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Tuncay S, Sarman A. Late-night eating and inactivity: Links to depression and suicide risk in adolescents living in Turkey. JOURNAL OF CHILD AND ADOLESCENT PSYCHIATRIC NURSING 2024; 37:e12474. [PMID: 38924640 DOI: 10.1111/jcap.12474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2024] [Revised: 06/13/2024] [Accepted: 06/14/2024] [Indexed: 06/28/2024]
Abstract
OBJECTIVE Depression, anxiety, and eating disorders are all common during adolescence. This study aims to investigate the potential relationship between eating at night, physical activity, and depression/suicide risk in adolescents. METHODS This study followed a cross-sectional descriptive design and involved collecting data from adolescents aged 13-18 years who attend four different high schools. The data collection was done through an online survey using Google Forms. Sociodemographic form, eating at night questionnaire, International Physical Activity Questionnaire (Short Form), Reynolds Adolescent Depression Scale, and Suicide Probability Scale were used for data collection. The data collected were analyzed electronically using descriptive statistics and correlation tests to examine relationships between different parameters. RESULTS The study revealed significant associations between academic achievement, daily sleep duration, and daily walking distance with depression and suicide probability (p < 0.05) among the participants. Adolescents who consumed food after 10 pm exhibited higher depression and suicide probability scores than their counterparts (p < 0.05). Additionally, an analysis of physical activity levels demonstrated that highly active adolescents had lower depression and suicide probability scores. CONCLUSIONS In conclusion, this study suggests that there is a significant relationship between eating at night, physical activity, and depression/suicide risk in adolescents. Specifically, academic success, daily sleep duration, daily walking distance, and eating habits were found to be associated with depression and suicide probability. Encouraging physical activity and healthy eating habits, particularly avoiding eating late at night, may be beneficial in reducing the risk of depression and suicide among adolescents.
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Affiliation(s)
- Suat Tuncay
- Department of Pediatric Nursing, Faculty of Health Science, Bingöl University, Bingöl, Turkey
| | - Abdullah Sarman
- Department of Pediatric Nursing, Faculty of Health Science, Bingöl University, Bingöl, Turkey
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Vaartstra LD, Taone T, Mezulis A. Cognitive reactivity as a risk factor for non-suicidal self-injury in young adults. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2024:1-7. [PMID: 38190282 DOI: 10.1080/07448481.2023.2269450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 10/06/2023] [Indexed: 01/10/2024]
Abstract
OBJECTIVES Non-suicidal self-injury (NSSI) risk in young adults is impacted by both affective and cognitive responses to stress. While previous research shows affective reactivity (AR) increases risk for NSSI, less research has examined the role of cognitive reactivity (CR). The current study examined how individual differences in CR to stress relate to NSSI. PARTICIPANTS The sample included 192 college students (M = 19.84 years, SD = 2.51, 82% women). METHODS Participants completed a baseline questionnaire followed by a laboratory visit involving measures before and after stress induction. RESULTS Analyses indicated that individuals who engage in NSSI reported more affective and cognitive reactivity to stress. Additionally, higher levels of affective and cognitive reactivity uniquely predicted NSSI. A combined model yielded mixed results. Higher levels of AR led to lower levels of CR, while higher levels of CR predicted more NSSI. CONCLUSION In sum, results demonstrated significant but unique effects of affective and cognitive reactivity to stress on NSSI.
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Affiliation(s)
- Luke D Vaartstra
- Department of Clinical Psychology, Seattle Pacific University, Seattle, Washington, USA
| | - Trevor Taone
- Department of Clinical Psychology, Seattle Pacific University, Seattle, Washington, USA
| | - Amy Mezulis
- Department of Clinical Psychology, Seattle Pacific University, Seattle, Washington, USA
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Kivelä LMM, Antypa N, Fried EI, Schoevers R, van Hemert AM, Penninx BWJH, van der Does AJW. Suicidal ideation across depressive episodes: 9-year longitudinal cohort study. BJPsych Open 2023; 9:e218. [PMID: 37981566 PMCID: PMC10755669 DOI: 10.1192/bjo.2023.608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 08/25/2023] [Accepted: 10/16/2023] [Indexed: 11/21/2023] Open
Abstract
BACKGROUND Depression is a highly recurrent disorder, with more than 50% of those affected experiencing a subsequent episode. Although there is relatively little stability in symptoms across episodes, some evidence indicates that suicidal ideation may be an exception. However, these findings warrant replication, especially over longer periods and across multiple episodes. AIMS To assess the relative stability of suicidal ideation in comparison with other non-core depressive symptoms across episodes. METHOD We examined 490 individuals with current major depressive disorder (MDD) at baseline and at least one subsequent episode during 9-year follow-up within the Netherlands Study of Depression and Anxiety (NESDA). The Inventory of Depressive Symptomatology (IDS) was used to assess DSM-5 non-core MDD symptoms (fatigue, appetite/weight change, sleep disturbance, psychomotor disturbance, concentration difficulties, worthlessness/guilt, suicidal ideation) at baseline and 2-, 4-, 6- and 9-year follow-up. We examined consistency in symptom presentation (i.e. whether the symptom met the diagnostic threshold, based on a binary categorisation of the IDS) using kappa (κ) and percentage agreement, and stability in symptom severity using Spearman correlation, based on the continuous IDS scores. RESULTS Out of all non-core depressive symptoms, insomnia appeared the most stable across episodes (r = 0.55-0.69, κ = 0.31-0.47) and weight decrease the least stable (r = 0.03-0.33, κ = 0.06-0.19). For suicidal ideation, correlations across episodes ranged from r = 0.36 to r = 0.55 and consistency ranged from κ = 0.28 to κ = 0.49. CONCLUSIONS Suicidal ideation is moderately stable in recurrent depression over 9 years. Contrary to prior reports, however, it does not exhibit substantially more stability than most other non-core symptoms of depression.
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Affiliation(s)
- Liia M. M. Kivelä
- Department of Clinical Psychology, Institute of Psychology, Leiden University, Leiden, The Netherlands
| | - Niki Antypa
- Department of Clinical Psychology, Institute of Psychology, Leiden University, Leiden, The Netherlands
| | - Eiko I. Fried
- Department of Clinical Psychology, Institute of Psychology, Leiden University, Leiden, The Netherlands
| | - Robert Schoevers
- University Center for Psychiatry, University Medical Center Groningen, Groningen, The Netherlands
| | - Albert M. van Hemert
- Department of Psychiatry, Leiden University Medical Center (LUMC), Leiden, The Netherlands
| | - Brenda W. J. H. Penninx
- Department of Psychiatry, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit, Amsterdam, The Netherlands
| | - A. J. Willem van der Does
- Department of Clinical Psychology, Institute of Psychology, Leiden University, Leiden, The Netherlands; and Leiden University Treatment Center (LUBEC), Leiden, The Netherlands
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Chen X, Li S. Serial mediation of the relationship between impulsivity and suicidal ideation by depression and hopelessness in depressed patients. BMC Public Health 2023; 23:1457. [PMID: 37525167 PMCID: PMC10388524 DOI: 10.1186/s12889-023-16378-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 07/24/2023] [Indexed: 08/02/2023] Open
Abstract
BACKGROUND Close relationships have been observed among impulsivity, depression, hopelessness, and suicidal ideation in depressed patients. However, the precise mechanism that connects these psychological symptoms remains unclear. This study aims to explore the mediation effect of depression and hopelessness on the relationship between impulsivity and suicidal ideation in depressed patients. METHODS A total of 258 depressed patients were evaluated using the Hamilton Depression Scale, the Beck Hopelessness Scale, the Scale for Suicide Ideation, and the Barratt Impulsiveness Scale. A path analysis was afterwards performed to determine the specified relationships in the proposed model. RESULTS The relationship between impulsivity and suicidal ideation was found to be serially mediated by depression and hopelessness. The mediating effect of depression and hopelessness accounted for 26.59% of the total effect. Specifically, in the pathway from impulsivity to hopelessness, the mediating effect of depression accounted for 40.26%. Moreover, the relationship between impulsivity and suicidal ideation was mediated by hopelessness, with the mediating effect accounting for 12.41%. It is important to note that these relationships were observed to be independent of age and marital status. Furthermore, the proposed model demonstrated a good fit with the data. CONCLUSIONS This study identified a serial mediation pathway between impulsivity and suicidal ideation, mediated by depression and hopelessness. Our findings indicate that impulsivity indirectly influences suicidal ideation through its association with depression, which subsequently contributes to feelings of hopelessness. These results emphasize the importance of addressing symptoms of depression and hopelessness in the prevention and intervention efforts targeting individuals with depression. Additionally, monitoring and addressing impulsivity levels may also be crucial in reducing the risk of suicidal ideation among this population. These findings provide valuable insights for future preventive programs and interventions aimed at mitigating suicidal ideation in individuals with depression.
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Affiliation(s)
- Xiaoli Chen
- School of Teacher Education, Weifang University, Shandong, China.
| | - Shupeng Li
- School of Economics and Management, Shandong Vocational College of Information Technology, Shandong, China
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Accettulli A, Corbo MR, Sinigaglia M, Speranza B, Campaniello D, Racioppo A, Altieri C, Bevilacqua A. Psycho-Microbiology, a New Frontier for Probiotics: An Exploratory Overview. Microorganisms 2022; 10:2141. [PMID: 36363733 PMCID: PMC9696884 DOI: 10.3390/microorganisms10112141] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 10/25/2022] [Accepted: 10/26/2022] [Indexed: 07/28/2023] Open
Abstract
Probiotics are gradually gaining importance in the field of psychiatry in the form of psychobiotics. Psychobiotics' studies examine the existing relationship between gut microbiota and mental phenomena; the intake of certain strains of probiotics, such as Bifidobacterium and Lactobacillus, for example, allow the gut microbial system to be modified in order to provide benefits at the psychic, immune, hormonal, and mental levels. Those who suffer from forms of depression, anxiety disorders, chronic stress, low mood, but also people who do not suffer from such disorders, can therefore benefit from the use of psychobiotics. Thanks to probiotics, neurochemicals can in fact be produced within the gut microbiota and interact with receptors of the enteric nervous system that innervate the entire gastrointestinal tract. Once they enter the portal circulation, these substances go on to influence components of the nervous system and ultimately the brain, through what is called the gut-brain axis. This article proposes an exploratory overview of the proven effects of probiotics on brain activity and psycho-related diseases, focusing on clinical studies and measurable outcomes. The search was conducted using two different online tools: ClinicalTrials.gov and PubMed.
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Hippocampal neuropathology in suicide: Gaps in our knowledge and opportunities for a breakthrough. Neurosci Biobehav Rev 2021; 132:542-552. [PMID: 34906612 DOI: 10.1016/j.neubiorev.2021.12.023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2021] [Revised: 12/03/2021] [Accepted: 12/10/2021] [Indexed: 01/27/2023]
Abstract
Suicide is a major global hazard. There is a need for increasing suicide awareness and effective and evidence-based interventions, targeting both suicidal ideation and conduct. However, anti-suicide pharmacological effects are unsatisfactory. The human hippocampus is vulnerable to neuropsychiatric damages and subsequently releases psychobiological signals. Human hippocampal studies of suicide completers have shown mechanistic changes in neurobiology, which, however, could not reflect the neuropathological 'fingerprints' of fatal suicide ideations and suicide attempts. In this review, we provide several leading theories of suicide, including the serotoninergic system, Wnt pathway and brain-derived neurotrophic factor/tropomyosin receptor kinase B signalling, and discuss the evidence for their roles in suicide and treatment. Moreover, the cognitive dysfunctions associated with suicide risk are discussed, as well as the novel evidence on cognitive therapies that decrease suicidal ideation. We highlight the need to apply multi-omics techniques (including single-nucleus RNA sequencing and mass spectrometry histochemistry) on hippocampal samples from donors who died by suicide or legal euthanasia, to clarify the aetiology of suicide and propose novel therapeutic strategies.
