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Kliem S, Lohmann A, Mößle T, Brähler E. German Beck Scale for Suicide Ideation (BSS): psychometric properties from a representative population survey. BMC Psychiatry 2017; 17:389. [PMID: 29202737 PMCID: PMC5716298 DOI: 10.1186/s12888-017-1559-9] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2017] [Accepted: 11/28/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Suicidal ideation has been identified as one of the major predictors of attempted or actual suicide. Routinely screening individuals for endorsing suicidal thoughts could save lives and protect many from severe psychological consequences following the suicide of loved ones. The aim of this study was to validate the German version of the Beck Scale for Suicide Ideation (BSS) in a sample representative for the Federal Republic of Germany. METHODS All 2450 participants completed the first part of the Scale, the BSS-Screen. A risk group of n = 112 individuals (4.6%) with active or passive suicidal ideation was identified and subsequently completed the entire BSS. RESULTS Satisfactory internal reliability (α = .97 for the BSS-Screen; α = .94 for the entire BSS) and excellent model fit indices for the one-dimensional factorial structure of the BSS-Screen (CFI = .998; TLI = .995; RMSEA = .045 [95%-CI: .030-.061]) were confirmed. Measurement invariance analyses supported strict invariance across gender, age, and depression status. We found correlations with related self-report measures in expected directions comparable to previous studies, indicating satisfactory construct validity. LIMITATIONS Our study involved cross sectional data, hence neither predictive validity nor retest-reliability were examined. As only the risk group of n = 112 individuals completed the entire measure, confirmatory factor analyses could not be conducted for the full BSS. CONCLUSION The German translation of the BSS is a reliable and valid instrument for assessing suicidal ideation in the general population. Using it as a screening device in general and specialized medical care could substantially advance suicide prevention.
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Affiliation(s)
- Sören Kliem
- Criminological Research Institute of Lower Saxony, Lützerodestraße 9, 30161 Hannover, Germany
| | - Anna Lohmann
- Criminological Research Institute of Lower Saxony, Lützerodestraße 9, 30161 Hannover, Germany
| | - Thomas Mößle
- State Police College of Baden-Wuerttemberg, Sturmbühlstraße 250, 78054 Villingen-Schwenningen, Germany
| | - Elmar Brähler
- Department of Psychosomatic Medicine and Psychotherapy, University of Mainz, Untere Zahlbacher Str. 8, 55131 Mainz, Germany
- Department of Medical Psychology and Medical Sociology, University of Leipzig, Philipp-Rosenthal-Str. 55, 04103 Leipzig, Germany
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152
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Fonseca-Pedrero E, Inchausti F, Pérez-Gutiérrez L, Aritio Solana R, Ortuño-Sierra J, Sánchez-García MªÁ, Lucas-Molina B, Domínguez C, Foncea D, Espinosa V, Gorría A, Urbiola-Merina E, Fernández M, Merina Díaz C, Gutiérrez C, Aures M, Campos MS, Domínguez-Garrido E, Pérez de Albéniz Iturriaga A. Suicidal ideation in a community-derived sample of Spanish adolescents. REVISTA DE PSIQUIATRIA Y SALUD MENTAL 2017; 11:76-85. [PMID: 29102308 DOI: 10.1016/j.rpsm.2017.07.004] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/13/2017] [Revised: 07/24/2017] [Accepted: 07/26/2017] [Indexed: 10/18/2022]
Abstract
INTRODUCTION Suicide is a current public health problem and among the main causes of mortality in adolescents and young adults. The main goal of this study was to analyse suicidal ideation in a representative sample of Spanish adolescents. Specifically, the prevalence rates of suicide ideation, the psychometric properties of the Paykel Suicide Scale (PSS) scores, and the socio-emotional adjustment of adolescents at risk for suicide were analysed. MATERIAL AND METHODS The sample consisted of 1,664 participants (M=16.12 years, SD=1.36, range 14-19 years), selected by stratified sampling by clusters. The instruments used were the PSS, the Strengths and Difficulties Questionnaire, the Personal Wellbeing Index-School Children, and the Oviedo Infrequency Scale. RESULTS The results showed that 4.1% of the sample indicated that they had tried to commit suicide in the previous year. Statistically significant differences were found according to gender but not according to age in the PSS mean scores. The analysis of the internal structure of the PSS showed that the one-dimensional model presented excellent goodness of fit indexes. This model showed measurement invariance across gender. The reliability of the scores, estimated with ordinal alpha, was 0.93. Participants who reported suicide ideation showed poorer mental health status and lower life satisfaction compared to the non-suicide ideation group. CONCLUSIONS Suicidal ideation is present during adolescence and is associated with poor subjective well-being and increased emotional and behavioural problems. PSS seems to show adequate psychometric behaviour to assess suicidal ideation in adolescents. These findings have clear implications, both in health and education systems, to improve the promotion of emotional well-being and prevention of psychological and psychiatric problems in this sector of the population.
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Affiliation(s)
- Eduardo Fonseca-Pedrero
- Departamento de Ciencias de la Educación, Universidad de La Rioja, Logroño, España; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Oviedo, España.
| | - Félix Inchausti
- Centro de Salud Mental Ermitagaña, Complejo Hospitalario de Navarra, Pamplona, España
| | | | - Rebeca Aritio Solana
- Departamento de Ciencias de la Educación, Universidad de La Rioja, Logroño, España
| | - Javier Ortuño-Sierra
- Departamento de Ciencias de la Educación, Universidad de La Rioja, Logroño, España
| | | | | | - César Domínguez
- Departamento de Matemáticas y Computación, Universidad de La Rioja, Logroño, España
| | - David Foncea
- Departamento de Ciencias de la Educación, Universidad de La Rioja, Logroño, España
| | - Virginia Espinosa
- Departamento de Ciencias de la Educación, Universidad de La Rioja, Logroño, España
| | - Ana Gorría
- Consejería de Salud, Gobierno de La Rioja, Logroño, España
| | | | | | | | | | - Marta Aures
- Consejería de Salud, Gobierno de La Rioja, Logroño, España
| | - María S Campos
- Consejería de Salud, Gobierno de La Rioja, Logroño, España
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153
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A Psycho-Educational Group Program for Divorced Parents in Spain: A Pilot Study. CONTEMPORARY FAMILY THERAPY 2017. [DOI: 10.1007/s10591-017-9419-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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154
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Chan Chee C, Paget LM. Le Recueil d’information médicalisé en psychiatrie (RIM-P) : un outil nécessaire pour la surveillance des hospitalisations suite à une tentative de suicide. Rev Epidemiol Sante Publique 2017; 65:349-359. [DOI: 10.1016/j.respe.2017.05.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2016] [Revised: 02/08/2017] [Accepted: 05/10/2017] [Indexed: 11/26/2022] Open
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155
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Impacto económico y carga de los trastornos mentales comunes en España: una revisión sistemática y crítica. ANSIEDAD Y ESTRES-ANXIETY AND STRESS 2017. [DOI: 10.1016/j.anyes.2017.10.003] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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156
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Joshi P, Song HB, Lee SA. Association of chronic disease prevalence and quality of life with suicide-related ideation and suicide attempt among Korean adults. Indian J Psychiatry 2017; 59:352-358. [PMID: 29085096 PMCID: PMC5659087 DOI: 10.4103/psychiatry.indianjpsychiatry_282_16] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
AIMS The aim of this study is to find the association of chronic disease prevalence (CDP) with suicide-related ideation (SI) and suicide attempt (SA) and to determine the combined effect of CDP and quality of life (QoL) with SI or SA. DESIGN This was a cross-sectional study. MATERIALS AND METHODS The data were collected from the nationally representative Korea National Health and Nutrition Examination Survey IV and V (2007-2012). For the analysis, a total of 35,075 adult participants were selected as the final sample, which included 5773 participants with SI and 331 with SA. STATISTICAL ANALYSIS Multiple logistic regression models were used to examine the odds ratio after adjusting for age, sex, marital status, education, occupation, and household income. RESULTS AND CONCLUSION SI was positively associated with selected CDP, such as cardiovascular disease (CVD), stroke, ischemic heart disease (IHD), cancer, diabetes, renal failure, and depression, except hypertension. Subjects with CVD, IHD, renal failure, and depression were found likely to have increased odds for SA as compared to non-SA controls. Lower QoL strongly affected SI and SA. Furthermore, the likelihood of SI increased for depressed and cancer subjects who had low QoL in comparison to subjects with high QoL and without chronic disease. Similarly, statistically, significant interaction was observed between lower QoL and depression in relation to SA compared to non-SA controls. These data suggest that suicide-related behavior could be predicted by the prevalence of chronic disease and low QoL.
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Affiliation(s)
- Pankaj Joshi
- Department of Preventive Medicine, Kangwon National University School of Medicine, Gangwon-do, 24341, South Korea.,BIT Medical Convergence Graduate Program, Kangwon National University School of Medicine, Gangwon-do, 24341, South Korea
| | - Han-Byol Song
- Department of Preventive Medicine, Kangwon National University School of Medicine, Gangwon-do, 24341, South Korea
| | - Sang-Ah Lee
- Department of Preventive Medicine, Kangwon National University School of Medicine, Gangwon-do, 24341, South Korea.,BIT Medical Convergence Graduate Program, Kangwon National University School of Medicine, Gangwon-do, 24341, South Korea
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157
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Affiliation(s)
- Arieh Shalev
- From the Steven and Alexandra Cohen Veterans Center for Posttraumatic Stress and TBI, Department of Psychiatry, New York University School of Medicine, New York (A.S., C.M.); and the Department of Psychiatry, University of Michigan, and the Mental Health Service, Veterans Affairs Ann Arbor Health Systems - both in Ann Arbor (I.L.)
| | - Israel Liberzon
- From the Steven and Alexandra Cohen Veterans Center for Posttraumatic Stress and TBI, Department of Psychiatry, New York University School of Medicine, New York (A.S., C.M.); and the Department of Psychiatry, University of Michigan, and the Mental Health Service, Veterans Affairs Ann Arbor Health Systems - both in Ann Arbor (I.L.)
| | - Charles Marmar
- From the Steven and Alexandra Cohen Veterans Center for Posttraumatic Stress and TBI, Department of Psychiatry, New York University School of Medicine, New York (A.S., C.M.); and the Department of Psychiatry, University of Michigan, and the Mental Health Service, Veterans Affairs Ann Arbor Health Systems - both in Ann Arbor (I.L.)
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158
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Kordrostami R, Akhgari M, Ameri M, Ghadipasha M, Aghakhani K. Forensic toxicology analysis of self-poisoning suicidal deaths in Tehran, Iran; trends between 2011-2015. ACTA ACUST UNITED AC 2017; 25:15. [PMID: 28610598 PMCID: PMC5470324 DOI: 10.1186/s40199-017-0181-1] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2017] [Accepted: 06/06/2017] [Indexed: 11/13/2022]
Abstract
Background Suicide ranks among the top ten causes of death in all age groups all over the world. There are many methods for committing suicide including self-poisoning, firearm and hanging. The aim of the present study was to provide an overview of self-poisoning related suicidal deaths with special focus on forensic toxicology analysis results in Tehran, Iran from 2011 to 2015. Methods All suspicious cases with the the history of self-poisoning were investigated to define the cause and manner of death under the supervision of forensic medicine practitioners. Postmortem samples were analysed in forensic toxicology laboratory to confirm the presence of drugs in cadaver of suicidal cases. Drugs and poisons were analysed using thin layer chromatography, high performance liquid chromatography, gas chromatography/mass spectrometry, headspace gas chromatography and gas chromatography equipped with nitrogen phosphorus detector. Demographic data were collected from autopsy reports of all cases with confirmed self-poisoning suicidal cause of death. Results Results showed that 674 cases of self-poisoning deaths were investigated during a five-year study period, of which 68.55% were male. The most often used suicide method was self-poisoning in young population. Phosphine gas liberated from aluminum phosphide tablets was the most toxic substance detected in postmortem samples (619 cases) followed by opioids, methamphetamine, organophosphates, cyanide and strychnine. Conclusion In conclusion self-poisoning suicidal death was predominant in young male population in Tehran, Iran. It seems that free access to suicide means such as drugs and poisons should be restricted by national and health authorities. Trial registration Not applicable.
