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Zhong S, Chen P, Lai S, Zhang Y, Chen G, He J, Pan Y, Tang G, Wang Y, Jia Y. Hippocampal Dynamic Functional Connectivity, HPA Axis Activity, and Personality Trait in Bipolar Disorder with Suicidal Attempt. Neuroendocrinology 2023; 114:179-191. [PMID: 37729896 DOI: 10.1159/000534033] [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: 06/22/2023] [Accepted: 09/05/2023] [Indexed: 09/22/2023]
Abstract
INTRODUCTION Suicide in bipolar disorder (BD) is a multifaceted behavior, involving specific neuroendocrine and psychological mechanisms. According to previous studies, we hypothesized that suicidal BD patients may exhibit impaired dynamic functional connectivity (dFC) variability of hippocampal subregions and hypothalamic-pituitary-adrenal (HPA) axis activity, which may be associated with suicide-related personality traits. The objective of our study was to clarify this. METHODS Resting-state functional magnetic resonance imaging data were obtained from 79 patients with BD, 39 with suicidal attempt (SA), and 40 without SA, and 35 healthy controls (HCs). The activity of the HPA axis was assessed by measuring morning plasma adrenocorticotropic hormone (ACTH) and cortisol (CORT) levels. All participants underwent personality assessment using Minnesota Multiphasic Personality Inventory-2 (MMPI-2). RESULTS BD patients with SA exhibited increased dFC variability between the right caudal hippocampus and the left superior temporal gyrus (STG) when compared with non-SA BD patients and HCs. BD with SA also showed significantly lower ACTH levels in comparison with HCs, which was positively correlated with increased dFC variability between the right caudal hippocampus and the left STG. BD with SA had significantly higher scores of Hypochondriasis, Depression, and Schizophrenia than non-SA BD. Additionally, multivariable regression analysis revealed the interaction of ACTH × dFC variability between the right caudal hippocampus and the left STG independently predicted MMPI-2 score (depression evaluation) in suicidal BD patients. CONCLUSION These results suggested that suicidal BD exhibited increased dFC variability of hippocampal-temporal cortex and less HPA axis hyperactivity, which may affect their personality traits.
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Affiliation(s)
- Shuming Zhong
- Department of Psychiatry, First Affiliated Hospital, Jinan University, Guangzhou, China,
| | - Pan Chen
- Medical Imaging Center, First Affiliated Hospital, Jinan University, Guangzhou, China
| | - Shunkai Lai
- Department of Psychiatry, First Affiliated Hospital, Jinan University, Guangzhou, China
| | - Yiliang Zhang
- Department of Psychiatry, First Affiliated Hospital, Jinan University, Guangzhou, China
| | - Guanmao Chen
- Medical Imaging Center, First Affiliated Hospital, Jinan University, Guangzhou, China
| | - Jiali He
- Department of Psychiatry, First Affiliated Hospital, Jinan University, Guangzhou, China
| | - Youling Pan
- Medical Imaging Center, First Affiliated Hospital, Jinan University, Guangzhou, China
| | - Guixian Tang
- Medical Imaging Center, First Affiliated Hospital, Jinan University, Guangzhou, China
| | - Ying Wang
- Medical Imaging Center, First Affiliated Hospital, Jinan University, Guangzhou, China
| | - Yanbin Jia
- Department of Psychiatry, First Affiliated Hospital, Jinan University, Guangzhou, China
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Wang Y, Zhang Y, Wang G, Duan Z, Wilson A, Yang Y, Sun S, Chen R. Latent profile analysis to identify subgroups of Chinese sexual minority adolescents at risk of suicidality. Prev Med 2022; 157:107007. [PMID: 35247440 DOI: 10.1016/j.ypmed.2022.107007] [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] [Received: 07/15/2021] [Revised: 02/14/2022] [Accepted: 02/26/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND This study aimed to identify latent class profiles of sexual minority adolescents (Men Sexually attracted to Men, Women Sexually attracted to Women, and Bisexual) with elevated suicidal ideation. METHODS Data were collected from 18 secondary schools in China. Sub-group classifications were identified using variables associated with suicidal ideation in sexual minority adolescents, including parental relationship quality, electronic equipment time, school bullying, and sleep quality using the Chinese version of the Pittsburgh Sleep Quality Index to measure sleep. Anxiety was measured using the Generalized Anxiety Disorder 7 (GAD-7), depression was measured using the Patient Health Questionnaire 9 (PHQ-9), hypomania using the Hypomanic Checklist-32 (HCL-32), positive coping style was identified using the Trait Coping Style Questionnaire, and self-efficacy was measured by the General Self-Efficacy Scale. RESULTS Four distinctive profiles were derived from the data. Compared to "low-risk" group (Class 3), the "adolescent with mood problems" group (Class 2) had a 9.81 times higher risk of suicidal ideation; the those who classified as "severe bullied adolescent" (Class 4) had a 9.26 times higher risk of suicidal ideation. and the "adolescents with low self-efficacy" group (Class 1) had a 4.48 times higher risk of suicidal ideation. CONCLUSIONS Sexual minority adolescents with mood problems have the highest risk of suicidal ideation, followed by adolescents frequently being bullied at school. Interventions aimed at reducing suicide risk among sexual minority adolescents may benefit from attending to such profile factors identified in this study to develop targeted clinical care.
