depression interact statistically in shaping risk for incident suicidal ideation among Army National Guard service members. A high-risk prevention approach including population-based screening for suicidality among patients with alcohol dependence, depression, and particularly those with both conditions is warranted in military populations.
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Affiliation(s)
- Gregory H Cohen
- Department of Epidemiology, Boston University School of Public Health, Boston, MA; Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY.
| | - David S Fink
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY
| | - Laura Sampson
- Department of Epidemiology, Boston University School of Public Health, Boston, MA
| | - Marijo Tamburrino
- Department of Psychiatry, University of Toledo Health Science Center, Toledo, OH
| | | | - Joseph R Calabrese
- Department of Psychiatry, University Hospitals Case Medical Center, Case Western Reserve University, Cleveland, OH
| | - Sandro Galea
- Department of Epidemiology, Boston University School of Public Health, Boston, MA; Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY
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96
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Abstract
Suicide is one of the leading causes of violent death in many countries and its prevention is included in worldwide health objectives. Currently, the DSM-5 considers suicidal behavior as an entity that requires further study. Among the three validators required for considering a psychiatric disorder, there is one based on psychological correlates, biological markers, and patterns of comorbidity. This review includes the most important and recent studies on psychological factors: cognitive, emotional, temperament, and personality correlates (unrelated to diagnostic criteria). We included classic factors related to suicidal behavior such as cognitive, inflexibility, problem-solving, coping, rumination, thought suppression, decision-making, autobiographical memory, working memory, language fluency, burdensomeness, belongingness, fearless, pain insensitivity, impulsiveness, aggressiveness, and hopelessness. The personality correlates reported are mainly based on the personality theories of Cloninger, Costa and McCrae, and Eysenck. Moreover, it explores conceptual links to other new pathways in psychological factors, emptiness, and psychological pain as a possible origin and common end path for a portion of suicidal behaviors.
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97
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Pulay AJ, Réthelyi JM. Multimarker analysis suggests the involvement of BDNF signaling and microRNA biosynthesis in suicidal behavior. Am J Med Genet B Neuropsychiatr Genet 2016; 171:763-76. [PMID: 26921221 DOI: 10.1002/ajmg.b.32433] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2015] [Accepted: 02/04/2016] [Indexed: 12/22/2022]
Abstract
Despite moderate heritability estimates the genetics of suicidal behavior remains unclear, genome-wide association and candidate gene studies focusing on single nucleotide associations reported inconsistent findings. Our study explored biologically informed, multimarker candidate gene associations with suicidal behavior in mood disorders. We analyzed the GAIN Whole Genome Association Study of Bipolar Disorder version 3 (n = 999, suicidal n = 358) and the GAIN Major Depression: Stage 1 Genomewide Association in Population-Based Samples (n = 1,753, suicidal n = 245) datasets. Suicidal behavior was defined as severe suicidal ideation or attempt. Candidate genes were selected based on literature search (Geneset1, n = 35), gene expression data of microRNA genes, (Geneset2, n = 68) and their target genes (Geneset3, n = 11,259). Quality control, dosage analyses were carried out with PLINK. Gene-based associations of Geneset1 were analyzed with KGG. Polygenic profile scores of suicidal behavior were computed in the major depression dataset both with PRSice and LDpred and validated in the bipolar disorder data. Several nominally significant gene-based associations were detected, but only DICER1 associated with suicidal behavior in both samples, while only the associations of NTRK2 in the depression sample reached family wise and experiment wise significance. Polygenic profile scores negatively predicted suicidal behavior in the bipolar sample for only Geneset2, with the strongest prediction by PRSice at Pt < 0.03 (Nagelkerke R(2) = 0.01, P < 0.007). Gene-based association results confirmed the potential involvement of the BDNF-NTRK2-CREB pathway in the pathogenesis of suicide and the cross-disorder association of DICER1. Polygenic risk prediction of the selected miRNA genes indicates that the miRNA system may play a mediating role, but with considerable pleiotropy. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Attila J Pulay
- Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary
| | - János M Réthelyi
- Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary.,Molecular Psychiatry Research Group, MTA-SE NAP-B, Hungarian Academy of Sciences and Semmelweis University, Budapest, Hungary
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98
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Thompson RG, Alonzo D, Hu MC, Hasin DS. The influences of parental divorce and maternal-versus-paternal alcohol abuse on offspring lifetime suicide attempt. Drug Alcohol Rev 2016; 36:408-414. [DOI: 10.1111/dar.12441] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2015] [Revised: 03/15/2016] [Accepted: 05/07/2016] [Indexed: 11/27/2022]
Affiliation(s)
- Ronald G. Thompson
- Department of Psychiatry, College of Physicians and Surgeons; Columbia University; New York USA
| | - Dana Alonzo
- Graduate School of Social Service; Fordham University; West Harrison USA
| | - Mei-Chen Hu
- Department of Psychiatry, College of Physicians and Surgeons; Columbia University; New York USA
| | - Deborah S. Hasin
- Department of Psychiatry, College of Physicians and Surgeons; Columbia University; New York USA
- Department of Epidemiology, Mailman School of Public Health; Columbia University; New York USA
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99
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Abstract
Suicide in the elderly is an underestimated and complex issue that has mainly been explored in sociological, clinical and psychological perspectives. Suicide in non-elderly adults has been associated with diverse neurobiological alterations that may shed light on future predictive markers and more efficient preventative interventions. The aim of this paper was to review studies specifically investigating the neurobiology of elderly suicidal behaviour. We performed a systematic English and French Medline and EMBASE search until 2013. Contrary to literature about the non-elderly, we found a paucity of studies investigating the biomarkers of suicidal risk in elderly adults. Main findings were found in the neurocognitive domain. Studies generally supported the existence of cognitive deficits, notably decision-making impairment and reduced cognitive inhibition, in patients with a history of suicidal act compared to patients without such history. However, replications are needed to confirm findings. Due to several limitations including the small number of available studies, frequent lack of replication and small sample size, no firm conclusions can be drawn. The authors encourage further investigations in this field as insight in the neurobiology of these complex behaviors may limit clichés about end of life and aging, as well as improve future prevention of suicide in the elderly.
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100
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Alonzo D. Suicidal Individuals and Mental Health Treatment: A Novel Approach to Engagement. Community Ment Health J 2016; 52:527-33. [PMID: 26748654 DOI: 10.1007/s10597-015-9980-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2014] [Accepted: 12/15/2015] [Indexed: 11/26/2022]
Abstract
To determine the feasibility and acceptability of a novel, manualized problem-solving and comprehensive contact intervention (PS-CCI) aimed at improving treatment engagement of suicidal individuals. The PS-CCI was administered to 44 individuals with mood disorders presenting to the ER with suicidal ideation and/or behavior. The PS-CCI has two components: (1) a problem-solving interview administered upon admission to the emergency room (ER), and (2) follow-up contact post-discharge from the ER. The average age of participants was 33.45 years (SD = ±12.30). The PS-CCI was completed by 75 % of patients. No subject (0 %) withdrew during the 3-month follow-up period; however, 27.2 % were unable to be reached for follow-up assessment. We have concluded that the intervention has a good feasibility because of high acceptability and adherence and further testing of its efficacy seems feasible.
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Affiliation(s)
- Dana Alonzo
- Fordham University Graduate School of Social Work, 113 West 60th Street, New York, NY, 10023, USA.
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