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Psychological risk factors and the course of depression and anxiety disorders: A review of 15 years NESDA research. J Affect Disord 2021; 295:1347-1359. [PMID: 34706448 DOI: 10.1016/j.jad.2021.08.086] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 08/24/2021] [Accepted: 08/26/2021] [Indexed: 02/05/2023]
Abstract
BACKGROUND The Netherlands Study of Depression and Anxiety (NESDA; Nbaseline=2981) is an ongoing longitudinal, multi-site, naturalistic, cohort study examining the etiology, course, and consequences of depression and anxiety. In this article we synthesize and evaluate fifteen years of NESDA research on prominent psychological risk factors for the onset, persistence, recurrence, and comorbidity of affective disorders. METHODS A narrative review of 62 NESDA articles examining the specificity and predictive value of neuroticism, behavioral inhibition, repetitive negative thinking, experiential avoidance, cognitive reactivity, locus of control, (implicit) self-esteem, (implicit) disorder-specific self-associations, and attentional bias for the course of affective disorders. RESULTS All self-reported risk factors showed cross-sectional relationships with singular and comorbid affective disorders, and prospective relationships with the development and chronicity of depression and anxiety disorders. High neuroticism, low self-esteem, and negative repetitive thinking showed most prominent transdiagnostic relationships, whereas cognitive reactivity showed most pronounced depression-specific associations. Implicit self-esteem showed predictive validity for the persistence and recurrence of anxiety and depression over and above self-reported risk factors. Automatic approach-avoidance behavior and attentional bias for negative, positive, or threat words showed no relationship with affective disorders. CONCLUSION NESDA identified both (a) transdiagnostic factors (e.g., neuroticism, low implicit self-esteem, repetitive negative thinking) that may help explain the comorbidity between affective disorders and overlap in symptoms, and (b) indications for disorder-specific risk factors (e.g., cognitive responsivity) which support the relevance of distinct disorder categories and disorder-specific mechanisms. Thus, the results point to the relevance of both transdiagnostic and disorder-specific targets for therapeutic interventions.
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Bahji A, Forth E, Hargreaves T, Harkness K. Genetic markers of the stress generation model: A systematic review. Psychiatry Res 2021; 304:114139. [PMID: 34371296 DOI: 10.1016/j.psychres.2021.114139] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 07/16/2021] [Accepted: 07/24/2021] [Indexed: 01/15/2023]
Abstract
AIM Robust evidence suggests that depression, and risk for depression, are associated with the generation of stressful life events. This tendency to generate stress may be genetically determined. This systematic review aimed to identify specific molecular genetic markers associated with the generation of interpersonal stressful life events, at least in part dependent on individuals' behavior. METHOD We followed the PRISMA guidelines in searching six electronic databases (PubMed, MEDLINE, PsycINFO, CINAHL, Cochrane, and EMBASE) from inception to January 2021, and we reviewed the reference lists of eligible articles for additional records. We restricted eligibility to empirical studies involving at least one genetic marker and including proximal life events. We evaluated the risk of bias using the Newcastle Ottawa Scale for observational studies. The outcome permitted a distinction between life events dependent on the individual's agency versus independent events. RESULTS Seven studies, including 3585 participants, met eligibility criteria. Three were longitudinal, and four were cross-sectional; six included adolescents and young adults, and one focused on middle adulthood. Four examined the serotonin-transporter-linked promoter region (5-HTTLPR), two examined the rs53576 single nucleotide polymorphism of the oxytocin receptor gene (OXTR), and one examined a multilocus genetic profile score including four hypothalamic-pituitary-adrenal (HPA) axis genes. There were no significant direct correlations between genotype and life events in any study. Instead, their relation was significantly moderated by symptoms, exposure to early adversity, or attachment. Consistent with the stress generation hypothesis, this moderation relation was significant in predicting exposure to dependent life events but was not significant in predicting independent life event exposure. CONCLUSIONS There is evidence that genetic variation in the serotonin, HPA axis, and oxytocin systems moderates the effects of psychosocial vulnerability markers on the generation of proximal, dependent life events. Future research should examine additional genetic markers in systems known to confer risk for stress generation. PROSPERO CRD42019136886.
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Affiliation(s)
- Anees Bahji
- Department of Psychiatry, University of Calgary, 2500 University Drive NW, Calgary, AB T2N 1N4, Canada.
| | - Evan Forth
- Centre for Neuroscience Studies, Queen's University, Kingston, ON, Canada
| | - Tegan Hargreaves
- Department of Psychiatry, Queen's University, Kingston, ON, Canada
| | - Kate Harkness
- Department of Psychiatry, Queen's University, Kingston, ON, Canada; Department of Psychology, Queen's University, Kingston, ON, Canada
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Li XM, Dobson KS. Cognitive Reactivity Related to Coping Behaviors: An Assessment of Explicit and Implicit Dimensions in Clinical Depression. COGNITIVE THERAPY AND RESEARCH 2021. [DOI: 10.1007/s10608-021-10229-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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10
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Bryan CJ, Bryan AO, Anestis MD. Associations among exaggerated threat perceptions, suicidal thoughts, and suicidal behaviors in U.S. firearm owners. J Psychiatr Res 2020; 131:94-101. [PMID: 32950708 DOI: 10.1016/j.jpsychires.2020.09.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 08/02/2020] [Accepted: 09/03/2020] [Indexed: 10/23/2022]
Abstract
Firearm availability has traditionally been conceptualized as an environmental risk factor for suicide mortality. Firearm acquisition for the primary purpose of self-protection (i.e., protective gun ownership) is often motivated by exaggerated threat expectancies-a central component of anticipatory anxiety-but firearm acquisition may paradoxically reinforce or exacerbate threat expectancies and contribute to behavioral disinhibition. Firearm ownership may therefore confer increased risk for suicide mortality through biobehavioral mechanisms. The present study conducted an initial test of this hypothesis by examining associations among firearm ownership, intentions to acquire additional firearms, threat expectancies, and past-month suicidal thoughts and behaviors using data collected from a national sample of 6200 U.S. adults. Results indicated threat expectancies and rates of suicide-related behaviors were significantly elevated among protective gun owners and participants who intended to acquire a firearm within the next year as compared to non-gun owners and non-protective gun owners. Threat expectancies were associated with significantly increased risk for past-month suicide-related behavior. Results suggest that threat expectancies in particular, and anticipatory anxiety more generally, may be biobehavioral processes associated with the correlation of firearm ownership and increased suicide risk.
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Affiliation(s)
- Craig J Bryan
- National Center for Veterans Studies, Salt Lake City, UT, USA; Department of Psychology, The University of Utah, Salt Lake City, UT, USA.
| | - AnnaBelle O Bryan
- National Center for Veterans Studies, Salt Lake City, UT, USA; Department of Psychology, The University of Utah, Salt Lake City, UT, USA
| | - Michael D Anestis
- Department of Psychology, University of Southern Mississippi, Hattiesburg, MS, USA
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Huang FF, Wen ZP, Li Q, Chen B, Weng WJ. Factors influencing cognitive reactivity among young adults at high risk for depression in China: a cross-sectional study. BMC Public Health 2020; 20:703. [PMID: 32414355 PMCID: PMC7227322 DOI: 10.1186/s12889-020-08845-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2019] [Accepted: 05/04/2020] [Indexed: 12/11/2022] Open
Abstract
Background Understanding the factors influencing cognitive reactivity (CR) may help identify individuals at risk for first episode depression and relapse and facilitate routine access to preventative treatments. However, few studies have examined the relationship between CR and depression in Asian countries. This study was performed to assess the current status of CR among Chinese young adults and explore influencing factors. Methods A national cross-sectional online study using convenience sampling was conducted among 1597 healthy young adults in China (response rate: 93.94%) with a mean age of 24.34 (SD = 5.76) years. Results The mean CR score was 51.36 ± 18.97 (range 0–130). Binary logistic regression showed that a low level of CR was associated with the following factors: high self-compassion, high social support, high resilience, high monthly household income, and living in a rural area, with odds ratios (ORs) ranging from 0.14 to 0.70. Young adults in full-time employment, experiencing poor sleep, with high neuroticism, who reported frequent sad mood, and who had a high intensity of negative life events had increased CR to depression, with ORs ranging from 1.18 to 6.66. The prediction probability of these factors was 75.40%. Causal relationships among the influencing factors and CR could not be explored. Conclusions The self-reported CR levels among Chinese young adults were moderate. Enhancing self-compassion, resilience, and social support for young adults and reducing negative life events, neuroticism, and poor sleep may help decrease CR. These findings may help healthcare providers or researchers determine how to cultivate and improve the CR of young adults by establishing documented policies and/or improving intervention efficacies.
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Affiliation(s)
- Fei Fei Huang
- School of Nursing, Fujian Medical University, No 1 Xueyu Road, Minhou county, Fuzhou, 350108, Fujian, China.
| | - Zhi Peng Wen
- Neurology Division, the affiliated hospital of Putian University, Putian, China
| | - Qi Li
- Neurosurgery Department, 900th Hospital, Fuzhou, Fujian, China
| | - Bin Chen
- Psychiatric Department, Fuzhou Fourth Hospital, Fuzhou, Fujian, China
| | - Wen Jie Weng
- Psychiatric Department, Putian psychiatric Hospital, Putian, Fujian, China
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Suicide Attempts in Turkish University Students: The Role of Cognitive Style, Hopelessness, Cognitive Reactivity, Rumination, Self-esteem, and Personality Traits. JOURNAL OF RATIONAL-EMOTIVE AND COGNITIVE-BEHAVIOR THERAPY 2020. [DOI: 10.1007/s10942-020-00354-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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de Beurs D, ten Have M, Cuijpers P, de Graaf R. The longitudinal association between lifetime mental disorders and first onset or recurrent suicide ideation. BMC Psychiatry 2019; 19:345. [PMID: 31694603 PMCID: PMC6836643 DOI: 10.1186/s12888-019-2328-8] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Accepted: 10/17/2019] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Although the cross-sectional association between mental disorders and suicide ideation is well studied, less is known about the prospective association. In this paper, we estimated among those without 12-month suicide ideation at baseline, the association between a wide variety of common mental disorders at baseline and suicide ideation within the 6-year follow-up period, after controlling for history of other mental disorders and demographic variables. METHODS Data were used from the Netherlands Mental Health Survey and Incidence Study-2 (NEMESIS-2), a prospective representative adult cohort study with baseline (n = 6646) with a 6-year follow-up period. Lifetime mental disorders were assessed at baseline with the Composite International Diagnostic Interview 3.0. Within the longitudinal design, participants with first time or recurrent suicide ideation were defined follows: having no suicide ideation in the 12 months before the baseline assessment, and reporting to have had seriously thought about suicide between baseline and the 6-year follow-up period. Multiple logistical regression was used to estimate the longitudinal association between suicide ideation and a specific mental disorder while controlling for comorbidity and baseline variables. To account for the prevalence of a disorder in the population, for each disorder, the population attributable risk proportion (PARP) was calculated. RESULTS 2.9% (n = 132) of the participants that did not report suicide ideation in the past 12 months at baseline reported suicide ideation at follow-up. Of these 132 cases, 81 (61%) experienced suicide ideation for the first time in their lives and could be viewed as first onset cases. 51 (39%) reported recurrent suicide ideation. After controlling for comorbidity, the only two disorders that were significantly related to suicide ideation at follow-up were lifetime major depressive disorder (MDD) and generalized anxiety disorder (GAD). PARP for MDD was 47.8 and 16.6% for GAD. CONCLUSIONS After controlling for all other mental disorders, a lifetime history of MDD and GAD were related to suicide ideation at follow-up. For clinical practice, this indicates that patients with a history of MDD or GAD stay vulnerable for suicide ideation, even though they did not report suicide ideation in the past year.
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Affiliation(s)
- Derek de Beurs
- Netherlands Institute of Health Services Research, Utrecht, Netherlands. .,Department of Clinical, Neuro and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands.
| | - Margreet ten Have
- 0000 0001 0835 8259grid.416017.5Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands
| | - Pim Cuijpers
- 0000 0004 1754 9227grid.12380.38Department of Clinical, Neuro and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Ron de Graaf
- 0000 0001 0835 8259grid.416017.5Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands
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Longitudinal course of suicidal ideation and predictors of its persistence - A NESDA study. J Affect Disord 2019; 257:365-375. [PMID: 31302526 DOI: 10.1016/j.jad.2019.07.042] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Revised: 06/17/2019] [Accepted: 07/04/2019] [Indexed: 12/11/2022]
Abstract
BACKGROUND Prior research indicates that the factors that trigger suicidal ideation may differ from those that maintain it, but studies into the maintenance of suicidal ideation remain scarce. Our aim was to assess the longitudinal course of suicidal ideation, and to identify predictors of persistent suicidal ideation. METHODS We used data from the Netherlands Study of Depression and Anxiety (NESDA). We performed a linear mixed-effects growth model analysis (n = 230 with current suicidal ideation at baseline) to assess the course of suicidal ideation over time (baseline through 2-, 4-, 6- and 9-year follow-up). We used logistic regression analysis (n = 195) to test whether factors previously associated with the incidence of suicidal ideation in the literature (insomnia, hopelessness, loneliness, borderline personality traits, childhood trauma, negative life events) also predict persistence of suicidal ideation (i.e., reporting ideation at two consecutive assessment points, 6- and 9-years). We controlled for socio-demographics, clinical diagnosis and severity, medication use, and suicide attempt history. RESULTS Suicidal ideation decreased over time, and this decrease became slower with increasing time, with the majority of symptom reductions occurring in the first two years of follow-up. More severe insomnia and hopelessness were associated with increased odds of persistent suicidal ideation, and hopelessness was a significant mediator of the relationship between insomnia and persistent suicidal ideation. LIMITATIONS Findings may not generalize to those with more severe suicidal ideation due to dropout of those with the worst clinical profile. CONCLUSIONS Targeting insomnia and hopelessness in treatment may be particularly important to prevent the persistence of suicidal ideation.
