1
|
Liu L, Wang W. Suicide attempts of friends and family during adolescence and long-term suicidal ideation and attempts: Findings from the 25-year Add Health study. J Affect Disord 2024; 358:377-382. [PMID: 38735584 DOI: 10.1016/j.jad.2024.05.053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2024] [Revised: 05/08/2024] [Accepted: 05/09/2024] [Indexed: 05/14/2024]
Abstract
BACKGROUND Suicide is a significant global public health concern. However, previous studies have predominantly focused on individual-level risk factors. Against this backdrop, microsystem suicide propinquity, which encompasses suicidal thoughts and behaviors (STB) within families and peer groups, is significant in elucidating the development and perpetuation of STB in adolescents. METHODS This study utilized data from the National Longitudinal Study of Adolescent to Adult Health (Add Health, 1994-2018). Adolescents who reported instances of suicide attempts among their friends and family members during Wave 1 were selected (N = 4826). Generalized estimation equations (GEE) and structural equation models (SEM) were employed. RESULTS GEE analyses indicated that individuals with friends who had attempted suicide exhibited higher risks for suicidal ideation (OR [95 % CI] = 2.57 [2.13, 3.11]) and suicide attempts (OR [95 % CI] = 2.47 [1.78, 3.42]). Also, individuals with family members who had attempted suicide exhibited higher risks for suicidal ideation (OR [95 % CI] = 2.37 [1.62, 3.46]) and attempts (OR [95 % CI] = 2.27 [1.17, 4.41]). However, friends' and family members' suicide attempts failed to show significant interactive effect. Besides, SEM analyses indicated that friends' and family members' suicide attempts were associated with one's long-term suicidal ideation and attempts via depressive symptoms. CONCLUSION Suicide attempts of friends and family during adolescence were long-term risk factors for suicidal ideation and attempts from adolescence to young adulthood. Moreover, depressive symptoms served as long-term mechanisms in these associations.
Collapse
Affiliation(s)
- Luming Liu
- Beijing Key Laboratory of Applied Experimental Psychology, National Demonstration Center for Experimental Psychology Education (Beijing Normal University), Faculty of Psychology, Beijing Normal University, Beijing 100875, China
| | - Wenchao Wang
- Beijing Key Laboratory of Applied Experimental Psychology, National Demonstration Center for Experimental Psychology Education (Beijing Normal University), Faculty of Psychology, Beijing Normal University, Beijing 100875, China; Department of Psychology, Faculty of Arts and Sciences, Beijing Normal University, Zhuhai 519087, China.
| |
Collapse
|
2
|
Ratzon R, Reiter J, Goltser-Dubner T, Segman R, Weisstub EG, Benarroch F, Ran SRZ, Kianski E, Giesser R, Weinberg PB, Ben-Ari A, Sela Y, Nitsan MB, Lotan A, Shalev A. Sleep measures as a predictor of suicidal ideation among high-risk adolescents. Eur Child Adolesc Psychiatry 2024; 33:2781-2790. [PMID: 38225414 DOI: 10.1007/s00787-023-02358-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 12/14/2023] [Indexed: 01/17/2024]
Abstract
Suicide is the second leading cause of death among youth aged 15-24 years. Identifying modifiable risk factors relevant to adolescents is crucial for suicide prevention. Sleep patterns have been linked to suicidality in adults, but lack sufficient study in youth. This ecological momentary assessment (EMA) study aimed to explore the relationship between objectively and subjectively measured sleep characteristics and next-day suicidal ideation in high-risk youth. We included 29 adolescents (12-18 years old) admitted to the inpatient psychiatric ward post-suicide attempt or due to suicidal intent within the previous month. We conducted objective (actigraphy) and subjective (sleep diary) sleep pattern assessments over ten consecutive days. Daily suicidal ideation was evaluated using a questionnaire based on the validated C-SSRS interview. A significant positive association was observed between sleep onset latency (SOL) and expressing a "death wish" the following day (OR = 1.06, 95% CI [1-1.11], p = .04), with each minute of longer SOL increased the risk for a death wish the following day by 6%. In addition, a marginally significant negative association was observed between total sleep time (TST) and expressing a "death wish" the following day (OR = 0.57, 95% CI [0.3-1.11], p = 0.1), with each one-hour decrease in objectively measured TST increasing the odds of a death wish by 43%. Our study highlights the interplay between sleep patterns and suicidal ideation, with SOL and TST playing a significant role that may function as proximal risk factors for suicidality and as a target for intervention while treating suicidal youth.
Collapse
Affiliation(s)
- Roy Ratzon
- The Herman-Danna Division of Pediatric Psychiatry, Department of Psychiatry, Hadassah Medical Organization, Faculty of Medicine, Hebrew University of Jerusalem, Kiryat Hadassah, Ein Kerem, P.O.B. 12000, Jerusalem, Israel
| | - Joel Reiter
- Pediatric Pulmonary and Sleep Unit, Department of Pediatrics, Hadassah Medical Organization, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Tanya Goltser-Dubner
- Molecular Psychiatry Laboratory, The Herman-Danna Division of Pediatric Psychiatry, Department of Psychiatry, Hadassah Medical Organization, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Ronen Segman
- Molecular Psychiatry Laboratory, The Herman-Danna Division of Pediatric Psychiatry, Department of Psychiatry, Hadassah Medical Organization, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Esti Galili Weisstub
- The Herman-Danna Division of Pediatric Psychiatry, Department of Psychiatry, Hadassah Medical Organization, Faculty of Medicine, Hebrew University of Jerusalem, Kiryat Hadassah, Ein Kerem, P.O.B. 12000, Jerusalem, Israel
| | - Fortunato Benarroch
- The Herman-Danna Division of Pediatric Psychiatry, Department of Psychiatry, Hadassah Medical Organization, Faculty of Medicine, Hebrew University of Jerusalem, Kiryat Hadassah, Ein Kerem, P.O.B. 12000, Jerusalem, Israel
| | - Shlomo Rahmani Zwi Ran
- Adult Inpatient Unit, The Biological Psychiatry Laboratory, Hadassah Medical Organization, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Ella Kianski
- The Herman-Danna Division of Pediatric Psychiatry, Department of Psychiatry, Hadassah Medical Organization, Faculty of Medicine, Hebrew University of Jerusalem, Kiryat Hadassah, Ein Kerem, P.O.B. 12000, Jerusalem, Israel
| | - Ruth Giesser
- The Herman-Danna Division of Pediatric Psychiatry, Department of Psychiatry, Hadassah Medical Organization, Faculty of Medicine, Hebrew University of Jerusalem, Kiryat Hadassah, Ein Kerem, P.O.B. 12000, Jerusalem, Israel
| | - Pnina Blum Weinberg
- The Donald Cohen Child and Adolescent Psychiatry Department, Eitanim Psychiatric Hospital, The Jerusalem Mental Health Center, Jerusalem, Israel
| | - Amichai Ben-Ari
- Department of Behavioral Sciences, Ariel University, Ariel, Israel
| | - Yaron Sela
- The Research Center for Internet Psychology (CIP), Sammy Ofer School of Communication, Reichman University, Herzliya, Israel
| | - Moriah Bar Nitsan
- The Herman-Danna Division of Pediatric Psychiatry, Department of Psychiatry, Hadassah Medical Organization, Faculty of Medicine, Hebrew University of Jerusalem, Kiryat Hadassah, Ein Kerem, P.O.B. 12000, Jerusalem, Israel
- Department of Behavioral Sciences, Ariel University, Ariel, Israel
| | - Amit Lotan
- Adult Inpatient Unit, The Biological Psychiatry Laboratory, Hadassah Medical Organization, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Amit Shalev
- The Herman-Danna Division of Pediatric Psychiatry, Department of Psychiatry, Hadassah Medical Organization, Faculty of Medicine, Hebrew University of Jerusalem, Kiryat Hadassah, Ein Kerem, P.O.B. 12000, Jerusalem, Israel.
| |
Collapse
|
3
|
Yu M, Li X, Lei T, He Y, Gan X, Wang W, Zhu D, Chen R, Zhou X. The familial transmission of suicide and non-suicidal self-injury in different income levels in town. Int J Soc Psychiatry 2024:207640241250312. [PMID: 38803229 DOI: 10.1177/00207640241250312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/29/2024]
Abstract
BACKGROUND Prior researches have established that suicide and non-suicidal self-injury (NSSI) exhibit familial transmission patterns. However, the extent to which these patterns vary across different income levels remains unclear, as well as the specific factors that influence them. This study aimed to explore these questions. METHODS We analyzed data from 13,988 parent-child pairs in Chongqing, China, where the children were aged from 7 to 12 years old. Six income levels were considered, and the children's depression and anxiety symptoms were assessed using standardized scales (the Center for Epidemiological Studies Depression Scale for Children, [CES-DC], and the Screen for Child Anxiety Related Emotional Disorders [SCARED], respectively). Binary logistic regression analysis was employed to examine the transmission of suicide and NSSI across different income levels. RESULTS Familial transmission of suicide was significant difference in all income levels except the highest, while familial transmission of NSSI was significant difference in all income levels except the lowest. Notably, in both low- and high-income levels, suicide and NSSI transmissions primarily occurred among male children, mothers with higher education, and children who spent long time with their mothers. Additionally, the transmissions were mediated partially or entirely by children's depression and anxiety symptoms. LIMITATIONS Future studies should investigate the separate effects of fathers' and mothers' suicide and NSSI histories on familial transmission patterns. CONCLUSION The familial transmissions of suicide and NSSI exhibited distinct patterns across different income levels.
Collapse
Affiliation(s)
- Mei Yu
- Vanke School of Public Health, Tsinghua University, China
- Institute for Healthy China, Tsinghua University, China
| | - Xuemei Li
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, China
| | - Tingting Lei
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, China
| | - Yuqian He
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, China
| | - Xieyu Gan
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, China
| | - Wenjing Wang
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, China
| | - Dan Zhu
- Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, China
| | - Runsen Chen
- Vanke School of Public Health, Tsinghua University, China
- Institute for Healthy China, Tsinghua University, China
| | - Xinyu Zhou
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, China
| |
Collapse
|
4
|
Stein MB, Jain S, Papini S, Campbell-Sills L, Choi KW, Martis B, Sun X, He F, Ware EB, Naifeh JA, Aliaga PA, Ge T, Smoller JW, Gelernter J, Kessler RC, Ursano RJ. Polygenic risk for suicide attempt is associated with lifetime suicide attempt in US soldiers independent of parental risk. J Affect Disord 2024; 351:671-682. [PMID: 38309480 PMCID: PMC11259154 DOI: 10.1016/j.jad.2024.01.254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Revised: 01/23/2024] [Accepted: 01/26/2024] [Indexed: 02/05/2024]
Abstract
BACKGROUND Suicide is a leading cause of death worldwide. Whereas some studies have suggested that a direct measure of common genetic liability for suicide attempts (SA), captured by a polygenic risk score for SA (SA-PRS), explains risk independent of parental history, further confirmation would be useful. Even more unsettled is the extent to which SA-PRS is associated with lifetime non-suicidal self-injury (NSSI). METHODS We used summary statistics from the largest available GWAS study of SA to generate SA-PRS for two non-overlapping cohorts of soldiers of European ancestry. These were tested in multivariable models that included parental major depressive disorder (MDD) and parental SA. RESULTS In the first cohort, 417 (6.3 %) of 6573 soldiers reported lifetime SA and 1195 (18.2 %) reported lifetime NSSI. In a multivariable model that included parental history of MDD and parental history of SA, SA-PRS remained significantly associated with lifetime SA [aOR = 1.26, 95%CI:1.13-1.39, p < 0.001] per standardized unit SA-PRS]. In the second cohort, 204 (4.2 %) of 4900 soldiers reported lifetime SA, and 299 (6.1 %) reported lifetime NSSI. In a multivariable model that included parental history of MDD and parental history of SA, SA-PRS remained significantly associated with lifetime SA [aOR = 1.20, 95%CI:1.04-1.38, p = 0.014]. A combined analysis of both cohorts yielded similar results. In neither cohort or in the combined analysis was SA-PRS significantly associated with NSSI. CONCLUSIONS PRS for SA conveys information about likelihood of lifetime SA (but not NSSI, demonstrating specificity), independent of self-reported parental history of MDD and parental history of SA. LIMITATIONS At present, the magnitude of effects is small and would not be immediately useful for clinical decision-making or risk-stratified prevention initiatives, but this may be expected to improve with further iterations. Also critical will be the extension of these findings to more diverse populations.
Collapse
Affiliation(s)
- Murray B Stein
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA; VA San Diego Healthcare System, San Diego, CA, USA; Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, La Jolla, CA, USA.
| | - Sonia Jain
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, La Jolla, CA, USA
| | - Santiago Papini
- Department of Psychology, University of Hawai'i at Mānoa, Honolulu, HI, USA
| | - Laura Campbell-Sills
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
| | - Karmel W Choi
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Brian Martis
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA; VA San Diego Healthcare System, San Diego, CA, USA
| | - Xiaoying Sun
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, La Jolla, CA, USA
| | - Feng He
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, La Jolla, CA, USA
| | - Erin B Ware
- Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
| | - James A Naifeh
- Center for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Pablo A Aliaga
- Center for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Tian Ge
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Jordan W Smoller
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Joel Gelernter
- Departments of Psychiatry, Genetics, and Neuroscience, Yale University School of Medicine, New Haven, CT, USA
| | - Ronald C Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
| | - Robert J Ursano
- Center for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| |
Collapse
|
5
|
Chen Q, Armstrong SE, Vakil F, Bridge JA, Keilp JG, Sheftall AH. Neurocognitive and clinical characteristics of elementary school-aged children with a history of suicidal thoughts and behaviors. J Affect Disord 2023; 339:318-324. [PMID: 37442443 PMCID: PMC10530242 DOI: 10.1016/j.jad.2023.07.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 06/16/2023] [Accepted: 07/08/2023] [Indexed: 07/15/2023]
Abstract
BACKGROUND Suicidal thoughts and behaviors (STBs) in elementary school-aged youth have increased in recent years. Understanding the risks associated with childhood STBs is necessary for prevention efforts. METHODS The current study examined clinical and neurocognitive characteristics of a community sample of elementary school-aged children with (STB+) and without (STB-) a history of STBs. The final sample included 93 families with children average age of 7.8 years (SD = 1.3). Children in this sample were racially diverse, evenly split by sex, and most identified as non-Hispanic. Neurocognitive functioning was assessed using computerized behavioral measures. Child clinical characteristics were assessed using self-report measures and STB history was assessed using semi-structured interviews. RESULTS Of the 93 families, 64 STB- children and 29 STB+ children participated. On average, STB+ children were older, reported higher levels of depressive and anxiety symptoms, and were more likely to have a parental history of suicidal behavior (PH+). Regarding neurocognitive functioning, STB+ children exhibited lower raw scores for both the NIH Dimensional Change Card Sort Task (NIH-DCCS) and NIH Flanker Inhibitory Control and Attention Test (NIH-Flanker). Multivariable regression analyses revealed raw scores for NIH-DCCS and NIH-Flanker, PH+ status, and child age were associated with childhood STBs. LIMITATIONS Prospective data is needed to confirm cross-sectional findings. CONCLUSIONS Poorer neurocognitive functioning and PH+ status may serve as risk markers for STBs in elementary school-aged children. Targeting prevention programming for these risks may reduce the likelihood of STBs in at-risk elementary school-aged youth.
Collapse
Affiliation(s)
- Qi Chen
- Columbia University, NY, New York, United States of America
| | | | - Fatima Vakil
- Abdul Latif Jameel Poverty Action Lab (J-PAL) North America, Massachusetts Institute of Technology (MIT), Cambridge, MA, United States of America
| | - Jeffrey A Bridge
- Center for Suicide Prevention and Research, The Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH, United States of America; Departments of Pediatrics and Psychiatry & Behavioral Health, The Ohio State University College of Medicine, Columbus, OH, United States of America
| | - John G Keilp
- Department of Psychiatry, Columbia University, NY, New York, United States of America
| | - Arielle H Sheftall
- Department of Psychiatry, University of Rochester Medical Center, Rochester, NY, United States of America.
| |
Collapse
|
6
|
Rabbany JM, Ellis S, Metts A, Burke A, Brent DA, Melhem N, Marcott S, Mann JJ. Mood Disorders and Aggressive Traits Mediate Effects of Reported Childhood Adversity on Suicide Attempt Risk. Arch Suicide Res 2023; 27:1207-1230. [PMID: 36052407 DOI: 10.1080/13811118.2022.2112118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
BACKGROUND Childhood adversity (CA) is linked to suicidal behavior as well as to mood disorders and aggressive traits. This raises the possibility that depression and aggressive traits mediate the relationship of childhood adversity to suicide risk. Moreover, it is not known if they operate independently or interactively. AIMS To determine whether, and how, mood disorders and aggressive traits mediate the effects of reported physical and sexual abuse on future suicidal behavior. METHODS Five hundred and forty-eight subjects, offspring of parents with mood disorders, were interviewed at baseline and at yearly follow-ups with questionnaires assessing aggression, mood disorders, and suicidal behavior. The mediation analysis involved a three-step process, testing the relationships between (1) CA and attempt; (2) CA and putative mediators; and (3) putative mediators and suicide attempt, adjusting for CA. RESULTS Aggressive trait severity and mood disorder onset each mediated the relationship between CA and future suicide attempts. Greater aggression severity also raised the hazard of the development of a mood disorder. If aggressive trait severity was clearly elevated, then onset of mood disorder did not increase further the hazard of the suicide attempt. Including family as a random effect had a much bigger effect on attempt outcome for physical abuse compared with sexual abuse. CONCLUSIONS Amelioration of aggressive traits and treatment of mood disorders in CA-exposed offspring of a parent with a mood disorder may prevent future suicide attempts and may reduce the risk of mood disorder. Familial factors influence the impact of childhood physical abuse but not sexual abuse. HIGHLIGHTSChildhood Adversity (CA) predicted future mood disorder and aggression severity.Depression and aggression mediate the relationship between CA and suicide attempts.When one mediator is present, the presence of the other does not increase the hazard.Between family variation contributed much more to suicidal behavior outcomes relative to the effect of physical abuse, but sexual abuse contributed to suicidal outcomes more than family variation.