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Affiliation(s)
- Yuanyuan Wang
- Division of Psychology, Faculty of Health and Life Sciences, De Montfort University, Leicester, UK; Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, China; School of Psychology, Center for Studies of Psychological Application, and Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, China
| | - Yanwen Zhang
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Guosheng Wang
- Suzhou Guangji Hospital Affiliated Guangji Hospital of Soochow University, Soochow University, Suzhou, China
| | - Zhizhou Duan
- Preventive Health Service, Jiangxi Provincial People's Hospital, Affiliated People's Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Amanda Wilson
- Division of Psychology, Faculty of Health and Life Sciences, De Montfort University, Leicester, UK
| | - Yong Yang
- Suzhou Guangji Hospital Affiliated Guangji Hospital of Soochow University, Soochow University, Suzhou, China.
| | - Shufang Sun
- Brown University School of Public Health, Department of Behavioral and Social Sciences, International Health Institute, USA
| | - Runsen Chen
- Vanke School of Public Health, Tsinghua University, Beijing, China; Institute for Healthy China, Tsinghua University, Beijing, China.
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Elrefaay SMM, Soltis-Jarrett V. Suicide Prevention Education for Psychiatric Inpatient Nurses in Egypt. J Psychosoc Nurs Ment Health Serv 2020; 58:32-38. [DOI: 10.3928/02793695-20200305-02] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Accepted: 01/17/2020] [Indexed: 12/11/2022]
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Bryan CJ, Rozek DC, Butner J, Rudd MD. Patterns of change in suicide ideation signal the recurrence of suicide attempts among high-risk psychiatric outpatients. Behav Res Ther 2019; 120:103392. [PMID: 31104763 PMCID: PMC7155814 DOI: 10.1016/j.brat.2019.04.001] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Revised: 01/28/2019] [Accepted: 04/02/2019] [Indexed: 11/17/2022]
Abstract
Suicide ideation is an inherently dynamic construct. Previous research implicates different temporal patterns in suicide ideation among individuals who have made multiple suicide attempts as compared to individuals who have not. Temporal patterns among first-time attempters might therefore distinguish those who eventually make a second suicide attempt. To test this possibility, the present study used a dynamical systems approach to model change patterns in suicide ideation over the course of brief cognitive behavioral therapy for suicide prevention (12 sessions total) among 33 treatment-seeking active duty Soldiers with one prior suicide attempt. Variable-centered models were constructed to determine if change patterns differed between those with and without a follow-up suicide whereas person-centered models were constructed to determine if within-person change patterns were associated with eventual suicide attempts. Severity of suicide ideation was not associated with the occurrence of suicide attempts during follow-up, but person-centered temporal patterns were. Among those who made an attempt during follow-up, suicide ideation demonstrated greater within-person variability across treatment. Results suggest certain change processes in suicide ideation may characterize vulnerability to recurrent suicide attempt among first-time attempters receiving outpatient behavioral treatment. Nonlinear dynamic models may provide advantages for suicide risk assessment and treatment monitoring in clinical settings.
