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Sohal A, Murphy D. A longitudinal analysis of person‐centred therapy with suicidal clients. COUNSELLING & PSYCHOTHERAPY RESEARCH 2022. [DOI: 10.1002/capr.12588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Amrita Sohal
- School of EducationUniversity of NottinghamNottinghamUK
| | - David Murphy
- School of EducationUniversity of NottinghamNottinghamUK
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Scheer V, Blanco C, Olfson M, Lemogne C, Airagnes G, Peyre H, Limosin F, Hoertel N. A comprehensive model of predictors of suicide attempt in individuals with panic disorder: Results from a national 3-year prospective study. Gen Hosp Psychiatry 2020; 67:127-135. [PMID: 33129137 DOI: 10.1016/j.genhosppsych.2020.09.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 09/20/2020] [Accepted: 09/28/2020] [Indexed: 02/04/2023]
Abstract
OBJECTIVE People with panic disorder are at increased risk of suicide. Multiple factors influence their risk suggesting a need to combine them into an integrative model to develop more effective suicide prevention strategies for this population. In this report, we sought to build a comprehensive model of the 3-year risk of suicide attempt in individuals with panic disorder using a longitudinal nationally representative study, the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC; wave 1, 2001-2002; wave 2, 2004-2005). METHOD We used structural equation modeling to simultaneously examine effects of six broad groups of clinical factors previously identified as potential predictors of suicide attempt in adults with panic disorder: 1) severity of panic disorder, 2) severity of comorbidity, 3) prior history of suicide attempt, 4) family history of psychiatric disorders, 5) sociodemographic characteristics and 6) treatment-seeking behavior. RESULTS The 3-year prevalence rate of suicide attempt was 4.6%. A general psychopathology factor, lower physical health-related quality of life, prior suicide attempt and a greater number of stressful life events at baseline significantly and independently predicted suicide attempt between the two waves (p < .05). R-square of the models ranged from 0.47 to 0.50. CONCLUSION This model may help inform future research and identify high-risk individuals among adults with panic disorder.
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Affiliation(s)
- Valentin Scheer
- Service de Psychiatrie et d'Addictologie de l'adulte et du sujet âgé, DMU Psychiatrie et Addictologie, AP-HP.Centre-Université de Paris, France.
| | - Carlos Blanco
- Division of Epidemiology, Services, and Prevention Research, National Institute on Drug Abuse, Bethesda, MD, USA
| | - Mark Olfson
- Department of Psychiatry, New York State Psychiatric Institute / Columbia University, New York, NY 10032, USA
| | - Cédric Lemogne
- Service de Psychiatrie et d'Addictologie de l'adulte et du sujet âgé, DMU Psychiatrie et Addictologie, AP-HP.Centre-Université de Paris, France; Faculté de médecine Paris Descartes, Université de Paris, Paris, France; Inserm U1266, Institut de Psychiatrie et Neurosciences de Paris, Paris, France
| | - Guillaume Airagnes
- Service de Psychiatrie et d'Addictologie de l'adulte et du sujet âgé, DMU Psychiatrie et Addictologie, AP-HP.Centre-Université de Paris, France; UMS 011, Population-based Epidemiological Cohorts, Inserm, Villejuif, France
| | - Hugo Peyre
- Robert Debré Hospital, Child and Adolescent Psychiatry Department, Assistance Publique-Hôpitaux de Paris, Paris, France; Cognitive Sciences and Psycholinguistic Laboratory, Ecole Normale Supérieure, Paris, France
| | - Frédéric Limosin
- Service de Psychiatrie et d'Addictologie de l'adulte et du sujet âgé, DMU Psychiatrie et Addictologie, AP-HP.Centre-Université de Paris, France; Faculté de médecine Paris Descartes, Université de Paris, Paris, France; Inserm U1266, Institut de Psychiatrie et Neurosciences de Paris, Paris, France
| | - Nicolas Hoertel
- Service de Psychiatrie et d'Addictologie de l'adulte et du sujet âgé, DMU Psychiatrie et Addictologie, AP-HP.Centre-Université de Paris, France; Faculté de médecine Paris Descartes, Université de Paris, Paris, France; Inserm U1266, Institut de Psychiatrie et Neurosciences de Paris, Paris, France
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The neural markers of MRI to differentiate depression and panic disorder. Prog Neuropsychopharmacol Biol Psychiatry 2019; 91:72-78. [PMID: 29705713 DOI: 10.1016/j.pnpbp.2018.04.013] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2018] [Revised: 04/05/2018] [Accepted: 04/23/2018] [Indexed: 12/23/2022]
Abstract
Depression and panic disorder (PD) share the common pathophysiology from the perspectives of neurotransmitters. The relatively high comorbidity between depression and PD contributes to the substantial obstacles to differentiate from depression and PD, especially for the brain pathophysiology. There are significant differences in the diagnostic criteria between depression and PD. However, the paradox of similar pathophysiology and different diagnostic criteria in these two disorders were still the issues needing to be addressed. Therefore the clarification of potential difference in the field of neuroscience and pathophysiology between depression and PD can help the clinicians and scientists to understand more comprehensively about significant differences between depression and PD. The researchers should be curious about the underlying difference of pathophysiology beneath the significant distinction of clinical symptoms. In this review article, I tried to find some evidences for the differences between depression and PD, especially for neural markers revealed by magnetic resonance imaging (MRI). The distinctions of structural and functional alterations in depression and PD are reviewed. From the structural perspectives, PD seems to have less severe gray matter alterations in frontal and temporal lobes than depression. The study of white matter microintegrity reveals more widespread alterations in fronto-limbic circuit of depression patients than PD patients, such as the uncinate fasciculus and anterior thalamic radiation. PD might have a more restrictive pattern of structural alterations when compared to depression. For the functional perspectives, the core site of depression pathophysiology is the anterior subnetwork of resting-state network, such as anterior cingulate cortex, which is not significantly altered in PD. A possibly emerging pattern of fronto-limbic distinction between depression and PD has been revealed by these explorative reports. The future trend for machine learning and pattern recognition might confirm the differentiation pattern between depression and PD based on the explorative results.