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Affiliation(s)
- Roya Kordrostami
- Forensic & Legal Medicine Department, Iran University of Medical Sciences, Tehran, Iran
| | - Maryam Akhgari
- Legal Medicine Research Center, Legal Medicine Organization, Tehran, Iran.
| | - Maryam Ameri
- Forensic & Legal Medicine Department, Iran University of Medical Sciences, Tehran, Iran
| | - Masoud Ghadipasha
- Legal Medicine Research Center, Legal Medicine Organization, Tehran, Iran
| | - Kamran Aghakhani
- Forensic & Legal Medicine Department, Iran University of Medical Sciences, Tehran, Iran
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159
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Kordrostami R, Akhgari M, Ameri M, Ghadipasha M, Aghakhani K. Forensic toxicology analysis of self-poisoning suicidal deaths in Tehran, Iran; trends between 2011-2015. Daru 2017. [DOI: https://doi.org/10.1186/s40199-017-0181-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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160
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Brake CA, Rojas SM, Badour CL, Dutton CE, Feldner MT. Self-disgust as a potential mechanism underlying the association between PTSD and suicide risk. J Anxiety Disord 2017; 47:1-9. [PMID: 28126678 DOI: 10.1016/j.janxdis.2017.01.003] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2016] [Revised: 11/17/2016] [Accepted: 01/05/2017] [Indexed: 01/04/2023]
Abstract
Suicide risk is highly prevalent among individuals with posttraumatic stress disorder (PTSD). Self-disgust, defined as disgust directed internally and comprised of disgust with oneself (disgusting self) and with one's behaviors (disgusting ways), may impact this increased risk. The present study examined self-disgust as a putative mechanism linking PTSD symptoms with suicide risk. A sample of 347 trauma-exposed undergraduates completed measures of PTSD symptoms, suicide risk, self-disgust, and depressive symptoms. Controlling for depressive symptoms, a process model indicated PTSD symptoms were positively linked to suicide risk via increased disgusting self but not disgusting ways. Process models examining individual PTSD symptom clusters revealed positive, indirect links between all PTSD symptom clusters except alterations in arousal and reactivity and suicide risk via disgusting self. These findings expand on growing literature documenting the importance of self-disgust in trauma-related pathology by identifying connections with suicide risk. Future directions and clinical considerations are discussed.
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Affiliation(s)
- C Alex Brake
- Department of Psychology, University of Kentucky, Lexington, KY, 40506, USA.
| | - Sasha M Rojas
- Department of Psychological Science, University of Arkansas, Fayetteville, AR, 72701, USA
| | - Christal L Badour
- Department of Psychology, University of Kentucky, Lexington, KY, 40506, USA
| | - Courtney E Dutton
- Department of Psychological Science, University of Arkansas, Fayetteville, AR, 72701, USA
| | - Matthew T Feldner
- Department of Psychological Science, University of Arkansas, Fayetteville, AR, 72701, USA; Laureate Institute for Brain Research, 6655 S. Yale Ave., Tulsa, OK, 74136, USA
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161
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Examining the role of psychological factors in the relationship between sleep problems and suicide. Clin Psychol Rev 2017; 54:1-16. [PMID: 28371648 PMCID: PMC5434037 DOI: 10.1016/j.cpr.2017.03.009] [Citation(s) in RCA: 67] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2016] [Revised: 11/29/2016] [Accepted: 03/27/2017] [Indexed: 01/08/2023]
Abstract
We sought to conduct the first systematic review of empirical evidence investigating the role of psychological factors in the relationship between sleep problems and suicidal thoughts and behaviours. Twelve studies were identified which examined psychological factors grouped into four categories of cognitive appraisals, psychosocial factors, emotion regulation strategies, and risk behaviours. Although there was substantial heterogeneity across studies with respect to measurement, sampling, and analysis, preliminary evidence indicated that negative cognitive appraisals, perceived social isolation, and unhelpful emotion regulation strategies may contribute to the association between sleep problems and suicidal thoughts and behaviours. Given that findings in this area are currently restricted to studies with cross-sectional designs, the directionality of the interrelationships between these psychological factors, sleep problems and suicidality, remains unclear. We integrate the findings of our review with contemporary psychological models of suicidal behaviour to develop a clear research agenda. Identified pathways should now be tested with longitudinal and experimental designs. In addition, a more thorough investigation of the complexities of sleep, psychological factors, and suicidal thoughts and behaviours is crucial for the development of targeted psychological interventions. Systematic review of the role of psychological factors in sleep/suicide relationships Review findings integrated with suicide theory to define a clear research agenda. Reliance on cross-sectional designs limits interpretation of directionality of pathways. Identified pathways should be investigated with longitudinal and experimental designs.
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162
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Moon CM, Jeong GW. Functional and morphological alterations associated with working memory dysfunction in patients with generalized anxiety disorder. Acta Radiol 2017; 58:344-352. [PMID: 27235455 DOI: 10.1177/0284185116649794] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background Generalized anxiety disorder (GAD) has been related to functional brain activities and structural brain abnormalities. Purpose To investigate the neural mechanism on working memory dysfunction in patients with GAD in terms of the combined functional and morphological brain abnormalities. Material and Methods Patients with GAD and healthy controls matched for age, sex, and education level underwent high-resolution T1-weighted (T1W) magnetic resonance imaging (MRI) and functional MRI (fMRI). In this study, fMRI and voxel-based morphometry (VBM) were used for assessing the differential brain activation patterns, as well as for comparing the morphological alterations between the two groups. Results In response to the neutral distractors, the patients showed significantly lower activities in the regions of the fusiform gyrus (FuG), superior parietal gyrus (SPG), precuneus (PCu), superior occipital gyrus (SOG), lingual gyrus (LiG), cuneus (Cun), calcarine cortex (CaC), parahippocampal gyrus (PHG) and cerebellar cortex (Cb) compared to the controls. In response to the anxiety-inducing distractors, the patients showed significantly higher activity in the hippocampus and lower activities in the regions of the dorsolateral prefrontal cortex (DLPFC), FuG, SPG, PCu, SOG, and Cb. Also, the patients showed a significant reduction of the white matter volumes in the DLPFC, anterior limb of the internal capsule (ALIC) and midbrain. Conclusion This study provides the first evidence for the association between the morphometric alterations and functional deficit in the working memory processing with the neutral and anxiety-inducing distractors in GAD patients. These findings would be helpful to understand the neural mechanisms on working memory impairment in connection with GAD symptoms.
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Affiliation(s)
- Chung-Man Moon
- Research Institute for Medical Imaging, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Gwang-Woo Jeong
- Research Institute for Medical Imaging, Chonnam National University Medical School, Gwangju, Republic of Korea
- Department of Radiology, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Republic of Korea
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163
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Moon CM, Jeong GW. Abnormalities in gray and white matter volumes associated with explicit memory dysfunction in patients with generalized anxiety disorder. Acta Radiol 2017; 58:353-361. [PMID: 27273376 DOI: 10.1177/0284185116649796] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background The neuroanatomical abnormalities associated with behavioral dysfunction on explicit memory in patients generalized anxiety disorder (GAD) have not yet been clearly identified. Purpose To investigate the regional gray matter (GM) and white matter (WM) volume alterations over the whole brain in patients with GAD, as well as the correlation between the brain structural abnormality and explicit memory dysfunction. Material and Methods Twenty patients with GAD and 20 healthy controls matched for age, sex, and education level underwent high-resolution T1-weighted magnetic resonance imaging (MRI). The participants performed the explicit memory tasks with the neutral and anxiety-inducing words. Results Patients with GAD showed significantly reduced GM volumes in the midbrain (MB), thalamus, hippocampus (Hip), insula, and superior temporal gyrus (STG); and reduced WM volumes in the MB, anterior limb of the internal capsule (ALIC), dorsolateral prefrontal cortex (DLPFC), and precentral gyrus (PrG). It is important to note that the GM volume of the Hip and the WM volume of the DLPFC were positively correlated with the recognition accuracy (%) in the explicit memory tasks with neutral and anxiety-inducing words, respectively. On the other hand, the WM volume of the PrG was negatively correlated with the reaction time in the same memory tasks. Conclusion This study demonstrated the regional volume changes on whole-brain GM and WM and the correlation between the brain structural alteration and explicit memory dysfunction in GAD patients. These findings would be helpful to understand the association between the brain structure abnormality and the functional deficit in the explicit memory in GAD.
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Affiliation(s)
- Chung-Man Moon
- Research Institute for Medical Imaging, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Gwang-Woo Jeong
- Research Institute for Medical Imaging, Chonnam National University Medical School, Gwangju, Republic of Korea
- Department of Radiology, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Republic of Korea
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164
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Teismann T, Glaesmer H, von Brachel R, Siegmann P, Forkmann T. A Prospective Examination of Perceived Burdensomeness and Thwarted Belongingness As Risk Factors for Suicide Ideation In Adult Outpatients Receiving Cognitive-Behavioral Therapy. J Clin Psychol 2017; 73:1393-1402. [DOI: 10.1002/jclp.22441] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2016] [Revised: 11/14/2016] [Accepted: 12/04/2016] [Indexed: 11/06/2022]
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165
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Xia L, Li S, Wang T, Guo Y, Meng L, Feng Y, Cui Y, Wang F, Ma J, Jiang G. Spontaneous alterations of regional brain activity in patients with adult generalized anxiety disorder. Neuropsychiatr Dis Treat 2017; 13:1957-1965. [PMID: 28790831 PMCID: PMC5530096 DOI: 10.2147/ndt.s133853] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVE We aimed to examine how spontaneous brain activity might be related to the pathophysiology of generalized anxiety disorder (GAD). PATIENTS AND METHODS Using resting-state functional MRI, we examined spontaneous regional brain activity in 31 GAD patients (mean age, 36.87±9.16 years) and 36 healthy control participants (mean age, 39.53±8.83 years) matched for age, education, and sex from December 2014 to October 2015. We performed a two-sample t-test on the voxel-based analysis of the regional homogeneity (ReHo) maps. We used Pearson correlation analysis to compare scores from the Hamilton Anxiety Rating Scale, Hamilton Depression Rating Scale, State-Trait Anxiety Scale-Trait Scale, and mean ReHo values. RESULTS We found abnormal spontaneous activity in multiple regions of brain in GAD patients, especially in the sensorimotor cortex and emotional regions. GAD patients showed decreased ReHo values in the right orbital middle frontal gyrus, left anterior cingulate cortex, right middle frontal gyrus, and bilateral supplementary motor areas, with increased ReHo values in the left middle temporal gyrus, left superior temporal gyrus, and right superior occipital gyrus. The ReHo value of the left middle temporal gyrus correlated positively with the Hamilton Anxiety Rating Scale scores. CONCLUSION These results suggest that altered local synchronization of spontaneous brain activity may be related to the pathophysiology of GAD.