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Affiliation(s)
- Craig J Bryan
- National Center for Veterans Studies, The University of Utah,USA.
| | - David C Rozek
- National Center for Veterans Studies, The University of Utah,USA
| | | | - M David Rudd
- National Center for Veterans Studies, The University of Utah,USA
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Brovelli S, Dorogi Y, Feiner AS, Golay P, Stiefel F, Bonsack C, Michaud L. Multicomponent Intervention for Patients Admitted to an Emergency Unit for Suicide Attempt: An Exploratory Study. Front Psychiatry 2017; 8:188. [PMID: 29021764 PMCID: PMC5623851 DOI: 10.3389/fpsyt.2017.00188] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2017] [Accepted: 09/14/2017] [Indexed: 11/13/2022] Open
Abstract
Suicide is a major cause of premature deaths worldwide and belongs to the top priority public health issues. While suicide attempt is the most important risk factor for completed suicide, intervention for suicide attempters (SA) have produced mixed results. Since an important proportion of SA request medical care, emergency units (EU) are an opportune setting to implement such interventions. This exploratory study evaluated the feasibility and acceptability of a multicomponent intervention for SA admitted to an EU. The intervention consisted of coordination by a case manager of a joint crisis plan (JCP), an early meeting with relatives and the existing care network, as well as phone contacts during 3 months after suicide attempt. Among 107 SA admitted to the emergency unit during the study period, 51 could not be included for logistical reason, 22 were excluded, and intervention was offered to 34. Of these, 15 refused the intervention, which was thus piloted with 19 SA. First-time attempters most frequently declined the intervention. Feasibility and acceptability of phone contacts and case manager were good, while JCPs and meetings were difficult to implement and perceived as less acceptable. Refusal pattern questions the global acceptability and is discussed: JCPs and meetings will have to be modified in order to improve their feasibility and acceptability, especially among first-time attempters.
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Affiliation(s)
- Sebastien Brovelli
- Service of Liaison Psychiatry, Department of Psychiatry, Lausanne University Hospital (CHUV), Lausanne, Switzerland
| | - Yves Dorogi
- Service of Liaison Psychiatry, Department of Psychiatry, Lausanne University Hospital (CHUV), Lausanne, Switzerland
| | - Adam-Scott Feiner
- Department of Emergency Medicine, Lausanne University Hospital, Lausanne, Switzerland
| | - Philippe Golay
- Service of Community Psychiatry, Department of Psychiatry, Lausanne University Hospital, Lausanne, Switzerland
| | - Friedrich Stiefel
- Service of Liaison Psychiatry, Department of Psychiatry, Lausanne University Hospital (CHUV), Lausanne, Switzerland
| | - Charles Bonsack
- Service of Community Psychiatry, Department of Psychiatry, Lausanne University Hospital, Lausanne, Switzerland
| | - Laurent Michaud
- Service of Liaison Psychiatry, Department of Psychiatry, Lausanne University Hospital (CHUV), Lausanne, Switzerland
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Lin Y, Lin C, Sun IW, Hsu CC, Fang CK, Lo MT, Huang HC, Liu SI. Resting respiratory sinus arrhythmia is related to longer hospitalization in mood-disordered repetitive suicide attempters. World J Biol Psychiatry 2016; 16:323-33. [PMID: 25839729 DOI: 10.3109/15622975.2015.1017603] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVES Our aims were (1) to measure respiratory sinus arrhythmia (RSA), a high-frequency spectrum component of heart rate variability (HRV) in mood-disordered suicide attempters and (2) to investigate the relationship of RSA to symptoms and length of hospitalization. METHODS Forty-nine female repetitive-suicide attempters with depressive disorder or bipolar disorder were recruited in a general hospital setting. Manic or psychotic patients were excluded. Resting RSA values were calculated from electrocardiogram data, and severity of clinical presentation shortly after admission and length of hospital stay were assessed. RESULTS RSA was positively associated with a higher Beck Scale for Suicidal Ideation score (r = 0.33 P = 0.019). Stepwise multiple regression analysis showed a significant correlation between RSA and hospitalization length after adjusting other variables (beta coefficient = 3.00; P = 0.030). Patients with a higher resting RSA had more prolonged hospitalizations (hospitalization beyond 30 days) after controlling for other variables (odds ratio = 5.08, P = 0.017). CONCLUSIONS Interaction between the environment and the autonomic nervous system is complex. Further and more comprehensive research is needed.