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De La Vega D, Giner L, Courtet P. Suicidality in Subjects With Anxiety or Obsessive-Compulsive and Related Disorders: Recent Advances. Curr Psychiatry Rep 2018; 20:26. [PMID: 29594718 DOI: 10.1007/s11920-018-0885-z] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
PURPOSE OF REVIEW Historically, anxiety disorders have not been considered as important determinants of suicide, but in the last years, many works have challenged this assumption. Here, we will review the available evidence on the relationship between suicide and anxiety disorders (e.g., obsessive-compulsive disorder, post-traumatic stress disorder, generalized anxiety disorder, panic disorder, and body dysmorphic disorder), with special emphasis on findings published in the last years. RECENT FINDINGS Overall, anxiety disorders increase the risk of suicide. Specifically, 16% of patients with social anxiety disorder reported suicidal ideation in the previous month, and 18% of them had a history of suicide attempts. Similarly, in patients with panic disorder, suicidal ideation prevalence ranged between 17 and 32%, and 33% of them had a history of suicide attempts. Generalized anxiety disorder (GAD) was the most frequent anxiety disorder in completed suicides (present in 3% of people who committed suicide) and also subthreshold GAD was clearly linked to suicide ideation. Post-traumatic stress disorder was positively associated with suicidal ideation, and in patients with obsessive-compulsive disorder, suicide ideation rates ranged from 10 to 53% and suicide attempts from 1 to 46%. Body dysmorphic disorders presented a suicide ideation prevalence of about 80%. Suicide risk is increased in subjects with anxiety disorder. This risk is higher in the presence of comorbidities, but it is not clear whether it is independent from such comorbidities in some disorders.
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Affiliation(s)
- Diego De La Vega
- Unidad de Hospitalización de Salud Mental, Unidad de Gestión Clínica de Salud Mental del Hospital Virgen Macarena, Servicio Andaluz de Salud, Sevilla, Spain
| | - Lucas Giner
- Department of Psychiatry, School of Medicine, Universidad de Sevilla, Av. Sánchez-Pizjuán s/n, 41009, Seville, Spain.
| | - Philippe Courtet
- CHRU Montpellier, University of Montpellier, INSERM unit 1061, Montpellier, France.,Fondamental Foundation, Créteil, France
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Lai CH. The regional homogeneity of cingulate-precuneus regions: The putative biomarker for depression and anxiety. J Affect Disord 2018; 229:171-176. [PMID: 29316519 DOI: 10.1016/j.jad.2017.12.086] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2017] [Revised: 11/02/2017] [Accepted: 12/31/2017] [Indexed: 11/28/2022]
Abstract
OBJECTIVES In addition to clinical interview, the modern putative biomarker to differentiate depression and anxiety would be warranted. The translational medicine characteristics of neuroimaging, such as the regional homogeneity (ReHo), is an option for depression and anxiety. Therefore we designed this study trying to identify the biomarker pattern for depression and anxiety. METHODS Resting-state functional magnetic resonance imaging was acquired for 53 patients with first-episode medicine-naïve major depressive disorder (MDD), 53 first-episode medicine-naïve patients with panic disorder (PD) and 54 controls. The calculation of ReHo was performed. The ANOVA repeated measures were applied for the 3 groups to investigate the putative differences between MDD and PD (FDR corrected p < 0.05). RESULTS After multiple comparisons, the major findings of ReHo were found in the bilateral anterior cingulate cortex and bilateral precuneus. MDD group had lower ReHo values than PD group in the left anterior cingulate cortex. MDD group had significant alterations of ReHo in the left anterior cingulate cortex and bilateral precuneus when compared to controls. PD group had alterations in the bilateral precuneus when compared to controls. CONCLUSION The specific cingulate alterations might be a putative ReHo biomarker to differentiate MDD from PD in cingulate-precuneus background for ReHo alterations.
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Affiliation(s)
- Chien-Han Lai
- Department of Psychiatry, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chia-Yi City, Taiwan, ROC; Department of Biomedical Imaging and Radiological Sciences, National Yang-Ming University, Taipei, Taiwan, ROC; Institute of Biophotonics, National Yang-Ming University, Taipei, Taiwan, ROC.
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Jeon HJ, Woo JM, Kim HJ, Fava M, Mischoulon D, Cho SJ, Chang SM, Park DH, Kim JW, Yoo I, Heo JY, Hong JP. Gender Differences in Somatic Symptoms and Current Suicidal Risk in Outpatients with Major Depressive Disorder. Psychiatry Investig 2016; 13:609-615. [PMID: 27909451 PMCID: PMC5128348 DOI: 10.4306/pi.2016.13.6.609] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2015] [Revised: 11/10/2015] [Accepted: 11/22/2015] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE Although somatic symptoms are common complaints of patients with major depressive disorder (MDD), their associations with suicide are still unclear. METHODS A total of 811 MDD outpatients of aged between 18 to 64 years were enrolled nationwide in Korea with the suicidality module of the Mini-International Neuropsychiatric Interview (MINI) and the Depression and Somatic Symptom Scale (DSSS). RESULTS On stepwise regression analysis, current suicidality scores were most strongly associated with chest pain in men, and neck or shoulder pain in women. Severe chest pain was associated with higher current suicidality scores in men than in women, whereas severe neck or shoulder pain showed no significant differences between the genders. In conclusion, MDD patients of both sexes with suicidal ideation showed significantly more frequent and severe somatic symptoms than those without. Current suicidal risk was associated with chest pain in men, and neck or shoulder pain in women. CONCLUSION We suggest that clinicians pay attention to patients' somatic symptoms in real world practice.