Collapse
|
7
|
Jiang MM, Chen JN, Huang XC, Zhang YL, Zhang JB, Zhang JW. The Effect of Teacher Discrimination Behavior on Adolescent Suicidal Ideation: A Cross-Sectional Survey. Psychol Res Behav Manag 2023; 16:2667-2680. [PMID: 37485285 PMCID: PMC10361406 DOI: 10.2147/prbm.s420978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Accepted: 07/07/2023] [Indexed: 07/25/2023] Open
Abstract
Introduction Suicidal ideation and suicidal behavior, as the most severe psychological and behavioral problems among adolescents, bring not only significant damage to individual social functioning but also cause enormous economic and social pressure, which will ultimately be detrimental to social development and social stability. This paper aimed to explore the potential relationship between teacher discrimination behavior, peer bullying victimization, anxiety disorders, and adolescent suicidal ideation based on the Vulnerability-Stress Model. Methods From September to November 2022, our research team surveyed 21,017 junior high school students from 12 secondary schools in ten cities in China. Mplus 8.3 software was used to analyze the pathways of teacher discrimination behavior on adolescent suicidal ideation. Results The results showed that teacher preference had a significant negative effect on suicidal ideation, and teacher prejudice significantly positively affected suicidal ideation. Mediation test results indicated that there were significant independent mediating effects of peer bullying victimization and anxiety disorders between teacher discrimination behavior and adolescents' suicidal ideation, as well as significant chain mediating effects. Conclusion Secondary school teachers should improve their self-quality and pay more attention to adolescents' suicidal ideation. Teachers are expected to put love into their education, respect and trust each student, and attend to their emotional needs unbiasedly. Educators should develop targeted prevention and intervention measures according to the actual situation of school bullying and also strengthen adolescents' life-value education to improve the psychological quality of adolescents and create a healthy campus atmosphere.
Collapse
Affiliation(s)
- Mao-Min Jiang
- School of Public Affairs, Xiamen University, Xiamen, People’s Republic of China
| | - Ji-Neng Chen
- Graduate School, St.Paul University Philippines, Tuguegarao, Philippines
| | - Xin-Cheng Huang
- School of Economics and Management, Beijing Institute of Graphic Communication, Beijing, People’s Republic of China
| | - Yi-Lin Zhang
- School of Humanities, Yangzhou University, Yangzhou, People’s Republic of China
| | - Jia-Bo Zhang
- School of Literature and Media, Lingnan Normal University, Zhanjiang, People’s Republic of China
| | - Jia-Wen Zhang
- School of Education, Silliman University, Dumaguete, 6200, Philippines
| |
Collapse
|
8
|
Pantazatos SP, Ogden T, Melhem NM, Brent DA, Lesanpezeshki M, Burke A, Keilp JG, Miller JM, Mann JJ. Smaller cornu ammonis (CA3) as a potential risk factor for suicidal behavior in mood disorders. J Psychiatr Res 2023; 163:262-269. [PMID: 37244064 DOI: 10.1016/j.jpsychires.2023.05.051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 05/05/2023] [Accepted: 05/15/2023] [Indexed: 05/29/2023]
Abstract
Mood disorders and suicidal behavior have moderate heritability and familial transmission, and are associated with smaller hippocampal volumes. However, it is unclear whether hippocampal alterations reflect heritable risk or epigenetic effects of childhood adversity, compensatory mechanisms, illness-related changes, or treatment effects. We sought to separate the relationships of hippocampal substructure volumes to mood disorder, suicidal behavior, and risk and resilience to both by examining high familial risk individuals (HR) who have passed the age of greatest risk for psychopathology onset. Structural brain imaging and hippocampal substructure segmentation quantified Cornu Ammonis (CA1-4), dentate gyrus, and subiculum gray matter volumes in healthy volunteers (HV, N = 25) and three groups with one or more relatives reporting early-onset mood disorder and suicide attempt: 1. Unaffected HR (N = 20); 2. HR with lifetime mood disorder and no suicide attempt (HR-MOOD, N = 25); and 3. HR with lifetime mood disorder and a previous suicide attempt (HR-MOOD + SA, N = 18). Findings were tested in an independent cohort not selected for family history (HV, N = 47; MOOD, N = 44; and MOOD + SA, N = 21). Lower CA3 volume was found in HR (vs. HV), consistent with the direction of previously published findings in MOOD+SA (vs. HV and MOOD), suggesting the finding reflects a familial biological risk marker, not illness or treatment-related sequelae, of suicidal behavior and mood disorder. Familial suicide risk may be mediated in part by smaller CA3 volume. The structure may serve as a risk indicator and therapeutic target for suicide prevention strategies in high-risk families.
Collapse
Affiliation(s)
- Spiro P Pantazatos
- Molecular Imaging and Neuropathology Area, New York State Psychiatric Institute, New York, NY, USA; Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, USA.
| | - Todd Ogden
- Molecular Imaging and Neuropathology Area, New York State Psychiatric Institute, New York, NY, USA; Mailman School of Public Health, Columbia University, New York, USA
| | - Nadine M Melhem
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - David A Brent
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Mohammad Lesanpezeshki
- Molecular Imaging and Neuropathology Area, New York State Psychiatric Institute, New York, NY, USA; Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, USA
| | - Ainsley Burke
- Molecular Imaging and Neuropathology Area, New York State Psychiatric Institute, New York, NY, USA; Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, USA
| | - John G Keilp
- Molecular Imaging and Neuropathology Area, New York State Psychiatric Institute, New York, NY, USA; Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, USA
| | - Jeffrey M Miller
- Molecular Imaging and Neuropathology Area, New York State Psychiatric Institute, New York, NY, USA; Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, USA
| | - J John Mann
- Molecular Imaging and Neuropathology Area, New York State Psychiatric Institute, New York, NY, USA; Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, USA.
| |
Collapse
|
9
|
Tumasian RA, Galfalvy HC, Enslow MR, Brent DA, Melhem N, Burke AK, Mann JJ, Grunebaum MF. Avoidant attachment transmission to offspring in families with a depressed parent. J Affect Disord 2023; 325:695-700. [PMID: 36681306 PMCID: PMC9911374 DOI: 10.1016/j.jad.2023.01.059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 12/19/2022] [Accepted: 01/15/2023] [Indexed: 01/20/2023]
Abstract
BACKGROUND Insecure attachment is associated with mental health morbidity. We explored associations between parent and offspring attachment style in a longitudinal study of families with a depressed parent. METHODS Parents (N = 169) with a DSM-IV mood disorder and their adult offspring (N = 267), completed the Adult Attachment Questionnaire at one or more time points during up to 9.7 years of follow-up. Linear mixed effects models explored associations between parent and offspring anxious and avoidant attachment scores. Residualized models accounted for parent and offspring depression severity. RESULTS Avoidant attachment scores were associated between parents and offspring with (p = .034) and without (p = .012) adjustment for baseline age and sex of parent and offspring. Depressed father-offspring relationships showed more avoidant attachment in offspring compared to depressed mother-offspring pairs (p = .010). After accounting for depression severity, parent average residualized avoidant attachment scores did not significantly correlate with those of offspring (unadjusted p = .052; adjusted p = .085), though the effect sizes did not change substantially, and 75 % of the correlation was retained. Parent-son relationships exhibited stronger avoidant attachment correlations compared to parent-daughter pairs (p = .048). LIMITATIONS Small sub-sample of fathers, parent and offspring assessments not always completed at the same time, and use of a self-report attachment style instrument. CONCLUSIONS Familial transmission of insecure avoidant attachment, a risk factor for negative mental health outcomes, merits research as a potential treatment target. In this preliminary study, its transmission to offspring seemed mostly independent of depression. Depressed fathers and their sons may deserve focus to reduce insecure avoidant attachment and improve clinical course.
Collapse
Affiliation(s)
- Robert A Tumasian
- Department of Biostatistics, Columbia University, New York, NY, United States of America
| | - Hanga C Galfalvy
- Department of Biostatistics, Columbia University, New York, NY, United States of America; Department of Psychiatry, Columbia University, New York, NY, United States of America; New York State Psychiatric Institute, New York, NY, United States of America
| | - Meghan R Enslow
- Department of Psychiatry, Columbia University, New York, NY, United States of America; New York State Psychiatric Institute, New York, NY, United States of America
| | - David A Brent
- Department of Psychiatry, UPMC Western Psychiatric Hospital, University of Pittsburgh Medical Center, Pittsburgh, PA, United States of America
| | - Nadine Melhem
- Department of Psychiatry, UPMC Western Psychiatric Hospital, University of Pittsburgh Medical Center, Pittsburgh, PA, United States of America
| | - Ainsley K Burke
- Department of Psychiatry, Columbia University, New York, NY, United States of America; New York State Psychiatric Institute, New York, NY, United States of America
| | - J John Mann
- Department of Psychiatry, Columbia University, New York, NY, United States of America; New York State Psychiatric Institute, New York, NY, United States of America
| | - Michael F Grunebaum
- Department of Psychiatry, Columbia University, New York, NY, United States of America; New York State Psychiatric Institute, New York, NY, United States of America.
| |
Collapse
|
10
|
Ortin-Peralta A, Keski-Säntti M, Gissler M, Veijola J, Sourander A, Duarte CS. Parental suicide attempts and offspring's risk of attempting or dying by suicide: does the timing of a parental suicide attempt matter? Psychol Med 2023; 53:977-986. [PMID: 34140058 DOI: 10.1017/s0033291721002397] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Studies on the transmission of suicide risk have focused on parental history of suicide attempts (SAs), overlooking when the attempt happened. This study examined how the offspring's risk of attempting or dying by suicide varied by the timing of a first parental SA and the sex of the parent who attempted suicide. METHODS Participants were 59 469 members of the 1987 Finnish Birth Cohort. The Finnish Hospital Discharge and Cause of Death Registers were the sources for parental and offspring SAs and offspring suicide. Timing of parental SA was coded as before (pre-pregnancy and pregnancy) and after the child's birth [infant/toddler years (0-2 years), childhood (3-11 years), adolescence (12-17 years), and young adulthood (18-26 years)]. RESULTS In the multivariate models, having a parent who attempted suicide increased the offspring's risk of attempting suicide (odds ratio (OR) = 1.77, 95% confidence interval (CI) 1.39-2.25), but not of dying by suicide. Compared to unexposed offspring, those exposed after child's birth were at higher risk of attempting suicide (OR = 1.90, 95% CI 1.46-2.47), specifically when the parent attempted during offspring's childhood, adolescence, and young adulthood. A first maternal SA increased offspring's risk of attempting suicide regardless of the timing. CONCLUSIONS The impact of a parental SA on offspring's risk of attempting suicide differed depending on the timing and sex of the parent who attempted suicide, suggesting that the transmission of suicide risk may occur through genetic as well as environmental factors. Our findings call for an intergenerational approach in suicide risk assessment.
Collapse
Affiliation(s)
- Ana Ortin-Peralta
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY, USA
- Department of Psychology, Hunter College, City University of New York, New York, NY, USA
| | | | - Mika Gissler
- Finnish Institute for Health and Welfare, Helsinki, Finland
- Department of Child Psychiatry, University of Turku, Turku, Finland
- Department of Neurobiology, Karolinska Institute, Stockholm, Sweden
| | - Juha Veijola
- Unit of Clinical Neuroscience, University of Oulu, Oulu, Finland
- Department of Psychiatry, University Hospital of Oulu, Oulu, Finland
| | - Andre Sourander
- Department of Child Psychiatry, University of Turku, Turku, Finland
- Department of Psychiatry, New York State Psychiatric Institute, Columbia University Irving Medical Center, New York, NY, USA
| | - Cristiane S Duarte
- Department of Psychiatry, New York State Psychiatric Institute, Columbia University Irving Medical Center, New York, NY, USA
| |
Collapse
|
11
|
Combined effects of nitric oxide synthase 3 genetic variant and childhood emotional abuse on earlier onset of suicidal behaviours. Prog Neuropsychopharmacol Biol Psychiatry 2022; 119:110617. [PMID: 35988847 DOI: 10.1016/j.pnpbp.2022.110617] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 07/28/2022] [Accepted: 08/14/2022] [Indexed: 11/22/2022]
Abstract
Marked heterogeneity in suicide attempters has been observed, with earlier onset being linked to stronger heritability, more childhood maltreatment. Nitric oxide signalling system might be implicated in this relationship through its role in the stress response/adaptation. This study examined how NOS genetic variants and childhood maltreatment were associated with age at first suicide attempt (SA). Adult patients with SA history (N = 414) filled in the Childhood Trauma Questionnaire, and six functionally relevant NOS2 and NOS3 polymorphisms were genotyped. Analyses included χ2, Mann-Whitney U tests, Kendall's regression, multivariate linear and Cox survival regressions, and a moderation analysis. The NOS3 promotor 27-bp variable number tandem repeat (VNTR) bb homozygous state and childhood emotional abuse were independently associated with earlier age at first SA, which was robust after controlling for confounders [regression coefficient - 3.975, 95% CI -6.980 - (-0.970), p = 0.010, and - 1.088, 95% CI -2.172 - (-0.004), p = 0.049]. No interaction was observed. In the Cox proportional hazards model for age at first SA, the hazard ratio for patients with childhood emotional abuse and NOS3 27-bp VNTR bb was 0.533 (95% CI 0.394-0.720, p < 0.001) compared to patients without. Intermediate scores were observed with either only the risk genotype or only childhood emotional abuse. A graded relationship was also observed for repeated SA, family history of SA, and severe SA history. These results are preliminary due to a low statistical power and call for replication and further characterization of the role of nitric oxide system in the susceptibility to early-onset SB.
Collapse
|
12
|
Farbstein D, Lukito S, Yorke I, Wilson E, Crudgington H, El-Aalem O, Cliffe C, Bergou N, Itani L, Owusu A, Sedgwick R, Singh N, Tarasenko A, Tucker G, Woodhouse E, Suzuki M, Myerscough AL, Lopez Chemas N, Abdel-Halim N, Del Giovane C, Epstein S, Ougrin D. Risk and protective factors for self-harm and suicide in children and adolescents: a systematic review and meta-analysis protocol. BMJ Open 2022; 12:e058297. [PMID: 36428021 PMCID: PMC9703327 DOI: 10.1136/bmjopen-2021-058297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 11/01/2022] [Indexed: 11/27/2022] Open
Abstract
INTRODUCTION Self-harm and suicide are major public health concerns among children and adolescents. Many risk and protective factors for suicide and self-harm have been identified and reported in the literature. However, the capacity of these identified risk and protective factors to guide assessment and management is limited due to their great number. This protocol describes an ongoing systematic review and meta-analysis which aims to examine longitudinal studies of risk factors for self-harm and suicide in children and adolescents, to provide a comparison of the strengths of association of the various risk factors for self-harm and suicide and to shed light on those that require further investigation. METHODS AND ANALYSIS We perform a systematic search of the literature using the databases EMBASE, PsycINFO, Medline, CINAHL and HMIC from inception up to 28 October 2020, and the search will be updated before the systematic review publication. Additionally, we will contact experts in the field, including principal investigators whose peer-reviewed publications are included in our systematic review as well as investigators from our extensive research network, and we will search the reference lists of relevant reviews to retrieve any articles that were not identified in our search. We will extract relevant data and present a narrative synthesis and combine the results in meta-analyses where there are sufficient data. We will assess the risk of bias for each study using the Newcastle-Ottawa Scale and present a summary of the quantity and the quality of the evidence for each risk or protective factor. ETHICS AND DISSEMINATION Ethical approval will not be sought as this is a systematic review of the literature. Results will be published in mental health journals and presented at conferences focused on suicide prevention. PROSPERO REGISTRATION NUMBER CRD42021228212.