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Affiliation(s)
- Ying Lin
- Department of Psychiatry, Mackay Memorial Hospital , Taipei , Taiwan
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Jung S, Wollmer MA, Kruger THC. The Hamburg-Hannover Agitation Scale (H2A): Development and validation of a self-assessment tool for symptoms of agitation. J Psychiatr Res 2015; 69:158-65. [PMID: 26343608 DOI: 10.1016/j.jpsychires.2015.08.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2015] [Revised: 08/06/2015] [Accepted: 08/07/2015] [Indexed: 11/25/2022]
Abstract
BACKGROUND Agitation has long been underestimated as a symptom occurring across psychiatric disorders. While several instruments exist for highly specific clinical target groups (e.g., dementia, traumatic brain injury), no tool captures agitation in a broader range of psychiatric patients. The Hamburg-Hannover Agitation Scale (H2A) has been designed to satisfy this demand. This study concentrated on the development and validation of the scale in a psychiatric and a healthy control sample. METHODS The H2A was developed, tested in an expert sample, and revised. The German version was validated in a study involving two clinical institutions. Patients (n = 180) completed the H2A and several other questionnaires in order to test for congruent and discriminant validity. Healthy subjects (n = 685) completed the H2A only. The H2A was translated into English. RESULTS The H2A showed very satisfying quality criteria (reliability, selectivity, item difficulty) and regression analysis demonstrated the H2A's ability to distinguish between subjects with a psychiatric diagnosis and healthy subjects with or without psychiatric record. Factor analysis revealed a three-factorial structure representing a physiological/somatic, a mental and a mixed ('psychophysiological') dimension of agitation. LIMITATIONS Although validation showed promising quality criteria and predictive value of the H2A, calibration tests with bigger and more balanced sample sizes are necessary. CONCLUSIONS Agitation has become more clinically relevant as a symptom occurring in various affective disorders, yet its assessment is limited. The H2A was developed in order to meet this need. Validation of the H2A revealed very satisfactory item and scale quality criteria promoting its utility.
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Affiliation(s)
- Stefanie Jung
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Germany; Asklepios Clinic North - Ochsenzoll, Asklepios Campus Hamburg, Medical Faculty, Semmelweis University, Germany.
| | - M Axel Wollmer
- Asklepios Clinic North - Ochsenzoll, Asklepios Campus Hamburg, Medical Faculty, Semmelweis University, Germany.
| | - Tillmann H C Kruger
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Germany.
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Bryan CJ, Gonzales J, Rudd MD, Bryan AO, Clemans TA, Ray-Sannerud B, Wertenberger E, Leeson B, Heron EA, Morrow CE, Etienne N. DEPRESSION MEDIATES THE RELATION OF INSOMNIA SEVERITY WITH SUICIDE RISK IN THREE CLINICAL SAMPLES OF U.S. MILITARY PERSONNEL. Depress Anxiety 2015; 32:647-55. [PMID: 26047362 DOI: 10.1002/da.22383] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2015] [Revised: 04/08/2015] [Accepted: 05/01/2015] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND A growing body of empirical research suggests insomnia severity is directly related to suicide ideation, attempts, and death in nonmilitary samples, even when controlling for depression and other suicide risk factors. Few studies have explored this relationship in U.S. military personnel. METHODS The present study entailed secondary data analyses examining the associations of insomnia severity with suicide ideation and attempts in three clinical samples: Air Force psychiatric outpatients (n = 158), recently discharged Army psychiatric inpatients (n = 168), and Army psychiatric outpatients (n = 54). Participants completed the Beck Scale for Suicide Ideation, the Beck Depression Inventory-II or Patient Health Questionnaire-9, the Insomnia Severity Index, and the Posttraumatic Stress Disorder Checklist at baseline; two samples also completed these measures during follow-up. RESULTS Sleep disturbance was associated with concurrent (β's > 0.21; P's < 0.059) and prospective (β's > 0.39; P's < 0.001) suicide ideation in all three samples. When adjusting for age, gender, depression, and posttraumatic stress, insomnia severity was no longer directly associated with suicide ideation either concurrently (β's < 0.19; P's > 0.200) or prospectively (β's < 0.26; P's > 0.063), but depression was (β's > 0.22; P's < 0.012). Results of a latent difference score mediation model indicated that depression mediated the relation of insomnia severity with suicide ideation. CONCLUSIONS Across three clinical samples of military personnel, depression explained the relationship between insomnia severity and suicide risk.