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Affiliation(s)
- Likun Xia
- Department of Magnetic Resonance Imaging, People's Hospital of Yuxi City, Yuxi
| | - Shumei Li
- Department of Medical Imaging, Guangdong No 2 Provincial People's Hospital, Guangzhou
| | - Tianyue Wang
- Department of Medical Imaging, Guangdong No 2 Provincial People's Hospital, Guangzhou
| | - Yaping Guo
- Department of Rehabilitation Medicine, People's Hospital of Yuxi City, Yuxi, People's Republic of China
| | - Lihong Meng
- Department of Rehabilitation Medicine, People's Hospital of Yuxi City, Yuxi, People's Republic of China
| | - Yunping Feng
- Department of Rehabilitation Medicine, People's Hospital of Yuxi City, Yuxi, People's Republic of China
| | - Yu Cui
- Department of Magnetic Resonance Imaging, People's Hospital of Yuxi City, Yuxi
| | - Fan Wang
- Department of Magnetic Resonance Imaging, People's Hospital of Yuxi City, Yuxi
| | - Jian Ma
- Department of Magnetic Resonance Imaging, People's Hospital of Yuxi City, Yuxi
| | - Guihua Jiang
- Department of Medical Imaging, Guangdong No 2 Provincial People's Hospital, Guangzhou
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166
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Kim M, Oh GJ, Lee YH. Gender-Specific Factors Associated with Suicide Attempts among the Community-Dwelling General Population with Suicidal Ideation: the 2013 Korean Community Health Survey. J Korean Med Sci 2016; 31:2010-2019. [PMID: 27822943 PMCID: PMC5102868 DOI: 10.3346/jkms.2016.31.12.2010] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2016] [Accepted: 08/23/2016] [Indexed: 11/21/2022] Open
Abstract
We identified traditional risk factors and investigated poorly understood risk factors for suicide attempts according to gender in a large Korean population. We analyzed the data from 6,768 males and 12,475 females with suicidal ideation obtained from the nationwide 2013 Korean Community Health Survey. The dependent variable was suicide attempts within the past year. There was a significant trend towards an increase in suicide attempts with decreasing age in both genders. Compared with those who were married, suicide attempts were significantly higher among those who were widowed, divorced, or separated for males (odds ratio [OR], 2.07; 95% confidence interval [CI], 1.34-3.20), but lower for females (OR, 0.66; 95% CI, 0.45-0.98). Current smoking and depression were significant risk factor for suicide attempts in males and females. However, monthly household income, myocardial infarction, and osteoporosis were significantly associated with suicide attempts only in males, whereas education level, recipient of National Basic Livelihood Security, family contact, leisure activity, and drinking frequency were significantly associated only in females. These findings indicate that gender difference should be considered in the assessment, prevention, and management of future suicide attempts by community policy-makers and clinicians.
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Affiliation(s)
- Mina Kim
- Department of Nursing, Graduate School, Chonnam National University, Gwangju, Korea
- Department of Counseling Psychology, Graduate School of Dongshin University, Naju, Korea
| | - Gyung Jae Oh
- Department of Preventive Medicine and Institute of Wonkwang Medical Science, Wonkwang University School of Medicine, Iksan, Korea
- Regional Cardiocerebrovascular Center, Wonkwang University Hospital, Iksan, Korea
| | - Young Hoon Lee
- Department of Preventive Medicine and Institute of Wonkwang Medical Science, Wonkwang University School of Medicine, Iksan, Korea
- Regional Cardiocerebrovascular Center, Wonkwang University Hospital, Iksan, Korea.
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167
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Cho SJ, Hong JP, Lee JY, Im JS, Na KS, Park JE, Cho MJ. Association between DSM-IV Anxiety Disorders and Suicidal Behaviors in a Community Sample of South Korean Adults. Psychiatry Investig 2016; 13:595-600. [PMID: 27909449 PMCID: PMC5128346 DOI: 10.4306/pi.2016.13.6.595] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2015] [Revised: 07/05/2015] [Accepted: 07/13/2015] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE There are conflicting reports about whether individual anxiety disorders are independently associated with suicidal ideation and suicide attempts. We examined whether anxiety disorders are related to suicidal ideation and suicide attempts in a community sample of South Korean adults. METHODS In-person interviews based on the South Korean version of the Composite International Diagnostic Interview were conducted to diagnose mental disorders. Multivariate logistic regression analysis was performed to examine whether anxiety disorders were associated with suicidal ideation and suicide attempts. Each regression model treated lifetime diagnosis of anxiety disorders as independent variables. Sociodemographic characteristics, cohabitation status, lifetime history of mood disorders, alcohol use disorders, and psychotic disorders were included as covariates. RESULTS Nationally representative sample of 6,510 South Korean adults aged 18-64 years was recruited. Multivariate analysis adjusted for psychiatric comorbidity and sociodemographic variables revealed that generalized anxiety disorder (GAD) [2.34, 95% confidence interval (CI) (1.27, 4.33)], post-traumatic stress disorder (PTSD) (3.50, 95% CI: 2.16, 5.68), specific phobia (1.55, 95% CI: 1.14, 2.11), social phobia (2.97, 95% CI: 1.27, 6.94), and obsessive-compulsive disorder (OCD) (5.58, 95% CI: 2.70, 11.6) were associated with suicidal ideation, whereas only social phobia (3.78, 95% CI: 1.41, 10.1) and PTSD (5.13, 95% CI: 2.81, 9.37) were associated with suicide attempts. CONCLUSION Individual anxiety disorders are independently associated with suicidal ideation and/or suicide attempts. The importance of the early detection of anxiety disorders and of assessing the suicide risk in individuals with anxiety disorders is emphasized.
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Affiliation(s)
- Seong-Jin Cho
- Department of Psychiatry, Gachon University Gil Medical Center, Incheon, Republic of Korea
| | - Jin Pyo Hong
- Department of Psychiatry, Samsung Medical Center, Sungkyunkwan University College of Medicine, Seoul, Republic of Korea
| | - Jun-Young Lee
- Department of Psychiatry and Behavioral Science, College of Medicine, Seoul National University, Boramae Hospital, Seoul, Republic of Korea
| | - Jeong Soo Im
- Department of Preventive Medicine, Gachon University Gil Medical Center, Incheon, Republic of Korea
| | - Kyoung-Sae Na
- Department of Psychiatry, Gachon University Gil Medical Center, Incheon, Republic of Korea
| | - Jee Eun Park
- Department of Psychiatry and Behavioral Science, College of Medicine, Seoul National University, Seoul, Republic of Korea
| | - Maeng Je Cho
- Department of Psychiatry and Behavioral Science, College of Medicine, Seoul National University, Seoul, Republic of Korea
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168
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Singh H, Chandra PS, Reddi VSK. Clinical Correlates of Suicide in Suicidal Patients with Schizophrenia Spectrum Disorders and Affective Disorders. Indian J Psychol Med 2016; 38:517-523. [PMID: 28031586 PMCID: PMC5178034 DOI: 10.4103/0253-7176.194910] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND The most common psychiatric illnesses in the background of suicide are schizophrenia spectrum disorders (SSD) and affective disorders (AD). While depression and hopelessness are important factors for suicide in psychiatric patients, the role of psychotic symptoms is unclear. We examine the comparative differences in the clinical correlates of suicide in SSD and AD patients with suicidal risk. MATERIALS AND METHODS One hundred and twenty suicidal psychiatric patients (aged between 17-60 years) were evaluated for depression severity, hopelessness, past attempts, and reasons for wanting to commit suicide at the emergency psychiatry centre. Of these 29% had SSD, 65% AD, and 6% other disorders. RESULTS Lifetime history of suicide attempts and suicide attempts in previous month were higher in SSD patients. Mean Beck Depression scores, Hopelessness, and Suicide Intention scores were significantly lower in patients with SSD as compared to AD (P ≤ 0.05). More than 60% patients with SSD attributed psychotic symptoms as a reason for wanting to commit suicide, while more than 50% patients with AD attributed it to family and personal stressors (P ≤ 0.001). CONCLUSIONS Factors associated with suicidal ideations were significantly different between SSD and AD patients. Hence, suicide prevention strategies should be based on the specific risk factors for each group, SSD and AD.
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Affiliation(s)
- Hemendra Singh
- Department of Psychiatry, M.S. Ramaiah Medical College, Bengaluru, Karnataka, India
| | - Prabha S Chandra
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - V Senthil Kumar Reddi
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
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169
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Yoo HJ, Hong JP, Cho MJ, Fava M, Mischoulon D, Heo JY, Kim K, Jeon HJ. Lifetime suicidal ideation and attempt in adults with full major depressive disorder versus sustained depressed mood. J Affect Disord 2016; 203:275-280. [PMID: 27314814 DOI: 10.1016/j.jad.2016.06.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2016] [Revised: 05/29/2016] [Accepted: 06/03/2016] [Indexed: 10/21/2022]
Abstract
BACKGROUND Major depressive disorder (MDD) is a well-known risk factor for suicidality, but depressed mood has been used non-specifically to describe the emotional state. We sought to compare influence of MDD versus sustained depressed mood on suicidality. METHODS A total of 12,532 adults, randomly selected through the one-person-per-household method, completed a face-to-face interview using the Korean version of Composite International Diagnostic Interview (K-CIDI) and a questionnaire for lifetime suicidal ideation (LSI) and lifetime suicidal attempt (LSA). RESULTS Of 12,361 adults, 565 were assessed as 'sustained depressed mood group' having depressed mood for more than two weeks without MDD (4.6%), and 810 adults were assessed as having full MDD (6.55%) which consisted of 'MDD with depressed mood group' (6.0%) and 'MDD without depressed mood group' (0.5%). The MDD with depressed mood group showed higher odds ratios for LSI and LSA than the sustained depressed mood group. Contrarily, no significant differences were found in LSI and LSA between the MDD group with and without depressed mood. MDD showed significant associations with LSI (AOR=2.83, 95%CI 2.12-3.78) and LSA (AOR=2.17, 95%CI 1.34-3.52), whereas sustained depressed mood showed significant associations with neither LSI nor LSA after adjusting for MDD and other psychiatric comorbidities. Interaction effect of sustained depressed mood with MDD was significant for LSI but not for LSA. CONCLUSIONS Sustained depressed mood was not related to LSI and LSA after adjusting for psychiatric comorbidities, whereas MDD was significantly associated with both LSI and LSA regardless of the presence of sustained depressed mood.
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Affiliation(s)
- Hye Jin Yoo
- Department of Psychiatry, Depression Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Jin Pyo Hong
- Department of Psychiatry, Depression Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Maeng Je Cho
- Department of Psychiatry & Behavioral Science, Seoul National University College of Medicine, Seoul, 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
| | - Jung-Yoon Heo
- Department of Psychiatry, Depression Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Kiwon Kim
- Department of Psychiatry, Depression Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, 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, Republic of Korea.
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170
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Maciejewski DF, Renteria ME, Abdellaoui A, Medland SE, Few LR, Gordon SD, Madden PAF, Montgomery G, Trull TJ, Heath AC, Statham DJ, Martin NG, Zietsch BP, Verweij KJH. The Association of Genetic Predisposition to Depressive Symptoms with Non-suicidal and Suicidal Self-Injuries. Behav Genet 2016; 47:3-10. [PMID: 27590903 PMCID: PMC5222948 DOI: 10.1007/s10519-016-9809-z] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2016] [Accepted: 08/23/2016] [Indexed: 11/25/2022]
Abstract
Non-suicidal and suicidal self-injury are very destructive, yet surprisingly common behaviours. Depressed mood is a major risk factor for non-suicidal self-injury (NSSI), suicidal ideation and suicide attempts. We conducted a genetic risk prediction study to examine the polygenic overlap of depressive symptoms with lifetime NSSI, suicidal ideation, and suicide attempts in a sample of 6237 Australian adult twins and their family members (3740 females, mean age = 42.4 years). Polygenic risk scores for depressive symptoms significantly predicted suicidal ideation, and some predictive ability was found for suicide attempts; the polygenic risk scores explained a significant amount of variance in suicidal ideation (lowest p = 0.008, explained variance ranging from 0.10 to 0.16 %) and, less consistently, in suicide attempts (lowest p = 0.04, explained variance ranging from 0.12 to 0.23 %). Polygenic risk scores did not significantly predict NSSI. Results highlight that individuals genetically predisposed to depression are also more likely to experience suicidal ideation/behaviour, whereas we found no evidence that this is also the case for NSSI.