Collapse
Affiliation(s)
- Dan Farbstein
- Child and Adolescent Psychiatry Unit, Psychiatric Division, Rambam Health Care Campus, Haifa, Israel
- Technion Israel Institute of Technology, The Ruth and Bruce Rappaport Faculty of Medicine, Haifa, Israel
| | - Steve Lukito
- Department of Child & Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Isabel Yorke
- Department of Child & Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Emma Wilson
- Economic and Social Research Council (ESRC) Centre for Society and Mental Health, King's College London, London, UK
- Department of Health Service and Population Research, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Holly Crudgington
- Economic and Social Research Council (ESRC) Centre for Society and Mental Health, King's College London, London, UK
- Department of Health Service and Population Research, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Omar El-Aalem
- South London and Maudsley NHS Foundation Trust, London, UK
| | - Charlotte Cliffe
- Department of Biostatistics & Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Nicol Bergou
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Lynn Itani
- Emirates Health Services, Maudsley Health, Al Amal Psychiatric Hospital, Dubai, UAE
| | - Andy Owusu
- South London and Maudsley NHS Foundation Trust, London, UK
| | | | - Nidhita Singh
- South London and Maudsley NHS Foundation Trust, London, UK
| | | | - Gavin Tucker
- South London and Maudsley NHS Foundation Trust, London, UK
| | - Emma Woodhouse
- Compass Psychological Services Ltd, London, UK
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Mimi Suzuki
- Unit for Social and Community Psychiatry, Queen Mary University of London & East London NHS Foundation Trust, London, UK
| | - Anna Louise Myerscough
- Unit for Social and Community Psychiatry, Queen Mary University of London & East London NHS Foundation Trust, London, UK
| | - Natalia Lopez Chemas
- Unit for Social and Community Psychiatry, Queen Mary University of London & East London NHS Foundation Trust, London, UK
| | - Nadia Abdel-Halim
- Unit for Social and Community Psychiatry, Queen Mary University of London & East London NHS Foundation Trust, London, UK
| | - Cinzia Del Giovane
- Department of Medical and Surgical Sciences for Children and Adults, University-Hospital of Modena and Reggio Emilia, Modena, Italy
- Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland
| | - Sophie Epstein
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Dennis Ougrin
- Department of Child & Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Youth Resilience Research Unit, WHO Collaborating Centre for Mental Health Services Development, Queen Mary University of London, London, UK
| |
Collapse
|
13
|
Abramova O, Soloveva K, Zorkina Y, Gryadunov D, Ikonnikova A, Fedoseeva E, Emelyanova M, Ochneva A, Andriushchenko N, Pavlov K, Pavlova O, Ushakova V, Syunyakov T, Andryushchenko A, Karpenko O, Savilov V, Kurmishev M, Andreuyk D, Gurina O, Chekhonin V, Kostyuk G, Morozova A. Suicide-Related Single Nucleotide Polymorphisms, rs4918918 and rs10903034: Association with Dementia in Older Adults. Genes (Basel) 2022; 13:2174. [PMID: 36421848 PMCID: PMC9690628 DOI: 10.3390/genes13112174] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 11/15/2022] [Accepted: 11/18/2022] [Indexed: 08/19/2024] Open
Abstract
Dementia has enormous implications for patients and the health care system. Genetic markers are promising for detecting the risk of cognitive impairment. We hypothesized that genetic variants associated with suicide risk might significantly increase the risk of cognitive decline because suicide in older adults is often a consequence of cognitive impairment. We investigated several single-nucleotide polymorphisms that were initially associated with suicide risk in dementia older adults and identified the APOE gene alleles. The study was performed with subjects over the age of 65: 112 patients with dementia and 146 healthy volunteers. The MMSE score was used to assess cognitive functions. Study participants were genotyped using real-time PCR (APOE: rs429358, rs7412; genes associated with suicide: rs9475195, rs7982251, rs2834789, rs358592, rs4918918, rs3781878, rs10903034, rs165774, rs16841143, rs11833579 rs10898553, rs7296262, rs3806263, and rs2462021). Genotype analysis revealed the significance of APOEε4, APOEε2, and rs4918918 (SORBS1) when comparing dementia and healthy control groups. The association of APOEε4, APOEε2, and rs10903034 (IFNLR1) with the overall MMSE score was indicated. The study found an association with dementia of rs4918918 (SORBS1) and rs10903034 (IFNLR1) previously associated with suicide and confirmed the association of APOEε4 and APOEε2 with dementia.
Collapse
Affiliation(s)
- Olga Abramova
- Mental-Health Clinic No. 1 Named after N.A. Alekseev, Zagorodnoe Highway 2, 115191 Moscow, Russia
- Department of Basic and Applied Neurobiology, V. Serbsky Federal Medical Research Centre of Psychiatry and Narcology, Kropotkinsky per. 23, 119034 Moscow, Russia
| | - Kristina Soloveva
- Mental-Health Clinic No. 1 Named after N.A. Alekseev, Zagorodnoe Highway 2, 115191 Moscow, Russia
| | - Yana Zorkina
- Mental-Health Clinic No. 1 Named after N.A. Alekseev, Zagorodnoe Highway 2, 115191 Moscow, Russia
- Department of Basic and Applied Neurobiology, V. Serbsky Federal Medical Research Centre of Psychiatry and Narcology, Kropotkinsky per. 23, 119034 Moscow, Russia
| | - Dmitry Gryadunov
- Center for Precision Genome Editing and Genetic Technologies for Biomedicine, Engelhardt Institute of Molecular Biology, Russian Academy of Sciences, 119991 Moscow, Russia
| | - Anna Ikonnikova
- Center for Precision Genome Editing and Genetic Technologies for Biomedicine, Engelhardt Institute of Molecular Biology, Russian Academy of Sciences, 119991 Moscow, Russia
| | - Elena Fedoseeva
- Center for Precision Genome Editing and Genetic Technologies for Biomedicine, Engelhardt Institute of Molecular Biology, Russian Academy of Sciences, 119991 Moscow, Russia
| | - Marina Emelyanova
- Center for Precision Genome Editing and Genetic Technologies for Biomedicine, Engelhardt Institute of Molecular Biology, Russian Academy of Sciences, 119991 Moscow, Russia
| | - Aleksandra Ochneva
- Mental-Health Clinic No. 1 Named after N.A. Alekseev, Zagorodnoe Highway 2, 115191 Moscow, Russia
- Department of Basic and Applied Neurobiology, V. Serbsky Federal Medical Research Centre of Psychiatry and Narcology, Kropotkinsky per. 23, 119034 Moscow, Russia
| | - Nika Andriushchenko
- Department of Basic and Applied Neurobiology, V. Serbsky Federal Medical Research Centre of Psychiatry and Narcology, Kropotkinsky per. 23, 119034 Moscow, Russia
- Department of Biology, Shenzhen MSU-BIT University, Ruyi Rd. 299, Shenzhen 518172, China
| | - Konstantin Pavlov
- Department of Basic and Applied Neurobiology, V. Serbsky Federal Medical Research Centre of Psychiatry and Narcology, Kropotkinsky per. 23, 119034 Moscow, Russia
| | - Olga Pavlova
- Department of Basic and Applied Neurobiology, V. Serbsky Federal Medical Research Centre of Psychiatry and Narcology, Kropotkinsky per. 23, 119034 Moscow, Russia
| | - Valeriya Ushakova
- Mental-Health Clinic No. 1 Named after N.A. Alekseev, Zagorodnoe Highway 2, 115191 Moscow, Russia
- Department of Basic and Applied Neurobiology, V. Serbsky Federal Medical Research Centre of Psychiatry and Narcology, Kropotkinsky per. 23, 119034 Moscow, Russia
- M.V. Lomonosov Moscow State University, 119991 Moscow, Russia
| | - Timur Syunyakov
- Mental-Health Clinic No. 1 Named after N.A. Alekseev, Zagorodnoe Highway 2, 115191 Moscow, Russia
- International Centre for Education and Research in Neuropsychiatry (ICERN), Samara State Medical University, 443016 Samara, Russia
| | - Alisa Andryushchenko
- Mental-Health Clinic No. 1 Named after N.A. Alekseev, Zagorodnoe Highway 2, 115191 Moscow, Russia
| | - Olga Karpenko
- Mental-Health Clinic No. 1 Named after N.A. Alekseev, Zagorodnoe Highway 2, 115191 Moscow, Russia
| | - Victor Savilov
- Mental-Health Clinic No. 1 Named after N.A. Alekseev, Zagorodnoe Highway 2, 115191 Moscow, Russia
| | - Marat Kurmishev
- Mental-Health Clinic No. 1 Named after N.A. Alekseev, Zagorodnoe Highway 2, 115191 Moscow, Russia
| | - Denis Andreuyk
- Mental-Health Clinic No. 1 Named after N.A. Alekseev, Zagorodnoe Highway 2, 115191 Moscow, Russia
- M.V. Lomonosov Moscow State University, 119991 Moscow, Russia
| | - Olga Gurina
- Department of Basic and Applied Neurobiology, V. Serbsky Federal Medical Research Centre of Psychiatry and Narcology, Kropotkinsky per. 23, 119034 Moscow, Russia
| | - Vladimir Chekhonin
- Department of Basic and Applied Neurobiology, V. Serbsky Federal Medical Research Centre of Psychiatry and Narcology, Kropotkinsky per. 23, 119034 Moscow, Russia
- Department of Medical Nanobiotechnology, Pirogov Russian National Research Medical University, 117997 Moscow, Russia
| | - Georgy Kostyuk
- Mental-Health Clinic No. 1 Named after N.A. Alekseev, Zagorodnoe Highway 2, 115191 Moscow, Russia
- Federal State Budgetary Educational Institution of Higher Education “Moscow State University of Food Production”, Volokolamskoye Highway 11, 125080 Moscow, Russia
| | - Anna Morozova
- Mental-Health Clinic No. 1 Named after N.A. Alekseev, Zagorodnoe Highway 2, 115191 Moscow, Russia
- Department of Basic and Applied Neurobiology, V. Serbsky Federal Medical Research Centre of Psychiatry and Narcology, Kropotkinsky per. 23, 119034 Moscow, Russia
| |
Collapse
|
14
|
Pantazatos SP, Melhem NM, Brent DA, Zanderigo F, Bartlett EA, Lesanpezeshki M, Burke A, Miller JM, Mann JJ. Ventral prefrontal serotonin 1A receptor binding: a neural marker of vulnerability for mood disorder and suicidal behavior? Mol Psychiatry 2022; 27:4136-4143. [PMID: 35760877 PMCID: PMC9722608 DOI: 10.1038/s41380-022-01671-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2021] [Revised: 06/01/2022] [Accepted: 06/10/2022] [Indexed: 02/07/2023]
Abstract
Mood disorders and suicidal behavior have moderate heritability and are associated with altered corticolimbic serotonin 1A receptor (5-HT1A) brain binding. However, it is unclear whether this reflects genetic effects or epigenetic effects of childhood adversity, compensatory mechanisms, or illness stress-related changes. We sought to separate such effects on 5-HT1A binding by examining high familial risk individuals (HR) who have passed through the age of greatest risk for psychopathology onset with and without developing mood disorder or suicidal behavior. PET imaging quantified 5-HT1A binding potential BPND using [11C]CUMI-101 in healthy volunteers (HV, N = 23) and three groups with one or more relatives manifesting early-onset mood disorder and suicide attempt: 1. unaffected HR (N = 23); 2. HR with lifetime mood disorder and no suicide attempt (HR-MOOD, N = 26); and 3. HR-MOOD with previous suicide attempt (HR-MOOD + SA, N = 20). Findings were tested in an independent cohort not selected for family history (HV, MOOD, and MOOD + SA, total N = 185). We tested for regional BPND differences and whether brain-wide patterns distinguished between groups. Low ventral prefrontal 5-HT1A BPND was associated with lifetime mood disorder diagnosis and suicide attempt, but only in subjects with a family history of mood disorder and suicide attempt. Brain-wide 5-HT1A BPND patterns including low ventral prefrontal and mesiotemporal cortical binding distinguished HR-MOOD + SA from HV. A biological endophenotype associated with resilience was not observed. Low ventral prefrontal 5-HT1A BPND may reflect familial mood disorder and suicide-related pathology. Further studies are needed to determine if higher ventral prefrontal 5-HT1A BPND confers resilience, reducing risk of suicidal behavior in the context of familial risk, and thereby offer a potential prevention target.
Collapse
Affiliation(s)
- Spiro P Pantazatos
- Molecular Imaging and Neuropathology Area, New York State Psychiatric Institute, New York, NY, USA.
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, USA.
| | - Nadine M Melhem
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - David A Brent
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
- UPMC Western Psychiatric Hospital, Pittsburgh, PA, USA
| | - Francesca Zanderigo
- Molecular Imaging and Neuropathology Area, New York State Psychiatric Institute, New York, NY, USA
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, USA
| | - Elizabeth A Bartlett
- Molecular Imaging and Neuropathology Area, New York State Psychiatric Institute, New York, NY, USA
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, USA
| | - Mohammad Lesanpezeshki
- Molecular Imaging and Neuropathology Area, New York State Psychiatric Institute, New York, NY, USA
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, USA
| | - Ainsley Burke
- Molecular Imaging and Neuropathology Area, New York State Psychiatric Institute, New York, NY, USA
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, USA
| | - Jeffrey M Miller
- Molecular Imaging and Neuropathology Area, New York State Psychiatric Institute, New York, NY, USA
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, USA
| | - J John Mann
- Molecular Imaging and Neuropathology Area, New York State Psychiatric Institute, New York, NY, USA.
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, USA.
| |
Collapse
|
15
|
Ranning A, Uddin MJ, Sørensen HJ, Laursen TM, Thorup AAE, Madsen T, Nordentoft M, Erlangsen A. Intergenerational transmission of suicide attempt in a cohort of 4.4 million children. Psychol Med 2022; 52:3202-3209. [PMID: 33827720 DOI: 10.1017/s0033291720005310] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
BACKGROUND The association between suicide attempts (SAs) in parents and children is unclear, and risk indicators for intergenerational transmission remain undocumented. We aimed to assess this association, considering the child's developmental period at the time of parents' attempted suicide, and the parental relation. METHODS Using a prospective cohort design, nationwide population data were linked to the Psychiatric Central Register and National Patient Register for all individuals aged 10 years or older living in Denmark between 1980 and 2016. We assessed incidence rate ratios (IRRs) and cumulative hazards for children's first SA. RESULTS In a cohort of 4 419 651 children, 163 056 (3.7%) had experienced a parental SA. An SA was recorded among 6996 (4.3%) of the exposed children as opposed to 70112 (1.6%) in unexposed individuals. Higher rates were noted when a parental SA occurred during early childhood (0 ⩽ age < 2) [IRR, 4.7; 95% confidence interval (CI) 4.2-5.4] v. late childhood (6 ⩽ age < 13) (IRR, 3.6; 95% CI 3.4-3.8) when compared to those unexposed. Children exposed prior to age 2 had the highest rates of all sub-groups when reaching age 13-17 (IRR, 6.5; 95% CI 6.0-7.1) and 18-25 years (IRR, 6.8; 95% CI 6.2-7.4). Maternal SA (IRR, 3.4; 95% CI 3.2-3.5) was associated with higher rates than paternal (IRR, 2.8; 95% CI 2.7-2.9). CONCLUSION Parental SA was associated with children's own SA. Exposure during early developmental stages was associated with the highest rates. Early preventive efforts are warranted as is monitoring of suicide risk in the children from age 13.
Collapse
Affiliation(s)
- Anne Ranning
- Copenhagen Research Center for Mental Health, Copenhagen, Denmark
- Danish Research Institute for Suicide Prevention, Mental Health Centre Copenhagen, Copenhagen, Denmark
- Department of Psychology, University of Copenhagen, Copenhagen, Denmark
| | - Md Jamal Uddin
- Copenhagen Research Center for Mental Health, Copenhagen, Denmark
- Department of Biostatistics, University of Copenhagen, Copenhagen, Denmark
- Department of Statistics, Shahjalal University of Science and Technology, Sylhet, Bangladesh
| | | | - Thomas Munk Laursen
- National Center for Register-based Research, Aarhus University, Aarhus, Denmark
| | - Anne A E Thorup
- Child and Adolescent Mental Health Center, Capital Region of Denmark, Denmark
| | - Trine Madsen
- Copenhagen Research Center for Mental Health, Copenhagen, Denmark
| | - Merete Nordentoft
- Copenhagen Research Center for Mental Health, Copenhagen, Denmark
- Danish Research Institute for Suicide Prevention, Mental Health Centre Copenhagen, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health Science, University of Copenhagen, Copenhagen, Denmark
| | - Annette Erlangsen
- Danish Research Institute for Suicide Prevention, Mental Health Centre Copenhagen, Copenhagen, Denmark
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Center of Mental Health Research, Australian National University, Canberra, Australia
| |
Collapse
|
16
|
Huang Y, Zhang S, Zhong S, Gou N, Sun Q, Guo H, Lin R, Guo W, Chen H, Wang J, Zhou J, Wang X. The association of childhood adversities and mental health problems with dual-harm in individuals with serious aggressive behaviors. BMC Psychiatry 2022; 22:385. [PMID: 35672721 PMCID: PMC9175457 DOI: 10.1186/s12888-022-04027-6] [Citation(s) in RCA: 2] [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: 02/01/2022] [Accepted: 05/30/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The coexistence of self-harm and aggression, which is referred to as dual-harm, is commonly seen in forensic population. Self-harm and aggression have often been studied separately, previous studies on risk factors of aggression or self-harm mainly focused on childhood adversities, emotional regulation, impulsivity and psychopathology, given their importance in the two behaviors. However, the factors associated with dual-harm remain unclear. This study aimed to explore potential risk factors associated with co-occurring self-harm among individuals with serious aggressive behaviors. METHODS This multi-center, cross-sectional case-control study was conducted from May 2013 to January 2016 and involved seven qualified forensic institutes located in seven provinces in China. Participants were individuals with serious aggressive behaviors and were suspected to have mental disorders. Lifetime history of self-harm was obtained by a self-report questionnaire, and serious aggressive behaviors were assessed with the use of participants' forensic archive. Sociodemographic and clinical information were collected using a self-designed standardized data collection form, and childhood adversities was assessed using a clinician-rated scale designed by our research team. The Psychopathy Checklist-Revised (PCL-R) was used to assess psychopathic traits and the Brief Psychiatric Rating Scale (BPRS) was used to assess psychiatric symptoms of the participants. Univariate and multivariate logistic regression analyses were performed to analyze the relevant factors for dual-harm. RESULTS A total of 423 individuals with serious aggressive behaviors were enrolled in the current study. Of them, 74 (17.5%) with self-harm history assigned into the dual-harm group (D-H) and 349 (82.5%) without self-harm history assigned into the aggression-only group (A-O). According to the binary logistic regression analysis, current diagnosis of mood disorder (OR = 3.2, 95%CI: 1.2-8.5), child abuse (OR = 2.8, 95%CI: 1.3-6.2), parental death (OR = 3.0, 95%CI: 1.2-7.5), and the score of the affective subscale in BPRS (OR = 1.7, 95%CI: 1.3-2.4) were significantly associated with dual-harm. CONCLUSIONS Our study suggested the necessity of integrated evaluation of self-harm among individuals with serious aggressive behaviors. Childhood adversities and psychiatric symptoms in this population require special attention.