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Affiliation(s)
- Craig J Bryan
- National Center for Veterans Studies, The University of Utah, Salt Lake City, Utah.,The University of Utah, Salt Lake City, Utah
| | - Jacqueline Gonzales
- National Center for Veterans Studies, The University of Utah, Salt Lake City, Utah.,The University of Utah, Salt Lake City, Utah
| | - M David Rudd
- National Center for Veterans Studies, The University of Utah, Salt Lake City, Utah.,The University of Memphis, Memphis, Tennessee
| | - AnnaBelle O Bryan
- National Center for Veterans Studies, The University of Utah, Salt Lake City, Utah.,The University of Utah, Salt Lake City, Utah
| | - Tracy A Clemans
- National Center for Veterans Studies, The University of Utah, Salt Lake City, Utah.,The University of Utah, Salt Lake City, Utah
| | - Bobbie Ray-Sannerud
- National Center for Veterans Studies, The University of Utah, Salt Lake City, Utah.,The University of Utah, Salt Lake City, Utah
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Bryan CJ, Hitschfeld MJ, Palmer BA, Schak KM, Roberge EM, Lineberry TW. Gender differences in the association of agitation and suicide attempts among psychiatric inpatients. Gen Hosp Psychiatry 2014; 36:726-31. [PMID: 25312276 DOI: 10.1016/j.genhosppsych.2014.09.013] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2014] [Revised: 09/03/2014] [Accepted: 09/22/2014] [Indexed: 10/24/2022]
Abstract
OBJECTIVE To determine if the relationship of agitation with suicide ideation and suicide attempts differed between men and women. METHOD Self-reported severity of agitation and other suicide risk factors was obtained from 7698 consecutive patients during admission for inpatient psychiatric treatment during a 5-year period. RESULTS Agitation was highest among men with a history of suicide attempts. Agitation was significantly associated with frequency of suicide ideation and history of suicide attempt, but the gender-by-suicide interaction was only significant as a predictor of suicide attempt history. For men, agitation was associated with significantly increased risk for suicide attempt, but for women, agitation was not associated with risk for suicide attempt history. Results were unchanged when analyses were repeated among the subgroup of patients with suicide ideation. CONCLUSIONS Agitation is associated with history of suicide attempt among male but not female psychiatric inpatients. Agitation differentiates between those men who have only thought about suicide and those who have made suicide attempts.
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Affiliation(s)
- Craig J Bryan
- National Center for Veterans Studies, The University of Utah, 260 S. Central Campus Dr., Room 205, Salt Lake City, UT 84112, USA.