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Huang FF, Li H, Lei Y, Li Q, Chen B. Adaptation and validation of the Chinese version of the modified Leiden index of depression sensitivity. J Affect Disord 2019; 256:458-467. [PMID: 31254721 DOI: 10.1016/j.jad.2019.06.022] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2019] [Revised: 05/30/2019] [Accepted: 06/21/2019] [Indexed: 11/18/2022]
Abstract
BACKGROUND The revised Leiden index of depression sensitivity (LEIDS-RR) is commonly used worldwide to measure a marker of depression vulnerability termed cognitive reactivity (CR). However, the optimal cut-off scores for this scale and for the Chinese version of LEIDS-RR (LEIDS-RR-CV) are unknown. OBJECTIVES The main aims were to examine the psychometric properties of the LEIDS-RR and establish appropriate cut-off scores for the Chinese population. METHODS Psychometric evaluation was performed for 330 healthy individuals and 330 depression patients in remission, by incorporating classical test theory and item response theory (IRT) methods. Receiver operating characteristic curve analysis was used to determine the optimal LEIDS-RR-CV cut-off. RESULTS Cronbach's α, two-week test-retest reliability, and marginal reliability for the LEIDS-RR-CV were 0.92, 0.40, and 0.96, respectively. Confirmatory factor analysis validated the five-factor model, and the cut-off values to screen a population at risk of depression were 60 and 55 for the healthy individuals and patients, respectively. Patients had higher CR than healthy individuals (t = 6.10, p = 0.00), and this was positively correlated with the total CES-D Scale score (r = 0.52, p = 0.00), also confirmed by IRT analysis, indicating the discriminative and concurrent validity of the scale. LIMITATIONS The generalizability of these findings may be limited given the sampling method and the fact that all patients were recruited from a tertiary hospital. CONCLUSIONS The 26-item LEIDS-RR-CV is a reliable and valid instrument to assess CR in Chinese populations. It can be used for screening at-risk populations and in epidemiological studies to guide the development of tailored intervention strategies.
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Affiliation(s)
- Fei Fei Huang
- School of Nursing, Fujian Medical University, Fuzhou, Fujian, China.
| | - Hong Li
- School of Nursing, Fujian Medical University, Fuzhou, Fujian, China; Fujian Provincial Hospital, Fuzhou, China
| | - Yang Lei
- School of Nursing, Nanjing Medical University,Nanjing, Jiangsu, China
| | - Qi Li
- Neurosurgery Department, 900 Hospital, Fuzhou, Fujian, China
| | - Bin Chen
- Psychiatric Department, Fuzhou Fourth Hospital, Fuzhou, Fujian, China
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16
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Chahwan B, Kwan S, Isik A, van Hemert S, Burke C, Roberts L. Gut feelings: A randomised, triple-blind, placebo-controlled trial of probiotics for depressive symptoms. J Affect Disord 2019; 253:317-326. [PMID: 31078831 DOI: 10.1016/j.jad.2019.04.097] [Citation(s) in RCA: 119] [Impact Index Per Article: 23.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Revised: 04/18/2019] [Accepted: 04/27/2019] [Indexed: 12/19/2022]
Abstract
BACKGROUND Depression is the leading cause of disability worldwide; with evidence suggesting that decreased gut barrier function and inflammation are correlated with depressive symptoms. We conducted a clinical trial to determine the effect of consumption of probiotic supplements (Winclove's Ecologic® Barrier) on depressive symptoms in a sample of participants with mild to severe depression. METHOD 71 participants were randomly allocated to either probiotic or placebo, which was, consumed daily over eight weeks. Pre- and post-intervention measures of symptoms and vulnerability markers of depression as well as gut microbiota composition were compared. Clinical trial participants were also compared on psychological variables and gut microbiota composition to a non-depressed group (n = 20). RESULTS All clinical trial participants demonstrated improvement in symptoms, suggesting non-specific therapeutic effects associated with weekly monitoring visits. Participants in the probiotic group demonstrated a significantly greater reduction in cognitive reactivity compared with the placebo group, particularly in the mild/moderate subgroup. Probiotics did not significantly alter the microbiota of depressed individuals, however, a significant correlation was found between Ruminococcus gnavus and one depression metric. LIMITATIONS There was a high attrition rate, which may be attributed to weekly monitoring visits. Additionally, modulation of the gut microbiota may need more specific testing to distinguish subtle changes. CONCLUSIONS While microbiota composition was similar between all groups, probiotics did affect a psychological variable associated with susceptibility to depression. Further research is needed to investigate how probiotics can be utilised to modify mental wellbeing, and whether they can act as an adjunct to existing treatments.
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Affiliation(s)
- Bahia Chahwan
- School of Life Sciences, University of Technology Sydney, PO Box 123 Broadway, NSW 2007, Australia
| | - Sophia Kwan
- Discipline of Clinical Psychology, Graduate School of Health, University of Technology Sydney, Australia
| | - Ashling Isik
- Discipline of Clinical Psychology, Graduate School of Health, University of Technology Sydney, Australia
| | | | - Catherine Burke
- School of Life Sciences, University of Technology Sydney, PO Box 123 Broadway, NSW 2007, Australia.
| | - Lynette Roberts
- Discipline of Clinical Psychology, Graduate School of Health, University of Technology Sydney, Australia.
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Brick LA, Marraccini ME, Micalizzi L, Benca-Bachman CE, Knopik VS, Palmer RHC. Overlapping genetic effects between suicidal ideation and neurocognitive functioning. J Affect Disord 2019; 249:104-111. [PMID: 30769295 PMCID: PMC6937431 DOI: 10.1016/j.jad.2019.02.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2018] [Revised: 01/18/2019] [Accepted: 02/05/2019] [Indexed: 02/08/2023]
Abstract
BACKGROUND Suicide is the second leading cause of death among adolescents and young adults. Several studies have indicated significant genetic influences on suicide-related phenotypes and mounting evidence from neurobiological research has linked deficits in neurocognitive abilities to suicide phenotypes. The goal of the present study was to estimate the heritability of suicidal ideation (SI) in a large sample of adolescents and determine if SI is genetically correlated with neurocognitive functioning. METHODS Genome-wide data (N = 3564 unrelated individuals of European Ancestry) were drawn from the Philadelphia Neurodevelopment Cohort. Adolescents completed a psychiatric assessment, as well as a computerized neurocognitive battery to assess performance across four domains: memory, executive function, social cognition, and complex cognition. Genomic-relatedness-matrix restricted maximum likelihood (GREML) estimation was used to determine SNP-heritability (h2SNP) of SI and the genetic correlation (rG) between SI and neurocognitive domains. RESULTS Nearly 17% of adolescents reported SI. The SNP-heritability estimate for SI was marginally significant (h2SNP = 11%, SE = 8%, p = 0.086). Bivariate analyses indicated a significant rG between SI and emotion identification (rG = 0.79, SE = 0.45, p = 0.006; phenotypic correlation r = 0.04, p = 0.017). LIMITATIONS It is possible that SI may represent a related, but differentially heritable construct from suicide attempts/completion and other comorbid psychopathology. Additionally, though genetic correlations point to shared genetic factors across traits, direct causal mechanisms cannot be deduced. CONCLUSIONS Common heritable factors contribute to variation in SI and neurocognitive functioning. Genetic factors influencing emotion identification have significant genetic overlap with SI.
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Affiliation(s)
- Leslie A Brick
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA.
| | - Marisa E Marraccini
- School of Education, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Lauren Micalizzi
- Center for Alcohol and Addiction Studies, Department of Behavioral and Social Sciences, School of Public Health, Brown University, Providence, RI, USA
| | - Chelsie E Benca-Bachman
- Behavioral Genetics of Addiction Laboratory, Department of Psychology, Emory University, Atlanta, GA, USA
| | - Valerie S Knopik
- Department of Human Development and Family Studies, Purdue University, West Lafayette, IN, USA
| | - Rohan H C Palmer
- Behavioral Genetics of Addiction Laboratory, Department of Psychology, Emory University, Atlanta, GA, USA
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van Ballegooijen W, Eikelenboom M, Fokkema M, Riper H, van Hemert AM, Kerkhof AJFM, Penninx BWJH, Smit JH. Comparing factor structures of depressed patients with and without suicidal ideation, a measurement invariance analysis. J Affect Disord 2019; 245:180-187. [PMID: 30396056 DOI: 10.1016/j.jad.2018.10.108] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2017] [Revised: 07/05/2018] [Accepted: 10/16/2018] [Indexed: 11/25/2022]
Abstract
BACKGROUND Suicidality could be associated with specific combinations of biological, social and psychological factors. Therefore, depressive episodes with suicidal ideation could be different from depressive episodes without suicidal ideation in terms of latent variable structures. METHODS In this study we compared latent variable structures between suicidal and non-suicidal depressed patients using confirmatory factor analysis (CFA), following a measurement invariance test procedure. Patients (N = 919) suffering from major depressive disorder were selected from the Netherlands Study of Depression and Anxiety (NESDA) and split into a group that showed no symptoms of suicidal ideation (non-SI; N = 691) and a suicidal ideation (SI) group that had one or more symptoms of suicidal ideation (N = 228). Depression and anxiety symptoms were measured using the short form of the Mood and Anxiety Symptoms Questionnaire (MASQ-D30). RESULTS CFA implied a difference in latent variable structures between the non-SI sample (CFI 0.957; RMSEA 0.041) and the SI sample (CFI 0.900; RMSEA 0.056). Subsequent multiple-group CFA showed violations of measurement invariance. The General distress and Anhedonic depression subscales were best indicated by hopelessness and lack of optimism in the SI sample and by dissatisfaction and not feeling lively in the non-SI sample. Overall, the SI sample had higher scores and lower inter-item correlations on the Anhedonic depression items. LIMITATIONS We have included very mild cases of suicidal ideation in our SI sample. CONCLUSIONS On a latent variable level, depression with suicidal ideation differs from depression without suicidal ideation. Results encourage further research into the symptom structure of depression among suicidal patients.
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Affiliation(s)
- Wouter van Ballegooijen
- Amsterdam UMC, Vrije Universiteit, Department of Psychiatry, Amsterdam, The Netherlands; GGZ inGeest Specialised Mental Health Care, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands; Vrije Universiteit Amsterdam, Section Clinical Psychology, Amsterdam, The Netherlands.
| | - Merijn Eikelenboom
- Amsterdam UMC, Vrije Universiteit, Department of Psychiatry, Amsterdam, The Netherlands; GGZ inGeest Specialised Mental Health Care, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Marjolein Fokkema
- Leiden University, Department of Methods & Statistics, Leiden, Netherlands
| | - Heleen Riper
- Amsterdam UMC, Vrije Universiteit, Department of Psychiatry, Amsterdam, The Netherlands; GGZ inGeest Specialised Mental Health Care, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands; Vrije Universiteit Amsterdam, Section Clinical Psychology, Amsterdam, The Netherlands
| | - Albert M van Hemert
- Leiden University Medical Centre, Department of Psychiatry, Leiden, Netherlands
| | - Ad J F M Kerkhof
- Vrije Universiteit Amsterdam, Section Clinical Psychology, Amsterdam, The Netherlands
| | - Brenda W J H Penninx
- Amsterdam UMC, Vrije Universiteit, Department of Psychiatry, Amsterdam, The Netherlands; GGZ inGeest Specialised Mental Health Care, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Jan H Smit
- Amsterdam UMC, Vrije Universiteit, Department of Psychiatry, Amsterdam, The Netherlands; GGZ inGeest Specialised Mental Health Care, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
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Papalini S, Michels F, Kohn N, Wegman J, van Hemert S, Roelofs K, Arias-Vasquez A, Aarts E. Stress matters: Randomized controlled trial on the effect of probiotics on neurocognition. Neurobiol Stress 2018; 10:100141. [PMID: 30937347 PMCID: PMC6430409 DOI: 10.1016/j.ynstr.2018.100141] [Citation(s) in RCA: 61] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2018] [Revised: 10/06/2018] [Accepted: 12/05/2018] [Indexed: 12/22/2022] Open
Abstract
Probiotics are microorganisms that provide health benefits when consumed. In animals, probiotics reverse gut microbiome-related alterations in depression-like symptoms, in cognition, and in hormonal stress response. However, in humans, a causal understanding of the gut-brain link in emotion and cognition is lacking. Additionally, whether the effects of probiotics on neurocognition are visible only in presence of stress, remains unclear. We investigated the effects of a multispecies probiotic (Ecologic®Barrier) on specific neurocognitive measures of emotion reactivity, emotion regulation, and cognitive control using fMRI. Critically, we also tested whether probiotics can buffer against the detrimental effects of acute stress on working memory. In a double blind, randomized, placebo-controlled, between-subjects intervention study, 58 healthy participants were tested once before and once after a 28-day intervention. Without stress induction, probiotics did not affect brain, behavioral, or related self-report measures. However, relative to placebo, the probiotics group did show a significant stress-related increase in working memory performance after supplementation. This change was associated with intervention-related neural changes in frontal cortex during cognitive control exclusively in the probiotics group. Overall, our results show neurocognitive effects of a multispecies probiotic in healthy women only under challenging situations, buffering against the detrimental effects of stress on cognition. We ran a randomized placebo-controlled fMRI study with a multispecies probiotic. Probiotics did not affect neurocognitive measures of emotion and cognitive control. Probiotics did affect stress-related working memory and neural correlates. Probiotics in healthy individuals can support cognition under stress.