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Affiliation(s)
- Hong Jin Jeon
- Department of Psychiatry, Depression Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
- Depression Clinical and Research Program, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Jong-Min Woo
- Department of Psychiatry, Seoul Paik Hospital, Inje University School of Medicine, Seoul, Republic of Korea
- Stress Research Institute, Inje University, Seoul, Republic of Korea
| | - Hyo-Jin Kim
- OR/RWD Team, Corporate Affairs·Health & Value Division, Pfizer Korea, Seoul, Republic of Korea
| | - Maurizio Fava
- Depression Clinical and Research Program, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - David Mischoulon
- Depression Clinical and Research Program, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Seong Jin Cho
- Department of Psychiatry, Gil Medical Center, Gachon Medical School, Incheon, Republic of Korea
| | - Sung Man Chang
- Department of Psychiatry, Kyungpook National University Hospital, Kyungpook National University School of Medicine, Daegu, Republic of Korea
| | - Doo-Heum Park
- Department of Psychiatry, Konkuk University School of Medicine, Seoul, Republic of Korea
| | - Jong Woo Kim
- Department of Psychiatry, Kyung Hee University Hospital, College of Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Ikki Yoo
- Department of Psychiatry, Depression Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Jung-Yoon Heo
- Department of Psychiatry, Depression Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Jin Pyo Hong
- Department of Psychiatry, Depression Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
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Nam YY, Kim CH, Roh D. Comorbid panic disorder as an independent risk factor for suicide attempts in depressed outpatients. Compr Psychiatry 2016; 67:13-8. [PMID: 27095329 DOI: 10.1016/j.comppsych.2016.02.011] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2015] [Revised: 01/15/2016] [Accepted: 02/13/2016] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVE Although comorbid panic disorder is associated with more severe symptoms and poorer therapeutic response in depressive patients, the relationship between panic disorder and risk of suicide attempt has not been confirmed. This study aimed to examine the relationship between comorbid panic disorder and clinical characteristics associated with suicidal risk as well as the likelihood of suicide attempt. METHOD A total of 223 outpatients with current major depressive disorder participated in the study. Both subjects with panic disorder (33%) and those without panic disorder (67%) were compared based on history of suicide attempts, current psychopathologies, and traits of impulsivity and anger. RESULTS Subjects with panic disorder had higher levels of impulsivity, depression, and hopelessness and were more likely to report a history of suicide attempts. Subjects with panic disorder were younger at the time of first suicide attempt than those without panic disorder. Logistic regression analyses indicated that comorbid panic disorder was significantly associated with a history of suicide attempts after adjusting for other clinical correlates (odds ratio = 2.8; p < 0.01). CONCLUSIONS These findings suggest that comorbid panic disorder in patients with major depressive disorder may be associated with a more severe burden of illness and may independently increase the likelihood of suicide attempt.
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Affiliation(s)
- Yoon-Young Nam
- Division of Planning and Public Relations, National Center for Mental Health, Seoul, Republic of Korea
| | - Chan-Hyung Kim
- Department of Psychiatry, Yonsei University College of Medicine, Seoul, Republic of Korea; Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Daeyoung Roh
- Department of Psychiatry, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon-si, Gangwon-do, Republic of Korea.
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Lai CH, Wu YT. The gray matter alterations in major depressive disorder and panic disorder: Putative differences in the pathogenesis. J Affect Disord 2015. [PMID: 26208214 DOI: 10.1016/j.jad.2015.07.022] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVE This is a comprehensive study to establish a diagnosis-specific gray matter deficit model for major depressive disorder (MDD) and panic disorder (PD). METHOD We enrolled 53 patients with first-episode medication-naïve PD, 54 healthy controls and 53 patients with first-episode medication-naïve MDD in this study. They were age, handedness and gender matched. All participating subjects all received baseline structural scanning by the 3-Tesla magnetic resonance scanner. The optimized voxel-based morphometry was performed on the 3 groups of subjects and the ANOVA analysis was used to estimate the inter-group gray matter differences between each group. RESULTS The PD group had higher gray matter volume than MDD group in the right medial frontal cortex and right temporal gyrus. The PD group had gray matter reductions in the right inferior frontal gyrus and right insula. The MDD group had gray matter reductions in bilateral medial frontal cortex, right superior frontal gyrus, right superior temporal gyrus and bilateral cerebellums. CONCLUSION The gray matter alterations of fronto-insula and fronto-temporo-cerebellum regions probably would be specific for PD and MDD respectively. In addition, the differences of gray matter volume in the fronto-temporal regions would be helpful to differentiate MDD from PD.
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Affiliation(s)
- Chien-Han Lai
- Department of Psychiatry, Cheng Hsin General Hospital, Taipei City, Taiwan, ROC; Department of Biomedical Imaging and Radiological Sciences, National Yang-Ming University, Taipei, Taiwan, ROC; Institute of Biophotonics, National Yang-Ming University, Taipei, Taiwan, ROC.
| | - Yu-Te Wu
- Department of Biomedical Imaging and Radiological Sciences, National Yang-Ming University, Taipei, Taiwan, ROC; Institute of Biophotonics, National Yang-Ming University, Taipei, Taiwan, ROC; Brain Research Center, National Yang-Ming University, Taipei, Taiwan, ROC.