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Affiliation(s)
- Dominique F Maciejewski
- Department of Clinical Developmental Psychology and EMGO Institute for Health and Care Research, Vrije Universiteit Amsterdam, 1081 BT, Amsterdam, The Netherlands
| | - Miguel E Renteria
- Genetic Epidemiology, Molecular Epidemiology and Neurogenetics Laboratories, QIMR Berghofer Medical Research Institute, Brisbane, QLD, 4006, Australia
| | - Abdel Abdellaoui
- Department of Biological Psychology, Vrije Universiteit Amsterdam, Van der Boechorststraat 1, 1081 BT, Amsterdam, The Netherlands
| | - Sarah E Medland
- Genetic Epidemiology, Molecular Epidemiology and Neurogenetics Laboratories, QIMR Berghofer Medical Research Institute, Brisbane, QLD, 4006, Australia
| | - Lauren R Few
- Department of Psychiatry, Washington University School of Medicine, St Louis, MO, 63110, USA
| | - Scott D Gordon
- Genetic Epidemiology, Molecular Epidemiology and Neurogenetics Laboratories, QIMR Berghofer Medical Research Institute, Brisbane, QLD, 4006, Australia
| | - Pamela A F Madden
- Department of Psychiatry, Washington University School of Medicine, St Louis, MO, 63110, USA
| | - Grant Montgomery
- Genetic Epidemiology, Molecular Epidemiology and Neurogenetics Laboratories, QIMR Berghofer Medical Research Institute, Brisbane, QLD, 4006, Australia
| | - Timothy J Trull
- Department of Psychological Sciences, University of Missouri, Columbia, MO, 65211, USA
| | - Andrew C Heath
- Department of Psychiatry, Washington University School of Medicine, St Louis, MO, 63110, USA
| | - Dixie J Statham
- Faculty of Arts and Social Sciences, University of Sunshine Coast, Sippy Downs, QLD, 4556, Australia
| | - Nicholas G Martin
- Genetic Epidemiology, Molecular Epidemiology and Neurogenetics Laboratories, QIMR Berghofer Medical Research Institute, Brisbane, QLD, 4006, Australia
| | - Brendan P Zietsch
- Genetic Epidemiology, Molecular Epidemiology and Neurogenetics Laboratories, QIMR Berghofer Medical Research Institute, Brisbane, QLD, 4006, Australia
- School of Psychology, University of Queensland, St. Lucia, Brisbane, QLD, 4029, Australia
| | - Karin J H Verweij
- Department of Biological Psychology, Vrije Universiteit Amsterdam, Van der Boechorststraat 1, 1081 BT, Amsterdam, The Netherlands.
- School of Psychology, University of Queensland, St. Lucia, Brisbane, QLD, 4029, Australia.
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171
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Moon CM, Sundaram T, Choi NG, Jeong GW. Working memory dysfunction associated with brain functional deficits and cellular metabolic changes in patients with generalized anxiety disorder. Psychiatry Res Neuroimaging 2016; 254:137-144. [PMID: 27442922 DOI: 10.1016/j.pscychresns.2016.06.013] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2015] [Revised: 06/24/2016] [Accepted: 06/24/2016] [Indexed: 12/14/2022]
Abstract
Generalized anxiety disorder (GAD) is associated with brain functional and morphological changes in connected with emotional dysregulation and cognitive deficit. This study dealt with the neural functional deficits and metabolic abnormalities in working memory (WM) task with emotion-inducing distractors in patients with GAD. Fourteen patients with GAD and 14 healthy controls underwent functional magnetic resonance imaging (fMRI) and proton magnetic resonance spectroscopy ((1)H-MRS) at 3T. In response to the emotional distractors in WM tasks, the patients concurrently showed higher activity in the hippocampus and lower activities in the superior occipital gyrus, superior parietal gyrus, dorsolateral prefrontal cortex (DLPFC) and precentral gyrus compared to the controls. MRS revealed significantly lower choline/creatine (Cho/Cr) and choline/N-acetylaspartate (Cho/NAA) ratios in the DLPFC. In particular, the Cho ratios were positively correlated with the brain activities based on blood oxygenation level-dependent signal change in the DLPFC. This study provides the first evidence for the association between the metabolic alterations and functional deficit in WM processing with emotion-inducing distractors in GAD. These findings will be helpful to understand the neural dysfunction in connection with WM impairment in GAD.
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Affiliation(s)
- Chung-Man Moon
- Research Institute for Medical Imaging, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Thirunavukkarasu Sundaram
- Department of Radiology, Rajah Muthiah Medical College Hospital, Annamalai University, Annamalai Nagar, Chidambaram, India
| | - Nam-Gil Choi
- Department of Radiology, DongShin University, Naju, Republic of Korea
| | - Gwang-Woo Jeong
- Research Institute for Medical Imaging, Chonnam National University Medical School, Gwangju, Republic of Korea; Department of Radiology, Chonnam National University Hospital, Chonnam Natioanl University Medical School, Gwangju, Republic of Korea.
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172
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Shao Y, Zhu C, Zhang Y, Yu H, Peng H, Jin Y, Shi G, Wang N, Chen Z, Chen Y, Jiang Q. Epidemiology and temporal trend of suicide mortality in the elderly in Jiading, Shanghai, 2003-2013: a descriptive, observational study. BMJ Open 2016; 6:e012227. [PMID: 27543591 PMCID: PMC5013362 DOI: 10.1136/bmjopen-2016-012227] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVES To investigate and describe the epidemiological characteristics of suicide in the elderly in Jiading, Shanghai, for the period 2003-2013. DESIGN Retrospective, observational, epidemiological study using routinely collected data. SETTING Jiading District, Shanghai. METHODS Suicide data were retrieved from the Shanghai Vital Registry database for the period 2003-2013. Crude and age-standardised mortality rates were calculated for various groups according to sex and age. Joinpoint regression was performed to estimate the percentage change (PC) and annual percentage change (APC) for suicide mortality. RESULT A total of 956 deaths due to suicide occurred among people aged ≥65 years during the study period, accounting for 76.7% (956/1247) of all suicide decedents. Among the 956 people with suicide deaths, 88.7% (848/956) had a history of a psychiatric condition. The age-standardised mortality rates for suicide without and with a psychotic history in people aged ≥65 years were much higher than those for people aged <65 years in both genders. Suicide mortality in the elderly showed a declining trend, with a PC of -51.5% for men and -47.5% for women. The APC was -29.1 in 2003-2005, 4.6 in 2005-2008 and -9.7 in 2008-2013 for aged men, and -12.2 in 2003-2006 and -5.2 in 2006-2013 for aged women, respectively. Women living in Jiading had a higher risk of suicide death than men, especially among the elderly. The mortality rate for suicide increased with age in the elderly, and was more marked for those with a psychiatric history than for those without. CONCLUSIONS Suicide mortality declined in Jiading during the study period 2003-2013 overall, but remained high in the elderly, especially those with a psychiatric history.
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Affiliation(s)
- Yueqin Shao
- Jiading District Center for Disease Control and Prevention, Shanghai, China
| | - Chenghua Zhu
- Key Laboratory of Public Health Safety of Ministry of Education, School of Public Health, Fudan University, Shanghai, China
| | - Yiying Zhang
- Jiading District Center for Disease Control and Prevention, Shanghai, China
| | - Hongjie Yu
- Jiading District Center for Disease Control and Prevention, Shanghai, China
| | - Hui Peng
- Jiading District Center for Disease Control and Prevention, Shanghai, China
| | - Yaqing Jin
- Jiading District Center for Disease Control and Prevention, Shanghai, China
| | - Guozheng Shi
- Jiading District Center for Disease Control and Prevention, Shanghai, China
| | - Na Wang
- Key Laboratory of Public Health Safety of Ministry of Education, School of Public Health, Fudan University, Shanghai, China
| | - Zheng Chen
- Jiading District Center for Disease Control and Prevention, Shanghai, China
| | - Yue Chen
- Faculty of Medicine, School of Epidemiology, Public Health, and Preventive Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Qingwu Jiang
- Key Laboratory of Public Health Safety of Ministry of Education, School of Public Health, Fudan University, Shanghai, China
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173
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Abstract
Because posttraumatic stress disorder (PTSD) is one of the few psychological conditions that predict suicidal behavior among those who think about suicide, many patients with PTSD present clinically with elevated suicide risk. Expert consensus and practice guidelines recommend against trauma-focused treatments for patients with elevated suicide risk, however. Research aimed at understanding the common mechanisms that underlie the association of PTSD and suicide risk has led to several advances in the effective care of suicidal patients diagnosed with PTSD. Based on these results, various combinations and sequences of suicide-focused treatments, risk management procedures, and trauma-focused treatments are implicated.
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Affiliation(s)
- Craig J Bryan
- National Center for Veterans Studies, The University of Utah, 332 S 1400 E, Room 4, Salt Lake City, UT, 84112, USA.
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174
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Teismann T, Forkmann T, Rath D, Glaesmer H, Margraf J. Perceived burdensomeness and suicide ideation in adult outpatients receiving exposure therapy for anxiety disorders. Behav Res Ther 2016; 85:1-5. [PMID: 27494708 DOI: 10.1016/j.brat.2016.07.011] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2016] [Revised: 06/27/2016] [Accepted: 07/26/2016] [Indexed: 11/15/2022]
Abstract
Perceived burdensomeness is considered a proximal risk factor for suicide ideation. However, there is a lack of prospective studies. Furthermore, it is unclear in as much psychotherapy for anxiety disorders is associated with a decrease in suicide ideation. A total of 105 adult outpatients suffering from panic disorder, agoraphobia, or specific phobia received manualized exposure-therapy. Perceived burdensomeness was considered as predictor of suicide ideation concurrently, after the fourth and the tenth therapy session and posttreatment - controlling for baseline symptom distress, suicide ideation, number of therapy sessions and age. Furthermore, pre-to post-changes in suicide ideation and perceived burdensomeness were assessed. Perceived burdensomeness emerged as a significant predictor of suicidal ideation concurrently and after the fourth and the tenth therapy session, but not at the end of therapy. Treatment had no effect on suicide ideation and only a marginal effect on perceptions of burdensomeness. In conclusion, the current study highlights the importance of perceptions of burdensomeness in understanding suicide ideation.
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Affiliation(s)
- Tobias Teismann
- Department of Clinical Psychology and Psychotherapy, Ruhr-Universität Bochum, Germany.
| | - Thomas Forkmann
- Institute of Medical Psychology and Medical Sociology, University Hospital of RWTH Aachen University, Germany
| | - Dajana Rath
- Institute of Medical Psychology and Medical Sociology, University Hospital of RWTH Aachen University, Germany
| | - Heide Glaesmer
- Department of Medical Psychology and Medical Sociology, University Leipzig, Germany
| | - Jürgen Margraf
- Department of Clinical Psychology and Psychotherapy, Ruhr-Universität Bochum, Germany
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175
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Toudehskchuie GRG, Fereidoon M. What Can Influence Iranian Suicide Attempters to Go Through the Process of Non-Fatal Suicide Act Once Again? A Preliminary Report. Community Ment Health J 2016; 52:597-608. [PMID: 26995684 DOI: 10.1007/s10597-015-9958-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2014] [Accepted: 10/07/2015] [Indexed: 10/22/2022]
Abstract
The thrust of this study was to examine some of the psycho-social risk factors for the recurrence of non-fatal suicide attempt in a sample of 1121 inmates admitted between April 2012 to June 2013 at the toxicology emergency ward, Noor Medical Centre, Isfahan, Iran. Out of the total participants, 240 of them reported history of suicide attempt and assumed the status of case group. The remaining 881 patients were admitted first their attempt and constituted the control group. Cases were compared to the controls with respect to select demographic features (i.e. age, sex, education, occupation, marital status, type of residence, and locale), current suicide attempt method, family history of suicide and drug abuse, history of psychiatric disorder, physical ailment and physical disability, substance abuse and alcohol use, psychiatric diagnosis, and recent life hassles (i.e. interpersonal, occupational, financial, medical, and home affairs). We used a structured interview schedule to interview the participants. Psychiatric diagnosis was based on the DSM-IV criteria. Data were computer analyzed using SPSS.21 and administering statistical analysis including Chi Square, t-student, and logistic regression. Demographic risk factors for recurrence of suicide attempts at the univariate level included occupational status [Crud odds Ratio (COR) = 0.53] and type of residence (COR = 1.40). Medical and psychiatric risk factors at the univariate level included substance abuse (COR = 1.97), physical ailment (COR = 1.76), alcohol use (COR = 1.84), psychiatric disorder (COR = 3.69), and history of suicide in the family of origin (COR = 1.86). Recent life hassles risk factors at the univariate level included financial constraints (COR = 1.46) and medical emergencies (COR = 3.48). A multivariate logistic regression model identified five variables (i.e. substance abuse, alcohol use, psychiatric illness, suicide in family, and medical emergencies) that were statistically associated with an increased risk for recurrence of nonfatal suicide attempt. The model predicted chances of repeating suicide attempt correctly 79 % of the time. These observations indicate that people who report to the toxicology emergency ward for nonfatal suicide not only need immediate relief but also careful psychiatric and social assessments which subsequently may lead to psychiatric admission and comprehensive community interventions.