Collapse
Affiliation(s)
- Ying Huang
- grid.452708.c0000 0004 1803 0208Department of Psychiatry, The Second Xiangya Hospital, Central South University, National Clinical Research Center for Mental Disorders, National Technology Institute on Mental Disorders, Hunan Key Laboratory of Psychiatry and Mental Health, Renming Road 139, Changsha, 410011 Hunan Province China
| | - Simei Zhang
- grid.452897.50000 0004 6091 8446Shenzhen Kangning Hospital, Shenzhen, China
| | - Shaoling Zhong
- grid.410737.60000 0000 8653 1072 Department of Community Mental Health, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Ningzhi Gou
- grid.452708.c0000 0004 1803 0208Department of Psychiatry, The Second Xiangya Hospital, Central South University, National Clinical Research Center for Mental Disorders, National Technology Institute on Mental Disorders, Hunan Key Laboratory of Psychiatry and Mental Health, Renming Road 139, Changsha, 410011 Hunan Province China
| | - Qiaoling Sun
- grid.452708.c0000 0004 1803 0208Department of Psychiatry, The Second Xiangya Hospital, Central South University, National Clinical Research Center for Mental Disorders, National Technology Institute on Mental Disorders, Hunan Key Laboratory of Psychiatry and Mental Health, Renming Road 139, Changsha, 410011 Hunan Province China
| | - Huijuan Guo
- grid.452708.c0000 0004 1803 0208Department of Psychiatry, The Second Xiangya Hospital, Central South University, National Clinical Research Center for Mental Disorders, National Technology Institute on Mental Disorders, Hunan Key Laboratory of Psychiatry and Mental Health, Renming Road 139, Changsha, 410011 Hunan Province China
| | - Ruoheng Lin
- grid.452708.c0000 0004 1803 0208Department of Psychiatry, The Second Xiangya Hospital, Central South University, National Clinical Research Center for Mental Disorders, National Technology Institute on Mental Disorders, Hunan Key Laboratory of Psychiatry and Mental Health, Renming Road 139, Changsha, 410011 Hunan Province China
| | - Weilong Guo
- grid.452708.c0000 0004 1803 0208Department of Psychiatry, The Second Xiangya Hospital, Central South University, National Clinical Research Center for Mental Disorders, National Technology Institute on Mental Disorders, Hunan Key Laboratory of Psychiatry and Mental Health, Renming Road 139, Changsha, 410011 Hunan Province China
| | - Hui Chen
- grid.452708.c0000 0004 1803 0208Department of Psychiatry, The Second Xiangya Hospital, Central South University, National Clinical Research Center for Mental Disorders, National Technology Institute on Mental Disorders, Hunan Key Laboratory of Psychiatry and Mental Health, Renming Road 139, Changsha, 410011 Hunan Province China
| | - Jizhi Wang
- grid.452708.c0000 0004 1803 0208Department of Psychiatry, The Second Xiangya Hospital, Central South University, National Clinical Research Center for Mental Disorders, National Technology Institute on Mental Disorders, Hunan Key Laboratory of Psychiatry and Mental Health, Renming Road 139, Changsha, 410011 Hunan Province China
| | - Jiansong Zhou
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, National Clinical Research Center for Mental Disorders, National Technology Institute on Mental Disorders, Hunan Key Laboratory of Psychiatry and Mental Health, Renming Road 139, Changsha, 410011, Hunan Province, China.
| | - Xiaoping Wang
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, National Clinical Research Center for Mental Disorders, National Technology Institute on Mental Disorders, Hunan Key Laboratory of Psychiatry and Mental Health, Renming Road 139, Changsha, 410011, Hunan Province, China.
| |
Collapse
|
17
|
Wang J, Naifeh JA, Mash HBH, Morganstein JC, Fullerton CS, Cozza SJ, Stein MB, Ursano RJ. Parental suicide attempt and subsequent risk of pre-enlistment suicide attempt among male and female new soldiers in the U.S. Army. Suicide Life Threat Behav 2022; 52:59-68. [PMID: 34060122 DOI: 10.1111/sltb.12772] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 01/29/2021] [Accepted: 03/11/2021] [Indexed: 01/20/2023]
Abstract
OBJECTIVE Suicide and suicide attempts among U.S. Army soldiers are a significant concern for public health. This study examined the association of parental suicide attempt prior to age 13 of the soldier with subsequent risk of pre-enlistment suicide attempt. METHOD We conducted secondary analyses of survey data from new soldiers who participated in the Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS) (N = 38,396). A series of logistic regression analyses were conducted. RESULTS Of all new soldiers, 1.4% reported that they attempted suicide between age 13 and entering the Army, and 2.3% reported a parental suicide attempt prior to age 13. Parental suicide attempt was associated with increased odds of subsequent suicide attempt; however, this association was moderated by gender and was significant only among male soldiers. The association between parental suicide attempt and pre-enlistment suicide attempt among male soldiers was still significant after controlling for socio-demographic characteristics, soldier/parental psychopathology, and childhood adversities. CONCLUSIONS These results highlight parental suicide attempt as a unique pre-enlistment risk factor for suicide attempt, especially among male new soldiers. Further studies are needed to separate the genetic and environmental contributions to intra-familial risk for suicidal behavior.
Collapse
Affiliation(s)
- Jing Wang
- Center for the Study of Traumatic Stress (CSTS), Department of Psychiatry, Uniformed Services University of the Health Sciences (USUHS), Bethesda, MD, USA.,Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, USA
| | - James A Naifeh
- Center for the Study of Traumatic Stress (CSTS), Department of Psychiatry, Uniformed Services University of the Health Sciences (USUHS), Bethesda, MD, USA.,Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, USA
| | - Holly B Herberman Mash
- Center for the Study of Traumatic Stress (CSTS), Department of Psychiatry, Uniformed Services University of the Health Sciences (USUHS), Bethesda, MD, USA.,Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, USA
| | - Joshua C Morganstein
- Center for the Study of Traumatic Stress (CSTS), Department of Psychiatry, Uniformed Services University of the Health Sciences (USUHS), Bethesda, MD, USA
| | - Carol S Fullerton
- Center for the Study of Traumatic Stress (CSTS), Department of Psychiatry, Uniformed Services University of the Health Sciences (USUHS), Bethesda, MD, USA
| | - Stephen J Cozza
- Center for the Study of Traumatic Stress (CSTS), Department of Psychiatry, Uniformed Services University of the Health Sciences (USUHS), Bethesda, MD, USA
| | - Murray B Stein
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA.,Department of Family Medicine and Public Health, University of California San Diego, La Jolla, CA, USA.,VA San Diego Healthcare System, San Diego, CA, USA
| | - Robert J Ursano
- Center for the Study of Traumatic Stress (CSTS), Department of Psychiatry, Uniformed Services University of the Health Sciences (USUHS), Bethesda, MD, USA
| |
Collapse
|
18
|
Rabinowitz JA, Jin J, Kahn G, Kuo SIC, Campos A, Rentería M, Benke K, Wilcox H, Ialongo NS, Maher BS, Kertes D, Eaton W, Uhl G, Wagner BM, Cohen D. Genetic propensity for risky behavior and depression and risk of lifetime suicide attempt among urban African Americans in adolescence and young adulthood. Am J Med Genet B Neuropsychiatr Genet 2021; 186:456-468. [PMID: 34231309 PMCID: PMC9976552 DOI: 10.1002/ajmg.b.32866] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 05/04/2021] [Accepted: 05/14/2021] [Indexed: 01/02/2023]
Abstract
Suicide attempts (SA) among African Americans have increased at a greater rate than any other racial/ethnic group. Research in European ancestry populations has indicated that SA are genetically influenced; however, less is known about the genetic contributors that underpin SA among African Americans. We examined whether genetic propensity for depression and risky behaviors (assessed via polygenic risk scores; PRS) independently and jointly are associated with SA among urban, African Americans and whether sex differences exist in these relations. Participants (N = 1,157, 45.0% male) were originally recruited as part of two first grade universal school-based prevention trials. Participants reported in adolescence and young adulthood on whether they ever attempted suicide in their life. Depression and risky behaviors PRS were created based on large-scale genome-wide association studies conducted by Howard et al. (2019) and Karlson Línner et al. (2019), respectively. There was a significant interaction between the risky behavior PRS and depression PRS such that the combination of high risky behavior polygenic risk and low/moderate polygenic risk for depression was associated with greater risk for lifetime SA among the whole sample and African American males specifically. In addition, the risky behavior PRS was significantly positively associated with lifetime SA among African American males. These findings provide preliminary evidence regarding the importance of examining risky behavior and depression polygenic risk in relation to SA among African Americans, though replication of our findings in other African American samples is needed.
Collapse
Affiliation(s)
- Jill A. Rabinowitz
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Jin Jin
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Geoffrey Kahn
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Sally I.-Chun Kuo
- Department of Psychology, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Adrian Campos
- Department of Genetics and Computational Biology, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
| | - Miguel Rentería
- Department of Genetics and Computational Biology, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
| | - Kelly Benke
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Holly Wilcox
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Nicholas S. Ialongo
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Brion S. Maher
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Darlene Kertes
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - William Eaton
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - George Uhl
- New Mexico VA Health Care System, Las Vegas, Nevada, USA
| | - Barry M. Wagner
- Department of Psychology, Catholic University, Washington, District of Columbia, USA
| | - Daniel Cohen
- College of Education, The University of Alabama College of Education, Tuscaloosa, Alabama, USA
| |
Collapse
|
19
|
Clayton MG, Pollak OH, Owens SA, Miller AB, Prinstein MJ. Advances in Research on Adolescent Suicide and a High Priority Agenda for Future Research. JOURNAL OF RESEARCH ON ADOLESCENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR RESEARCH ON ADOLESCENCE 2021; 31:1068-1096. [PMID: 34820949 DOI: 10.1111/jora.12614] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Suicide is the second leading cause of death for adolescents in the United States, yet remarkably little is known regarding risk factors for suicidal thoughts and behaviors (STBs), relatively few federal grants and scientific publications focus on STBs, and few evidence-based approaches to prevent or treat STBs are available. This "decade in review" article discusses five domains of recent empirical findings that span biological, environmental, and contextual systems and can guide future research in this high priority area: (1) the role of the central nervous system; (2) physiological risk factors, including the peripheral nervous system; (3) proximal acute stress responses; (4) novel behavioral and psychological risk factors; and (5) broader societal factors impacting diverse populations and several additional nascent areas worthy of further investigation.
Collapse
|
20
|
Mukherjee S, Wei Z. Suicide disparities across metropolitan areas in the US: A comparative assessment of socio-environmental factors using a data-driven predictive approach. PLoS One 2021; 16:e0258824. [PMID: 34818324 PMCID: PMC8612572 DOI: 10.1371/journal.pone.0258824] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2020] [Accepted: 10/06/2021] [Indexed: 11/19/2022] Open
Abstract
Disparity in suicide rates across various metropolitan areas in the US is growing. Besides personal genomics and pre-existing mental health conditions affecting individual-level suicidal behaviors, contextual factors are also instrumental in determining region-/community-level suicide risk. However, there is a lack of quantitative approach to model the complex associations and interplays of the socio-environmental factors with the regional suicide rates. In this paper, we propose a holistic data-driven framework to model the associations of socio-environmental factors (demographic, socio-economic, and climate) with the suicide rates, and compare the key socio-environmental determinants of suicides across the large and medium/small metros of the vulnerable US states, leveraging a suite of advanced statistical learning algorithms. We found that random forest outperforms all the other models in terms of both in-sample goodness-of-fit and out-of-sample predictive accuracy, which is then used for statistical inferencing. Overall, our findings show that there is a significant difference in the relationships of socio-environmental factors with the suicide rates across the large and medium/small metropolitan areas of the vulnerable US states. Particularly, suicides in medium/small metros are more sensitive to socio-economic and demographic factors, while that in large metros are more sensitive to climatic factors. Our results also indicate that non-Hispanics, native Hawaiian or Pacific islanders, and adolescents aged 15-29 years, residing in the large metropolitan areas, are more vulnerable to suicides compared to those living in the medium/small metropolitan areas. We also observe that higher temperatures are positively associated with higher suicide rates, with large metros being more sensitive to such association compared to that of the medium/small metros. Our proposed data-driven framework underscores the future opportunities of using big data analytics in analyzing the complex associations of socio-environmental factors and inform policy actions accordingly.
Collapse
Affiliation(s)
- Sayanti Mukherjee
- Department of Industrial and Systems Engineering, University at Buffalo - The State University of New York, Buffalo, NY, United States of America
| | - Zhiyuan Wei
- Department of Industrial and Systems Engineering, University at Buffalo - The State University of New York, Buffalo, NY, United States of America
| |
Collapse
|
21
|
Mann JJ. Can Knowledge of Genetic and Environmental Causal Factors of Fatal and Nonfatal Suicidal Behavior Be Translated Into Better Prevention? Am J Psychiatry 2021; 178:994-997. [PMID: 34734746 DOI: 10.1176/appi.ajp.2021.21090913] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- J John Mann
- Division of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, andDepartment of Psychiatry, Columbia University, New York
| |
Collapse
|
22
|
DiBlasi E, Kang J, Docherty AR. Genetic contributions to suicidal thoughts and behaviors. Psychol Med 2021; 51:2148-2155. [PMID: 34030748 PMCID: PMC8477225 DOI: 10.1017/s0033291721001720] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Revised: 03/28/2021] [Accepted: 04/19/2021] [Indexed: 12/27/2022]
Abstract
Suicidal ideation, suicide attempt (SA) and suicide are significantly heritable phenotypes. However, the extent to which these phenotypes share genetic architecture is unclear. This question is of great relevance to determining key risk factors for suicide, and to alleviate the societal burden of suicidal thoughts and behaviors (STBs). To help address the question of heterogeneity, consortia efforts have recently shifted from a focus on suicide within the context of major psychopathology (e.g. major depressive disorder, schizophrenia) to suicide as an independent entity. Recent molecular studies of suicide risk by members of the Psychiatric Genomics Consortium and the International Suicide Genetics Consortium have identified genome-wide significant loci associated with SA and with suicide death, and have examined these phenotypes within and outside of the context of major psychopathology. This review summarizes important insights from epidemiological and biometrical research on suicide, and discusses key empirical findings from molecular genetic examinations of STBs. Polygenic risk scores for these phenotypes have been observed to be associated with case-control status and other risk phenotypes. In addition, estimated shared genetic covariance with other phenotypes suggests specific medical and psychiatric risks beyond major depressive disorder. Broadly, molecular studies suggest a complexity of suicide etiology that cannot simply be accounted for by depression. Discussion of the state of suicide genetics, a growing field, also includes important ethical and clinical implications of studying the genetic risk of suicide.
Collapse
Affiliation(s)
- Emily DiBlasi
- Department of Psychiatry & the Center for Genomic Medicine, University of Utah School of Medicine, Salt Lake City, UT, USA
- Huntsman Mental Health Institute, Salt Lake City, UT, USA
| | - Jooeun Kang
- Division of Genetic Medicine, Department of Medicine, Vanderbilt Genetics Institute, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Anna R. Docherty
- Department of Psychiatry & the Center for Genomic Medicine, University of Utah School of Medicine, Salt Lake City, UT, USA
- Huntsman Mental Health Institute, Salt Lake City, UT, USA
- Virginia Institute for Psychiatric & Behavioral Genetics, Virginia Commonwealth University School of Medicine, Richmond, VA, USA
| |
Collapse
|
23
|
Melhem NM, Zhong Y, Miller JM, Zanderigo F, Ogden RT, Sublette ME, Newell M, Burke A, Keilp JG, Lesanpezeshki M, Bartlett E, Brent DA, Mann JJ. Brain 5-HT1A Receptor PET Binding, Cortisol Responses to Stress, and the Familial Transmission of Suicidal Behavior. Int J Neuropsychopharmacol 2021; 25:36-45. [PMID: 34555145 PMCID: PMC8756092 DOI: 10.1093/ijnp/pyab060] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Revised: 07/22/2021] [Accepted: 10/04/2021] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND The serotonin 1A (5-HT1A) receptor has been implicated in depression and suicidal behavior. Lower resting cortisol levels are associated with higher 5-HT1A receptor binding, and both differentiate suicide attempters with depression. However, it is not clear whether 5-HT1A receptor binding and cortisol responses to stress are related to familial risk and resilience for suicidal behavior. METHODS [11C]CUMI-101 positron emission tomography imaging to quantify regional brain 5-HT1A receptor binding was conducted in individuals considered to be at high risk for mood disorder or suicidal behavior on the basis of having a first- or second-degree relative(s) with an early onset mood disorder and history of suicidal behavior. These high-risk individuals were subdivided into the following groups: high risk resilient having no mood disorder or suicidal behavior (n = 29); high risk with mood disorder and no suicidal behavior history (n = 31); and high risk with mood disorder and suicidal behavior (n = 25). Groups were compared with healthy volunteers without a family history of mood disorder or suicidal behavior (n = 34). Participants underwent the Trier Social Stress Task (TSST). All participants were free from psychotropic medications at the time of the TSST and PET scanning. RESULTS We observed no group differences in 5-HT1A receptor binding considering all regions simultaneously, nor did we observe heterogeneity of the effect of group across regions. These results were similar across outcome measures (BPND for all participants and BPp in a subset of the sample) and definitions of regions of interest (ROIs; standard or serotonin system-specific ROIs). We also found no group differences on TSST outcomes. Within the high risk with mood disorder and suicidal behavior group, lower BPp binding (β = -0.084, SE = 0.038, P = .048) and higher cortisol reactivity to stress (β = 9.25, 95% CI [3.27,15.23], P = .004) were associated with higher lethality attempts. There were no significant relationships between 5-HT1A binding and cortisol outcomes. CONCLUSIONS 5-HT1A receptor binding in ROIs was not linked to familial risk or resilience protecting against suicidal behavior or mood disorder although it may be related to lethality of suicide attempt. Future studies are needed to better understand the biological mechanisms implicated in familial risk for suicidal behavior and how hypothalamic-pituitary-adrenal axis function influences such risk.