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Affiliation(s)
- S. Papalini
- Radboud University, Donders Institute for Brain Cognition and Behaviour, Centre for Cognitive Neuroimaging, Nijmegen, the Netherlands
| | - F. Michels
- Radboud University, Donders Institute for Brain Cognition and Behaviour, Centre for Cognitive Neuroimaging, Nijmegen, the Netherlands
| | - N. Kohn
- Radboud University, Donders Institute for Brain Cognition and Behaviour, Centre for Cognitive Neuroimaging, Nijmegen, the Netherlands
| | - J. Wegman
- Radboud University, Donders Institute for Brain Cognition and Behaviour, Centre for Cognitive Neuroimaging, Nijmegen, the Netherlands
| | | | - K. Roelofs
- Radboud University, Donders Institute for Brain Cognition and Behaviour, Centre for Cognitive Neuroimaging, Nijmegen, the Netherlands
| | - A. Arias-Vasquez
- Radboud University Medical Center, Departments of Psychiatry, Human Genetics & Cognitive Neuroscience, Nijmegen, the Netherlands
| | - E. Aarts
- Radboud University, Donders Institute for Brain Cognition and Behaviour, Centre for Cognitive Neuroimaging, Nijmegen, the Netherlands
- Corresponding author. Kapittelweg 29, 6525 EN, Nijmegen, the Netherlands.
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20
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Figueroa CA, Mocking RJT, Mahmoud GA, Koeter MW, Bockting CL, van der Does W, Ruhe HG, Schene AH. The measurement of cognitive reactivity to sad mood in patients remitted from major depressive disorder. BRITISH JOURNAL OF CLINICAL PSYCHOLOGY 2018; 57:313-327. [PMID: 29488231 PMCID: PMC6099317 DOI: 10.1111/bjc.12175] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Revised: 01/31/2018] [Indexed: 11/28/2022]
Abstract
OBJECTIVES Cognitive reactivity (CR) to sad mood is a risk factor for major depressive disorder (MDD). CR is usually measured by assessing change on the Dysfunctional Attitudes Scale (DAS-change) after sad mood-induction. It has, however, been suggested that the versions of the DAS (A/B) are not interchangeable, impacting the reliability and validity of the change score. The Leiden Index of Depression Sensitivity-Revised (LEIDS-R) is an alternative self-report measure of CR. Studies examining the relationship between LEIDS-R and DAS-change have shown mixed results. We examined whether scores of these CR measures differed between remitted MDD and controls, the relationship between these CR measures, and the effect of order of DAS administration on DAS-change. DESIGN Cross-sectional design with two groups (remitted MDD and controls). METHODS Sixty-eight MDD patients remitted from ≥2 previous episodes, not taking antidepressants, and 43 never-depressed controls participated in a mood-induction and filled in the DAS-A/B in randomized order before and after mood-induction, and LEIDS-R separately. RESULTS LEIDS-R scores and pre-mood-induction DAS scores were significantly higher in remitted MDD than controls (p < .001, Cohen's d = 1.48; p = .001, Cohen's d = 0.66, respectively). DAS-change did not differ between these groups (p = .67, Cohen's d = 0.08). LEIDS-R correlated with DAS-change (r = .30, p = .042), but only in the group that filled in DAS-B before DAS-A. In remitted MDD, DAS-change was dependent on the order of DAS versions before and after mood-induction (10.6 ± 19.0 vs. -1.2 ± 10.5, for order B-A and A-B, respectively), with a significant group × order interaction (p = .012). CONCLUSIONS Existing DAS versions are not interchangeable, which compromises the usefulness of mood-inductions in clinical practice. The LEIDS-R seems a valid measure of cognitive vulnerability to depression. PRACTITIONER POINTS Clinical implications: Cognitive reactivity (CR) is a risk factor of depressive recurrence. The current measurement of CR, by assessing change on the Dysfunctional Attitudes Scale (DAS) after mood-induction, is not reliable. The Leiden Index Depression Sensitivity-Revised (LEIDS-R) is an alternative CR measure. In contrast to mood-induction, it reliably assesses depression vulnerability. The use of mood-inductions for clinical/research purposes is unnecessary. LIMITATIONS OF THE STUDY We were not able to examine the effect of previous treatment, which could have affected results as psychological treatments probably have differential effects on CR. Examining un-medicated patients may have led to selection of a sample not completely representative for the general MDD population. We did not administer both parallel versions of the DAS (A/B) before and after mood-induction. This might have provided better understanding of their differential sensitivity to change.
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Affiliation(s)
- Caroline A. Figueroa
- Department of PsychiatryProgram for Mood DisordersAcademic Medical CenterUniversity of AmsterdamThe Netherlands
- Department of PsychiatryWarneford HospitalUniversity of OxfordUK
| | - Roel J. T. Mocking
- Department of PsychiatryProgram for Mood DisordersAcademic Medical CenterUniversity of AmsterdamThe Netherlands
| | - Gelera A. Mahmoud
- Department of PsychiatryProgram for Mood DisordersAcademic Medical CenterUniversity of AmsterdamThe Netherlands
| | - Maarten W. Koeter
- Department of PsychiatryProgram for Mood DisordersAcademic Medical CenterUniversity of AmsterdamThe Netherlands
| | | | - Willem van der Does
- Department of PsychologyLeiden UniversityThe Netherlands
- Department of PsychiatryLeiden University Medical CenterThe Netherlands
| | - Henricus G. Ruhe
- Department of PsychiatryProgram for Mood DisordersAcademic Medical CenterUniversity of AmsterdamThe Netherlands
- Department of PsychiatryWarneford HospitalUniversity of OxfordUK
- Department of PsychiatryRadboud University Medical CenterNijmegenThe Netherlands
| | - Aart H. Schene
- Department of PsychiatryProgram for Mood DisordersAcademic Medical CenterUniversity of AmsterdamThe Netherlands
- Department of PsychiatryRadboud University Medical CenterNijmegenThe Netherlands
- Donders Institute for Brain, Cognition and BehaviorRadboud University NijmegenThe Netherlands
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21
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Bryan CJ, Butner JE, Sinclair S, Bryan ABO, Hesse CM, Rose AE. Predictors of Emerging Suicide Death Among Military Personnel on Social Media Networks. Suicide Life Threat Behav 2018; 48:413-430. [PMID: 28752655 DOI: 10.1111/sltb.12370] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2016] [Accepted: 03/28/2017] [Indexed: 11/30/2022]
Abstract
Suicide is a leading cause of death in the United States and is the second leading cause of death in the U.S. military. Previous research suggests that data obtained from social media networks may provide important clues for identifying at-risk individuals. To test this possibility, the social media profiles from 315 military personnel who died by suicide (n = 157) or other causes (n = 158) were coded for the presence of stressful life situations (i.e., triggers), somatic complaints or health issues (i.e., physical), maladaptive or avoidant coping strategies (i.e., behaviors), negative mood states (i.e., emotion), and/or negative cognitive appraisals (cognition). Content codes were subsequently analyzed using multilevel models from a dynamical systems perspective to identify temporal change processes characteristic of suicide death. Results identified temporal sequences unique to suicide, notably social media posts about triggers followed by more posts about cognitions, posts about cognitions followed by more posts about triggers, and posts about behaviors followed by fewer posts about cognitions. Results suggest that certain sequences in social media content may predict cause of death and provide an estimate of when a social media user is likely to die by suicide.
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Affiliation(s)
- Craig J Bryan
- National Center for Veterans Studies, The University of Utah, Salt Lake City, UT, USA
| | - Jonathan E Butner
- National Center for Veterans Studies, The University of Utah, Salt Lake City, UT, USA
| | - Sungchoon Sinclair
- National Center for Veterans Studies, The University of Utah, Salt Lake City, UT, USA
| | - Anna Belle O Bryan
- National Center for Veterans Studies, The University of Utah, Salt Lake City, UT, USA
| | | | - Andree E Rose
- Department of Defense's Office of People Analytics, Seaside, CA, USA
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22
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Thesing CS, Bot M, Milaneschi Y, Giltay EJ, Penninx BWJH. The association of omega-3 fatty acid levels with personality and cognitive reactivity. J Psychosom Res 2018; 108:93-101. [PMID: 29602331 DOI: 10.1016/j.jpsychores.2018.02.016] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Revised: 02/27/2018] [Accepted: 02/27/2018] [Indexed: 02/08/2023]
Abstract
OBJECTIVE Low omega (n)-3 polyunsaturated fatty acid (PUFA) levels have been found in patients with various major psychiatric disorders. This study aims to identify whether psychological vulnerabilities (personality and cognitive reactivity) underlying these psychiatric conditions are also associated with n-3 PUFA blood levels. METHODS Data was used from 2912 subjects (mean age 41.9 years, 66.4% female) from the Netherlands Study of Depression and Anxiety (NESDA). Five personality dimensions (NEO Five Factor Inventory) and cognitive reactivity measures (Leiden Index of Depression Sensitivity-Revised and Anxiety Sensitivity Index) were assessed. Plasma n-3 PUFA and docosahexaenoic acid (DHA) levels (as ratios against total fatty acids; mmol%) were assessed using a nuclear magnetic resonance platform. RESULTS Low n-3 PUFA and DHA levels were associated with high neuroticism (Standardized beta (Beta) = -0.045, 95% Confidence Interval (CI) = -0.079 to -0.010, p = 0.011; Beta = -0.058, 95%CI = -0.093 to -0.022, p = 0.001), low extraversion (Beta = 0.065, 95%CI = 0.031 to 0.099, p < 0.001; Beta = 0.074, 95%CI = 0.039 to 0.109, p < 0.001) and low conscientiousness (Beta = 0.060, 95%CI = 0.027 to 0.093, p < 0.001; Beta = 0.074, 95%CI = 0.039 to 0.108, p < 0.001). Low n-3 PUFA and DHA levels were related to high hopelessness/suicidality (Beta = -0.059, 95%CI = -0.096 to -0.023, p = 0.001; Beta = -0.078, 95%CI = -0.116 to -0.041, p < 0.001), but not with other cognitive reactivity measures. Directions of associations were generally consistent in subjects with and without a current depressive disorder. CONCLUSION Low n-3 PUFA and DHA levels are associated with personality (high neuroticism, low extraversion and low conscientiousness) and cognitive reactivity (high hopelessness/suicidality). Effect sizes were rather small, but in line with previous research on personality and chronic diseases. Future research should examine which lifestyle and/or biological pathways underlie these associations.