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Affiliation(s)
| | - Mahsa Fereidoon
- Department of Psychiatry, Isfahan University of Medical Sciences, Isfahan, Islamic Republic of Iran
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176
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Farré A, Portella MJ, De Angel L, Díaz A, de Diego-Adeliño J, Vegué J, Duran-Sindreu S, Faus G, Tejedor C, Álvarez E, Pérez V. Benefits of a Secondary Prevention Program in Suicide. CRISIS 2016; 37:281-289. [DOI: 10.1027/0227-5910/a000388] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Abstract. Background: The effectiveness of suicide intervention programs has not been assessed with experimental designs. Aim: To determine the risk of suicide reattempts in patients engaged in a secondary prevention program. Method: We included 154 patients with suicidal behavior in a quasi-experimental study with a nontreatment concurrent control group. In all, 77 patients with suicidal behavior underwent the Suicide Behavior Prevention Program (SBPP), which includes specialized early assistance during a period of 3–6 months. A matched sample of patients with suicidal behavior (n = 77) was selected without undergoing any specific suicide prevention program. Data on sociodemographics, clinical characteristics, and suicidal behavior were collected at baseline (before SBPP) and at 12 months. Results: After 12 months, SBPP patients showed a 67% lower relative risk of reattempt (χ2 = 11.75, p = .001, RR = 0.33 95% CI = 0.17–0.66). Cox proportional hazards models revealed that patients under SBPP made a new suicidal attempt significantly much later than control patients did (Cox regression = 0.293, 95% CI = 0.138–0.624, p = .001). The effect was even stronger among first attempters. Limitations: Sampling was naturalistic and patients were not randomized. Conclusion: The SBPP was effective in delaying and preventing suicide reattempts at least within the first year after the suicide behavior. In light of our results, implementation of suicide prevention programs is strongly advisable.
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Affiliation(s)
- Adriana Farré
- Department of Psychiatry – Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona (UAB), Institut d'Investigació Biomèdica Sant Pau (IIB Sant Pau), Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain
- Institut de Neuropsiquiatria i Addicions, Hospital del Mar, Universitat Autònoma de Barcelona (UAB), CIBERSAM, Barcelona, Spain
| | - Maria J. Portella
- Department of Psychiatry – Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona (UAB), Institut d'Investigació Biomèdica Sant Pau (IIB Sant Pau), Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain
| | | | - Ana Díaz
- Department of Psychiatry – Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona (UAB), Institut d'Investigació Biomèdica Sant Pau (IIB Sant Pau), Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain
| | - Javier de Diego-Adeliño
- Department of Psychiatry – Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona (UAB), Institut d'Investigació Biomèdica Sant Pau (IIB Sant Pau), Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain
| | - Joan Vegué
- CPB Centres Salut Mental, Barcelona, Spain
| | - Santiago Duran-Sindreu
- Department of Psychiatry – Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona (UAB), Institut d'Investigació Biomèdica Sant Pau (IIB Sant Pau), Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain
| | | | - Carmen Tejedor
- Department of Psychiatry – Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona (UAB), Institut d'Investigació Biomèdica Sant Pau (IIB Sant Pau), Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain
| | - Enric Álvarez
- Department of Psychiatry – Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona (UAB), Institut d'Investigació Biomèdica Sant Pau (IIB Sant Pau), Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain
| | - Víctor Pérez
- Department of Psychiatry – Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona (UAB), Institut d'Investigació Biomèdica Sant Pau (IIB Sant Pau), Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain
- Institut de Neuropsiquiatria i Addicions, Hospital del Mar, Universitat Autònoma de Barcelona (UAB), CIBERSAM, Barcelona, Spain
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177
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Abstract
The World Health Organization estimates that in the year 2000, approximately one million people died from suicide worldwide. Over the last 45 years, suicide rates have increased by 60%, with a particularly precipitous rise among young people. The underlying psychology of suicide is complex and individual. However, certain themes emerge from studying individuals who have attempted or completed suicides. This paper will provide an overview of suicide and suicidal behaviour as it relates to trauma practitioners, detailing risk factors, biologic and genetic interactions, and opportunities for prevention and treatment.
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Affiliation(s)
- Marie Crandall
- Department of Surgery, Northwestern University, Chicago, IL 60611, USA,
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Fortuna LR, Álvarez K, Ramos Ortiz Z, Wang Y, Mozo Alegría X, Cook BL, Alegría M. Mental health, migration stressors and suicidal ideation among Latino immigrants in Spain and the United States. Eur Psychiatry 2016; 36:15-22. [PMID: 27311103 DOI: 10.1016/j.eurpsy.2016.03.001] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2015] [Revised: 02/12/2016] [Accepted: 03/08/2016] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Immigration stress appears to augment the risk for suicide behaviors for Latinos. Yet, specific risk factors that contribute to suicidal ideation (SI) among diverse Latino immigrant populations are not well established. METHODS Data were collected in Boston, Madrid and Barcelona using a screening battery assessing mental health, substance abuse risk, trauma exposure, demographics, and sociocultural factors. Prevalence rates of lifetime and 30-day SI were compared across sites. Logistic regression modeling was used to identify sociodemographic, clinical, and sociocultural-contextual factors associated with 30-day SI. RESULTS Five hundred and sixty-seven Latino patients from primary care, behavioral health and HIV clinics and community agencies participated. Rates of lifetime SI ranged from 29-35%; rates for 30-day SI were 21-23%. Rates of SI were not statistically different between sites. Factors associated with SI included exposure to discrimination, lower ethnic identity, elevated family conflict, and low sense of belonging (P<0.01). In the adjusted model, higher scores on depression, posttraumatic stress disorder, and trauma exposure were significantly associated with 30-day SI (OR=1.14, 1.04, and 7.76, respectively). Greater number of years living in the host country was significantly associated with increased odds of having SI (OR=2.22) while having citizenship status was associated with lower odds (OR=0.45). CONCLUSION Latinos suffering depression, trauma exposure, and immigration stressors are more likely to experience SI. Despite differences in country of origin, education, and other demographic factors between countries, rates of SI did not differ. Recommendations for prevention and clinical practice for addressing suicidal ideation risk among Latino immigrants are discussed.
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Affiliation(s)
- L R Fortuna
- Boston University Medical School, Boston Medical Center, Child and Adolescent Psychiatry, 850, Harrison Avenue, Dowling Building, 7th Floor, Boston, MA 02118 USA; Disparities Research Unit, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, 50, Staniford Street, Suite 830 Boston, MA 02114 USA
| | - K Álvarez
- Disparities Research Unit, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, 50, Staniford Street, Suite 830 Boston, MA 02114 USA
| | - Z Ramos Ortiz
- Disparities Research Unit, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, 50, Staniford Street, Suite 830 Boston, MA 02114 USA
| | - Y Wang
- Disparities Research Unit, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, 50, Staniford Street, Suite 830 Boston, MA 02114 USA
| | - X Mozo Alegría
- Hospital Universitari Vall d'Hebron, Paseo de la Vall d'Hebron, 119-129, 08035 Barcelona, Spain
| | - B L Cook
- Health Equity Research Lab, Cambridge Health Alliance and Harvard Medical School, 1035, Cambridge Street, Cambridge MA 02141 USA
| | - M Alegría
- Disparities Research Unit, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, 50, Staniford Street, Suite 830 Boston, MA 02114 USA.
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179
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Paget LM, Chan Chee C, Sauvage C, Saboni L, Beltzer N, Velter A. Facteurs associés aux tentatives de suicide chez les minorités sexuelles : résultats de l’enquête presse gays et lesbiennes 2011. Rev Epidemiol Sante Publique 2016; 64:153-63. [DOI: 10.1016/j.respe.2016.01.098] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2015] [Revised: 11/26/2015] [Accepted: 01/04/2016] [Indexed: 11/28/2022] Open
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Burshtein S, Dohrenwend BP, Levav I, Werbeloff N, Davidson M, Weiser M. Religiosity as a protective factor against suicidal behaviour. Acta Psychiatr Scand 2016; 133:481-8. [PMID: 27059615 DOI: 10.1111/acps.12555] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/17/2015] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Data suggest that adherence to religious beliefs is associated with lower rates of suicide. A number of mediating factors have been hypothesized to explain this association, including enhanced social support, less substance abuse, and lower rates of psychopathology. METHOD We utilized data from a two-phase population-based, epidemiological study of mental disorders among young Jewish Israel born in a 10-year birth-cohort conducted in the 1980s. This study included data on religiosity and suicidal behaviour. Twenty-five years thereafter, mortality data were obtained from a national vital statistics registry. RESULTS Rates of suicidal ideation were similar among secular, partially observant, and religious subjects (9.4%, 6.7%, and 6.2%, respectively; adjusted OR for linear trend: 0.80, 95% CI: 0.58-1.09). Rates of suicide attempts were significantly lower among religious subjects (2.4%, 2.5%, and 0.4% for secular, partially observant, and religious, respectively; adjusted OR for linear trend: 0.62, 95% CI: 0.43-0.88). Of the 4914 subjects, eight died by suicide: Seven of them were secular and one was partially observant (χ(2) = 2.52, P = 0.09). There were no differences in social functioning or rates of psychopathology among the study groups. CONCLUSION Religiosity has a protective effect against suicide attempts, which is independent of social functioning, psychopathology, and substance use.
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Affiliation(s)
- S Burshtein
- Psychiatry, Chaim Sheba Medical Center, Tel Hashomer, Israel
| | - B P Dohrenwend
- Department of Psychiatry and Mailman School of Public Health, Columbia University, New York, NY, USA
| | - I Levav
- Mental Health, Ministry of Health, Jerusalem, Israel
| | - N Werbeloff
- Psychiatry, Chaim Sheba Medical Center, Tel Hashomer, Israel
| | - M Davidson
- Psychiatry, Chaim Sheba Medical Center, Tel Hashomer, Israel
| | - M Weiser
- Psychiatry, Chaim Sheba Medical Center, Tel Hashomer, Israel
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181
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Hajji K, Marrag I, Bouanene I, Ben Mohamed B, Younes S, Hadj Ammar M, Nasr M. Facteurs associés aux tentatives de suicide. TOXICOLOGIE ANALYTIQUE ET CLINIQUE 2016. [DOI: 10.1016/j.toxac.2016.01.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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182
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Mallick F, McCullumsmith CB. Ketamine for Treatment of Suicidal Ideation and Reduction of Risk for Suicidal Behavior. Curr Psychiatry Rep 2016; 18:61. [PMID: 27194043 DOI: 10.1007/s11920-016-0680-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Ketamine, an NMDA receptor antagonist with efficacy as a rapid anti-depressant, has early evidence for action to reduce suicidal ideation. This review will explore several important questions that arise from these studies. First, how do we measure reductions in suicidal ideation that occur over minutes to hours? Second, are the reductions in suicidal ideation after ketamine treatment solely a result of its rapid anti-depressant effect? Third, is ketamine only effective in reducing suicidal ideation in patients with mood disorders? Fourth, could ketamine's action lead us to a greater understanding of the neurobiology of suicidal processes? Last, do the reductions in depression and suicidal ideation after ketamine treatment translate into decreased risk for suicidal behavior? Our review concludes that ketamine treatment can be seen as a double-edged sword, clinically to help provide treatment for acutely suicidal patients and experimentally to explore the neurobiological nature of suicidal ideation and suicidal behavior.