Collapse
Affiliation(s)
- Nadine M Melhem
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, United States
- Correspondence: Nadine Melhem, PhD, 3811 O’Hara Street, Pittsburgh, PA 15213, USA ()
| | - Yongqi Zhong
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, United States
- Graduate School of Public Health, University of Pittsburgh
| | - Jeffrey M Miller
- Molecular Imaging and Neuropathology Area, New York State Psychiatric Institute, New York, New York, United States
- Department of Psychiatry, Columbia University, New York, New York, United States
| | - Francesca Zanderigo
- Molecular Imaging and Neuropathology Area, New York State Psychiatric Institute, New York, New York, United States
- Department of Psychiatry, Columbia University, New York, New York, United States
| | - R Todd Ogden
- Molecular Imaging and Neuropathology Area, New York State Psychiatric Institute, New York, New York, United States
- Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, New York, United States
| | - M Elizabeth Sublette
- Molecular Imaging and Neuropathology Area, New York State Psychiatric Institute, New York, New York, United States
- Department of Psychiatry, Columbia University, New York, New York, United States
| | - Madison Newell
- Molecular Imaging and Neuropathology Area, New York State Psychiatric Institute, New York, New York, United States
| | - Ainsley Burke
- Molecular Imaging and Neuropathology Area, New York State Psychiatric Institute, New York, New York, United States
- Department of Psychiatry, Columbia University, New York, New York, United States
| | - John G Keilp
- Molecular Imaging and Neuropathology Area, New York State Psychiatric Institute, New York, New York, United States
- Department of Psychiatry, Columbia University, New York, New York, United States
| | - Mohammad Lesanpezeshki
- Molecular Imaging and Neuropathology Area, New York State Psychiatric Institute, New York, New York, United States
- Department of Psychiatry, Columbia University, New York, New York, United States
| | - Elizabeth Bartlett
- Molecular Imaging and Neuropathology Area, New York State Psychiatric Institute, New York, New York, United States
- Department of Psychiatry, Columbia University, New York, New York, United States
| | - David A Brent
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, United States
| | - J John Mann
- Molecular Imaging and Neuropathology Area, New York State Psychiatric Institute, New York, New York, United States
- Department of Psychiatry, Columbia University, New York, New York, United States
| |
Collapse
|
24
|
Boussat ML, Fourcade L, Mourouvaye M, Grandclerc S, Moro MR, Lachal J. [Qualitative study of parents' experience after their teen's suicide attempt]. Encephale 2021; 48:390-396. [PMID: 34538622 DOI: 10.1016/j.encep.2021.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 04/23/2021] [Accepted: 05/11/2021] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Suicidal attempts are frequent during adolescence and concern the whole family, particularly parents whose role is crucial in provision of therapeutic support. Yet very few studies have been performed bearing on their lived experience. In this study, we will analyze the experience of parents after the suicidal attempt of their adolescent. PARTICIPANTS & METHODS Qualitative study based on semi-structured interviews of 13 parents of teenagers followed in child and adolescent psychiatry for suicidal behavior. Interview included 5 to 6 open and conversational questions. We analyzed interviews, after transcription, using the Interpretative Phenomenological Analysis approach. RESULTS The parents' wellness and behavior are directly affected by their child's mental status. When they are informed of the suicidal attempt, they feel very deep sadness, in a form of initial distress which is part of the grieving process regarding their image of idealized parents. They feel anger against the teenager, their anger is also directed against family members and close friends as well as against caregivers. Given the uncertainty, they doubt their own educative and empathetic competences, and lack confidence in their capacity for providing help. They express their need for help and support with regard to understanding their child's suicidal attempt, with regard to the emotional turmoil they experience and in reinforcing their competencies as carers. CONCLUSION It appears that parents are extremely touched by their teenager suicidal attempt. They need a personal follow up, including familial medical care but also a personal space of support. Parents group, as well as psycho educative intervention, are also welcomed to give efficient method to lift their child.
Collapse
Affiliation(s)
- M L Boussat
- APHP, Hôpital Cochin, Maison de Solenn, 75014 Paris, France
| | - L Fourcade
- APHP, Hôpital Necker, Department of Child and Adolescent Psychiatry, 75015 Paris, France
| | - M Mourouvaye
- APHP, Hôpital Necker, Department of Child and Adolescent Psychiatry, 75015 Paris, France
| | - S Grandclerc
- APHP, Hôpital Cochin, Maison de Solenn, 75014 Paris, France; Université Paris-Saclay, UVSQ, Inserm, CESP, Team DevPsy, 94807 Villejuif, France; Établissement public de santé mentale ERASME, pôle de psychiatrie de l'enfant et de l'adolescent, 92160 Antony, France
| | - M-R Moro
- APHP, Hôpital Cochin, Maison de Solenn, 75014 Paris, France; Université de Paris, PCPP, 92100 Boulogne-Billancourt, France; Université Paris-Saclay, UVSQ, Inserm, CESP, Team DevPsy, 94807 Villejuif, France
| | - J Lachal
- Université Paris-Saclay, UVSQ, Inserm, CESP, Team DevPsy, 94807 Villejuif, France; Service de Psychiatrie de l'Enfant et de l'Adolescent, CHU de Clermont-Ferrand, 63000 Clermont-Ferrand, France; Université Clermont Auvergne, 63000 Clermont-Ferrand, France.
| |
Collapse
|
25
|
Oquendo MA, Galfalvy HC, Choo TH, Kandlur R, Burke AK, Sublette ME, Miller JM, Mann JJ, Stanley BH. Highly variable suicidal ideation: a phenotypic marker for stress induced suicide risk. Mol Psychiatry 2021; 26:5079-5086. [PMID: 32576966 PMCID: PMC7755748 DOI: 10.1038/s41380-020-0819-0] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Revised: 05/31/2020] [Accepted: 06/10/2020] [Indexed: 11/24/2022]
Abstract
Suicidal behavior (SB) can be impulsive or methodical; violent or not; follow a stressor or no obvious precipitant. This study tested whether childhood trauma, affective lability, and aggressive and impulsive traits predicted greater SI variability. We also assessed whether affective lability, aggressive or impulsive traits explain childhood trauma's effects on SI variability and whether those with highly variable SI respond to stressful events with increases in SI. Finally, we assessed variable SI's trajectory over 2 years. Depressed participants (n = 51) had ecological momentary assessments (EMA) over 7 days at baseline, 3, 6, 12, 18, and 24 months. SI variability was assessed using the square Root of the Mean Square of Successive Deviations. Mixed Effects Models were fit as appropriate. Childhood trauma was associated with subsequent aggression. Physical abuse predicted both aggression and affective lability as well as SI variability, but not impulsivity. In two-predictor models, physical abuse's effect on SI variability was no longer significant, when controlling for the effect of higher aggression and impulsivity. Those with high SI variability exhibited greater increases in SI after stressors compared with those with less variability. We did not find that SI variability changed over time, suggesting it might be trait-like, at least over 2 years. Variable SI predisposes to marked SI increases after stressful events and may be a trait increasing risk for impulsive SB, at least over 2 years.
Collapse
Affiliation(s)
- Maria A Oquendo
- University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA, USA.
| | - Hanga C Galfalvy
- Columbia University, Vagelos College of Physicians and Surgeons, New York, NY, USA
| | - Tse-Hwei Choo
- Columbia University, Vagelos College of Physicians and Surgeons, New York, NY, USA
| | | | - Ainsley K Burke
- Columbia University, Vagelos College of Physicians and Surgeons, New York, NY, USA
| | - M Elizabeth Sublette
- Columbia University, Vagelos College of Physicians and Surgeons, New York, NY, USA
| | - Jeffrey M Miller
- Columbia University, Vagelos College of Physicians and Surgeons, New York, NY, USA
| | - J John Mann
- Columbia University, Vagelos College of Physicians and Surgeons, New York, NY, USA
| | - Barbara H Stanley
- Columbia University, Vagelos College of Physicians and Surgeons, New York, NY, USA
| |
Collapse
|
26
|
Lee YJ, Lee JY, Kim M. Parental Factors Related to Adolescent Girls' Suicide Attempts: A Cross-Sectional Study from 2015 to 2018. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18158122. [PMID: 34360417 PMCID: PMC8345805 DOI: 10.3390/ijerph18158122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 07/29/2021] [Accepted: 07/30/2021] [Indexed: 11/16/2022]
Abstract
Adolescent suicide is a serious global health concern. Although familial transmission of suicidal behaviors has been identified in previous research, the effects of parental gender remain unknown. This study identified the influence of parental suicidal behaviors on suicide attempts among adolescent girls. We collected data through a cross-sectional, nationwide, population-based survey in South Korea and evaluated data from 890 adolescent girls (aged 12–18 years) who had attempted suicide and their parents. Hierarchical logistic regression was used to analyze the risk factors related to suicide attempts among adolescent girls. The final model indicated that mothers’ suicidal plans and attempts (OR = 6.39, OR = 12.38, respectively) were important risk factors for suicide attempts in adolescent girls. Future studies should identify specific methods for effective prevention and treatment through path analysis of the related factors affecting suicidal behavior of adolescents according to their parents’ gender.
Collapse
Affiliation(s)
- Yeon-Jung Lee
- Department of Psychiatry, Soonchunhyang University Seoul Hospital, College of Medicine, Soonchunhyang University, Seoul 04401, Korea;
- Correspondence: ; Tel.: +82-2-709-9081
| | - Jin-Young Lee
- Department of Applied Statistics, Chung-Ang University, Seoul 06911, Korea;
| | - Minjae Kim
- Department of Psychiatry, Soonchunhyang University Seoul Hospital, College of Medicine, Soonchunhyang University, Seoul 04401, Korea;
| |
Collapse
|
27
|
Sheftall AH, Vakil F, Armstrong SE, Rausch JR, Feng X, Kerns KA, Brent DA, Bridge JA. Clinical risk factors, emotional reactivity/regulation and suicidal ideation in elementary school-aged children. J Psychiatr Res 2021; 138:360-365. [PMID: 33930615 PMCID: PMC8192478 DOI: 10.1016/j.jpsychires.2021.04.021] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 03/30/2021] [Accepted: 04/12/2021] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Suicidal behavior (SB) in young children is rare yet in 2019, suicide was the fifth leading cause of death in 5-12-year-old youth. Understanding the risks associated with childhood suicidal ideation (SI) and SB will determine which factors should be targeted for prevention programming. This study examined clinical characteristics and emotional reactivity/regulation (ERR) in children with (SI+) and without (SI-) SI. METHOD One hundred seventeen children, 6-9 years, and one biological parent were enrolled. Children completed interviews concerning SI/SB and parents completed interviews/self-reports about SI/SB, psychiatric distress, and history of abuse/neglect and their child's SI/SB, mental health, and ERR. Independent t-tests and Chi-square analyses using Bonferroni correction were conducted to examine SI group differences. Variables were then screened using forward stepwise logistic regression to determine association with SI + status. The final logistic regression included variables that survived screening procedures only. RESULTS Univariate analyses revealed SI + children were more likely to have a parental history of suicide attempt (PH+), higher rates of current psychotropic medication use, higher scores on the CBCL-DSM oriented scales (e.g., ADHD problems), and higher negative affect compared to SI- children. After analytic screening procedures, PH+, anxiety problems, ADHD problems, and anger survived. The final logistic regression revealed PH + status and anxiety problems were associated with SI + status. CONCLUSION Long-term follow-up is needed to determine if these factors are predictive of a first-time suicide attempt in this at-risk group.
Collapse
Affiliation(s)
- Arielle H Sheftall
- Center for Suicide Prevention and Research, The Abigail Wexner Research Institute, Nationwide Children's Hospital, USA; Department of Pediatrics, The Ohio State University, College of Medicine, USA.
| | - Fatima Vakil
- Center for Suicide Prevention and Research, The Abigail Wexner Research Institute, Nationwide Children's Hospital, USA
| | - Sarah E Armstrong
- Center for Suicide Prevention and Research, The Abigail Wexner Research Institute, Nationwide Children's Hospital, USA
| | - Joseph R Rausch
- Center for Suicide Prevention and Research, The Abigail Wexner Research Institute, Nationwide Children's Hospital, USA
| | - Xin Feng
- Department of Human Sciences, College of Education and Human Ecology, Ohio State University, USA
| | - Kathryn A Kerns
- Department of Psychological Sciences, Kent State University, USA
| | - David A Brent
- Department of Psychiatry, University of Pittsburgh Medical Center, Western Psychiatric Hospital, University of Pittsburgh School of Medicine, USA
| | - Jeffrey A Bridge
- Center for Suicide Prevention and Research, The Abigail Wexner Research Institute, Nationwide Children's Hospital, USA; Departments of Pediatrics and Psychiatry & Behavioral Health, Ohio State University College of Medicine, USA
| |
Collapse
|
28
|
Almeida VFD, Bezerra-Filho S, Studart-Bottó P, Léda-Rego G, Silva ITF, Kapczinski F, Miranda-Scippa Â. History of suicide attempts in patients with bipolar disorder type I: socio-demographic and clinical factors, quality of life and functioning. Nord J Psychiatry 2021; 75:306-313. [PMID: 33302763 DOI: 10.1080/08039488.2020.1853230] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
INTRODUCTION This study aims to evaluate sociodemographic and clinical factors, quality of life (QoL) and functioning associated with history of suicide attempts (SA) in a sample of bipolar disorder (BD) type I patients. METHODS A total of 417 BD type I patients, with and without history of SA were recruited from two Brazilian specialized Mood Disorder Centers. They were assessed with a sociodemographic and clinical questionnaire, the Young Mania Rating Scale, the Hamilton Depression Rating Scale, the Structured Clinical Interviews for DSM-IV Axis I Disorders, the World Health Organization Quality of Life-BREF, and the Sheehan Disability Scale. RESULTS One hundred and seventy-nine (42.9%) patients had a history of SA. There were no statistically significant sociodemographic differences between BD patients with and without a history of SA. Logistic regression found that lifetime hospitalization, comorbid anxiety disorders, depressive polarity in the first episode, current intensity of depressive symptoms, history of rapid cycling, family history of suicide and age at onset were significantly associated with SA in BD. Multiple linear regression showed that SA had no effect on QoL and functioning, which were affected mainly by comorbid anxiety disorders and current intensity of depressive symptoms, even in patients considered euthymic. CONCLUSION Suicidal behavior in patients with BD is a complex phenomenon and reflects a more severe course of illness. Patients with history of SA may have worse QoL and functional impairment not because of its direct effect, but because of the greater association with clinical factors related to poor prognosis.
Collapse
Affiliation(s)
| | | | - Paula Studart-Bottó
- Mood and Anxiety Disorders Program (CETHA), UFBA, Salvador, Brazil.,Postgraduate Program in Medicine and Health, UFBA, Salvador, Brazil
| | - Gabriela Léda-Rego
- Mood and Anxiety Disorders Program (CETHA), UFBA, Salvador, Brazil.,Postgraduate Program in Medicine and Health, UFBA, Salvador, Brazil
| | | | - Flávio Kapczinski
- Mood Disorders Program, Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Canada
| | - Ângela Miranda-Scippa
- Mood and Anxiety Disorders Program (CETHA), UFBA, Salvador, Brazil.,Postgraduate Program in Medicine and Health, UFBA, Salvador, Brazil.,Department of Neurosciences and Mental Health, Bahia Medical School, UFBA, Salvador, Brazil
| |
Collapse
|
29
|
A direct comparison of theory-driven and machine learning prediction of suicide: A meta-analysis. PLoS One 2021; 16:e0249833. [PMID: 33844698 PMCID: PMC8041204 DOI: 10.1371/journal.pone.0249833] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2020] [Accepted: 03/25/2021] [Indexed: 11/19/2022] Open
Abstract
Theoretically-driven models of suicide have long guided suicidology; however, an approach employing machine learning models has recently emerged in the field. Some have suggested that machine learning models yield improved prediction as compared to theoretical approaches, but to date, this has not been investigated in a systematic manner. The present work directly compares widely researched theories of suicide (i.e., BioSocial, Biological, Ideation-to-Action, and Hopelessness Theories) to machine learning models, comparing the accuracy between the two differing approaches. We conducted literature searches using PubMed, PsycINFO, and Google Scholar, gathering effect sizes from theoretically-relevant constructs and machine learning models. Eligible studies were longitudinal research articles that predicted suicide ideation, attempts, or death published prior to May 1, 2020. 124 studies met inclusion criteria, corresponding to 330 effect sizes. Theoretically-driven models demonstrated suboptimal prediction of ideation (wOR = 2.87; 95% CI, 2.65-3.09; k = 87), attempts (wOR = 1.43; 95% CI, 1.34-1.51; k = 98), and death (wOR = 1.08; 95% CI, 1.01-1.15; k = 78). Generally, Ideation-to-Action (wOR = 2.41, 95% CI = 2.21-2.64, k = 60) outperformed Hopelessness (wOR = 1.83, 95% CI 1.71-1.96, k = 98), Biological (wOR = 1.04; 95% CI .97-1.11, k = 100), and BioSocial (wOR = 1.32, 95% CI 1.11-1.58, k = 6) theories. Machine learning provided superior prediction of ideation (wOR = 13.84; 95% CI, 11.95-16.03; k = 33), attempts (wOR = 99.01; 95% CI, 68.10-142.54; k = 27), and death (wOR = 17.29; 95% CI, 12.85-23.27; k = 7). Findings from our study indicated that across all theoretically-driven models, prediction of suicide-related outcomes was suboptimal. Notably, among theories of suicide, theories within the Ideation-to-Action framework provided the most accurate prediction of suicide-related outcomes. When compared to theoretically-driven models, machine learning models provided superior prediction of suicide ideation, attempts, and death.