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Affiliation(s)
- Carisha S Thesing
- Department of Psychiatry, Amsterdam Public Health Research Institute and Amsterdam Neuroscience, VU University Medical Center, Amsterdam, The Netherlands.
| | - Mariska Bot
- Department of Psychiatry, Amsterdam Public Health Research Institute and Amsterdam Neuroscience, VU University Medical Center, Amsterdam, The Netherlands
| | - Yuri Milaneschi
- Department of Psychiatry, Amsterdam Public Health Research Institute and Amsterdam Neuroscience, VU University Medical Center, Amsterdam, The Netherlands
| | - Erik J Giltay
- Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands
| | - Brenda W J H Penninx
- Department of Psychiatry, Amsterdam Public Health Research Institute and Amsterdam Neuroscience, VU University Medical Center, Amsterdam, The Netherlands
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23
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Chang CC, Tzeng NS, Kao YC, Yeh CB, Chang HA. The relationships of current suicidal ideation with inflammatory markers and heart rate variability in unmedicated patients with major depressive disorder. Psychiatry Res 2017; 258:449-456. [PMID: 28886903 DOI: 10.1016/j.psychres.2017.08.076] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2016] [Revised: 07/11/2017] [Accepted: 08/27/2017] [Indexed: 10/19/2022]
Abstract
Studies investigating inflammatory status and autonomic functioning simultaneously in depressed patients with current suicidal ideation (SI) are lacking. We recruited 58 unmedicated depressed patients with current SI but without lifetime history of suicidal behavior, as well as 61 equally depressed patients without lifetime history of SI or suicidal behavior. We measured serum cortisol, high-sensitivity C-reactive protein (hs-CRP), erythrocyte sedimentation rate (ESR), and autonomic functioning evaluated by frequency-domain measures of heart rate variability (HRV). The intensity of current SI was rated with the Columbia Suicide Severity Rating Scale. Chronic psychological stress was assessed using the Chinese version of the Perceived Stress Scale (PSS). Patients with current SI showed higher hs-CRP and ESR but lower variance (total HRV), low frequency (LF), and high frequency (HF) HRV than those without lifetime history of SI. We found no differences in cortisol levels and PSS scores. The intensity of current SI was negatively correlated with variance, LF, and HF but positively correlated with hs-CRP. Our results help improve the understanding of the relationships among current SI, inflammation, and autonomic functioning in depressed patients. The combined use of inflammatory markers and HRV indices may one day be applied in predicting and monitoring patients' suicide risk.
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Affiliation(s)
- Chuan-Chia Chang
- Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Nian-Sheng Tzeng
- Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan; Student Counseling Center, National Defense Medical Center, Taipei, Taiwan
| | - Yu-Chen Kao
- Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan; Department of Psychiatry, Tri-Service General Hospital Songshan Branch, Taipei, Taiwan
| | - Chin-Bin Yeh
- Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Hsin-An Chang
- Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
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Cameron S, Brown VJ, Dritschel B, Power K, Cook M. Understanding the relationship between suicidality, current depressed mood, personality, and cognitive factors. Psychol Psychother 2017; 90:530-549. [PMID: 28296207 DOI: 10.1111/papt.12123] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2015] [Revised: 02/05/2017] [Indexed: 12/21/2022]
Abstract
OBJECTIVES Links between suicidality and depressed mood are well established. There is, however, little information about the emotional regulation processes that underlie the relationship between suicidality and current low mood, and how these processes differ between groups of never-suicidal (NS), suicidal ideators, and suicide attempters. As suicidality and depression are heterogeneous constructs, this study aimed to conduct within- and between-group comparisons of known suicide risk factors that are associated with emotion regulation (neuroticism, trait aggression, brooding, impulsivity, and overgeneral autobiographical memories). DESIGN Correlational design using between- and within-group comparisons from self-report measures. METHODS Inter- and intragroup differences were identified using Pearson's correlation coefficients and tests of difference. An analysis of indirect effects was used to investigate whether the relationship between suicidality and current low mood was mediated by neuroticism, trait aggression, brooding, impulsivity, and overgeneral autobiographical memories, and if this relationship varied according to group type. RESULTS Brooding appeared to be a consistent feature of all three groups and was closely related to current low mood. Compared to the NS group, the relationship between suicide attempts and current low mood showed greater associations with brooding, trait aggression, and overgeneral autobiographical memories. Compared to the NS group, the suicidal ideation group showed stronger associations with neuroticism and impulsivity, but these factors did not correlate with low mood. CONCLUSION These results suggest a need for larger studies to focus on heterogeneity within suicidal populations and consider how different combinations of risk factors may heighten or reduce suicide risk. PRACTITIONER POINTS It is well known that the severity and intensity of suicide and depressed presentations vary because of underlying dispositional and contextual factors (Fried & Nesse, ) which, in turn, affect how events are interpreted and responded to. Despite this, there is little research about how these mechanisms operate in different types of suicide groups, and their influence on the relationship between suicidality and current low mood. Understanding interrelationships that affect current low mood is of clinical significance because past suicidal history and deteriorations in already negative mood are linked to repeated suicide attempts and completion. Our findings show that ruminative brooding, defined as a tendency to repeatedly think about emotional aspects of an event, consistently correlates with current low mood across different types of suicidal groups (NS, suicidal ideators, and suicide attempters), and across analyses. Findings also show that suicidal ideation and attempt groups were associated with specific personality characteristics that increased the propensity of emotional responding and interpretation compared to the NS group. The relationship between suicide attempt and current low mood had a higher propensity to be influenced by trait aggression, brooding, and overgenerality compared to the NS group. In contrast, although the suicidal ideation group correlated more strongly with neuroticism and impulsivity, these factors did not influence current low mood. In terms of clinical practice, these findings imply that specific styles of interpretation and thinking may maintain the relationship between suicidality and current low mood. Given the cross-sectional nature of the study, however, it is not possible to imply causality. Nevertheless, the findings obtained provide some support for transdiagnostic models of cognitive-behavioural processes that could be developed further.
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Affiliation(s)
| | | | | | - Kevin Power
- Tayside Area Psychological Therapies Service, Dundee Health and Social Care Partnership, Dundee, Scotland
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Olliac B, Ouss L, Charrier A. Suicide attempts in children and adolescents: The place of clock genes and early rhythm dysfunction. ACTA ACUST UNITED AC 2017; 110:461-466. [PMID: 29154930 DOI: 10.1016/j.jphysparis.2017.11.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2017] [Revised: 11/06/2017] [Accepted: 11/13/2017] [Indexed: 02/01/2023]
Abstract
Suicide remains one of the leading causes of death among young people, and suicidal ideation and behavior are relatively common in healthy and clinical populations. Suicide risk in childhood and adolescence is often approached from the perspective of nosographic categories to which predictive variables for suicidal acts are often linked. The cascading effects resulting from altered clock genes in a pediatric population could participate in biological rhythm abnormalities and the emergence of suicide attempts through impaired regulation of circadian rhythms and emotional states with neurodevelopmental effects. Also, early trauma and stressful life events can alter the expression of clock genes and contribute to the emergence of suicide attempts. Alteration of clock genes might lead to desynchronized and abnormal circadian rhythms impairing in turn the synchronization between external and internal rhythms and therefore the adaptation of the individual to his/her internal and external environment with the development of psychiatric disorders associated with increased risk for suicide attempts.
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Affiliation(s)
- Bertrand Olliac
- Pôle Universitaire de Psychiatrie de l'enfant et de l'adolescent, Centre Hospitalier Esquirol, 15 rue du docteur Marcland, 87025 Limoges, France; Institut National de la Santé et de la Recherche Médicale Unité Mixte de Recherche 1094, Tropical Neuroepidemiology, Université de Limoges, Limoges, France.
| | - Lisa Ouss
- Department of Child and Adolescent Psychiatry, Necker-Enfants-Malades Hospital, APHP, Université Paris Descartes, 149 rue de Sèvres, 75015 Paris, France.
| | - Annaëlle Charrier
- Pôle Hospitalo-Universitaire de Psychiatrie de l'Enfant et de l'Adolescent (PHUPEA), Université de Rennes 1, Centre Hospitalier Guillaume-Régnier, 154 Rue de Châtillon, 35000 Rennes, France.
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26
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Antypa N, Verkuil B, Molendijk M, Schoevers R, Penninx BWJH, Van Der Does W. Associations between chronotypes and psychological vulnerability factors of depression. Chronobiol Int 2017; 34:1125-1135. [PMID: 28759270 DOI: 10.1080/07420528.2017.1345932] [Citation(s) in RCA: 76] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Chronotypes have been associated with psychopathology. The eveningness chronotype has been consistently linked with depressed states or depressive disorder, but the underlying mechanism remains unclear. Prior studies have shown associations between chronotype and personality traits that are linked to depression (e.g. neuroticism), but other psychological vulnerability factors have not been previously investigated in relation to chronotypes. The aim of this study was to examine the association between chronotypes, depression and psychological risk factors of depression (namely, cognitive reactivity and worry), in a large cohort of depressed patients and healthy individuals. We used data from the Netherlands Study of Depression and Anxiety (n = 1654), which includes 1227 clinically diagnosed individuals with a lifetime diagnosis of depression and 427 healthy controls. We assessed cognitive reactivity (Leiden Index of Depression Sensitivity-Revised) and trait worry (Penn State Worry Questionnaire). We controlled for sociodemographic factors as well as for insomnia and neuroticism. We found that the evening type is associated with higher cognitive reactivity scores, especially with increased rumination. Cognitive reactivity also mediated the relationship between chronotype and depression status, even when controlling for neuroticism and insomnia. Trait worry was not associated with chronotype. Our findings show that depressogenic cognitions are more prevalent in evening types and perhaps mediate the association between chronotype and depression. Further prospective research is needed to determine the timeline of the association. Nevertheless, results imply that targeting depressogenic cognitive processes, perhaps in combination with chronotherapeutic treatments, may be particularly useful in evening types.
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Affiliation(s)
- Niki Antypa
- a Department of Clinical Psychology , Institute of Psychology, Leiden University , Leiden , The Netherlands.,b Leiden Institute of Brain and Cognition, Leiden University , Leiden , The Netherlands
| | - Bart Verkuil
- a Department of Clinical Psychology , Institute of Psychology, Leiden University , Leiden , The Netherlands.,b Leiden Institute of Brain and Cognition, Leiden University , Leiden , The Netherlands
| | - Marc Molendijk
- a Department of Clinical Psychology , Institute of Psychology, Leiden University , Leiden , The Netherlands.,b Leiden Institute of Brain and Cognition, Leiden University , Leiden , The Netherlands
| | - Robert Schoevers
- c Department of Psychiatry , University of Groningen, University Medical Center Groningen , Groningen , The Netherlands
| | - Brenda W J H Penninx
- d Department of Psychiatry , Amsterdam Public Health and Amsterdam Neuroscience, VU University Medical Center/GGZ inGeest , Amsterdam , The Netherlands
| | - Willem Van Der Does
- a Department of Clinical Psychology , Institute of Psychology, Leiden University , Leiden , The Netherlands.,b Leiden Institute of Brain and Cognition, Leiden University , Leiden , The Netherlands.,e Department of Psychiatry , Leiden University Medical Center , Leiden , The Netherlands
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27
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Rumination, Suicidal Ideation, and Suicide Attempts: A Meta-Analytic Review. REVIEW OF GENERAL PSYCHOLOGY 2017. [DOI: 10.1037/gpr0000101] [Citation(s) in RCA: 105] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Rumination has been implicated as a risk factor for suicidal ideation and attempts, yet the literature to date has not been synthesized. We conducted a meta-analysis of the association between rumination and both suicidal ideation and attempts to consolidate the existing literature ( k = 29). Results indicated that the relationships between global rumination ( k = 13; Hedge's g = .74, p < .001, 95% CI [.45, 1.04]), brooding ( k = 12; Hedge's g = .63, p < .001, 95% CI [.35, .90]), and reflection ( k = 12; Hedge's g = .38, p = .002, 95% CI [.10, .65]) with suicidal ideation were significant. Associations between global rumination ( k = 3; Hedge's g = .26, p < .001, 95% CI [.08, .44]) and brooding ( k = 4; Hedge's g = .47, p = .004, 95% CI [.02, .91]) and suicide attempts were significant, but reflection ( k = 4; Hedge's g = .09, p = .646, 95% CI [−.54, .72]) was unrelated. However, given the limited studies included in suicide attempt analyses—and the exclusive use of cross-sectional designs and heterogeneity with regard to samples and measures—these parameters should be taken with caution. Generally, age, gender, race/ethnicity, and year of publication were not moderators, and there was little evidence for publication bias across effects, with the exception of the effect of global rumination on suicidal ideation. Several future research directions are discussed.
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28
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Ducasse D, Jaussent I, Guillaume S, Azorin JM, Bellivier F, Belzeaux R, Bougerol T, Etain B, Gard S, Henry C, Kahn JP, Leboyer M, Loftus J, Passerieux C, Olié E, Courtet P. Affect lability predicts occurrence of suicidal ideation in bipolar patients: a two-year prospective study. Acta Psychiatr Scand 2017; 135:460-469. [PMID: 28260234 DOI: 10.1111/acps.12710] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/23/2017] [Indexed: 02/06/2023]
Abstract
OBJECTIVE The aim of our study was to investigate, in bipolar patients, whether affect lability was associated with suicidal ideation incidence during 2-year follow-up, and which subtype of affect lability was associated with suicidal ideation. METHOD A total of 319 euthymic or mildly depressed bipolar outpatients recruited in the French FondaMental Advanced Centres of Expertise for Bipolar Disorder were divided into two subgroups according to the occurrence of suicidal ideation during a 2-year follow-up. Affect lability was assessed by the French version of the Affect Lability Scale. RESULTS Bipolar patients with high affect lability were more likely to report suicidal ideation during follow-up, even after adjustment for age, study level, rapid cycling, current depression level, anxiety disorder, and lifetime history SA (OR = 2.47; 95% CI [1.15-5.30], P = 0.01). The risk of suicidal ideation increased with the level of affect lability. More specifically, the propensity to switch from neutral to elation affect, from anxious to depressive affect (or inversely), and from neutral to anger affect predicted suicidal ideation. CONCLUSION Reducing affective lability could become a new therapeutic target of suicidal prevention in bipolar disorder.