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Kim B, Oh J, Kim MK, Lee S, Tae WS, Kim CM, Choi TK, Lee SH. White matter alterations are associated with suicide attempt in patients with panic disorder. J Affect Disord 2015; 175:139-46. [PMID: 25617685 DOI: 10.1016/j.jad.2015.01.001] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2014] [Revised: 01/03/2015] [Accepted: 01/03/2015] [Indexed: 02/07/2023]
Abstract
BACKGROUND Panic disorder (PD) is associated with an increased risk of suicide attempt (SA). However, no study has examined the neural correlates of SA in PD. The goal of this study was to evaluate alterations in white matter (WM) and gray matter (GM) in patients with PD with and without a history of SA. METHODS Twelve patients with PD and a history of SA (PD+SA) and 24 patients with PD and no history of SA (PD-SA) underwent magnetic resonance imaging (MRI). All patients completed the Scale for Suicide Ideation (SSI), the Panic Disorder Severity Scale (PDSS), and the Beck Depression Inventory (BDI). The groups were matched for age, sex, and BDI and PDSS scores. Voxel-based morphometry and tract-based spatial statistics were used for the imaging analysis. RESULTS Although no GM or WM volume differences were observed, increased fractional anisotropy (FA) values were found in the WM tracts of the PD+SA group compared with the PD-SA group. The regions with increased FA included the internal capsule, splenium of the corpus callosum, superior and posterior corona radiata, thalamic radiations, sagittal stratum, and superior longitudinal fasciculus. The FA values for the internal capsule and thalamic radiations were significantly correlated with the SSI scores in the PD+SA group. LIMITATIONS The results should be considered preliminary due to the relatively small sample size. CONCLUSIONS Our data suggest that the aberrant WM integrity of the internal capsule and thalamic radiations may be the significant neural correlate of SA in patients with PD.
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Affiliation(s)
- Borah Kim
- Department of Psychiatry, CHA Bundang Medical Center, CHA University, Seongnam, Republic of Korea
| | - Jongsoo Oh
- Department of Psychiatry, CHA Bundang Medical Center, CHA University, Seongnam, Republic of Korea
| | - Min-Kyoung Kim
- Department of Psychiatry, CHA Bundang Medical Center, CHA University, Seongnam, Republic of Korea
| | - Sungjae Lee
- Department of Psychiatry, CHA Bundang Medical Center, CHA University, Seongnam, Republic of Korea
| | - Woo Suk Tae
- Neuroscience Research Institute, Kangwon National University Hospital, Chuncheon, Republic of Korea
| | - Chan Mo Kim
- Department of Business Administration, Kwangwoon University, Seoul, Republic of Korea
| | - Tai Kiu Choi
- Department of Psychiatry, CHA Bundang Medical Center, CHA University, Seongnam, Republic of Korea
| | - Sang-Hyuk Lee
- Department of Psychiatry, CHA Bundang Medical Center, CHA University, Seongnam, Republic of Korea.
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Al-Asadi AM, Klein B, Meyer D. Comorbidity structure of psychological disorders in the online e-PASS data as predictors of psychosocial adjustment measures: psychological distress, adequate social support, self-confidence, quality of life, and suicidal ideation. J Med Internet Res 2014; 16:e248. [PMID: 25351885 PMCID: PMC4259919 DOI: 10.2196/jmir.3591] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2014] [Revised: 07/16/2014] [Accepted: 08/13/2014] [Indexed: 12/02/2022] Open
Abstract
Background A relative newcomer to the field of psychology, e-mental health has been gaining momentum and has been given considerable research attention. Although several aspects of e-mental health have been studied, 1 aspect has yet to receive attention: the structure of comorbidity of psychological disorders and their relationships with measures of psychosocial adjustment including suicidal ideation in online samples. Objective This exploratory study attempted to identify the structure of comorbidity of 21 psychological disorders assessed by an automated online electronic psychological assessment screening system (e-PASS). The resulting comorbidity factor scores were then used to assess the association between comorbidity factor scores and measures of psychosocial adjustments (ie, psychological distress, suicidal ideation, adequate social support, self-confidence in dealing with mental health issues, and quality of life). Methods A total of 13,414 participants were assessed using a complex online algorithm that resulted in primary and secondary Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition, Text Revision) diagnoses for 21 psychological disorders on dimensional severity scales. The scores on these severity scales were used in a principal component analysis (PCA) and the resulting comorbidity factor scores were related to 4 measures of psychosocial adjustments. Results A PCA based on 17 of the 21 psychological disorders resulted in a 4-factor model of comorbidity: anxiety-depression consisting of all anxiety disorders, major depressive episode (MDE), and insomnia; substance abuse consisting of alcohol and drug abuse and dependency; body image–eating consisting of eating disorders, body dysmorphic disorder, and obsessive-compulsive disorders; depression–sleep problems consisting of MDE, insomnia, and hypersomnia. All comorbidity factor scores were significantly associated with psychosocial measures of adjustment (P<.001). They were positively related to psychological distress and suicidal ideation, but negatively related to adequate social support, self-confidence, and quality of life. Conclusions This exploratory study identified 4 comorbidity factors in the e-PASS data and these factor scores significantly predicted 5 psychosocial adjustment measures. Trial Registration Australian and New Zealand Clinical Trials Registry ACTRN121611000704998; http://www.anzctr.org.au/trial_view.aspx?ID=336143 (Archived by WebCite at http://www.webcitation.org/618r3wvOG).