| | - Mario J Hitschfeld
- Mayo Clinic, Department of Psychiatry and Psychology, 200 First Street Southwest, Rochester, MN 55905, USA; Sotero Del Rio Hospital, Department of Psychiatry, Av. Concha y Toro 3459, Puente Alto, Santiago 8207257, Chile
| | - Brian A Palmer
- Mayo Clinic, Department of Psychiatry and Psychology, 200 First Street Southwest, Rochester, MN 55905, USA
| | - Kathryn M Schak
- Mayo Clinic, Department of Psychiatry and Psychology, 200 First Street Southwest, Rochester, MN 55905, USA
| | - Erika M Roberge
- National Center for Veterans Studies, The University of Utah, 260 S. Central Campus Dr., Room 205, Salt Lake City, UT 84112, USA
| | - Timothy W Lineberry
- Mayo Clinic, Department of Psychiatry and Psychology, 200 First Street Southwest, Rochester, MN 55905, USA
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Abstract
The aim of this study is to identify the characteristic features of suicide reattempters. The recognition of the suicide reattempters population as a distinct clinical population may encourage future preventive and clinical work with this high-risk subgroup and thus reduce deaths. A systematic literature review was carried out in order to identify the key demographic, psychological, and clinical variables associated with the repetition of suicide attempts. In addition, we wished to analyze the operational definitions of the repetition of suicide attempts proposed in the scientific literature. Studies published from 2000 to 2012 were identified in PubMed, PsycINFO, and Web of Science databases and were selected according to predetermined criteria. We examined a total of 1480 articles and selected 86 that matched our search criteria. The literature is heterogeneous, with no consensus regarding the operational definitions of suicide reattempters. Comparison groups in the literature have also been inconsistent and include subjects making a single lifetime attempt and subjects who did not reattempt during a defined study period. Suicide reattempters were associated with higher rates of the following characteristics: unemployment, unmarried status, diagnosis of mental disorders, suicidal ideation, stressful life events, and family history of suicidal behavior. Additional research is needed to establish adequate differentiation and effective treatment plans for this population.
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Puntil C, York J, Limandri B, Greene P, Arauz E, Hobbs D. Competency-based training for PMH nurse generalists: inpatient intervention and prevention of suicide. J Am Psychiatr Nurses Assoc 2013; 19:205-10. [PMID: 23950543 DOI: 10.1177/1078390313496275] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Suicide is the tenth leading cause of death in the United States. Approximately 90,000 psychiatric mental health (PMH) nurse generalists work in hospitals in the United States, mostly on inpatient psychiatric units where the most acutely suicidal patients are hospitalized. Although competencies have been developed for mental health clinicians in assessing and managing suicide risk, there are no standard competencies for PMH nurse generalists. Widely accepted nursing practices do not meet suicide-specific standards of care or evidence-based criteria. Although both the Commission on Collegiate Nursing Education Essentials for Baccalaureate Education and the Quality and Safety Education for Nurses competencies stress the necessity for comprehensive assessment, safe clinical practices, patient-centered care, evidence-based interventions, and interprofessional communication and collaboration, there are no specific requirements for suicide prevention training in educational and clinical programs. The American Psychiatric Nurses Association has an opportunity to provide leadership in developing, implementing, and evaluating competency-based training for nurses and partner with the national effort to increase the competencies in suicide prevention in the behavioral health workforce.
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Affiliation(s)
- Cheryl Puntil
- Resnick Neuropsychiatric Hospital at UCLA, Los Angeles, CA 90095, USA.
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Horon R, McManus T, Schmollinger J, Barr T, Jimenez M. A study of the use and interpretation of standardized suicide risk assessment: measures within a psychiatrically hospitalized correctional population. Suicide Life Threat Behav 2013; 43:17-38. [PMID: 23356783 DOI: 10.1111/j.1943-278x.2012.00124.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2011] [Accepted: 08/02/2012] [Indexed: 12/01/2022]
Abstract
The reliability, validity, and utility of the Adult Suicidal Ideation Questionnaire (ASIQ), Beck Hopelessness Scale (BHS), Beck Scale for Suicide Ideation (BSS), and Reasons for Attempting Suicide Questionnaire (RASQ) with correctional mental health populations was evaluated. Evidence was found indicating good to excellent reliability for all measures. Each of the measures significantly differentiated multiple attempters from single attempters and nonattempters, providing evidence of convergent and divergent validity. Logistic regression and receiver operating characteristic analyses revealed strong associations between multiple attempts and the ASIQ, BSS, and RASQ, but not the BHS. Implications for suicide risk assessment processes in correctional settings are discussed.
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Affiliation(s)
- Robert Horon
- Department of State Hospitals-Vacaville, Vacaville Psychiatric Program, Vacaville, CA 95696, USA.