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Affiliation(s)
- D Ducasse
- CHU Montpellier, Hôpital Lapeyronie, Department of Emergency Psychiatry and Post Acute Care, CHRU Montpellier, Montpellier, France.,Inserm, U1061 Montpellier, University of Montpellier, Montpellier, France.,Fondation FondaMental, Créteil, France
| | - I Jaussent
- Inserm, U1061 Montpellier, University of Montpellier, Montpellier, France
| | - S Guillaume
- CHU Montpellier, Hôpital Lapeyronie, Department of Emergency Psychiatry and Post Acute Care, CHRU Montpellier, Montpellier, France.,Inserm, U1061 Montpellier, University of Montpellier, Montpellier, France.,Fondation FondaMental, Créteil, France
| | - J M Azorin
- Fondation FondaMental, Créteil, France.,AP HM, Psychiatric Pole, Sainte Marguerite, Marseille, France
| | - F Bellivier
- Fondation FondaMental, Créteil, France.,Hospital Saint-Louis - Lariboisière - Fernand Widal, AP-HP, Paris, France
| | - R Belzeaux
- Fondation FondaMental, Créteil, France.,AP HM, Psychiatric Pole, Sainte Marguerite, Marseille, France
| | - T Bougerol
- Fondation FondaMental, Créteil, France.,Academic Hospital of Grenoble, Grenoble, France
| | - B Etain
- Fondation FondaMental, Créteil, France.,Université Paris-Est, Hopital Henri Mondor, DHU PePSY and AP-HP, Créteil, France
| | - S Gard
- Fondation FondaMental, Créteil, France.,Charles Perrens Hospital, Bordeaux, France
| | - C Henry
- Fondation FondaMental, Créteil, France.,Université Paris-Est, Hopital Henri Mondor, DHU PePSY and AP-HP, Créteil, France
| | - J P Kahn
- Fondation FondaMental, Créteil, France.,Brabois Hospital, Academic Hospital of Nancy, Vandoeuvre Les Nancy, France
| | - M Leboyer
- Fondation FondaMental, Créteil, France.,Université Paris-Est, Hopital Henri Mondor, DHU PePSY and AP-HP, Créteil, France
| | - J Loftus
- Fondation FondaMental, Créteil, France.,Department of Psychiatry, Princesse-Grace Hospital, Monaco
| | - C Passerieux
- Fondation FondaMental, Créteil, France.,Academic Hospital of Versailles, Le Chesnay, France
| | | | - E Olié
- CHU Montpellier, Hôpital Lapeyronie, Department of Emergency Psychiatry and Post Acute Care, CHRU Montpellier, Montpellier, France.,Inserm, U1061 Montpellier, University of Montpellier, Montpellier, France.,Fondation FondaMental, Créteil, France
| | - P Courtet
- CHU Montpellier, Hôpital Lapeyronie, Department of Emergency Psychiatry and Post Acute Care, CHRU Montpellier, Montpellier, France.,Inserm, U1061 Montpellier, University of Montpellier, Montpellier, France.,Fondation FondaMental, Créteil, France
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29
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Paans NPG, Bot M, Gibson-Smith D, Van der Does W, Spinhoven P, Brouwer I, Visser M, Penninx BWJH. The association between personality traits, cognitive reactivity and body mass index is dependent on depressive and/or anxiety status. J Psychosom Res 2016; 89:26-31. [PMID: 27663107 DOI: 10.1016/j.jpsychores.2016.07.013] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2016] [Revised: 07/15/2016] [Accepted: 07/21/2016] [Indexed: 11/19/2022]
Abstract
OBJECTIVE A range of biological, social and psychological factors, including depression and anxiety disorders, is thought to be associated with higher body mass index (BMI). Depression and anxiety disorders are associated with specific psychological vulnerabilities, like personality traits and cognitive reactivity, that may also be associated with BMI. The relationship between those psychological vulnerabilities and BMI is possibly different in people with and without depression and anxiety disorders. Therefore, we examined the relationship between personality traits, cognitive reactivity and severity of affective symptoms with BMI in people with and without depression and anxiety disorders. METHODS Data from 1249 patients with current major depressive and/or anxiety disorder and 631 healthy controls were sourced from the Netherlands Study of Depression and Anxiety. Linear and logistic regression analyses were used to determine the associations between personality traits (neuroticism, extraversion, conscientiousness), cognitive reactivity (hopelessness, aggression, rumination, anxiety sensitivity), depression and anxiety symptoms with BMI classes (normal: 18.5-24.9, overweight: 25-29.9, and obese: ≥30kg/m(2)) and continuous BMI. Due to significant statistical interaction, analyses were stratified for healthy individuals and depressed/anxious patients. RESULTS Personality traits were not consistently related to BMI. In patients, higher hopelessness and aggression reactivity and higher depression and anxiety symptoms were associated with higher BMI. In contrast, in healthy individuals lower scores on hopelessness, rumination, aggression reactivity and anxiety sensitivity were associated with higher BMI. CONCLUSION These results suggest that, particularly in people with psychopathology, cognitive reactivity may contribute to obesity.
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Affiliation(s)
- Nadine P G Paans
- Department of Psychiatry, EMGO Institute for Health and Care Research and Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands.
| | - Mariska Bot
- Department of Psychiatry, EMGO Institute for Health and Care Research and Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - Deborah Gibson-Smith
- Department of Psychiatry, EMGO Institute for Health and Care Research and Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - Willem Van der Does
- Institute of Psychology, Leiden University, Leiden, The Netherlands; Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands
| | - Philip Spinhoven
- Institute of Psychology, Leiden University, Leiden, The Netherlands; Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands
| | - Ingeborg Brouwer
- Department of Health Sciences, Faculty of Earth and Life Sciences, and the EMGO Institute for Health and Care Research, VU University, Amsterdam, The Netherlands; Department of Nutrition and Dietetics, Internal Medicine, VU University Medical Center, Amsterdam, The Netherlands
| | - Marjolein Visser
- Department of Health Sciences, Faculty of Earth and Life Sciences, and the EMGO Institute for Health and Care Research, VU University, Amsterdam, The Netherlands; Department of Nutrition and Dietetics, Internal Medicine, VU University Medical Center, Amsterdam, The Netherlands
| | - Brenda W J H Penninx
- Department of Psychiatry, EMGO Institute for Health and Care Research and Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
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30
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Batmaz S, Kocbiyik S, Yuncu OA. Cognitive Reactivity in Depressed Outpatients: How Different is Severe Depression? JOURNAL OF RATIONAL-EMOTIVE AND COGNITIVE-BEHAVIOR THERAPY 2016. [DOI: 10.1007/s10942-016-0249-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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31
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Chesin MS, Benjamin-Phillips CA, Keilp J, Fertuck EA, Brodsky BS, Stanley B. Improvements in Executive Attention, Rumination, Cognitive Reactivity, and Mindfulness Among High–Suicide Risk Patients Participating in Adjunct Mindfulness-Based Cognitive Therapy: Preliminary Findings. J Altern Complement Med 2016; 22:642-9. [DOI: 10.1089/acm.2015.0351] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Megan S. Chesin
- Department of Psychology, William Paterson University, Wayne, NJ
- Molecular Imagining and Neuropathology Division, New York State Psychiatric Institute, New York, NY
| | | | - John Keilp
- Molecular Imagining and Neuropathology Division, New York State Psychiatric Institute, New York, NY
| | - Eric A. Fertuck
- Molecular Imagining and Neuropathology Division, New York State Psychiatric Institute, New York, NY
- Department of Psychology, City College and Graduate Center, City University of New York, New York, NY
| | - Beth S. Brodsky
- Molecular Imagining and Neuropathology Division, New York State Psychiatric Institute, New York, NY
| | - Barbara Stanley
- Molecular Imagining and Neuropathology Division, New York State Psychiatric Institute, New York, NY
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Jiménez E, Arias B, Mitjans M, Goikolea JM, Ruíz V, Brat M, Sáiz PA, García-Portilla MP, Burón P, Bobes J, Oquendo MA, Vieta E, Benabarre A. Clinical features, impulsivity, temperament and functioning and their role in suicidality in patients with bipolar disorder. Acta Psychiatr Scand 2016; 133:266-76. [PMID: 26726104 DOI: 10.1111/acps.12548] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/07/2015] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Our aim was to analyse sociodemographic and clinical differences between non-suicidal (NS) bipolar patients (BP), BP reporting only suicidal ideation (SI) and BP suicide attempters according to Columbia-Suicide Severity Rating Scale (C-SRSS) criteria. Secondarily, we also investigated whether the C-SRSS Intensity Scale was associated with emergence of suicidal behaviour (SB). METHOD A total of 215 euthymic bipolar out-patients were recruited. Semistructured interviews including the C-SRSS were used to assess sociodemographic and clinical data. Patients were grouped according to C-SRSS criteria: patients who scored ≤1 on the Severity Scale were classified as NS. The remaining patients were grouped into two groups: 'patients with history of SI' and 'patients with history of SI and SB' according to whether they did or did not have a past actual suicide attempt respectively. RESULTS Patients from the three groups differed in illness onset, diagnosis, number of episodes and admissions, family history, comorbidities, rapid cycling and medication, as well as level of education, functioning, impulsivity and temperamental profile. CONCLUSION Our results suggest that increased impulsivity, higher rates of psychiatric admissions and a reported poor controllability of SI significantly increased the risk for suicidal acts among patients presenting SI.
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Affiliation(s)
- E Jiménez
- Bipolar Disorder Unit, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - B Arias
- Anthropology Section, Department of Animal Biology, Faculty of Biology, University of Barcelona, IBUB, CIBERSAM, Instituto de Salud Carlos III, Barcelona, Catalonia, Spain
| | - M Mitjans
- Anthropology Section, Department of Animal Biology, Faculty of Biology, University of Barcelona, IBUB, CIBERSAM, Instituto de Salud Carlos III, Barcelona, Catalonia, Spain.,Clinical Neuroscience, Max Planck Institute of Experimental Medicine, Göttingen, Germany
| | - J M Goikolea
- Bipolar Disorder Unit, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - V Ruíz
- Institut Clinic de Neurociencies, Hospital Clinic, Barcelona, Catalonia, Spain
| | - M Brat
- Bipolar Disorder Unit, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - P A Sáiz
- Department of Psychiatry, School of Medicine, University of Oviedo, CIBERSAM, Instituto de Neurociencias del Principado de Asturias, INEUROPA, Oviedo, Spain.,Servicio de Salud del Principado de Asturias (SESPA), Oviedo, Spain
| | - M P García-Portilla
- Department of Psychiatry, School of Medicine, University of Oviedo, CIBERSAM, Instituto de Neurociencias del Principado de Asturias, INEUROPA, Oviedo, Spain.,Servicio de Salud del Principado de Asturias (SESPA), Oviedo, Spain
| | - P Burón
- Department of Psychiatry, School of Medicine, University of Oviedo, CIBERSAM, Instituto de Neurociencias del Principado de Asturias, INEUROPA, Oviedo, Spain
| | - J Bobes
- Department of Psychiatry, School of Medicine, University of Oviedo, CIBERSAM, Instituto de Neurociencias del Principado de Asturias, INEUROPA, Oviedo, Spain.,Servicio de Salud del Principado de Asturias (SESPA), Oviedo, Spain
| | - M A Oquendo
- Department of Psychiatry, New York State Psychiatric Institute and Columbia University, New York, NY, USA
| | - E Vieta
- Bipolar Disorder Unit, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - A Benabarre
- Bipolar Disorder Unit, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
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Nascimento ER, Maia ACO, Soares-Filho G, Nardi AE, Cardoso A. Predictors of suicidal ideation in coronary artery disease. Compr Psychiatry 2015; 57:16-20. [PMID: 25464838 DOI: 10.1016/j.comppsych.2014.10.017] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2014] [Revised: 10/24/2014] [Accepted: 10/27/2014] [Indexed: 11/28/2022] Open
Abstract
CONTEXT In clinical practice, the importance of screening for anxiety and depression in patients with medical illness is highlighted. In many cases, the suicidal ideation makes up the framework of mental disorders, which may be exacerbated in these individuals. OBJECTIVE To investigate the role of symptoms of mental disorders in the presence of suicidal ideation. METHODS A total of 103 patients with diagnosis of coronary artery disease in cardiac treatment were interviewed for symptoms of anxiety and depression using the Beck Depression Inventory and Hospital Anxiety and Depression Scale. All patients were also analyzed for presence of suicidal ideation, wishes, attitude and suicidal plans using the Beck Suicidal Ideation Scale. The relationship between social and demographic variables and mental disturbances and the presence of suicidal ideation was assessed using chi-square test and coefficient of sperm. Logistic regression analysis was used to explain the change in the role of each of the variables in suicidal ideation. RESULTS The results showed that predictors for suicidal ideation were isolated anxiety (B=0.29; Wald 4.77; p=0.03) with an odds ratio of 1.34 (CI 1.03-1.75) and isolated depression (B=0.33; Wald 5.35; p=0.02) with an odds ratio of 1.39 (CI 1.05-1.85). Frequencies of interaction depression and anxiety were higher among patients who were single, widowed and divorced. Chi-square test and the coefficient of sperm showed an association between marital status and suicidal ideation (χ(2)(2)=9.17; p=0.01). CONCLUSION Anxiety and depression are risk factors for isolated patients with suicidal ideation. Early clinical identification of mental disorders in patients with medical illness contributed to preventing the risk of suicide.