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Affiliation(s)
- Ali M Al-Asadi
- School of Health Sciences, Swinburne University of Technology, Hawthorn, Australia.
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Uebelacker LA, Weisberg R, Millman M, Yen S, Keller M. Prospective study of risk factors for suicidal behavior in individuals with anxiety disorders. Psychol Med 2013; 43:1465-1474. [PMID: 23137440 PMCID: PMC3686832 DOI: 10.1017/s0033291712002504] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Anxiety disorders are very common and increase risk for suicide attempts. Little is known about predictors of increased risk specifically among individuals with anxiety disorders. The purpose of this study was to investigate whether specific anxiety disorders and other co-morbid psychiatric disorders, physical health, or work or social functioning increased the future likelihood of a suicide attempts among individuals with anxiety disorders. Method In this prospective study, 676 individuals with an anxiety disorder were followed for an average of 12 years. RESULTS As hypothesized, we found that post-traumatic stress disorder, major depressive disorder (MDD), intermittent depressive disorder (IDD), epilepsy, pain, and poor work and social functioning all predicted a shorter time to a suicide attempt in univariate analyses. In multivariate analyses, baseline MDD and IDD were independent predictors of time to suicide attempt, even when controlling for a past history of suicide attempt. No specific anxiety disorder was an independent predictor of time to attempt in this anxiety-disordered sample. Adding baseline physical health variables and social functioning did not improve the ability of the model to predict time to suicide attempt. CONCLUSIONS Mood disorders and past history of suicide attempts are the most powerful predictors of a future suicide attempt in this sample of individuals, all of whom have an anxiety disorder.
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Affiliation(s)
- L A Uebelacker
- Department of Psychiatry and Human Behavior Department of Family Medicine, Warren Alpert Medical School of Brown University, Providence, RI 02906, USA.
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Bi B, Xiao X, Zhang H, Gao J, Tao M, Niu H, Wang Y, Wang Q, Chen C, Sun N, Li K, Fu J, Gan Z, Sang W, Zhang G, Yang L, Tian T, Li Q, Yang Q, Sun L, Li Y, Rong H, Guan C, Zhao X, Ye D, Zhang Y, Ma Z, Li H, He K, Chen J, Cai Y, Zhou C, Luo Y, Wang S, Gao S, Liu J, Guo L, Guan J, Kang Z, Di D, Li Y, Shi S, Li Y, Chen Y, Flint J, Kendler K, Liu Y. A comparison of the clinical characteristics of women with recurrent major depression with and without suicidal symptomatology. Psychol Med 2012; 42:2591-2598. [PMID: 22716960 PMCID: PMC3488812 DOI: 10.1017/s003329171200058x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2011] [Revised: 03/02/2012] [Accepted: 03/06/2012] [Indexed: 11/22/2022]
Abstract
BACKGROUND The relationship between recurrent major depression (MD) in women and suicidality is complex. We investigated the extent to which patients who suffered with various forms of suicidal symptomatology can be distinguished from those subjects without such symptoms. METHOD We examined the clinical features of the worst episode in 1970 Han Chinese women with recurrent DSM-IV MD between the ages of 30 and 60 years from across China. Student's t tests, and logistic and multiple logistic regression models were used to determine the association between suicidality and other clinical features of MD. RESULTS Suicidal symptomatology is significantly associated with a more severe form of MD, as indexed by both the number of episodes and number of MD symptoms. Patients reporting suicidal thoughts, plans or attempts experienced a significantly greater number of stressful life events. The depressive symptom most strongly associated with lifetime suicide attempt was feelings of worthlessness (odds ratio 4.25, 95% confidence interval 2.9-6.3). Excessive guilt, diminished concentration and impaired decision-making were also significantly associated with a suicide attempt. CONCLUSIONS This study contributes to the existing literature on risk factors for suicidal symptomatology in depressed women. Identifying specific depressive symptoms and co-morbid psychiatric disorders may help improve the clinical assessment of suicide risk in depressed patients. These findings could be helpful in identifying those who need more intense treatment strategies in order to prevent suicide.