Collapse
|
30
|
Benczkowski T, Kostoroski C, Stabile M, Holler K. The Impact of Adverse Childhood Experiences (ACEs) on Suicidal Ideation and Suicide Attempts in an Inpatient Adolescent Sample. ADOLESCENT PSYCHIATRY 2021. [DOI: 10.2174/2210676611666210111094448] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Background:
Suicidal ideation (SI) and suicide attempts (SAs) among adolescents are a significant public health concern worldwide. The current study extends previous research by exploring the association between adverse childhood experiences (ACEs) and SI and SAs in a sample of inpatient adolescents as well as identifying specific predictors for increased risk of SI and SAs.
Methods:
Associations between ACE scores and self-reported SI and SAs were explored in a sample of 154 inpatient adolescents via clinical interview and by analyzing the association between cumulative ACE scores and scores on the Suicidal Tendency scale of a larger personality measure. We also tested for independent relationships between 19 ACEs and SI and SAs to determine unique predictors for suicidality.
Results:
One-way ANOVA analyses revealed that those who attempted suicide reported significantly more ACEs compared to those who did not attempt suicide. Witnessing violence in the home, school, or neighborhood and experiences of discrimination increased one’s likelihood to attempt suicide by two to threefold, while sexual abuse, neglect, and physical abuse increased this likelihood by three-to-fourfold. Stepwise linear regression analyses demonstrated that emotional abuse, living with someone who had mental health problems or attempted suicide were most associated with elevated Suicidal Tendency scores on a personality measure.
Conclusions:
Early identification, education and intervention are imperative to limit or eliminate ACEs from occurring. The impact of cumulative as well as specific ACEs on suicide risk should be closely considered as areas for such intervention. Areas for future research include extending to include more diverse populations such as the LGBTQ community as well as more ethnically and racially diverse populations.
Collapse
Affiliation(s)
| | | | - Mackenzie Stabile
- Department of Clinical Psychology, University of Connecticut, Storrs, CT, United States
| | | |
Collapse
|
31
|
Song W, Li H, Sun F, Guo T, Jiang S, Wang X. Pain Avoidance and Its Relation to Neural Response to Punishment Characterizes Suicide Attempters with Major Depression Disorder. Psychiatry Res 2020; 294:113507. [PMID: 33075650 DOI: 10.1016/j.psychres.2020.113507] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Accepted: 10/08/2020] [Indexed: 10/23/2022]
Abstract
Diminished neural responses to punitive stimulus related to high level of pain avoidance may be biomarkers in distinguishing patients with history of suicide attempts from those without such histories. Outpatients with Major Depression Disorder (MDD, n=44) and healthy controls (HCs, n=28) were administered the Beck Depression Inventory-I (BDI-I), the Three-Dimensional Psychological Pain Scale (TDPPS), and the Beck Scale for Suicide Ideation (BSS), and then patients were allocated to two groups: suicide attempts (MDD-SA, n=12) and suicidal ideation (MDD-SI, n=32). All participants were required to complete the measurements and performed the Monetary Incentive Delay (MID) task with recording of electroencephalography synchronously. The MDD-SA group scored higher in the BDI-I, total TDPPS, pain avoidance subscale, and BSS-W scores than the MDD-SI and healthy control groups. Pain avoidance subscale scores had the highest correlations with SA than other inventory scores. The P3 elicited by negative feedback under punitive condition was significantly larger than those of reward and neutral conditions in the MDD-SA group, whereas no significant differences were found between the MDD-SI and HC groups. The P3 elicited by punitive and reward cues was negatively correlated to the total TDPPS and pain avoidance scores, and the P3 elicited by positive feedback in reward and punitive conditions was negatively correlated to the total TDPPS and painful feeing scores. Pain avoidance is a strong behavioral index in distinguishing suicide attempters from suicide ideators. The P3 patterns elicited by punitive cue and feedback may represent psychological pain processing which contribute to suicide act.
Collapse
Affiliation(s)
- Wei Song
- Department of Psychology, Renmin University of China, Beijing, 100872, P.R China
| | - Huanhuan Li
- Department of Psychology, Renmin University of China, Beijing, 100872, P.R China.
| | - Fang Sun
- Department of Psychology, Renmin University of China, Beijing, 100872, P.R China
| | - Ting Guo
- Department of Psychology, Renmin University of China, Beijing, 100872, P.R China
| | - Songyuan Jiang
- Department of Psychology, Renmin University of China, Beijing, 100872, P.R China
| | - Xiang Wang
- Second Xiangya Hospital of Central South University
| |
Collapse
|
32
|
Sheftall AH, Bergdoll EE, James M, Bauer C, Spector E, Vakil F, Armstrong E, Allen J, Bridge JA. Emotion Regulation in Elementary School-Aged Children with a Maternal History of Suicidal Behavior: A Pilot Study. Child Psychiatry Hum Dev 2020; 51:792-800. [PMID: 32488436 PMCID: PMC7529823 DOI: 10.1007/s10578-020-01010-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Parental history of suicidal behavior is associated with an increased risk of early onset suicidal behavior in their offspring. The objective of this pilot study was to compare clinical characteristics, temperament, and emotion regulation in children, aged 6-9 years, with (PH+) and without (PH-) a maternal history of suicidal behavior to determine which factors could be markers of early vulnerability. At baseline, PH+ children, compared to PH- children, demonstrated more difficulties with temperament, emotion regulation, and experienced more life events in the year prior to their baseline appointment. At study follow-ups, however, no differences were found between PH+ and PH- children. Results suggest there are some signals of early vulnerability present in children with a maternal history of suicidal behavior and recruitment/retention of this group of youth is feasible.
Collapse
Affiliation(s)
- Arielle H Sheftall
- The Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH, USA.
- Department of Pediatrics at The Ohio State University College of Medicine, Columbus, OH, USA.
- Center for Suicide Prevention and Research, The Abigail Wexner Research Institute at Nationwide Children's Hospital, Big Lots Behavioral Health Pavilion, 2nd Floor, 444 Butterfly Gardens Dr, Columbus, OH, 43215, USA.
| | - Emory E Bergdoll
- Department of Counseling, Xavier University, Cincinnati, OH, USA
| | - Monaé James
- The Rutgers School of Public Health, New Brunswick, NJ, USA
| | - Connor Bauer
- The Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH, USA
| | | | - Fatima Vakil
- The Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH, USA
| | - Emily Armstrong
- The Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH, USA
| | - Jakob Allen
- John Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Jeffrey A Bridge
- The Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH, USA
- Departments of Pediatrics and Psychiatry & Behavioral Health at The Ohio State University College of Medicine, Columbus, OH, USA
| |
Collapse
|
33
|
Orri M, Geoffroy MC, Turecki G, Feng B, Brendgen M, Vitaro F, Dionne G, Paquin S, Galera C, Renaud J, Tremblay RE, Côté SM, Boivin M. Contribution of genes and environment to the longitudinal association between childhood impulsive-aggression and suicidality in adolescence. J Child Psychol Psychiatry 2020; 61:711-720. [PMID: 31782164 DOI: 10.1111/jcpp.13163] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/10/2019] [Indexed: 12/01/2022]
Abstract
BACKGROUND Population-based and family studies showed that impulsive-aggression predicts suicidality; however, the underlying etiological nature of this association is poorly understood. The objective was to determine the contribution of genes and environment to the association between childhood impulsive-aggression and serious suicidal ideation/attempt in young adulthood. METHODS N = 862 twins (435 families) from the Quebec Newborn Twin Study were followed up from birth to 20 years. Repeated measures of teacher-assessed impulsive-aggression were modeled using a genetically informed latent growth model including intercept and slope parameters reflecting individual differences in the baseline level (age 6 years) and in the change (increase/decrease) of impulsive-aggression during childhood (6 to 12 years), respectively. Lifetime suicidality (serious suicidal ideation/attempt) was self-reported at 20 years. Associations of impulsive-aggression intercept and slope with suicidality were decomposed into additive genetic (A) and unique environmental (E) components. RESULTS Additive genetic factors accounted for an important part of individual differences in impulsive-aggression intercept (A = 90%, E = 10%) and slope (A = 65%, E = 35%). Genetic (50%) and unique environmental (50%) factors equally contributed to suicidality. We found that 38% of the genetic factors accounting for suicidality were shared with those underlying impulsive-aggression slope, whereas 40% of the environmental factors accounting for suicidality were shared with those associated with impulsive-aggression intercept. The genetic correlation between impulsive-aggression slope and suicidality was 0.60, p = .027. CONCLUSIONS Genetic and unique environmental factors underlying suicidality significantly overlap with those underlying childhood impulsive-aggression. Future studies should identify putative genetic and environmental factors to inform prevention.
Collapse
Affiliation(s)
- Massimiliano Orri
- McGill Group for Suicide Studies, Douglas Mental Health University Institute, Department of Psychiatry, McGill University, Montréal, QC, Canada.,Bordeaux Population Health Research Centre, INSERM U1219, University of Bordeaux, Bordeaux, France
| | - Marie-Claude Geoffroy
- McGill Group for Suicide Studies, Douglas Mental Health University Institute, Department of Psychiatry, McGill University, Montréal, QC, Canada.,Department of Educational and Counselling Psychology, McGill University, Montréal, QC, Canada
| | - Gustavo Turecki
- McGill Group for Suicide Studies, Douglas Mental Health University Institute, Department of Psychiatry, McGill University, Montréal, QC, Canada
| | - Bei Feng
- School of Psychology, Université Laval, Québec City, QC, Canada
| | - Mara Brendgen
- Department of Psychology, Université du Québec à Montréal, Montréal, QC, Canada
| | - Frank Vitaro
- School of Psychoéducation, University of Montréal, Montréal, QC, Canada
| | - Ginette Dionne
- School of Psychoéducation, University of Montréal, Montréal, QC, Canada
| | - Stephane Paquin
- School of Psychology, Université Laval, Québec City, QC, Canada.,Department of Sociology, University of Montréal, Montréal, Montréal, QC, Canada
| | - Cedric Galera
- Bordeaux Population Health Research Centre, INSERM U1219, University of Bordeaux, Bordeaux, France
| | - Johanne Renaud
- McGill Group for Suicide Studies, Douglas Mental Health University Institute, Department of Psychiatry, McGill University, Montréal, QC, Canada.,Manulife Centre for Breakthroughs in Teen Depression and Suicide Prevention, Montréal, QC, Canada
| | - Richard E Tremblay
- Department of Pediatrics and Psychology, University of Montréal, Montréal, QC, Canada.,School of Public Health, University College Dublin, Dublin, Ireland
| | - Sylvana M Côté
- Department of Social and Preventive Medicine, University of Montréal, Montréal, QC, Canada
| | - Michel Boivin
- School of Psychology, Université Laval, Québec City, QC, Canada
| |
Collapse
|
34
|
Psychosocial risk factors and outcomes associated with suicide attempts in childhood: A retrospective study. J Psychiatr Res 2020; 125:129-135. [PMID: 32278224 PMCID: PMC7217666 DOI: 10.1016/j.jpsychires.2020.03.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2019] [Revised: 03/04/2020] [Accepted: 03/13/2020] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To examine factors differentiating individuals whose first suicide attempt was during childhood (ages 5-12 yrs) from those who first attempted suicide during adolescence (13-19 yrs) and during adulthood (≥20 yrs). METHOD A sample of 418 participants (ages 18-64 yrs) with a mood disorder and ≥1 lifetime suicide attempt was divided into three groups according to age of first suicide attempt (childhood: N = 43, adolescent: N = 149, adulthood: N = 226) and compared on demographics, childhood adversity, parental psychopathology, comorbid lifetime axis I diagnoses, self-harm and characteristics of first attempt. RESULTS Participants in the Childhood Attempt group were more likely to report childhood adversity, parental alcohol use disorder and subsequent suicide attempts than the two other groups. They were also more likely to have a depressed mother, non-suicidal self-injury (NSSI) during childhood and adolescence, lifetime PTSD and aggressive behavior than the Adulthood Attempt group. The Adolescent Attempt group had more childhood adversity, parental suicidal behavior, lifetime PTSD and NSSI during adolescence than the Adulthood Attempt group. The groups differed on methods of first attempt, and its lethality was related to age of attempt. CONCLUSIONS Early adversity and parental psychopathology are particularly prominent in those who make childhood suicide attempts, suggesting that this group may represent a suicidal behavior subtype.
Collapse
|
35
|
O'Reilly LM, Kuja-Halkola R, Rickert ME, Class QA, Larsson H, Lichtenstein P, D'Onofrio BM. The intergenerational transmission of suicidal behavior: an offspring of siblings study. Transl Psychiatry 2020; 10:173. [PMID: 32474571 PMCID: PMC7261287 DOI: 10.1038/s41398-020-0850-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Revised: 04/21/2020] [Accepted: 05/01/2020] [Indexed: 11/09/2022] Open
Abstract
We examined the extent to which genetic factors shared across generations, measured covariates, and environmental factors associated with parental suicidal behavior (suicide attempt or suicide) account for the association between parental and offspring suicidal behavior. We used a Swedish cohort of 2,762,883 offspring born 1973-2001. We conducted two sets of analyses with offspring of half- and full-siblings: (1) quantitative behavior genetic models analyzing maternal suicidal behavior and (2) fixed-effects Cox proportional hazard models analyzing maternal and paternal suicidal behavior. The analyses also adjusted for numerous measured covariates (e.g., parental severe mental illness). Quantitative behavior genetic analyses found that 29.2% (95% confidence interval [CI], 5.29, 53.12%) of the intergenerational association was due to environmental factors associated with exposure to maternal suicidal behavior, with the remainder due to genetic factors. Statistical adjustment for parental behavioral health problems partially attenuated the environmental association; however, the results were no longer statistically significant. Cox hazard models similarly found that offspring were at a 2.74-fold increased risk [95% CI, 2.67, 2.83]) of suicidal behavior if their mothers attempted/died by suicide. After adjustment for familial factors and measured covariates, associations attenuated but remained elevated for offspring of discordant half-siblings (HR, 1.57 [95% CI, 1.45, 1.71]) and full-siblings (HR, 1.62 [95% CI, 1.57, 1.67]). Cox hazard models demonstrated a similar pattern between paternal and offspring suicidal behavior. This study found that the intergenerational transmission of suicidal behavior is largely due to shared genetic factors, as well as factors associated with parental behavioral health problems and environmental factors associated with parental suicidal behavior.
Collapse
Affiliation(s)
| | | | | | | | - Henrik Larsson
- Karolinska Institutet, Solna, Sweden
- Örebro University, Örebro, Sweden
| | | | - Brian M D'Onofrio
- Indiana University, Bloomington, IN, USA
- Karolinska Institutet, Solna, Sweden
| |
Collapse
|
36
|
O'Reilly LM, Pettersson E, Quinn PD, Klonsky ED, Lundström S, Larsson H, Lichtenstein P, D'Onofrio BM. The association between general childhood psychopathology and adolescent suicide attempt and self-harm: A prospective, population-based twin study. JOURNAL OF ABNORMAL PSYCHOLOGY 2020; 129:364-375. [PMID: 32271026 PMCID: PMC7179089 DOI: 10.1037/abn0000512] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Few quantitative behavior genetic studies have examined why psychopathology is associated with suicide attempt (SA) and self-harm (SH) in adolescence. The present study analyzed data from the Child and Adolescent Twin Study in Sweden to examine the extent to which genetic and environmental factors explain SA/SH and its association with psychopathology in childhood, an often-cited risk factor of subsequent SA/SH. When children were 9 or 12 years old (n = 30,444), parents completed the Autism-Tics, AD/HD and other Comorbidities Inventory (Larson et al., 2010) regarding their children's psychiatric problems as part of an ongoing, longitudinal study. At age 18 years (n = 10,269), adolescents completed self-report questionnaires, including SA/SH assessments. In a bifactor model of childhood psychopathology, a general factor of psychopathology was a statistically significant predictor of adolescent SA/SH at a higher magnitude (β, 0.25, 95% confidence interval [CI; 0.15, 0.34] for suicide attempt), as compared with specific factors of inattention, impulsivity, oppositional behavior, and anxiety/emotion symptoms. Quantitative genetic modeling indicated that the additive genetic influences on the general factor accounted for the association with each outcome (β, 0.24, 95% CI [0.13, 0.34] for suicide attempt). The results remained virtually identical when we fit a higher order factors model. Two additional outcomes demonstrated comparable results. The results extend current literature by revealing the shared genetic overlap between general psychopathology during childhood and adolescent SA/SH. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
Collapse
|
37
|
McManimen S, Wong MM. Prospective Investigation of the Interaction Between Social Problems and Neuropsychological Characteristics on the Development of Suicide Ideation. Suicide Life Threat Behav 2020; 50:545-557. [PMID: 31799701 PMCID: PMC7426060 DOI: 10.1111/sltb.12608] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Accepted: 10/18/2019] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Negative social interactions are known to contribute to the development of suicide ideation. However, it is unclear how this risk factor interacts with other predisposing risk factors. The purpose of this study was to determine how social and neuropsychological factors interact as a prospective predictor of the emergence of suicide ideation in adolescents. METHOD Data were collected from adolescents (M age = 13.12, SD = 1.48) over 3 years as part of a larger study. Participants completed the MINI-Kid and Youth Self-Report, which were used to assess for suicidality. Negative social interactions were operationalized as the Social Problems scale of the YSR. Additionally, adolescents completed a neuropsychological battery at each wave of data collection. RESULTS Logistic moderation analyses demonstrated a significant interaction between task switching and endorsement of negative social interactions in the prediction of suicide ideation one year later, Wald χ2 (1) = 4.94, OR = 0.90, p < .05. Distractibility was a significant predictor, Wald χ2 (1) = 5.52, OR = 3.45, p < .05, but it did not demonstrate an interaction effect. Perseveration failed to reach statistical significance independently and in the interaction. CONCLUSIONS The results indicate that certain neuropsychological characteristics can aid in predicting which adolescents will develop suicide ideation in the presence of negative social interactions, which may have significant clinical implications.