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Affiliation(s)
- Faryal Mallick
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati, Cincinnati, OH, USA
| | - Cheryl B McCullumsmith
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati, Cincinnati, OH, USA.
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Cheek SM, Nestor BA, Liu RT. SUBSTANCE USE AND SUICIDALITY: SPECIFICITY OF SUBSTANCE USE BY INJECTION TO SUICIDE ATTEMPTS IN A NATIONALLY REPRESENTATIVE SAMPLE OF ADULTS WITH MAJOR DEPRESSION. Depress Anxiety 2016; 33:541-8. [PMID: 26393336 PMCID: PMC4958618 DOI: 10.1002/da.22407] [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: 03/31/2015] [Revised: 06/22/2015] [Accepted: 08/11/2015] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND Although several risk factors for suicidal ideation (SI) have been identified in the research literature, there is a pressing need for studies evaluating markers of risk differentiating ideators from people who have attempted. According to the interpersonal theory of suicide, habituation to painful or provocative experiences increases one's acquired capability for suicide, a necessary component for the transition from SI to attempts. This theory further posits that the acquired capability for suicide should be unrelated to risk for SI. This study tested this theory by examining injection drug use, relative to less painful means of drug use, in relation to SI, suicide plans, and suicide attempts. METHODS Data were drawn from the National Survey on Drug Use and Health (NSDUH), a nationally representative survey conducted annually. Participants included 10,203 adults with a history of injectable drug use and major depression. RESULTS Injection drug use was positively associated with suicide attempts (Odds Ratio [OR] = 1.66, 95% confidence interval [CI] = 1.18-2.34), but not SI or suicide plans in the full sample. Injection drug use was also associated with suicide attempts (OR = 1.64, 95% CI = 1.14-2.35), but not plans, among ideators. Lastly, injection drug use was associated with the suicide attempts among suicide planners (OR = 1.76, 95% CI = 1.01-3.06). All analyses included sex, age, race/ethnicity, family income, substance use disorder symptom severity for injectable drugs, and depressive symptom severity as covariates. CONCLUSIONS Consistent with the interpersonal theory of suicide, injection drug use was associated with specific risk for suicide attempts but not SI or suicide plans.
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Affiliation(s)
- Shayna M. Cheek
- Alpert Medical School; Brown University; Providence Rhode Island
| | | | - Richard T. Liu
- Alpert Medical School; Brown University; Providence Rhode Island
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Beristianos MH, Maguen S, Neylan TC, Byers AL. TRAUMA EXPOSURE AND RISK OF SUICIDAL IDEATION AMONG ETHNICALLY DIVERSE ADULTS. Depress Anxiety 2016; 33:495-501. [PMID: 26992150 PMCID: PMC4889491 DOI: 10.1002/da.22485] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2015] [Revised: 11/22/2015] [Accepted: 02/18/2016] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND Little is known about the association between trauma exposure and suicidal ideation across racial/ethnic groups. Our study aim was to determine the association between trauma exposure and suicidal ideation in a nationally representative ethnically diverse sample of adults. METHODS This study included 14,866 White, Hispanic, Black, and Asian participants 18 years and older involved in the Collaborate Psychiatric Epidemiology Surveys (2001-2003), comprised of three nationally representative studies (NCS-R, NSAL, and NLAAS). Lifetime history of suicidal ideation as assessed in the World Health Organization's World Mental Health Survey Initiative version of the Composite International Diagnostic Interview (WMH-CIDI). RESULTS Of the 81% respondents who reported being exposed to trauma as assessed in the WMH-CIDI, 12.1% endorsed lifetime suicidal ideation. Additionally, of the 19% who did not report trauma, 1.1% endorsed lifetime suicidal ideation. Fully adjusted, multivariable logistic regression models revealed two traumas consistently associated with significantly higher odds for suicidal ideation across all four racial groups examined: Assaultive/interpersonal violence and child maltreatment. Asians, in particular, had the highest likelihood for suicidal ideation in both trauma categories, with a near threefold increased odds for assaultive/interpersonal violence exposure (OR: 2.56; 95% CI: 1.71-3.83) and nearly ninefold increased odds for child maltreatment exposure (OR: 8.43; 95% CI: 4.91-14.49). DISCUSSION Suicidal ideation in racially/ethnically diverse American adults is strongly associated with assaultive/interpersonal violence and child maltreatment, independent of PTSD, MDD, and substance use. These findings highlight the need for monitoring of suicidal behavior following assaultive/interpersonal trauma and child maltreatment, regardless of the presence of a psychiatric disorder.
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Affiliation(s)
- Matthew H. Beristianos
- Department of Psychiatry, University of California, San Francisco,San Francisco Veterans Affairs Medical Center, San Francisco, CA,Alliant International University, San Francisco, CA
| | - Shira Maguen
- Department of Psychiatry, University of California, San Francisco,San Francisco Veterans Affairs Medical Center, San Francisco, CA
| | - Thomas C. Neylan
- Department of Psychiatry, University of California, San Francisco,San Francisco Veterans Affairs Medical Center, San Francisco, CA
| | - Amy L. Byers
- Department of Psychiatry, University of California, San Francisco,San Francisco Veterans Affairs Medical Center, San Francisco, CA
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185
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Wang Y, Lopez JMS, Bolge SC, Zhu VJ, Stang PE. Depression among people with type 2 diabetes mellitus, US National Health and Nutrition Examination Survey (NHANES), 2005-2012. BMC Psychiatry 2016; 16:88. [PMID: 27044315 PMCID: PMC4820858 DOI: 10.1186/s12888-016-0800-2] [Citation(s) in RCA: 65] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2015] [Accepted: 03/31/2016] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Depression in people with diabetes can result in increased risk for diabetes-related complications. The prevalence of depression has been estimated to be 17.6 % in people with type 2 diabetes mellitus (T2DM), based on studies published between 1980 and 2005. There is a lack of more recent estimates of depression prevalence among the US general T2DM population. METHODS The present study used the US National Health and Nutrition Examination Survey (NHANES) 2005-2012 data to provide an updated, population-based estimate for the prevalence of depression in people with T2DM. NHANES is a cross-sectional survey of a nationally representative sample of the civilian, non-institutionalized US population. Starting from 2005, the Patient Health Questionnaire (PHQ-9) was included to measure signs and symptoms of depression. We defined PHQ-9 total scores ≥ 10 as clinically relevant depression (CRD), and ≥ 15 as clinically significant depression (CSD). Self-reported current antidepressant use was also combined to estimate overall burden of depression. Predictors of CRD and CSD were investigated using survey logistic regression models. RESULTS A total of 2182 participants with T2DM were identified. The overall prevalence of CRD and CSD among people with T2DM is 10.6 % (95 % confidence interval (CI) 8.9-12.2 %), and 4.2 % (95 % CI 3.4-5.1 %), respectively. The combined burden of depressive symptoms and antidepressants may be as high as 25.4 % (95 % CI 23.0-27.9 %). Significant predictors of CRD include age (younger than 65), sex (women), income (lower than 130 % of poverty level), education (below college), smoking (current or former smoker), body mass index (≥30 kg/m(2)), sleep problems, hospitalization in the past year, and total cholesterol (≥200 mg/dl). Significant predictors of CSD also include physical activity (below guideline) and cardiovascular diseases. CONCLUSIONS The prevalence of CRD and CSD among people with T2DM in the US may be lower than in earlier studies, however, the burden of depression remains high. Further research with longitudinal follow-up for depression in people with T2DM is needed to understand real world effectiveness of depression management.
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Affiliation(s)
- Yiting Wang
- Janssen Research & Development, LLC, 1125 Trenton Harbourton Road, Titusville, NJ, 08560, USA.
| | - Janice M. S. Lopez
- Janssen Scientific Affairs, LLC, Raritan, 1000 US Route 202, Raritan, NJ 08869 USA
| | - Susan C. Bolge
- Janssen Scientific Affairs, LLC, Raritan, 1000 US Route 202, Raritan, NJ 08869 USA
| | - Vivienne J. Zhu
- Department of Public Health Sciences, Medical University of South Carolina, 135 Cannon Street Suite 303, Charleston, SC 29425 USA
| | - Paul E. Stang
- Janssen Research & Development, LLC, 1125 Trenton Harbourton Road, Titusville, NJ 08560 USA
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186
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Győrffy Z, Dweik D, Girasek E. Workload, mental health and burnout indicators among female physicians. HUMAN RESOURCES FOR HEALTH 2016; 14:12. [PMID: 27039083 PMCID: PMC4818422 DOI: 10.1186/s12960-016-0108-9] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/27/2015] [Accepted: 03/23/2016] [Indexed: 05/06/2023]
Abstract
BACKGROUND Female doctors in Hungary have worse indicators of physical and mental health compared with other professional women. We aimed to cast light on possible indicators of mental health, workload, and burnout of female physicians. METHODS Two time-points (T) were compared, in 2003 (T1 n = 408) and 2013 (T2 n = 2414), based on two nationally representative surveys of female doctors, and comparison made with data from other professional control groups. Independent samples t test or chi-squared test was used both for the two time-point comparison and the comparison between the index and the control groups. The background factors of sleep disorders and burnout were assessed by binary logistic regression analysis. RESULTS No significant differences in the rates of depressive symptoms and suicidal thoughts and attempts were detected between the 2003 and 2013 cohorts, but the prevalence of sleep disorders increased. The workload increased, and there was less job satisfaction in 2013 than in 2003, coupled to more stressful or difficult work-related situations. The personal accomplishment component of burnout significantly decreased in line with the declining work-related satisfaction. Compared to the professional control groups, the prevalence of depressive symptoms, suicide attempts, and sleep disorders was higher among female physicians at both time-points. The number of workplaces, frequency of work-related stressful situations, and intensive role conflict was associated with sleep disorders and decreased personal accomplishment. CONCLUSIONS In comparison with the other professional groups, female doctors had worse mental health indicators with regard to depression, suicidal ideas, and sleep disorders both in 2003 and 2013 while within professional strata the changes seemed to be less. Increasing workload had a clear impact on sleep disorders and the personal accomplishment dimension of burnout.
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Affiliation(s)
- Zsuzsa Győrffy
- />Institute of Behavioural Sciences, Semmelweis University, Nagyvárad square 4, Budapest, H-1089 Hungary
| | - Diana Dweik
- />Department of Obstetrics and Gynecology, University of Szeged, Semmelweis st. 1, Szeged, H-6725 Hungary
| | - Edmond Girasek
- />Health Services Management Training Centre, Semmelweis University, Kútvölgyi st 2, Budapest, H-1125 Hungary
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187
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Kim SYH, De Vries R, Peteet JR. Euthanasia and Assisted Suicide of Patients With Psychiatric Disorders in the Netherlands 2011 to 2014. JAMA Psychiatry 2016; 73:362-8. [PMID: 26864709 PMCID: PMC5530592 DOI: 10.1001/jamapsychiatry.2015.2887] [Citation(s) in RCA: 117] [Impact Index Per Article: 14.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
IMPORTANCE Euthanasia or assisted suicide (EAS) of psychiatric patients is increasing in some jurisdictions such as Belgium and the Netherlands. However, little is known about the practice, and it remains controversial. OBJECTIVES To describe the characteristics of patients receiving EAS for psychiatric conditions and how the practice is regulated in the Netherlands. DESIGN, SETTING, AND PARTICIPANTS This investigation reviewed psychiatric EAS case summaries made available online by the Dutch regional euthanasia review committees as of June 1, 2015. Two senior psychiatrists used directed content analysis to review and code the reports. In total, 66 cases from 2011 to 2014 were reviewed. MAIN OUTCOMES AND MEASURES Clinical and social characteristics of patients, physician review process of the patients' requests, and the euthanasia review committees' assessments of the physicians' actions. RESULTS Of the 66 cases reviewed, 70% (n = 46) were women. In total, 32% (n = 21) were 70 years or older, 44% (n = 29) were 50 to 70 years old, and 24% (n = 16) were 30 to 50 years old. Most had chronic, severe conditions, with histories of attempted suicides and psychiatric hospitalizations. Most had personality disorders and were described as socially isolated or lonely. Depressive disorders were the primary psychiatric issue in 55% (n = 36) of cases. Other conditions represented were psychotic, posttraumatic stress or anxiety, somatoform, neurocognitive, and eating disorders, as well as prolonged grief and autism. Comorbidities with functional impairments were common. Forty-one percent (n = 27) of physicians performing EAS were psychiatrists. Twenty-seven percent (n = 18) of patients received the procedure from physicians new to them, 14 of whom were physicians from the End-of-Life Clinic, a mobile euthanasia clinic. Consultation with other physicians was extensive, but 11% (n = 7) of cases had no independent psychiatric input, and 24% (n = 16) of cases involved disagreement among consultants. The euthanasia review committees found that one case failed to meet legal due care criteria. CONCLUSIONS AND RELEVANCE Persons receiving EAS for psychiatric disorders in the Netherlands are mostly women and of diverse ages, with complex and chronic psychiatric, medical, and psychosocial histories. The granting of their EAS requests appears to involve considerable physician judgment, usually involving multiple physicians who do not always agree (sometimes without independent psychiatric input), but the euthanasia review committees generally defer to the judgments of the physicians performing the EAS.