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Affiliation(s)
- B. Bi
- The First Hospital of China Medical University, Shenyang, People's Republic of China (PRC)
| | - X. Xiao
- The First Hospital of China Medical University, Shenyang, People's Republic of China (PRC)
| | - H. Zhang
- The First Hospital of China Medical University, Shenyang, People's Republic of China (PRC)
| | - J. Gao
- ZheJiang Traditional Chinese Medical Hospital, Hangzhou, PRC
| | - M. Tao
- Second Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, PRC
| | - H. Niu
- No. 1 Hospital of Zhengzhou University, Zhengzhou, PRC
| | - Y. Wang
- Shandong Mental Health Center, Shan Dong, PRC
| | - Q. Wang
- Beijing Anding Hospital, Capital Medical University, Beijing, PRC
| | - C. Chen
- No. 1 Hospital of Medical College of Xian Jiaotong University, Xian, Shaan Xi, PRC
| | - N. Sun
- No. 1 Hospital of Shanxi Medical University, Shanxi, PRC
| | - K. Li
- Mental Hospital of Jiangxi Province, Jiangxi, PRC
| | - J. Fu
- ShengJing Hospital of China Medical University, Liaoning, PRC
| | - Z. Gan
- No. 3 Affiliated Hospital of Zhongshan University, Guangdong, PRC
| | - W. Sang
- Hebei Mental Health Center, Hebei, PRC
| | - G. Zhang
- No. 4 Affiliated Hospital of Jiangsu University, Jiang Su, PRC
| | - L. Yang
- Jilin Brain Hospital, Jilin, PRC
| | - T. Tian
- Tianjin Anding Hospital, Tianjin, PRC
| | - Q. Li
- No. 1 Mental Health Center Affiliated Harbin Medical University, Heilongjiang, PRC
| | - Q. Yang
- Chongqing Mental Health Center, Chongqing, PRC
| | - L. Sun
- Psychiatric Hospital of Henan Province, Henan, PRC
| | - Ying Li
- Dalian No. 7 People's Hospital and Dalian Mental Health Center, Dalian, PRC
| | - H. Rong
- Shenzhen Kangning Hospital, Shenzhen, PRC
| | - C. Guan
- Nanjing Brain Hospital, Jiang Su, PRC
| | - X. Zhao
- The First Hospital of Hebei Medical University, Shijiazhuang, PRC
| | - D. Ye
- Sichuan Mental Health Center, Sichuan, PRC
| | - Y. Zhang
- Lanzhou University Second Hospital, Second Clinical Medical College of Lanzhou University, Gansu Province, PRC
| | - Z. Ma
- No. 1 Hospital of Chongqing Medical University, Chongqing, PRC
| | - H. Li
- Mental Health Center of West China Hospital of Sichuan University, Si Chuan, PRC
| | - K. He
- Shanghai Tongji University Affiliated Tongji Hospital, Shanghai, PRC
| | - J. Chen
- Shanghai Jiao Tong University School of Medicine Affiliated Shanghai Mental Health Center, Shanghai, PRC
| | - Y. Cai
- Fudan University Affiliated Huashan Hospital, Shanghai, PRC
| | - C. Zhou
- Wuhan Mental Health Center, Hubei, PRC
| | - Y. Luo
- No. 3 Hospital of Heilongjiang Province, Heilongjiang, PRC
| | - S. Wang
- The First Affiliated Hospital of Jinan University, Guangzhou, PRC
| | - S. Gao
- Ningbo Kangning Hospital, Zhejiang, PRC
| | - J. Liu
- Suzhou Guangji Hospital, Jiangsu, PRC
| | - L. Guo
- The Fourth Military Medical University Affiliated Xijing Hospital, Shaanxi, PRC
| | - J. Guan
- Guangzhou Brain Hospital/Guangzhou Psychiatric Hospital, Guangzhou, PRC
| | - Z. Kang
- No. 4 People's Hospital of Liaocheng, Shandong, PRC
| | - D. Di
- Mental Health Institute of Jining Medical College, Shandong, PRC
| | - Yajuan Li
- Xian Mental Health Center, Xian, Shanxi, PRC
| | - S. Shi
- Fudan University Affiliated Huashan Hospital, Shanghai, PRC
| | - Yihan Li
- Wellcome Trust Centre for Human Genetics, Oxford, UK
| | - Y. Chen
- Clinical Trial Service Unit, Richard Doll Building, Oxford, UK
| | - J. Flint
- Wellcome Trust Centre for Human Genetics, Oxford, UK
| | - K. Kendler
- Virginia Commonwealth University (VCU), Department of Psychiatry, Virginia Institute for Psychiatric and Behavioral Genetics, Richmond, VA, USA
| | - Y. Liu
- The First Hospital of China Medical University, Shenyang, People's Republic of China (PRC)
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Eikelenboom M, Smit JH, Beekman ATF, Penninx BWJH. Do depression and anxiety converge or diverge in their association with suicidality? J Psychiatr Res 2012; 46:608-15. [PMID: 22340981 DOI: 10.1016/j.jpsychires.2012.01.025] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2011] [Revised: 01/17/2012] [Accepted: 01/24/2012] [Indexed: 10/28/2022]
Abstract
Depressive disorders have been strongly linked to suicidality, but the association with anxiety disorders is less well established. This exploratory study aims to examine whether anxiety and depressive disorders are both independent risk factors for suicidal ideation and attempted suicide, and additionally examined the role of specific clinical characteristics (disorder type, severity, duration, onset age) in suicidality. Data are from 1693 persons with a current (6-month) CIDI based depressive or anxiety disorder and 644 healthy controls participating in the baseline measurement of the Netherlands Study of Depression and Anxiety, which is an existing dataset. Suicidal ideation in the week prior to baseline and attempted suicide ever in life were assessed. Results showed that compared to persons with only an anxiety disorder, persons with a depressive disorder were at significantly higher risk to have current suicidal ideation or a history of attempted suicide. When examining the association between type of disorder and suicidality the odds ratio for MDD was significantly higher than those for the separate anxiety disorders. Although depression and anxiety severity were univariate risk indicators for suicidal ideation and attempted suicide, only depression severity remained a risk indicator for suicidal ideation and attempted suicide in multivariate analyses. Additional risk indicators were an early age at disorder onset for both suicidal ideation and attempted suicide, male gender for suicidal ideation and lower education for attempted suicide. These findings suggest that although anxiety and depression tend to converge in many important areas, they appear to diverge with respect to suicidality.
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Affiliation(s)
- Merijn Eikelenboom
- Department of Psychiatry, VU University Medical Center, Amsterdam, The Netherlands.