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13
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Drapeau CW, DeBrule DS. The Relationship of Hypomania, Creativity, and Suicidal Ideation in Undergraduates. CREATIVITY RESEARCH JOURNAL 2013. [DOI: 10.1080/10400419.2013.752231] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Pompili M, Innamorati M, Szanto K, Di Vittorio C, Conwell Y, Lester D, Tatarelli R, Girardi P, Amore M. Life events as precipitants of suicide attempts among first-time suicide attempters, repeaters, and non-attempters. Psychiatry Res 2011; 186:300-5. [PMID: 20889216 DOI: 10.1016/j.psychres.2010.09.003] [Citation(s) in RCA: 84] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2010] [Revised: 09/04/2010] [Accepted: 09/11/2010] [Indexed: 11/27/2022]
Abstract
The aims of this study were to investigate risk factors for suicide attempts and propose a model explaining the associations among life events and suicide status. We assessed 263 subjects admitted following a suicide attempt to the Division of Psychiatry of the Department of Neurosciences of the University of Parma and compared them with 263 non-attempter clinical control subjects. Attempters reported significantly more adverse life events both in the last 6 months, and between the ages of 0-15 years than non-attempters. A multinomial logistic regression analysis with stepwise forward entry indicated that the best model to explain suicide status was one which included life events in the last 6 months, life events during age 0-15 years, and their interaction. First-time attempter status (vs. non-attempters) was more likely to be linked to life events in the last 6 months, the interaction between life events in the last 6 months and life events during age 0-15 years, and low social support. Those attempters with one or more prior attempts (repeat attempters) were more likely than non-attempters to be linked to the interaction between life events in the last 6 months and life events during age 0-15 years, and to higher rates of psychopharmacological treatment before the index admission. Guided by these findings, monitoring the impact of early-life and recent events in vulnerable individuals should be part of risk assessment and treatment.
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Abstract
Impulsivity, a breakdown in the balance between initiation and screening of action that leads to reactions to stimuli without adequate reflection or regard for consequences, is a core feature of bipolar disorder and is prominent in manic episodes. Catecholaminergic function is related to impulsivity and mania. Manic individuals have abnormal dopaminergic reactions to reward and abnormal responses in the ventral prefrontal cortex that are consistent with impulsive behavior. Impulsivity in mania is pervasive, encompassing deficits in attention and behavioral inhibition. Impulsivity is increased with severe course of illness (eg, frequent episodes, substance use disorders, and suicide attempts). In mixed states, mania-associated impulsivity combines with depressive symptoms to increase the risk of suicide. Clinical management of impulsivity in mania involves addressing interpersonal distortions inherent in mania; reducing overstimulation; alertness to medical-, trauma-, or substance-related problems; and prompt pharmacologic treatment. Manic episodes must be viewed in the context of the life course of bipolar disorder.
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Affiliation(s)
- Alan C Swann
- Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, 1300 Moursund Street, Room 270, Houston, TX 77030, USA.
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Abstract
The goal of the present study was to test the hypothesis that suicide attempts have a cathartic effect. We retrospectively investigated sociodemographic and clinical characteristics of suicide attempters admitted to the emergency department of a university hospital who were referred for a psychiatric assessment. The participants were 158 consecutive patients admitted to the emergency department because of a suicide attempt between January, 2006, and February, 2007; controls were 360 consecutive psychiatric referrals who did not report suicidal behavior. More than 70% of suicide attempters were coded on the triage classification system as critical/urgent. Loglinear analysis indicated that the risk of suicidal ideation was 9 times higher (p <0.001) and the risk of depressive mood was twice as high (p <0.001) among the attempters as in the control group of nonattempters, while their risk of anxiety (p <0.05) and agitation (p <0.05) was approximately half that of the nonattempters. The attempters also had a 5 times greater risk of being diagnosed with bipolar disorder (p <0.001) than the nonattempters. However, despite the fact that bipolar disorders were overrepresented in the group of attempters, suicidal ideation in the few hours after a suicide attempt was associated only with depressive mood. Based on these findings, it is recommended that psychiatric evaluation of suicide attempters in the emergency department should ideally include the use of psychometric instruments evaluating suicide ideation and suicide risk.
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