Collapse
Affiliation(s)
- Stephanie McManimen
- Department of Psychology, Idaho State University, Pocatello, United States of America,Corresponding author: Idaho State University, 921 S 8 Ave, Stop 8112, Pocatello, Idaho 83209,
| | - Maria M. Wong
- Department of Psychology, Idaho State University, Pocatello, United States of America
| |
Collapse
|
38
|
Hill NTM, Robinson J, Pirkis J, Andriessen K, Krysinska K, Payne A, Boland A, Clarke A, Milner A, Witt K, Krohn S, Lampit A. Association of suicidal behavior with exposure to suicide and suicide attempt: A systematic review and multilevel meta-analysis. PLoS Med 2020; 17:e1003074. [PMID: 32231381 PMCID: PMC7108695 DOI: 10.1371/journal.pmed.1003074] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Accepted: 02/21/2020] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Exposure to suicidal behavior may be associated with increased risk of suicide, suicide attempt, and suicidal ideation and is a significant public health problem. However, evidence to date has not reliably distinguished between exposure to suicide versus suicide attempt, nor whether the risk differs across suicide-related outcomes, which have markedly different public health implications. Our aim therefore was to quantitatively assess the independent risk associated with exposure to suicide and suicide attempt on suicide, suicide attempt, and suicidal ideation outcomes and to identify moderators of this risk using multilevel meta-analysis. METHODS AND FINDINGS We systematically searched MEDLINE, Embase, PsycINFO, CINAHL, ASSIA, Sociological Abstracts, IBSS, and Social Services Abstracts from inception to 19 November 2019. Eligible studies included comparative data on prior exposure to suicide, suicide attempt, or suicidal behavior (composite measure-suicide or suicide attempt) and the outcomes of suicide, suicide attempt, and suicidal ideation in relatives, friends, and acquaintances. Dichotomous events or odds ratios (ORs) of suicide, suicide attempt, and suicidal ideation were analyzed using multilevel meta-analyses to accommodate the non-independence of effect sizes. We assessed study quality using the National Heart, Lung, and Blood Institute quality assessment tool for observational studies. Thirty-four independent studies that presented 71 effect sizes (exposure to suicide: k = 42, from 22 independent studies; exposure to suicide attempt: k = 19, from 13 independent studies; exposure to suicidal behavior (composite): k = 10, from 5 independent studies) encompassing 13,923,029 individuals were eligible. Exposure to suicide was associated with increased odds of suicide (11 studies, N = 13,464,582; OR = 3.23, 95% CI = 2.32 to 4.51, P < 0.001) and suicide attempt (10 studies, N = 121,836; OR = 2.91, 95% CI = 2.01 to 4.23, P < 0.001). However, no evidence of an association was observed for suicidal ideation outcomes (2 studies, N = 43,354; OR = 1.85, 95% CI = 0.97 to 3.51, P = 0.06). Exposure to suicide attempt was associated with increased odds of suicide attempt (10 studies, N = 341,793; OR = 3.53, 95% CI = 2.63 to 4.73, P < 0.001), but not suicide death (3 studies, N = 723; OR = 1.64, 95% CI = 0.90 to 2.98, P = 0.11). By contrast, exposure to suicidal behavior (composite) was associated with increased odds of suicide (4 studies, N = 1,479; OR = 3.83, 95% CI = 2.38 to 6.17, P < 0.001) but not suicide attempt (1 study, N = 666; OR = 1.10, 95% CI = 0.69 to 1.76, P = 0.90), a finding that was inconsistent with the separate analyses of exposure to suicide and suicide attempt. Key limitations of this study include fair study quality and the possibility of unmeasured confounders influencing the findings. The review has been prospectively registered with PROSPERO (CRD42018104629). CONCLUSIONS The findings of this systematic review and meta-analysis indicate that prior exposure to suicide and prior exposure to suicide attempt in the general population are associated with increased odds of subsequent suicidal behavior, but these exposures do not incur uniform risk across the full range of suicide-related outcomes. Therefore, future studies should refrain from combining these exposures into single composite measures of exposure to suicidal behavior. Finally, future studies should consider designing interventions that target suicide-related outcomes in those exposed to suicide and that include efforts to mitigate the adverse effects of exposure to suicide attempt on subsequent suicide attempt outcomes.
Collapse
Affiliation(s)
- Nicole T. M. Hill
- Orygen, Centre for Youth Mental Health, University of Melbourne, Parkville, Victoria, Australia
- Telethon Kids Institute, Perth, Western Australia, Australia
| | - Jo Robinson
- Orygen, Centre for Youth Mental Health, University of Melbourne, Parkville, Victoria, Australia
| | - Jane Pirkis
- Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Parkville, Victoria, Australia
| | - Karl Andriessen
- Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Parkville, Victoria, Australia
| | - Karolina Krysinska
- Orygen, Centre for Youth Mental Health, University of Melbourne, Parkville, Victoria, Australia
| | - Amber Payne
- Orygen, Centre for Youth Mental Health, University of Melbourne, Parkville, Victoria, Australia
- Northeastern University, Boston, Massachusetts, United States of America
| | - Alexandra Boland
- Orygen, Centre for Youth Mental Health, University of Melbourne, Parkville, Victoria, Australia
| | - Alison Clarke
- Orygen, Centre for Youth Mental Health, University of Melbourne, Parkville, Victoria, Australia
| | - Allison Milner
- Centre for Health Equity, School of Population and Global Health, University of Melbourne, Parkville, Victoria, Australia
| | - Katrina Witt
- Orygen, Centre for Youth Mental Health, University of Melbourne, Parkville, Victoria, Australia
| | - Stephan Krohn
- Department of Neurology, Charité–Universitätsmedizin Berlin, Berlin, Germany
- Berlin School of Mind and Brain, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Amit Lampit
- Department of Neurology, Charité–Universitätsmedizin Berlin, Berlin, Germany
- Berlin School of Mind and Brain, Humboldt-Universität zu Berlin, Berlin, Germany
- Department of Psychiatry, University of Melbourne, Parkville, Victoria, Australia
| |
Collapse
|
39
|
de Souza ALP, Segolin BW, Pessanha PB, Abreu TQDA, Mino YEE, de Freitas FAC, Botti NCL. Characterization of suicidal behavior among children in a depressive episode: case series study. TRENDS IN PSYCHIATRY AND PSYCHOTHERAPY 2020; 41:394-400. [PMID: 31967198 DOI: 10.1590/2237-6089-2018-0111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Accepted: 04/07/2019] [Indexed: 11/21/2022]
Abstract
INTRODUCTION Child suicidal behavior is related to specific childhood variations, constituting risk factors, including predisposing factors, internal factors, and environmental factors. OBJECTIVE To characterize suicidal behavior among children aged 5 to 12 years diagnosed with a depressive episode. METHODS Fifteen participants, aged 5 to 12, were assessed at a child and adolescent mental health center in Belo Horizonte, state of Minas Gerais, Brazil. All participants had a history of suicide attempt and were in a depressive episode at the time of assessment. RESULTS Vulnerabilities related to the children themselves were self-harm, aggression, loss of an important family figure, sexual abuse, sexuality disorders, use of alcohol or other drugs, and ill-treatment. Factors of family structure and dynamics found were psychiatric illness in family members, family conflict or violence, abandonment or rejection, history of suicidal behavior in family, parents users of alcohol and other drugs, and separated parents. Factors related to school were bullying, school difficulties/delays, high school performance, bad behavior, physical aggression, school dropout, and aggressiveness. The main methods used in suicide attempts were injury by sharp or blunt objects and intentional self-poisoning. CONCLUSIONS Psychiatric comorbidities and a previous history of disturbances in the family and at school are important factors to consider with relation to suicidal behavior by children with depressive episodes.
Collapse
Affiliation(s)
| | | | - Paula Bedim Pessanha
- Faculdade de Medicina, Universidade Federal de São João del Rei (UFSJ), Divinópolis, MG, Brazil
| | | | - Yasmin Emi Enemu Mino
- Faculdade de Medicina, Universidade Federal de São João del Rei (UFSJ), Divinópolis, MG, Brazil
| | - Filipe Augusto Cursino de Freitas
- Programa de Residência Médica em Psiquiatria da Infância e Adolescência, Centro Psíquico da Adolescência e Infância (CEPAI/FHEMIG), Belo Horizonte, MG, Brazil
| | - Nadja Cristiane Lappann Botti
- Programa de Pós-Graduação Mestrado e Residência Multiprofissional em Saúde do Adolescente, UFSJ, Divinópolis, MG, Brazil
| |
Collapse
|
40
|
Genome-wide association studies identify polygenic effects for completed suicide in the Japanese population. Neuropsychopharmacology 2019; 44:2119-2124. [PMID: 31476763 PMCID: PMC6887868 DOI: 10.1038/s41386-019-0506-5] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Revised: 08/07/2019] [Accepted: 08/24/2019] [Indexed: 12/02/2022]
Abstract
Suicide is a significant public health problem worldwide, and several Asian countries including Japan have relatively high suicide rates on a world scale. Twin, family, and adoption studies have suggested high heritability for suicide, but genetics lags behind due to difficulty in obtaining samples from individuals who died by suicide, especially in non-European populations. In this study, we carried out genome-wide association studies combining two independent datasets totaling 746 suicides and 14,049 non-suicide controls in the Japanese population. Although we identified no genome-wide significant single-nucleotide polymorphisms (SNPs), we demonstrated significant SNP-based heritability (35-48%; P < 0.001) for completed suicide by genomic restricted maximum-likelihood analysis and a shared genetic risk between two datasets (Pbest = 2.7 × 10-13) by polygenic risk score analysis. This study is the first genome-wide association study for suicidal behavior in an East Asian population, and our results provided the evidence of polygenic architecture underlying completed suicide.
Collapse
|
41
|
Abstract
Although recent years have seen large decreases in the overall global rate of suicide fatalities, this trend is not reflected everywhere. Suicide and suicidal behaviour continue to present key challenges for public policy and health services, with increasing suicide deaths in some countries such as the USA. The development of suicide risk is complex, involving contributions from biological (including genetics), psychological (such as certain personality traits), clinical (such as comorbid psychiatric illness), social and environmental factors. The involvement of multiple risk factors in conveying risk of suicide means that determining an individual's risk of suicide is challenging. Improving risk assessment, for example, by using computer testing and genetic screening, is an area of ongoing research. Prevention is key to reduce the number of suicide deaths and prevention efforts include universal, selective and indicated interventions, although these interventions are often delivered in combination. These interventions, combined with psychological (such as cognitive behavioural therapy, caring contacts and safety planning) and pharmacological treatments (for example, clozapine and ketamine) along with coordinated social and public health initiatives, should continue to improve the management of individuals who are suicidal and decrease suicide-associated morbidity.
Collapse
|
42
|
Brent DA, Hur K, Gibbons RD. Association Between Parental Medical Claims for Opioid Prescriptions and Risk of Suicide Attempt by Their Children. JAMA Psychiatry 2019; 76:941-947. [PMID: 31116357 PMCID: PMC6537764 DOI: 10.1001/jamapsychiatry.2019.0940] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
IMPORTANCE The rate of youth suicide has increased over the past 15 years in the United States as has the rate of death due to opioid overdose in adults of parental age. OBJECTIVE To explore the possible connection between parental use of prescription opioids and the increasing rate of youth suicide. DESIGN, SETTING, AND PARTICIPANTS A pharmacoepidemiologic study was conducted from January 1, 2010, to December 31, 2016, linking medical claims for parental opioid prescriptions with medical claims for suicide attempts by their children. The study used MarketScan medical claims data covering more than 150 million privately insured people in the United States. The study included 121 306 propensity score-matched 30- to 50-year-old parents who used opioids and parents who did not use opioids and their 10- to 19-year-old children (148 395 children of parents who did not use opioids and 184 142 children of parents who used opioids). Propensity score matching was used to identify relevant control families based on demographic features and concomitant use of psychotropic medication. EXPOSURES Opioid use in a parent was defined as having prescription fills covering more than 365 days of an opioid between 2010 and 2016. MAIN OUTCOMES AND MEASURES Suicide attempt rate in the children of parents who used opioids and those who did not use opioids. RESULTS A total of 148 395 children (75 575 sons and 72 820 daughters; mean [SD] age, 11.5 [1.6] years at the start of follow-up) had parents who did not use opioids and 184 142 children (94 502 sons and 89 640 daughters; mean [SD] age, 11.8 [1.8] years at the start of follow-up) with parents who did use opioids. There were 100 899 children aged 10 to 14 years and 47 496 children aged 15 to 19 years with parents who did not use opioids and 96 975 children aged 10 to 14 years and 87 163 children aged 15 to 19 years with parents who did use opioids. Of the children with parents who did not use opioids, 212 (0.14%) attempted suicide; of the children with parents who did use opioids, 678 (0.37%) attempted suicide. Parental use of opioids was associated with a doubling of the risk of a suicide attempt by their offspring (odds ratio [OR], 1.99; 95% CI, 1.71-2.33). The association remained significant after adjusting for child age and sex (OR, 1.85; 95% CI, 1.58-2.17), addition of child and parental depression and diagnoses of substance use disorder (OR, 1.46; 95% CI, 1.24-1.72), and addition of parental history of suicide attempt (OR, 1.45; 95% CI, 1.23-1.71). Geographical variation in opioid use did not change the association (OR, 2.00; 95% CI, 1.71-2.34). CONCLUSIONS AND RELEVANCE Children of parents who use prescription opioids are at increased risk for suicide attempts, which could be a contributing factor to the time trend in adolescent suicidality. The care of families with a parent who uses opioids should include mental health screening of their children.
Collapse
Affiliation(s)
- David A. Brent
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Kwan Hur
- Center for Health Statistics, University of Chicago, Chicago, Illinois
| | - Robert D. Gibbons
- Center for Health Statistics, University of Chicago, Chicago, Illinois,Department of Medicine, University of Chicago, Chicago, Illinois,Department of Public Health Sciences, University of Chicago, Chicago, Illinois
| |
Collapse
|
43
|
Radde S, Gutwinski S, Stuke F, Fuchs A, Schouler-Ocak M, Bermpohl F, Henssler J. [Suicidal tendencies in adolescence : Dysfunctional familiar communication as risk factor]. DER NERVENARZT 2019; 89:1254-1261. [PMID: 29872879 DOI: 10.1007/s00115-018-0549-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
BACKGROUND Suicide is one of the four most common causes of death in adolescence worldwide. Although it is well known that suicidal people often have insufficient communication strategies, the importance of family communication for adolescent suicidality has not yet been sufficiently explored. OBJECTIVE The aim of this study was to provide a systematic review of family communication as a risk factor for adolescent suicidal tendencies and to develop treatment recommendations. METHODS In this study a systematic literature search was conducted in PubMed, Embase, CENTRAL and PsychINFO. The methodological quality of the studies was evaluated and a summary prepared. RESULT A total of 195 studies were extracted and screened for their suitability. Of these studies, 7 which examined a total of 13,107 adolescents aged 11-22 years were included in this review and critically evaluated. Of the studies evaluated six found a correlative relationship between dysfunctional parent-child communication and adolescent suicidality. Communication with the mother appears to be more essential. CONCLUSION The results of this literature search indicate that functional communication with parents seems to be protective for suicidal adolescents. From this, recommendations can be derived for preventive measures in families with adolescents who are otherwise at increased risk of suicide. Longitudinal study designs are needed to conclusively answer the research question.