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14
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Weighing the evidence for an association between obesity and suicide risk. Surg Obes Relat Dis 2012; 8:98-107. [DOI: 10.1016/j.soard.2011.10.007] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2011] [Revised: 10/06/2011] [Accepted: 10/07/2011] [Indexed: 02/02/2023]
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Abstract
Background: Previous research has suggested that patients with panic disorder but no comorbid disorder are not at greater risk for suicidal behavior. Aims: The present study followed up patients with panic disorder in order to assess the frequency of their suicidal behavior. Methods: A sample of 281 outpatients with panic disorder, but without a comorbid psychiatric disorder, was followed up for an average of 5 years. The patients were given 6–8 weeks of cognitive therapy, and 65% were prescribed SSRIs. Results: At the time of first admission, 5 patients (1.7%) reported a previous (lifetime) suicide attempt, and 53 patients (18.2%) reported previous (lifetime) suicidal ideation (both thoughts and plans), not greatly different from the Hungarian population in general. During the follow-up period, no patient committed suicide, 2 patients attempted suicide (0.7%), and 4 patients (1.4%) reported suicidal ideation. Conclusions: This study indicates that people with panic disorders without comorbid disorders have no higher suicidal risk than the general population in Hungary. After treatment with cognitive therapy and SSRIs, 38.5% were symptom-free, and only 7.8% required continued close therapeutic contact after the follow-up period.
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Affiliation(s)
- Tamas Zonda
- Hungarian Association for Suicide Prevention, Hungary
| | - Gabriella Nagy
- Outpatient Care Unit for Panic Disorders. Jahn F. Hospital, Budapest, Hungary
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Association study of a functional catechol-O-methyltransferase (COMT) Val108/158Met polymorphism and suicide attempts in patients with alcohol dependence. Int J Neuropsychopharmacol 2011; 14:377-88. [PMID: 20860878 DOI: 10.1017/s1461145710001057] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Alcohol dependence is frequently associated with aggressive and suicidal behaviour. Genetic factors contribute to both behaviours. Candidate genes, related to suicide and aggression, include genes involved in serotonin, norepinephrine and dopamine pathways. The enzyme catechol-O-methyl transferase (COMT) degrades dopamine, epinephrine and norepinephrine. The functional polymorphism (COMT Val108/158Met) affects COMT activity, with the valine (Val) variant associated with higher and the methionine (Met) variant with lower COMT activity. This polymorphism is associated with aggressive and suicidal behaviour, but the literature data on this relationship is contradictory and inconsistent. The hypothesis of this study was that Met allele carriers with alcohol dependence will have a higher frequency of suicide attempts compared to other genotypes. Participants were 312 male and 81 female medication-free patients with alcohol dependence and 487 male and 122 female unrelated, non-suicidal medication-free Caucasian healthy subjects. Our results showed significant (χ2 test with standardized residuals) differences in the frequencies of COMT variants in all alcoholics, alcoholics with different comorbid diagnoses, and in male but not in female alcoholics, with or without suicide attempts. Male alcoholic suicide attempters, compared to male non-attempters, had the higher frequency of Met/Met genotype or Met allele, and significantly (Kruskal-Wallis ANOVA on ranks and Mann-Whitney test) higher aggression and depression scores. These results confirmed the associations between Met allele and aggressive behaviour or violent suicide attempts in various psychiatric diagnoses, and suggested that Met allele of the COMT Val108/158 Met might be used as an independent biomarker of suicidal behaviour across different psychopathologies.
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Buoli M, Dell'osso B, Bosi MF, Altamura C. Slow vs standard up-titration of paroxetine in the treatment of panic disorder: a prospective randomized trial. Psychiatry Clin Neurosci 2010; 64:612-9. [PMID: 21040188 DOI: 10.1111/j.1440-1819.2010.02136.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIM Patients with panic disorder (PD) might be sensitive to the stimulating effects of selective serotonin reuptake inhibitors (SSRI), thus requiring low dosages at treatment initiation. The aim of the present study was to assess eventual differences in terms of effectiveness and tolerability between a slow up-titration with paroxetine and a standard one. METHODS In an open randomized, multicenter, primary-care study, 60 patients (44 women and 16 men) with PD with or without agoraphobia were enrolled and randomized to receive a slow up-titration with paroxetine (increments of 2.5 mg/day every 2 days) or a standard one (increments of 10 mg/day every week) up to a maximum daily dose of 20 mg. Repeated-measures anova on sub-items scores of the Panic Attack Anticipatory Anxiety Scale (PAAS) and Dosage Record and Treatment Emergent Symptom Scale (DOTES), respectively, used as outcome measures of effectiveness and tolerability, were performed. Significance level was set at 0.05 and it was not corrected. RESULTS anova showed no differences between the two treatments in terms of effectiveness and tolerability. Post hoc analysis found only one significant difference in the intensity of spontaneous panic attacks (Panic and Anticipatory Anxiety Scale) in the first 9 days of treatment between the two treatment groups, which was that this item was less intense in the slow-titration group (treatment effect: F = 4.89, P = 0.03, effect size = 0.1). CONCLUSION Present findings suggest only a small superiority for a slow up-titration regimen of paroxetine compared to a standard one in the first 9 days of treatment but no differences at end-point.
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Affiliation(s)
- Massimiliano Buoli
- Department of Psychiatry, University of Milan, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Luigi Sacco Hospital, Milan, Italy.