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Affiliation(s)
- Scott Y H Kim
- Corresponding author. Department of Bioethics, National Institutes of Health and Adjunct Professor of Psychiatry, University of Michigan. 10 Center Drive, 1C118, Bethesda, MD 20892, USA
| | - Raymond De Vries
- Center for Bioethics and Social Sciences in Medicine, University of Michigan Medical School; and CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, the Netherlands
| | - John R Peteet
- Department of Psychiatry, Brigham and Women’s Hospital and Harvard Medical School
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188
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Werbeloff N, Dohrenwend BP, Levav I, Haklai Z, Yoffe R, Large M, Davidson M, Weiser M. Demographic, Behavioral, and Psychiatric Risk Factors for Suicide. CRISIS 2016; 37:104-11. [DOI: 10.1027/0227-5910/a000359] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Abstract. Background: There have been very few prospective studies of death by suicide in the general population. Rather, studies of suicide have generally used psychological autopsies, a method that has the potential weakness of recall bias. Aims: To examine correlates of death by suicide among a community-based nonclinical sample prospectively assessed years before death by suicide. Method: We analyzed data from an epidemiological study of a 10-year birth cohort (n = 4,914) conducted in Israel in the 1980s, with follow-up mortality data over 25 years. Results: Eight participants died by suicide during follow-up (6/100,000 per year; mean follow-up to suicide = 18.3 ± 2.0 years), the majority of whom were rated as functioning relatively well at baseline. Male sex, psychiatric hospitalizations, major depressive disorder, and previous suicide attempts were associated with later suicide. Conclusion: In this nonclinical sample of persons assessed between ages 25 and 34, several correlates of suicide were identified, but the majority of persons who died by suicide were relatively high functioning at baseline. Major precursors of suicide may be more proximal factors of acute or chronic negative changes in life circumstances.
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Affiliation(s)
- Nomi Werbeloff
- Department of Psychiatry, Sheba Medical Center, Tel-Hashomer, Israel
- Division of Psychiatry, University College of London, UK
| | - Bruce P. Dohrenwend
- Department of Psychiatry and Mailman School of Public Health, Columbia University, New York, USA
- New York State Psychiatric Institute, NY, USA
| | | | | | | | - Matthew Large
- School of Psychiatry, University of New South Wales, Sydney, Australia
| | - Michael Davidson
- Department of Psychiatry, Sheba Medical Center, Tel-Hashomer, Israel
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Mark Weiser
- Department of Psychiatry, Sheba Medical Center, Tel-Hashomer, Israel
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
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189
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Risk of completed suicide in 89,049 young males assessed by a mental health professional. Eur Neuropsychopharmacol 2016; 26:341-349. [PMID: 26712325 DOI: 10.1016/j.euroneuro.2015.12.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2015] [Revised: 11/11/2015] [Accepted: 12/04/2015] [Indexed: 11/24/2022]
Abstract
In an individual who seeks help or is referred to a mental health professional it is common sense and clinical practice to assume that suicidal thoughts and previous attempts constitute risk factors for imminent suicide. However, this assumption has not been supported by large, population-based longitudinal studies. The current study investigated whether reports of current suicidal ideation and a history of suicide attempts indeed increase risk for later completed suicide in a historical prospective study design. Sequential records on 89,049 young males assessed by mental health professionals were screened for suicidal ideation and a history of suicide attempts. The data were linked with death records from the Israeli Central Bureau of Statistics. Over a follow-up period ranging from 2 months to 9.8 years, 54 individuals died by suicide, constituting an average suicide rate of 6.48 per 100,000 person-years. Overall, neither reporting current suicidal ideation (without a history of suicide attempts; HR=1.29, 95% CI=0.57-2.90) nor reporting a history of suicide attempts (with or without current suicidal ideation; HR=1.67, 95% CI=0.71-3.97) were significantly associated with increased risk for later completed suicide. However, young males with a previously diagnosed psychiatric disorder who reported current suicidal ideation (HR=4.52, 95% CI=1.08-18.91) or a history of suicide attempts (HR=6.43, 95% CI=1.54-26.90) were at increased risk of death by suicide. These findings indicate that in this particular population reports of current suicidal ideation or of a history of suicide attempts are helpful in predicting future suicide only among those with a previous diagnosis of a psychiatric disorder.
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190
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Reynders A, Kerkhof AJFM, Molenberghs G, Van Audenhove C. Stigma, Attitudes, and Help-Seeking Intentions for Psychological Problems in Relation to Regional Suicide Rates. Suicide Life Threat Behav 2016. [PMID: 26207530 DOI: 10.1111/sltb.12179] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
In this ecological study, we investigated whether help-seeking related to stigma, intentions, and attitudes toward suicide are associated with the suicide rates of 20 regions within the Netherlands and Belgium. Significant associations were found between regional suicide rates and the intention to seek informal help (β = -1.47, p = .001), self-stigma (β = 1.33, p = .038), and shame (β = .71, p = .030). The association between self-stigma and suicide rate was mediated by intentions to seek informal help. These results suggest that to promote suicide prevention at the level of the regional population, stigma, shame, and intentions to seek help should be targeted in the public domain.
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Affiliation(s)
| | - Ad J F M Kerkhof
- Department of Clinical Psychology, VU University and EMGO+ Institute, Amsterdam, The Netherlands
| | - Geert Molenberghs
- Interuniversity Institute for Biostatistics and statistical Bioinformatics (I-BioStat), KU Leuven - UHasselt, Leuven, Belgium
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191
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Calati R, Artero S, Courtet P, Lopez-Castroman J. Framing the impact of physical pain on suicide attempts. A reply to Stubbs. J Psychiatr Res 2016; 72:102-3. [PMID: 26613346 DOI: 10.1016/j.jpsychires.2015.10.018] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2015] [Accepted: 10/26/2015] [Indexed: 10/22/2022]
Affiliation(s)
- Raffaella Calati
- INSERM U1061, La Colombière Hospital, University of Montpellier UM1, Montpellier, France; Department of Psychiatric Emergency & Acute Care, Lapeyronie Hospital, CHU Montpellier, Montpellier, France; FondaMental Foundation, France.
| | - Sylvaine Artero
- INSERM U1061, La Colombière Hospital, University of Montpellier UM1, Montpellier, France
| | - Philippe Courtet
- INSERM U1061, La Colombière Hospital, University of Montpellier UM1, Montpellier, France; Department of Psychiatric Emergency & Acute Care, Lapeyronie Hospital, CHU Montpellier, Montpellier, France; FondaMental Foundation, France
| | - Jorge Lopez-Castroman
- INSERM U1061, La Colombière Hospital, University of Montpellier UM1, Montpellier, France; Department of Adult Psychiatry, CHRU Nimes, Nimes, France
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Lee JY, Park YK, Cho KH, Kim SM, Choi YS, Kim DH, Nam GE, Han KD, Kim YH. Suicidal ideation among postmenopausal women on hormone replacement therapy: The Korean National Health and Nutrition Examination Survey (KNHANES V) from 2010 to 2012. J Affect Disord 2016; 189:214-9. [PMID: 26451506 DOI: 10.1016/j.jad.2015.09.068] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2015] [Revised: 09/28/2015] [Accepted: 09/30/2015] [Indexed: 11/19/2022]
Abstract
BACKGROUND Suicide is a major public health problem around the world. Some studies have found that hormone replacement therapy (HRT) is associated with depression in postmenopausal women. Depression is a well-known risk factor for suicide; therefore, we investigated the relationship between HRT and suicidal ideation in postmenopausal Korean women. METHODS We included 2286 postmenopausal women with or without HRT from the Korean National Health and Nutrition Examination Survey 2010-2012. The use and duration of HRT and mental health status, including stress, depressive mood, and suicidal ideation and attempts, were assessed by self-report questionnaires. RESULTS The proportion of participants with depressive mood and suicidal ideation was higher in the HRT group than the non-HRT group (all p values<0.05). As the duration of HRT increased, the percentage of participants with suicidal ideation increased (p for trend=0.006). After adjusting for all covariates, the odds ratio (95% confidence intervals) for suicidal ideation was 1.742 (1.223-2.482) in the women with HRT, compared to women without HRT. HRT duration longer than 10 years was associated with suicidal ideation (odds ratio=2.089 and 95% confidence intervals=1.069-4.084). LIMITATIONS The cross-sectional design, a possibility of incorrect answer about menopausal status, and no assessment of the type of HRT are the main limitations of this study. CONCLUSION Postmenopausal women receiving HRT, especially for more than 10 years, showed increased suicidal ideation compared with postmenopausal women without HRT. Physicians should pay attention to mood symptoms and suicidal ideation in postmenopausal women with HRT.
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Affiliation(s)
- Ji-Yoon Lee
- Department of Family Medicine, Korea University College of Medicine, Seoul, South Korea
| | - Yong-Kyu Park
- Department of Medical Statistics, Catholic University College of Medicine, Seoul, South Korea
| | - Kyung-Hwan Cho
- Department of Family Medicine, Korea University College of Medicine, Seoul, South Korea
| | - Seon-Mee Kim
- Department of Family Medicine, Korea University College of Medicine, Seoul, South Korea
| | - Youn-Seon Choi
- Department of Family Medicine, Korea University College of Medicine, Seoul, South Korea
| | - Do-Hoon Kim
- Department of Family Medicine, Korea University College of Medicine, Seoul, South Korea
| | - Ga-Eun Nam
- Department of Family Medicine, Korea University College of Medicine, Seoul, South Korea
| | - Kyung-Do Han
- Department of Medical Statistics, Catholic University College of Medicine, Seoul, South Korea
| | - Yang-Hyun Kim
- Department of Family Medicine, Korea University College of Medicine, Seoul, South Korea.
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193
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Trujillo A, Feixas G, Bados A, García-Grau E, Salla M, Medina JC, Montesano A, Soriano J, Medeiros-Ferreira L, Cañete J, Corbella S, Grau A, Lana F, Evans C. Psychometric properties of the Spanish version of the Clinical Outcomes in Routine Evaluation - Outcome Measure. Neuropsychiatr Dis Treat 2016; 12:1457-66. [PMID: 27382288 PMCID: PMC4922811 DOI: 10.2147/ndt.s103079] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE The objective of this paper is to assess the reliability and validity of the Spanish translation of the Clinical Outcomes in Routine Evaluation - Outcome Measure, a 34-item self-report questionnaire that measures the client's status in the domains of Subjective well-being, Problems/Symptoms, Life functioning, and Risk. METHOD Six hundred and forty-four adult participants were included in two samples: the clinical sample (n=192) from different mental health and primary care centers; and the nonclinical sample (n=452), which included a student and a community sample. RESULTS The questionnaire showed good acceptability and internal consistency, appropriate test-retest reliability, and acceptable convergent validity. Strong differentiation between clinical and nonclinical samples was found. As expected, the Risk domain had different characteristics than other domains, but all findings were comparable with the UK referential data. Cutoff scores were calculated for clinical significant change assessment. CONCLUSION The Spanish version of the Clinical Outcomes in Routine Evaluation - Outcome Measure showed acceptable psychometric properties, providing support for using the questionnaire for monitoring the progress of Spanish-speaking psychotherapy clients.