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Affiliation(s)
| | - Ana Claudia Ornelas Maia
- Institute of Psychiatry, Federal University of Rio de Janeiro (IPUB/UFRJ), Rio de Janeiro, Brazil.
| | - Gastão Soares-Filho
- Institute of Psychiatry, Federal University of Rio de Janeiro (IPUB/UFRJ), Rio de Janeiro, Brazil.
| | - Antonio Egidio Nardi
- Institute of Psychiatry, Federal University of Rio de Janeiro (IPUB/UFRJ), Rio de Janeiro, Brazil; National Institute of Science and Technology for Translational Medicine (INCT-TM/CNPq), Rio de Janeiro, Brazil.
| | - Adriana Cardoso
- Institute of Psychiatry, Federal University of Rio de Janeiro (IPUB/UFRJ), Rio de Janeiro, Brazil; National Institute of Science and Technology for Translational Medicine (INCT-TM/CNPq), Rio de Janeiro, Brazil.
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34
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Forkmann T, Wichers M, Geschwind N, Peeters F, van Os J, Mainz V, Collip D. Effects of mindfulness-based cognitive therapy on self-reported suicidal ideation: results from a randomised controlled trial in patients with residual depressive symptoms. Compr Psychiatry 2014; 55:1883-90. [PMID: 25218397 DOI: 10.1016/j.comppsych.2014.08.043] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2014] [Revised: 08/07/2014] [Accepted: 08/11/2014] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION The aim of the present study was to investigate the effects of mindfulness-based cognitive therapy (MBCT) on suicidal ideation in an open-label randomised controlled trial of patients with residual depressive symptoms. Furthermore, this study aimed at examining whether an effect of MBCT on suicidal ideation was dependent on a reduction in depression severity, worry and rumination, or an increase in mindfulness. METHODS One hundred and thirty participants were randomised to a treatment arm (treatment as usual plus MBCT) or a wait list arm. Change in depression, change in worry, change in rumination and change in mindfulness were entered as covariates in a repeated measures ANOVA in order to assess to what degree MBCT-induced changes in suicidal ideation were independent from changes in these parameters. RESULTS There was a significant group×time (pre vs. post) interaction on suicidal ideation indicating a significant reduction of suicidal ideation in the MBCT group, but not in the control group. The interaction remained significant after addition of the above covariates. Change in worry was the only covariate associated with change in suicidal ideation, causing a moderate reduction in the interaction effect size. CONCLUSIONS The results suggest that MBCT may affect suicidal ideation in patients with residual depressive symptoms and that this effect may be mediated, in part, by participants' enhanced capacity to distance themselves from worrying thoughts.
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Affiliation(s)
- Thomas Forkmann
- Institute of Medical Psychology and Medical Sociology, University Hospital of RWTH Aachen University, Pauwelsstraße 19, 52074 Aachen, Germany.
| | - Marieke Wichers
- Department of Psychiatry and Psychology, Maastricht University Medical Centre, School for Mental Health and Neuroscience, The Netherlands.
| | - Nicole Geschwind
- Faculty of Psychology and Neuroscience, Maastricht University, The Netherlands.
| | - Frenk Peeters
- Department of Psychiatry and Psychology, Maastricht University Medical Centre, School for Mental Health and Neuroscience, The Netherlands.
| | - Jim van Os
- Department of Psychiatry and Psychology, Maastricht University Medical Centre, School for Mental Health and Neuroscience, The Netherlands; King's College London, King's Health Partners, Department of Psychosis Studies, Institute of Psychiatry, De Crespigny Park, London SE5 8AF, UK.
| | - Verena Mainz
- Institute of Medical Psychology and Medical Sociology, University Hospital of RWTH Aachen University, Pauwelsstraße 19, 52074 Aachen, Germany.
| | - Dina Collip
- Department of Psychiatry and Psychology, Maastricht University Medical Centre, School for Mental Health and Neuroscience, The Netherlands.
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Hendriks SM, Licht CMM, Spijker J, Beekman ATF, Hardeveld F, de Graaf R, Penninx BWJH. Disorder-specific cognitive profiles in major depressive disorder and generalized anxiety disorder. BMC Psychiatry 2014; 14:96. [PMID: 24690413 PMCID: PMC3975137 DOI: 10.1186/1471-244x-14-96] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2013] [Accepted: 03/25/2014] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND This investigation examines differences in cognitive profiles in subjects with major depressive disorder (MDD) and generalized anxiety disorder (GAD). METHODS Data were used from subjects with current MDD (n = 655), GAD (n = 107) and comorbid MDD/GAD (n = 266) diagnosis from the Netherlands Study of Depression and Anxiety (NESDA). The Composite Interview Diagnostic Instrument was used to diagnose MDD and GAD. Cognitive profiles were measured using the Leiden Index of Depression Sensitivity, the Anxiety Sensitivity Index, and the Penn State Worry Questionnaire. RESULTS Results showed that differences in cognitive profiles between single MDD and single GAD subjects were present: scores on hopelessness/suicidality and rumination were significantly higher in MDD than GAD, whereas anxiety sensitivity for physical concerns and pathological worry were higher in GAD than MDD. The cognitive profile of comorbid MDD/GAD showed more extreme depression cognitions compared to single disorders, and a similar anxiety profile compared to single GAD subjects. CONCLUSIONS Despite the commonalities in cognitive profiles in MDD and GAD, there are differences suggesting that MDD and GAD have disorder-specific cognitive profiles. Findings of this investigation give support for models like the cognitive content-specificity model and the tripartite model and could provide useful handles for treatment focus.
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Affiliation(s)
- Sanne M Hendriks
- Department of Psychiatry, Pro Persona Mental Health Care, Willy Brandtlaan 20, Ede 6717 RR, The Netherlands.
| | - Carmilla MM Licht
- Department of Psychiatry, VU University Amsterdam, A.J. Ernststraat 887, Amsterdam 1081 HL, The Netherlands
| | - Jan Spijker
- Pro Persona Mental Health Care, Radboud University Nijmegen, Reinier Postlaan 6, 6525 GC Nijmegen, The Netherlands,Netherlands Institute of Mental Health and Addiction, Da Costakade 45, Utrecht 3521 VS, The Netherlands
| | - Aartjan TF Beekman
- Department of Psychiatry, VU University Amsterdam, A.J. Ernststraat 887, Amsterdam 1081 HL, The Netherlands
| | - Florian Hardeveld
- Department of Psychiatry, Pro Persona Mental Health Care, Willy Brandtlaan 20, Ede 6717 RR, The Netherlands
| | - Ron de Graaf
- Netherlands Institute of Mental Health and Addiction, Da Costakade 45, Utrecht 3521 VS, The Netherlands
| | - Brenda WJH Penninx
- Department of Psychiatry, VU University Amsterdam, A.J. Ernststraat 887, Amsterdam 1081 HL, The Netherlands,Department of Psychiatry, Leiden University Medical Center, Albinusdreef 2, Leiden 2333 ZA, The Netherlands,Department of Psychiatry, University Medical Center Groningen, Hanzeplein 1, Groningen 9713 GZ, The Netherlands
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Jun WH, Lee EJ, Park JS. Effects of a suicide prevention programme for hospitalised patients with mental illness in South Korea. J Clin Nurs 2013; 23:1845-56. [DOI: 10.1111/jocn.12417] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/14/2013] [Indexed: 11/27/2022]
Affiliation(s)
- Won Hee Jun
- Department of Nursing and Research Institute for Basic Science; Hoseo University; Asan-si Chungnam South Korea
| | - Eun Ju Lee
- Department of Nursing; Andong Science College; Andong-si Gyeongbuk South Korea
| | - Jeong Soon Park
- Catholic University Uijeongbu; St. Mary Hospital; Uijeongbu Kyunggido South Korea
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Struijs SY, Groenewold NA, Oude Voshaar RC, de Jonge P. Cognitive vulnerability differentially predicts symptom dimensions of depression. J Affect Disord 2013; 151:92-9. [PMID: 23787407 DOI: 10.1016/j.jad.2013.05.057] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2012] [Revised: 05/20/2013] [Accepted: 05/21/2013] [Indexed: 12/14/2022]
Abstract
BACKGROUND We examined the association of cognitive vulnerability to depression with changes in homogeneous measures of depressive symptoms. METHODS Baseline and 1-year follow-up data were obtained from 2981 participants of the Netherlands study of depression and anxiety. Multivariate regression analyses were carried out on cognitive reactivity, locus of control and implicit and explicit self-depressive associations in combination with negative life events. The purpose of this analysis was to predict changes on the mood/cognition and anxiety/arousal subscales of the inventory of depressive symptomatology - self report. RESULTS Cognitive reactivity, locus of control and explicit self-depressive associations were independently associated with changes in depressive symptoms after adjustment for covariates and baseline severity (all p<0.01). Negative life-events interacted with cognitive vulnerability to depression to predict depressive symptoms. Locus of control (b1=0.16, SE=0.02, η(2)=0.01; b2=0.10, SE=0.02, η(2)=0.004, F=8.69, p<0.01) and explicit self-depressive associations (b1=0.10, SE=0.03, η(2)=0.02; b2=0.02, SE=0.04, F=7.50, p<0.01) were more strongly associated with the cognitive (b1) than the somatic (b2) symptom dimension of depression. LIMITATIONS The study sample is over-inclusive of depressed patients. Therefore it might be problematic generalizing the findings to the general population. CONCLUSION Cognitive etiological factors may play a role in a "cognitive" subtype of depression. The findings strengthen the notion that homogeneous measures of depressive symptoms enable a greater degree of discrimination between subtypes than a multidimensional conception of depression.
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Affiliation(s)
- Sascha Y Struijs
- Department of Psychiatry, University Medical Center Groningen, Hanzeplein 1, PO Box 30.001, 9700 RB Groningen, The Netherlands
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MAOA and MAOB polymorphisms and anger-related traits in suicidal participants and controls. Eur Arch Psychiatry Clin Neurosci 2013; 263:393-403. [PMID: 23111930 DOI: 10.1007/s00406-012-0378-8] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2012] [Accepted: 10/15/2012] [Indexed: 12/11/2022]
Abstract
MAOA and, to a lesser extent, MAOB polymorphisms have been related to aggression traits and suicidality. We aimed to investigate the role of MAOA and MAOB in suicidal versus non-suicidal participants and interactions between genetic variation and suicidal status on aggression and anger-related traits. The sample was composed of three groups: one group of suicide attempters (n = 171, males 35.1 %), one group of suicide completers (n = 90, males 57.8 %) and a healthy control group (n = 317, males 43.8 %). We examined the following markers: MAOA rs909525, rs6323, and rs2064070, and MAOB rs1799836. Anger traits were measured with the state-trait anger expression inventory (STAXI) and aggression traits with the questionnaire for measuring factors of aggression (FAF). Associations were separately examined for males and females. Variation in the three MAOA variants was associated with higher levels of anger expressed outwards (STAXI "anger-out" subscale) in male suicidal patients compared to controls (p < 0.001). In females, the C allele of rs6323 showed higher scores on the same subscale ("anger out") (p = 0.002). Allele frequencies of the MAOA rs909525 were associated with suicidality (p < 0.007). Our findings show an association between genetic variation in three polymorphisms of the MAOA and anger traits in suicidal males and one replication for the functional variant rs6323 in females. This relationship was stronger than a direct genetic association with suicide status. Future studies incorporating endophenotypic measures of anger and aggression in suicidal participants are warranted.