Collapse
Affiliation(s)
- S Radde
- St. Hedwig-Krankenhaus, Tagesklinik Wedding, Psychiatrische Universitätsklinik der Charité, Müllerstraße 56-58, 13349, Berlin, Deutschland.
| | - S Gutwinski
- St. Hedwig-Krankenhaus, Tagesklinik Wedding, Psychiatrische Universitätsklinik der Charité, Müllerstraße 56-58, 13349, Berlin, Deutschland
| | - F Stuke
- St. Hedwig-Krankenhaus, Tagesklinik Wedding, Psychiatrische Universitätsklinik der Charité, Müllerstraße 56-58, 13349, Berlin, Deutschland
| | - A Fuchs
- Klinik für Kinder- und Jugendpsychiatrie, Zentrum für Psychosoziale Medizin, Universitätsklinikum Heidelberg, Heidelberg, Deutschland
| | - M Schouler-Ocak
- St. Hedwig-Krankenhaus, Tagesklinik Wedding, Psychiatrische Universitätsklinik der Charité, Müllerstraße 56-58, 13349, Berlin, Deutschland
| | - F Bermpohl
- St. Hedwig-Krankenhaus, Tagesklinik Wedding, Psychiatrische Universitätsklinik der Charité, Müllerstraße 56-58, 13349, Berlin, Deutschland
| | - J Henssler
- St. Hedwig-Krankenhaus, Tagesklinik Wedding, Psychiatrische Universitätsklinik der Charité, Müllerstraße 56-58, 13349, Berlin, Deutschland
| |
Collapse
|
44
|
Ballard ED, Cui L, Vandeleur C, Castelao E, Zarate CA, Preisig M, Merikangas KR. Familial Aggregation and Coaggregation of Suicide Attempts and Comorbid Mental Disorders in Adults. JAMA Psychiatry 2019; 76:826-833. [PMID: 30916728 PMCID: PMC6583867 DOI: 10.1001/jamapsychiatry.2019.0248] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
IMPORTANCE Clarification of the joint influence of familial patterns of suicide attempts and comorbid mental disorders can enhance the understanding and prevention of suicide attempts. OBJECTIVE To investigate the familial patterns of suicide attempts and comorbid mental disorders and their associations in a 2-site family study of mood and anxiety disorders. DESIGN, SETTING, AND PARTICIPANTS Data were obtained from 2 parallel community-based family studies conducted in the United States (National Institute of Mental Health [NIMH] study) and in Lausanne, Switzerland (PsyCoLaus study), on the comorbidity of mood and anxiety disorders. The study sample comprised 1119 adult probands and 5355 first-degree relatives. Data were collected and analyzed from October 2004 to December 2016. MAIN OUTCOMES AND MEASURES Lifetime suicide attempt and mental disorders in first-degree relatives, obtained through direct interviews or family history reports. RESULTS The study included 1119 adult probands (675 female [60.3%] and a mean [SD] age of 50 [12.0] years) and 5355 first-degree relatives (2752 female [51.4%] and a mean [SD] age of 52 [1.5] years). Of these participants, 90 (8.0%) of 1119 probands and 199 (3.7%) of 5355 relatives had a lifetime history of suicide attempt. Those with such a history had higher rates of all mental disorders, a greater number of disorders, and statistically significantly poorer current and lifetime global functioning. After adjustment for age and sex, a statistically significant association between suicide attempts in probands and in relatives was found at the NIMH site (OR, 2.6; 95% CI, 1.5-4.7), at the Lausanne site (OR, 3.1; 95% CI, 1.6-6.0), and in the combined data (OR, 2.9; 95% CI, 1.9-4.5). All mood disorder subtypes and substance use disorders were statistically significantly associated with suicide attempts. The familial association between lifetime suicide attempts in probands and relatives was not statistically significant for the combined sample (OR, 1.6; 95% CI, 1.0-2.7) after adjustment for comorbid conditions in probands and relatives. Social anxiety disorder in probands was associated with suicide attempts in relatives (OR, 2.4; 95% CI, 1.7-3.5) after controlling for comorbid mood, anxiety, and substance use disorders. CONCLUSIONS AND RELEVANCE Familiality of suicide attempts appears to be explained by a history of mental disorders among those with suicide attempts; the novel finding of a common familial diathesis for suicide attempts and social anxiety, particularly in combination with mood disorders, has heuristic value for future research and may be a risk marker that can inform prevention efforts.
Collapse
Affiliation(s)
- Elizabeth D. Ballard
- Experimental Therapeutics & Pathophysiology Branch, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland
| | - Lihong Cui
- Genetic Epidemiology Research Branch, Intramural Research Program, National Institute of Mental Health, Bethesda, Maryland
| | - Caroline Vandeleur
- Department of Psychiatry, University Hospital of Lausanne, Lausanne, Switzerland
| | - Enrique Castelao
- Department of Psychiatry, University Hospital of Lausanne, Lausanne, Switzerland
| | - Carlos A. Zarate
- Experimental Therapeutics & Pathophysiology Branch, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland
| | - Martin Preisig
- Department of Psychiatry, University Hospital of Lausanne, Lausanne, Switzerland
| | - Kathleen Ries Merikangas
- Genetic Epidemiology Research Branch, Intramural Research Program, National Institute of Mental Health, Bethesda, Maryland
| |
Collapse
|
45
|
Characteristics of Child Psychiatric Outpatients at Highest Risk for Suicidal Thoughts and Behaviors. Child Psychiatry Hum Dev 2019; 50:505-519. [PMID: 30656508 DOI: 10.1007/s10578-018-0858-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
On average, compared to non-referred youth, child psychiatric outpatients show elevated rates of suicidal thoughts and behaviors (STBs), which are predictors of completed suicide. Determining the psychopathology features that associate with highest risk for STBs among youth outpatients may yield opportunities for targeted prevention/intervention. Yet, outpatient studies are limited and have not systematically examined comorbidity and dimensional psychopathology. In 758 youth, aged 6-18, consecutively referred for neuropsychiatric evaluation, we examined the extent to which diagnostic groups, comorbid subgroups and dimensional symptoms associated with STBs. After controlling for comorbidity, mood, anxiety and conduct disorders associated with elevated STB risk. Regarding dimensions, symptoms of depression, aggression and psychosis all contributed to higher STB risk. Although ADHD (as a diagnosis or dimension) did not associate with elevated STB risk independently, ADHD that was comorbid with other conditions did. Suicide prevention/intervention efforts should be investigated in youth outpatients with the highest risk for STBs.
Collapse
|
46
|
Melhem NM, Porta G, Oquendo MA, Zelazny J, Keilp JG, Iyengar S, Burke A, Birmaher B, Stanley B, Mann JJ, Brent DA. Severity and Variability of Depression Symptoms Predicting Suicide Attempt in High-Risk Individuals. JAMA Psychiatry 2019; 76:603-613. [PMID: 30810713 PMCID: PMC6551844 DOI: 10.1001/jamapsychiatry.2018.4513] [Citation(s) in RCA: 107] [Impact Index Per Article: 21.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
IMPORTANCE Predicting suicidal behavior continues to be among the most challenging tasks in psychiatry. OBJECTIVES To examine the trajectories of clinical predictors of suicide attempt (specifically, depression symptoms, hopelessness, impulsivity, aggression, impulsive aggression, and irritability) for their ability to predict suicide attempt and to compute a risk score for suicide attempts. DESIGN, SETTING, AND PARTICIPANTS This is a longitudinal study of the offspring of parents (or probands) with mood disorders who were recruited from inpatient units at Western Psychiatric Institute and Clinic (Pittsburgh) and New York State Psychiatric Institute. Participants were recruited from July 15, 1997, to September 6, 2005, and were followed up through January 21, 2014. Probands and offspring (n = 663) were interviewed at baseline and at yearly follow-ups for 12 years. Lifetime and current psychiatric disorders were assessed, and self-reported questionnaires were administered. Model evaluation used 10-fold cross-validation, which split the entire data set into 10 equal parts, fit the model to 90% of the data (training set), and assessed it on the remaining 10% (test set) and repeated that process 10 times. Preliminary analyses were performed from July 20, 2015, to October 5, 2016. Additional analyses were conducted from July 26, 2017, to July 24, 2018. MAIN OUTCOMES AND MEASURES The broad definition of suicide attempt included actual, interrupted, and aborted attempts as well as suicidal ideation that prompted emergency referrals during the study. The narrow definition referred to actual attempt only. RESULTS The sample of offspring (n = 663) was almost equally distributed by sex (316 female [47.7%]) and had a mean (SD) age of 23.8 (8.5) years at the time of censored observations. Among the 663 offspring, 71 (10.7%) had suicide attempts over the course of the study. The trajectory of depression symptoms with the highest mean scores and variability over time was the only trajectory to predict suicide attempt (odds ratio [OR], 4.72; 95% CI, 1.47-15.21; P = .01). In addition, we identified the following predictors: younger age (OR, 0.82; 95% CI, 0.74-0.90; P < .001), lifetime history of unipolar disorder (OR, 4.71; 95% CI, 1.63-13.58; P = .004), lifetime history of bipolar disorder (OR, 3.4; 95% CI, 0.96-12.04; P = .06), history of childhood abuse (OR, 2.98; 95% CI, 1.40-6.38; P = .01), and proband actual attempt (OR, 2.24; 95% CI, 1.06-4.75; P = .04). Endorsing a score of 3 or higher on the risk score tool resulted in high sensitivity (87.3%) and moderate specificity (63%; area under the curve = 0.80). CONCLUSIONS AND RELEVANCE The specific predictors of suicide attempt identified are those that clinicians already assess during routine psychiatric evaluations; monitoring and treating depression symptoms to reduce their severity and fluctuation may attenuate the risk for suicidal behavior.
Collapse
Affiliation(s)
- Nadine M. Melhem
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Giovanna Porta
- University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - Maria A. Oquendo
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Jamie Zelazny
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - John G. Keilp
- Department of Psychiatry, Columbia University, New York, New York
| | - Satish Iyengar
- Department of Statistics, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Ainsley Burke
- Department of Psychiatry, Columbia University, New York, New York
| | - Boris Birmaher
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Barbara Stanley
- Department of Psychiatry, Columbia University, New York, New York
| | - J. John Mann
- Department of Psychiatry, Columbia University, New York, New York
| | - David A. Brent
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| |
Collapse
|
47
|
Benarous X, Consoli A, Cohen D, Renaud J, Lahaye H, Guilé JM. Suicidal behaviors and irritability in children and adolescents: a systematic review of the nature and mechanisms of the association. Eur Child Adolesc Psychiatry 2019; 28:667-683. [PMID: 30293122 DOI: 10.1007/s00787-018-1234-9] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2017] [Accepted: 10/01/2018] [Indexed: 11/29/2022]
Abstract
While many psychiatric disorders are associated with an increased risk for suicidal behaviors (SB) in children and adolescents, a few studies have explored the role of clinical symptoms based on a dimensional approach. Irritability is seen as a marker, a general psychopathology, and a symptom of both externalizing and internalizing disorders. In this review, we are interested in determining whether and how irritability can predict SB in youth. First, we reviewed consistencies and variation in the literature linking irritability to suicidal ideation (SI) and suicide attempt (SA). Second, based on the available models, we proposed specific mechanistic pathways, whereby irritability may modulate the risk for SB. Irritability has been found associated with SB both in cross-sectional and in longitudinal studies. The relation is consistent in different settings (i.e., general population and clinical settings) and across psychiatric disorders. The association is reduced but persists after adjusting for psychiatric disorder, including depression. On one hand, irritability constitutes a risk factor for SI via the onset of internalized disorder. On the other hand, irritable youth may be more prone to attempt suicide when experiencing SI. The measures for irritability were heterogeneous. A limited number of studies were designed to explore the role of mediators and/or moderators. Recognizing irritability in children and adolescents is a key issue with regards to suicide prevention.
Collapse
Affiliation(s)
- Xavier Benarous
- Department of Child and Adolescent Psychiatry, Pitié-Salpêtrière Hospital, 83, boulevard de l'Hôpital, 75013, Paris, France. .,INSERM Unit U1105 Research Group for Analysis of the Multimodal Cerebral Function, University of Picardy Jules Verne (UPJV), Amiens, France.
| | - Angèle Consoli
- Department of Child and Adolescent Psychiatry, Pitié-Salpêtrière Hospital, 83, boulevard de l'Hôpital, 75013, Paris, France.,GRC-15, Dimensional approach of Child and Adolescent Psychotic Episodes, Pierre and Marie Curie University (UPMC), Paris, France
| | - David Cohen
- Department of Child and Adolescent Psychiatry, Pitié-Salpêtrière Hospital, 83, boulevard de l'Hôpital, 75013, Paris, France.,CNRS, UMR 7222, Institute for Intelligent Systems and Robotics, Sorbonne Université, UPMC, Paris, France
| | - Johanne Renaud
- Manulife Centre for Breakthroughs in Teen Depression and Suicide Prevention, Douglas Mental Health University Institute, McGill University, Montreal, Canada.,Department of Psychiatry, McGill University, Montreal, Canada
| | - Hélène Lahaye
- Child and Adolescent Psychopathology Department, Amiens University Hospital, Amiens, France
| | - Jean-Marc Guilé
- INSERM Unit U1105 Research Group for Analysis of the Multimodal Cerebral Function, University of Picardy Jules Verne (UPJV), Amiens, France.,Department of Psychiatry, McGill University, Montreal, Canada.,Child and Adolescent Psychopathology Department, Amiens University Hospital, Amiens, France
| |
Collapse
|
48
|
Ho TC, Cichocki AC, Gifuni AJ, Catalina Camacho M, Ordaz SJ, Singh MK, Gotlib IH. Reduced dorsal striatal gray matter volume predicts implicit suicidal ideation in adolescents. Soc Cogn Affect Neurosci 2019; 13:1215-1224. [PMID: 30256980 PMCID: PMC6234322 DOI: 10.1093/scan/nsy089] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2018] [Accepted: 09/23/2018] [Indexed: 11/20/2022] Open
Abstract
Suicidal ideation (SI), a potent risk factor for suicide attempts, increases in adolescence. While alterations in dopaminergic functioning have been implicated in suicidal acts—particularly in adults—we do not know whether morphological alterations in dopamine-rich regions of the brain, such as the striatum, are vulnerability factors for the emergence of SI in adolescents. At baseline, a community sample of 152 adolescents (89 female; mean age: 11.41 ± 1.01 years) completed a magnetic resonance imaging (MRI) scan that was used to estimate gray matter volumes (GMVs) of three striatal structures: caudate, nucleus accumbens and putamen. At a 24 month follow-up session, participants completed a self-report measure of SI frequency [Suicidal Ideation Questionnaire (SIQ)] and the death version of the Implicit Association Test (IAT). Robust linear regression models were conducted to predict SIQ and IAT scores from striatal GMV. Bilateral putamen and left caudate GMV significantly predicted IAT scores (all Ps < 0.03). No other associations were significant (all Ps > 0.05). Our finding of reduced dorsal striatal GMV predicting implicit SI may indicate that downstream dopaminergic dysfunction is implicated in the development of overt suicidal behaviors. Self-reported SI was not associated with striatal GMV, suggesting that biological correlates of suicide risk may correlate specifically with objective measurements of SI in adolescents.
Collapse
Affiliation(s)
- Tiffany C Ho
- Department of Psychology, Stanford University, Stanford, CA, USA.,Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
| | - Anna C Cichocki
- Department of Psychology, Stanford University, Stanford, CA, USA
| | - Anthony J Gifuni
- McGill University and Douglas Mental Health University Institute, Montreal, Quebec, Canada
| | | | - Sarah J Ordaz
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
| | - Manpreet K Singh
- University of Pittsburgh, Center for Neuroscience, Pittsburgh, PA, USA
| | - Ian H Gotlib
- Department of Psychology, Stanford University, Stanford, CA, USA
| |
Collapse
|
49
|
Goodday SM, Shuldiner J, Bondy S, Rhodes AE. Exposure to parental psychopathology and offspring's risk of suicide-related thoughts and behaviours: a systematic review. Epidemiol Psychiatr Sci 2019; 28:179-190. [PMID: 28748774 PMCID: PMC6998933 DOI: 10.1017/s2045796017000397] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Accepted: 07/03/2017] [Indexed: 12/31/2022] Open
Abstract
AIMS The primary objective of this systematic review was to identify and synthesise analytic studies examining the association between exposure to parental psychopathology in childhood and the nature of subsequent suicide-related thoughts (SRT) and suicide-related behaviour (SRB) (severity of ideation, planned/unplanned attempts/lethality) and to describe the direction, and magnitude of associations. The secondary objective was to determine if the associations from the primary objective differ by the type(s) and timing of parental psychopathology, sex/gender of the parent and child and is mediated by child psychiatric symptoms and family functioning. METHODS A systematic review was conducted using guidelines from the PRISMA statement. MEDLINE, CINAHL, EMBASE, psycINFO, Web of Science and grey literature sources were searched by two reviewers to March, 2017. Studies were included if they examined any parental psychopathology (Diagnostic and Statistical Manual of Mental Disorders criteria or equivalent) or SRT or SRB and offspring SRT or SRB occurring from birth <25 years of age. RESULTS Out of 10 231 studies identified, 54 were included for review. Studies were clinically and methodologically heterogeneous with none at low risk of bias (ROB). Nine studies with moderate ROB indicated a significantly increased risk of offspring SRT, suicide attempts (SA) and suicide among those exposed to maternal SA and suicide in childhood or adolescence. In the remaining 45 studies with higher ROB this association persisted. Several studies (67%) did not confirm that the exposure occurred in the offspring's childhood or adolescence. Findings were suggestive of a mediating effect of offspring psychiatric symptoms, however, few studies examined mediation and effect modification of contextual variables. CONCLUSIONS Offspring exposed to maternal SA are at an increased risk of these same behaviours early in life. Prospective attention to the types and timing of maternal and paternal psychopathology and the intermediate pathways to offspring SRT and SRB onset is needed and could have implications for informing modifiable targets for early intervention and prevention.
Collapse
Affiliation(s)
- S. M. Goodday
- Department of Epidemiology, University of Toronto, Dalla Lana School of Public Health, Toronto, Ontario, Canada
| | - J. Shuldiner
- Department of Epidemiology, University of Toronto, Dalla Lana School of Public Health, Toronto, Ontario, Canada
| | - S. Bondy
- Department of Epidemiology, University of Toronto, Dalla Lana School of Public Health, Toronto, Ontario, Canada
| | - A. E. Rhodes
- Department of Epidemiology, University of Toronto, Dalla Lana School of Public Health, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Dalla Lana School of Public Health, Toronto, Ontario, Canada
- McMaster University, The Offord Centre for Child Studies, Hamilton, Ontario, Canada
| |
Collapse
|
50
|
Cognition and self-injurious thoughts and behaviors: A systematic review of longitudinal studies. Clin Psychol Rev 2019; 69:97-111. [DOI: 10.1016/j.cpr.2018.07.002] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2017] [Revised: 07/08/2018] [Accepted: 07/12/2018] [Indexed: 12/11/2022]
|