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Chachamovich E, Stefanello S, Botega N, Turecki G. [Which are the recent clinical findings regarding the association between depression and suicide?]. BRAZILIAN JOURNAL OF PSYCHIATRY 2009; 31 Suppl 1:S18-25. [PMID: 19565147 DOI: 10.1590/s1516-44462009000500004] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
OBJECTIVE Suicide is one of the leading causes of mortality worldwide, especially among young subjects. Suicide is considered the outcome of a multidimensional and complex phenomenon, which is a result of the interaction between several factors. The association between psychopathology and suicide has been extensively investigated. Major depression plays an important role among the psychiatric diagnoses associated with suicide. This finding seems to be confirmed by different study designs, and in distinct populations. The present paper aims to briefly review the recent findings regarding the suicide-related clinical features of depression. Moreover, strategies for suicide prevention were also reviewed. REVIEW Recent references were identified and grouped in order to illustrate the main contributions about depression and suicide. Briefly, the literature review stresses the high prevalence of major depression among subjects presenting suicide behaviors. Psychopathological traits, such as aggression and impulsivity play a relevant role in triggering suicidal behaviors. Strategies for suicide prevention were also reviewed in Brazil and internationally. In general, detection and treatment are effective in reducing suicide rates. CONCLUSION Studies regarding suicide behaviors have had a pragmatic approach, and generated a large body of evidence about correlates of suicide. However, these studies have not been able to provide a consistent theoretical explanation for this phenomenon. The recent adoption of modern strategies represents a possibility of enhancing the research capability of such studies. In order to be clinically useful, findings should make it possible to deepen the understanding over the experience of a suicidal person, as well as to design specific strategies for prevention and treatment in population subgroups.
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Affiliation(s)
- Eduardo Chachamovich
- McGill Group for Suicide Studies, Department of Psychiatry, McGill University, Montreal, Canada
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Bitsika V, Sharpley CF, Bell R. The contribution of anxiety and depression to fatigue among a sample of Australian university students: suggestions for university counsellors. COUNSELLING PSYCHOLOGY QUARTERLY 2009. [DOI: 10.1080/09515070903216929] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Diaconu G, Turecki G. Family history of suicidal behavior predicts impulsive-aggressive behavior levels in psychiatric outpatients. J Affect Disord 2009; 113:172-8. [PMID: 18504057 DOI: 10.1016/j.jad.2008.03.028] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2008] [Revised: 03/25/2008] [Accepted: 03/26/2008] [Indexed: 12/15/2022]
Abstract
OBJECTIVES Impulsive-aggressive traits have been proposed as mediators of the transmission of suicidal behavior in families. Our aim was to investigate the association between family history of suicidal behavior, and expressions of impulsivity and aggressive behavior, in a clinical population. METHODS A sample of n=474 psychiatric outpatient subjects were assessed by means of standardized interviews for Axis I and II psychopathology, history of suicidal behavior in subjects and their family, and measures of impulsive-aggressive behaviors (IAB). RESULTS A total of n=38 (8%) probands had a family history of suicidal behavior. This was three times more frequent in patients with a personal history of suicidality, irrespective of their own psychopathology (p<0.001), and four times more frequent in suicide attempters with depression vs. depressed non-attempters (p<0.005). A family history of suicidal behavior was associated with higher impulsive (p<0.005) and aggressive behavior measures (p<0.01) in probands. LIMITATIONS Retrospective design and family-history methodology; Limited sample; Contagion and imitation effects could not be assessed based on available data. CONCLUSIONS Impulsive-aggressive behaviors are significantly elevated in persons who have a familial loading of suicidal behavior.
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Affiliation(s)
- Gabriel Diaconu
- McGill Group for Suicide Studies, Douglas Hospital Research Centre, McGill University, Montréal, Québec, Canada
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Nakagawa A, Grunebaum MF, Oquendo MA, Burke AK, Kashima H, Mann JJ. Clinical correlates of planned, more lethal suicide attempts in major depressive disorder. J Affect Disord 2009; 112:237-42. [PMID: 18485486 PMCID: PMC3178835 DOI: 10.1016/j.jad.2008.03.021] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2007] [Revised: 03/16/2008] [Accepted: 03/24/2008] [Indexed: 11/24/2022]
Abstract
BACKGROUND Assessment of suicide plans is standard in acute psychiatric care, but there is a limited evidence base to guide this routine clinical practice. The purpose of this study was to investigate clinical correlates of suicide planning in depressed patients. METHODS 151 patients with major depressive disorder and a lifetime history of suicide attempt were studied. Subjects received a comprehensive evaluation including structured diagnostic interview for Axis I and II disorders, current symptoms, impulsivity, and systematic assessment of suicide planning prior to the most recent suicide attempt. RESULTS Seriousness of suicide attempt planning correlated with lethality of suicidal acts. Comorbid anxiety disorder and anxiety correlated with less suicide planning. Specifically, this negative correlation was with comorbid panic disorder. Planning did not correlate with severity of depression or aggressive/impulsive traits. LIMITATIONS Cross-sectional design, retrospective recall of suicide planning data, limited applicability to completed suicide or other psychiatric disorders. CONCLUSIONS In major depression, comorbid panic disorder appears protective against more carefully planned, higher lethality suicide attempts. Surprisingly, severity of depression and aggressive impulsive traits do not predict planning or lethality of suicide attempts. We have previously reported that anxiety severity protects against the probability of a suicide attempt and now extend that observation to show there is protection against lethality of a suicide attempt. Treatment of anxiety without directly treating major depression may place patients at greater risk of suicidal behavior.
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Affiliation(s)
- Atsuo Nakagawa
- Division of Molecular Imaging and Neuropathology, New York State Psychiatric Institute and the Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, NY, USA,Department of Psychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Michael F. Grunebaum
- Division of Molecular Imaging and Neuropathology, New York State Psychiatric Institute and the Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Maria A. Oquendo
- Division of Molecular Imaging and Neuropathology, New York State Psychiatric Institute and the Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Ainsley K. Burke
- Division of Molecular Imaging and Neuropathology, New York State Psychiatric Institute and the Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Haruo Kashima
- Department of Psychiatry, Keio University School of Medicine, Tokyo, Japan
| | - J. John Mann
- Division of Molecular Imaging and Neuropathology, New York State Psychiatric Institute and the Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, NY, USA
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