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Affiliation(s)
- Adriana Trujillo
- Department of Personality, Assessment and Psychological Treatments, Faculty of Psychology; Institute for Brain, Cognition and Behaviour, University of Barcelona
| | - Guillem Feixas
- Department of Personality, Assessment and Psychological Treatments, Faculty of Psychology; Institute for Brain, Cognition and Behaviour, University of Barcelona
| | - Arturo Bados
- Department of Personality, Assessment and Psychological Treatments, Faculty of Psychology
| | - Eugeni García-Grau
- Department of Personality, Assessment and Psychological Treatments, Faculty of Psychology
| | - Marta Salla
- Department of Personality, Assessment and Psychological Treatments, Faculty of Psychology
| | - Joan Carles Medina
- Department of Personality, Assessment and Psychological Treatments, Faculty of Psychology
| | - Adrián Montesano
- Department of Personality, Assessment and Psychological Treatments, Faculty of Psychology; Institute for Brain, Cognition and Behaviour, University of Barcelona
| | | | | | - Josep Cañete
- Hospital of Mataró, Sanitary Consortium of Maresme, Mataró
| | | | | | - Fernando Lana
- MAR Health Park, CAEMIL, Santa Coloma de Gramenet, Spain
| | - Chris Evans
- East London NHS Foundation Trust, NPDDNet, London, UK
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194
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Cheung T, Lee PH, Yip PS. Suicidality among Hong Kong nurses: prevalence and correlates. J Adv Nurs 2015; 72:836-48. [DOI: 10.1111/jan.12869] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/14/2015] [Indexed: 11/28/2022]
Affiliation(s)
- Teris Cheung
- School of Nursing; Hong Kong Polytechnic University; Hong Kong
| | - Paul H. Lee
- School of Nursing; Hong Kong Polytechnic University; Hong Kong
| | - Paul S.F. Yip
- Centre for Suicide Research and Prevention; the University of Hong Kong; Hong Kong
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195
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Moon CM, Jeong GW. Brain morphological alterations and cellular metabolic changes in patients with generalized anxiety disorder: A combined DARTEL-based VBM and (1)H-MRS study. Magn Reson Imaging 2015; 34:429-36. [PMID: 26708039 DOI: 10.1016/j.mri.2015.12.017] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2015] [Accepted: 12/13/2015] [Indexed: 10/22/2022]
Abstract
Generalized anxiety disorder (GAD) is characterized by emotional dysregulation and cognitive deficit in conjunction with brain morphometric and metabolic alterations. This study assessed the combined neural morphological deficits and metabolic abnormality in patients with GAD. Thirteen patients with GAD and 13 healthy controls matched for age, sex, and education level underwent high-resolution T1-weighted MRI and proton magnetic resonance spectroscopy ((1)H-MRS) at 3Tesla. In this study, the combination of voxel-based morphometry (VBM) and (1)H-MRS was used to assess the brain morphometric and metabolic alterations in GAD. The patients showed significantly reduced white matter (WM) volumes in the midbrain (MB), precentral gyrus (PrG), dorsolateral prefrontal cortex (DLPFC) and anterior limb of the internal capsule (ALIC) compared to the controls. In MRS study, the choline/creatine (Cho/Cr) and choline/N-acetylaspartate (Cho/NAA) ratios in the DLPFC were significantly lower in the patients. Particularly, the WM volume variation of the DLPFC was positively correlated with both of the Cho/Cr and Cho/NAA ratios in patients with GAD. This study provides an evidence for the association between the morphometric deficit and metabolic changes in GAD. This finding would be helpful to understand the neural dysfunction and pathogenesis in connection with cognitive impairments in GAD.
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Affiliation(s)
- Chung-Man Moon
- Research Institute for Medical Imaging, Chonnam National University Hospital, Gwangju, Republic of Korea
| | - Gwang-Woo Jeong
- Research Institute for Medical Imaging, Chonnam National University Hospital, Gwangju, Republic of Korea; Department of Radiology, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Republic of Korea.
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196
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Ildirli S, Şair YB, Dereboy F. Persistent Depression as a Novel Diagnostic Category: Results from the Menderes Depression Study. Noro Psikiyatr Ars 2015; 52:359-366. [PMID: 28360740 DOI: 10.5152/npa.2015.7589] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2013] [Accepted: 09/20/2014] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION Persistent depressive disorder (PDD) introduced in the Diagnostic and Statistical Manual of Mental Disorders (DSM) 5 as a novel diagnostic category represents a consolidation of two separate DSM-IV categories, chronic major depressive disorder (MDD) and dysthymic disorder. The present study aims to investigate the frequency and clinical as well as socio-demographic correlates of PDD in comparison with those of episodic MDD among patients seeking treatment for depressive symptoms. METHODS Participants were 140 depressive out-and in-patients under treatment at the psychiatry clinic of the Adnan Menderes University Research Hospital. Each patient was assessed by means of a structured clinical interview (SCID-I) and relevant psychometric instruments including the Hamilton Depression Inventory and Eskin Suicidal Behavior Inventory. RESULTS Among the depressive patients, 61% fulfilled the criteria for PDD and 39% for episodic MDD. As compared with patients with episodic MDD, the PDD patients were older (d=.54), lower in educational attainment (d=.55), more likely to have comorbid generalized anxiety disorder (OR=3.7), and more prone to report symptoms of anxiety, hopelessness, pessimism, and somatic complaints. Nevertheless, the PDD patients displayed heterogeneous characteristics with respect to clinical severity and suicidal behavior. CONCLUSION Our findings suggest that majority of depressive patients, including those fulfilling the criteria for MDD, have been suffering from a persistent ailment rather than an episodic disorder. Clinicians with a cross-sectional perspective are more likely to diagnose MDD, whereas those with a longitudinal perspective are more likely to identify PDD in the majority of depressive patients. The incorporation of both of these perspectives into DSM-5 in a complementary manner will possibly enhance our insight into depressive disorders and improve our treatment results.
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Affiliation(s)
- Saliha Ildirli
- Clinic of Psychiatry, Ermenek State Hospital, Karaman, Turkey
| | - Yaşan Bilge Şair
- Clinic of Psychiatry, İzmir Tepecik Training and Research Hospital, İzmir, Turkey
| | - Ferhan Dereboy
- Department of Psychiatry, Adnan Menderes University Faculty of Medicine, Aydın, Turkey
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197
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Valid Psychological Injury Claims: Respecting the Needs of Survivors. PSYCHOLOGICAL INJURY & LAW 2015. [DOI: 10.1007/s12207-015-9234-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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198
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[Economic evaluation of desvenlafaxine in the treatment of major depressive disorder in Spain]. REVISTA DE PSIQUIATRIA Y SALUD MENTAL 2015; 9:87-96. [PMID: 26475204 DOI: 10.1016/j.rpsm.2015.08.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/30/2015] [Revised: 07/27/2015] [Accepted: 08/19/2015] [Indexed: 12/28/2022]
Abstract
INTRODUCTION The objective of this analysis was to evaluate the clinical and economic value of the use of 50mg-desvenlafaxine compared to the usual care (mix of duloxetine and venlafaxine) in the outpatient treatment of major depressive disorder after first line treatment failure (relapse) in Spain. MATERIALS AND METHODS A Markov model was used to follow up a cohort of major depressive disorder patients for one year after failure of first-line treatment with a serotonin-specific reuptake inhibitor and estimate outcome measures (percentage remission and depression-free days) and accrued and direct costs incurred during outpatient treatment of major depressive disorder. In order to obtain the efficacy data related to the treatment alternatives, a literature review of clinical trials was performed. A panel of clinical experts validated the use of clinical resources employed in the estimation of economic outcomes together with model assumptions. The analysis was performed in 2014 from the perspective of the National Health System. RESULTS Due to fewer discontinuations, initiating second line treatment with desvenlafaxine was associated with more depression-free days and a higher percentage of patients in remission versus usual care: 1.7 days and 0.5%, respectively. This was translated into lower drug and events management costs, and an overall cost reduction of €108 for the National Health System. CONCLUSIONS In patients who have not responded to a first-line serotonin-specific reuptake inhibitor therapy, desvenlafaxine-50mg was clinically similar in effectiveness, but a less costly option, compared with a weighted average of duloxetine and venlafaxine for the second-line treatment of major depressive disorder patients from a payer (National Health System) perspective in Spain.
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199
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Li F, Liu X, Zhang D. Fish consumption and risk of depression: a meta-analysis. J Epidemiol Community Health 2015; 70:299-304. [PMID: 26359502 DOI: 10.1136/jech-2015-206278] [Citation(s) in RCA: 110] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2015] [Accepted: 08/03/2015] [Indexed: 01/11/2023]
Affiliation(s)
- Fang Li
- Department of Epidemiology and Health Statistics, The Medical College of Qingdao University, Qingdao, Shandong Province, People's Republic of China
| | - Xiaoqin Liu
- Department of Epidemiology and Health Statistics, The Medical College of Qingdao University, Qingdao, Shandong Province, People's Republic of China
| | - Dongfeng Zhang
- Department of Epidemiology and Health Statistics, The Medical College of Qingdao University, Qingdao, Shandong Province, People's Republic of China
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200
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Oh SH, Kim HJ, Kim SH, Kim YM, Park KN. Which deliberate self-poisoning patients are most likely to make high-lethality suicide attempts? Int J Ment Health Syst 2015; 9:35. [PMID: 26347801 PMCID: PMC4561421 DOI: 10.1186/s13033-015-0028-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2015] [Accepted: 08/31/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The risk/rescue rating scale (RRRS) assesses the lethality of a suicide attempt, which is defined as the probability of inflicting irreversible damage. We assessed the lethality of suicide attempts using the RRRS and identified the socio-demographic profiles of patients who achieved high lethality in deliberate self-poisoning (DSP). METHODS A retrospective study was conducted to evaluate DSP patients who visited the emergency department of a tertiary teaching hospital between 2000 and 2011. The data included socio-demographic information, clinical variables, risk factors (e.g., the method used, whether consciousness was impaired, toxicity, reversibility and whether treatment was required) and rescue factors (e.g., location, who initiated the rescue, the probability of discovery, the accessibility of rescue, and delay until discovery). The high-risk group consisted of patients with 11-15 risk points, whereas patients in the low-rescue group had 5-11 risk points. We examined the characteristics of high-lethality suicide attempts (high-risk/low-rescue group). RESULTS A total of 1114 patients were enrolled in this study. Pearson's correlation analysis showed that the total risk score for patients with DSP was negatively associated with the total rescue score (r = -0.201, p < 0.001). Of the total number of DSP patients, 42 were included in the high-risk/low-rescue group. The multivariate logistic regression analyses showed significant associations between high-lethality suicide attempts and male gender (OR 2.70, 95 % CI 1.41-5.18, p = 0.003), older age (OR 1.02, 95 % CI 1.01-1.04, p = 0.015), and unemployment (OR 2.98, 95 % CI 1.41-6.33, p = 0.004). CONCLUSION This retrospective study demonstrates that male gender, advanced age, and unemployed status were associated with high-lethality suicide attempts in DSP patients.
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Affiliation(s)
- Sang Hoon Oh
- Department of Emergency Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, 137-701 Republic of Korea
| | - Han Joon Kim
- Department of Emergency Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, 137-701 Republic of Korea
| | - Soo Hyun Kim
- Department of Emergency Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, 137-701 Republic of Korea
| | - Young Min Kim
- Department of Emergency Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, 137-701 Republic of Korea
| | - Kyu Nam Park
- Department of Emergency Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, 137-701 Republic of Korea
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