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Kruijt AW, Antypa N, Booij L, de Jong PJ, Glashouwer K, Penninx BWJH, Van der Does W. Cognitive reactivity, implicit associations, and the incidence of depression: a two-year prospective study. PLoS One 2013; 8:e70245. [PMID: 23922962 PMCID: PMC3724814 DOI: 10.1371/journal.pone.0070245] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2013] [Accepted: 06/18/2013] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND Cognitive reactivity to sad mood is a vulnerability marker of depression. Implicit self-depressed associations are related to depression status and reduced remission probability. It is unknown whether these cognitive vulnerabilities precede the first onset of depression. AIM To test the predictive value of cognitive reactivity and implicit self-depressed associations for the incidence of depressive disorders. METHODS Prospective cohort study of 834 never-depressed individuals, followed over a two-year period. The predictive value of cognitive reactivity and implicit self-depressed associations for the onset of depressive disorders was assessed using binomial logistic regression. The multivariate model corrected for baseline levels of subclinical depressive symptoms, neuroticism, for the presence of a history of anxiety disorders, for family history of depressive or anxiety disorders, and for the incidence of negative life events. RESULTS As single predictors, both cognitive reactivity and implicit self-depressed associations were significantly associated with depression incidence. In the multivariate model, cognitive reactivity was significantly associated with depression incidence, together with baseline depressive symptoms and the number of negative life events, whereas implicit self-depressed associations were not. CONCLUSION Cognitive reactivity to sad mood is associated with the incidence of depressive disorders, also when various other depression-related variables are controlled for. Implicit self-depressed associations predicted depression incidence in a bivariate test, but not when controlling for other predictors.
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Affiliation(s)
- Anne-Wil Kruijt
- Institute of Psychology, Leiden University, Leiden, The Netherlands.
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van Hees NJM, Van der Does W, Giltay EJ. Coeliac disease, diet adherence and depressive symptoms. J Psychosom Res 2013; 74:155-60. [PMID: 23332531 DOI: 10.1016/j.jpsychores.2012.11.007] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2012] [Revised: 11/09/2012] [Accepted: 11/13/2012] [Indexed: 12/17/2022]
Abstract
OBJECTIVES We aimed to investigate whether long-term adherence to a gluten-free diet is related to depressive symptoms in coeliac disease (CD) patients. METHODS A cross-sectional survey was performed in 2265 adult CD patients recruited through the Dutch Coeliac Association. Self-reported diet adherence was compared among groups based on self-reported depressive symptoms (categorized into current [1-month], remitted, and never). RESULTS The life-time prevalence rate of self-reported depressive symptoms was 39.0% (n=883), of whom 270 (11.9%) suffered from current depressive symptoms. Adherence to gluten-free diet was strict in 50.2% of patients, sufficient in 46.3%, and insufficient in 3.6%. Insufficient adherence was not associated with current depressive symptoms (odds ratio [OR] 0.95; 95% confidence interval [CI]: 0.48-1.92). Keeping a gluten-free diet for longer than five years was associated with lower OR of current depressive symptoms compared to being on a diet for less than two years (OR 0.69; 95% CI: 0.50-0.95). CONCLUSIONS Lifetime depressive symptoms may be present in one third of the CD patients who adhere to gluten-free diet. Long-term adherence to the gluten-free diet may reduce the risk of current depressive symptoms.
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Verhoeven FEA, Booij L, Kruijt AW, Cerit H, Antypa N, Does W. The effects of MAOA genotype, childhood trauma, and sex on trait and state-dependent aggression. Brain Behav 2012; 2:806-13. [PMID: 23170243 PMCID: PMC3500467 DOI: 10.1002/brb3.96] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2012] [Revised: 07/11/2012] [Accepted: 09/03/2012] [Indexed: 01/11/2023] Open
Abstract
Monoamine oxidase A (MAOA) genotypic variation has been associated with variation in aggression, especially in interaction with childhood trauma or other early adverse events. Male carriers of the low-expressing variant (MAOA-L) with childhood trauma or other early adverse events seem to be more aggressive, whereas female carriers with the high-expressing variant (MAOA-H) with childhood trauma or other early adverse events may be more aggressive. We further investigated the effects of MAOA genotype and its interaction with sex and childhood trauma or other early adverse events on aggression in a young adult sample. We hypothesized that the association between genotype, childhood trauma, and aggression would be different for men and women. We also explored whether this association is different for dispositional (trait) aggression versus aggression in the context of dysphoric mood. In all, 432 Western European students (332 women, 100 men; mean age 20.2) were genotyped for the MAOA gene. They completed measures of childhood trauma, state and trait measures of aggression-related behaviors (STAXI), and cognitive reactivity to sad mood (LEIDS-R), including aggression reactivity. Women with the MAOA-H had higher aggression reactivity scores than women with the MAOA-L. This effect was not observed in men, although the nonsignificant findings in men may be a result of low power. Effects on the STAXI were not observed, nor were there gene by environment interactions on any of the aggression measures. A protective effect of the low-expression variant in women on aggression reactivity is consistent with previous observations in adolescent girls. In females, the MAOA-H may predispose to aggression-related problems during sad mood.
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Goldstein G, Luther JF, Haas GL. Medical, psychiatric and demographic factors associated with suicidal behavior in homeless veterans. Psychiatry Res 2012; 199:37-43. [PMID: 22521899 DOI: 10.1016/j.psychres.2012.03.029] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2011] [Revised: 02/27/2012] [Accepted: 03/18/2012] [Indexed: 10/28/2022]
Abstract
This study assessed potential for suicidal behaviors associated with sociodemographic, predisposing physical and mental health factors and self-reported psychological problems among homeless veterans in a large northeastern region. Data were obtained from a demographic and clinical history interview conducted with 3595 homeless veterans. Odds-ratio (OR) statistics were used to assess potential for suicidal behavior. Statistically significant ratios were similar for ideation and attempts. The highest ratios were for self-report of depression and difficulty controlling violence, but statistically significant ratios were found for reporting sleeping in a treatment facility the night before the interview, receiving VA support for a psychiatric condition, and the diagnoses of Alcoholism, Mood Disorder and Post Traumatic Stress Disorder (PTSD). Low but statistically significant odds-ratios were obtained for most of the physical health items. A negative odds-ratio was obtained for African-American ethnicity. Logistic regression results indicated that for ideation and attempts items entered first involved subjective report of trouble controlling violent behavior and experiencing depression. High odds ratios for the interview items concerning experiencing serious depression and having difficulties controlling violence may have strong implications for treatment and management of homeless veterans. There may be up to 14-1 odds that an individual who reports being seriously depressed or having difficulty inhibiting aggression may have a serious potential for suicidal behaviors.
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Affiliation(s)
- Gerald Goldstein
- Mental Illness Research, Educational and Clinical Center, VA Pittsburgh Healthcare System, Pittsburgh, PA, USA.
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Marchetti I, Koster EHW, Sonuga-Barke EJ, De Raedt R. The default mode network and recurrent depression: a neurobiological model of cognitive risk factors. Neuropsychol Rev 2012; 22:229-51. [PMID: 22569771 DOI: 10.1007/s11065-012-9199-9] [Citation(s) in RCA: 180] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2012] [Accepted: 04/11/2012] [Indexed: 12/12/2022]
Abstract
A neurobiological account of cognitive vulnerability for recurrent depression is presented based on recent developments of resting state neural networks. We propose that alterations in the interplay between task positive (TP) and task negative (TN) elements of the Default Mode Network (DMN) act as a neurobiological risk factor for recurrent depression mediated by cognitive mechanisms. In the framework, depression is characterized by an imbalance between TN-TP components leading to an overpowering of TP by TN activity. The TN-TP imbalance is associated with a dysfunctional internally-focused cognitive style as well as a failure to attenuate TN activity in the transition from rest to task. Thus we propose the TN-TP imbalance as overarching neural mechanism involved in crucial cognitive risk factors for recurrent depression, namely rumination, impaired attentional control, and cognitive reactivity. During remission the TN-TP imbalance persists predisposing to vulnerability of recurrent depression. Empirical data to support this model is reviewed. Finally, we specify how this framework can guide future research efforts.
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Affiliation(s)
- Igor Marchetti
- Department of Experimental-Clinical and Health Psychology, Ghent University, Henri Dunantlaan 2, 9000 Ghent, Belgium.
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Hill RM, Pettit JW, Green KL, Morgan ST, Schatte DJ. Precipitating events in adolescent suicidal crises: exploring stress-reactive and nonreactive risk profiles. Suicide Life Threat Behav 2012; 42:11-21. [PMID: 22320193 DOI: 10.1111/j.1943-278x.2011.00067.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Factors distinguishing adolescents who experienced a precipitating event in the week preceding a suicidal crisis from those who did not were examined. Among 130 suicidal inpatients (mean age = 15.01 years), those who experienced a precipitating event reported significantly lower depressive symptom scores, better perceived problem solving, less suicidal intent, and a lower rate of prior suicide attempts than those without a precipitating event. Levels of trait impulsivity, suicidal ideation, and current attempt status did not differentiate groups. Findings provide preliminary evidence consistent with at least two possible pathways to a suicidal crisis. Clinical implications and future directions are discussed.
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Affiliation(s)
- Ryan M Hill
- Ryan M. Hill, Jeremy W.Pettit, Department of Psychology, Florida International University, Miami, FL, USA; Kelly L.Green, Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA; Sharon T.Morgan, Department of Psychology, Prairie View A&M University, Prairie View, TX, USA; Dawnelle J.Schatte, Department of Psychiatry, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Jeremy W Pettit
- Ryan M. Hill, Jeremy W.Pettit, Department of Psychology, Florida International University, Miami, FL, USA; Kelly L.Green, Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA; Sharon T.Morgan, Department of Psychology, Prairie View A&M University, Prairie View, TX, USA; Dawnelle J.Schatte, Department of Psychiatry, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Kelly L Green
- Ryan M. Hill, Jeremy W.Pettit, Department of Psychology, Florida International University, Miami, FL, USA; Kelly L.Green, Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA; Sharon T.Morgan, Department of Psychology, Prairie View A&M University, Prairie View, TX, USA; Dawnelle J.Schatte, Department of Psychiatry, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Sharon T Morgan
- Ryan M. Hill, Jeremy W.Pettit, Department of Psychology, Florida International University, Miami, FL, USA; Kelly L.Green, Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA; Sharon T.Morgan, Department of Psychology, Prairie View A&M University, Prairie View, TX, USA; Dawnelle J.Schatte, Department of Psychiatry, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Dawnelle J Schatte
- Ryan M. Hill, Jeremy W.Pettit, Department of Psychology, Florida International University, Miami, FL, USA; Kelly L.Green, Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA; Sharon T.Morgan, Department of Psychology, Prairie View A&M University, Prairie View, TX, USA; Dawnelle J.Schatte, Department of Psychiatry, University of Texas Health Science Center at Houston, Houston, TX, USA
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A common and functional mineralocorticoid receptor haplotype enhances optimism and protects against depression in females. Transl Psychiatry 2011; 1:e62. [PMID: 22832354 PMCID: PMC3309494 DOI: 10.1038/tp.2011.59] [Citation(s) in RCA: 103] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Mineralocorticoid (MR) and glucocorticoid receptors (GR) are abundantly expressed in the limbic brain and mediate cortisol effects on the stress-response and behavioral adaptation. Dysregulation of the stress response impairs adaptation and is a risk factor for depression, which is twice as abundant in women than in men. Because of the importance of MR for appraisal processes underlying the initial phase of the stress response we investigated whether specific MR haplotypes were associated with personality traits that predict the risk of depression. We discovered a common gene variant (haplotype 2, frequency ∼0.38) resulting in enhanced MR activity. Haplotype 2 was associated with heightened dispositional optimism in study 1 and with less hopelessness and rumination in study 2. Using data from a large genome-wide association study we then established that haplotype 2 was associated with a lower risk of depression. Interestingly, all effects were restricted to women. We propose that common functional MR haplotypes are important determinants of inter-individual variability in resilience to depression in women by differentially mediating cortisol effects on the stress system.
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Drost J, Van der Does AJW, Antypa N, Zitman FG, Van Dyck R, Spinhoven P. General, Specific and Unique Cognitive Factors Involved in Anxiety and Depressive Disorders. COGNITIVE THERAPY AND RESEARCH 2011; 36:621-633. [PMID: 23144515 PMCID: PMC3490077 DOI: 10.1007/s10608-011-9401-z] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Comorbidity among anxiety and depressive disorders is the rule rather than the exception. The Integrative Hierarchical Model proposes that each of these disorders contains general (common to all), specific (common to some) and unique components. However, research into this model is limited and hampered by small (clinical) sample sizes. The aim of the present study is to investigate the incremental validity of the cognitive constructs Anxiety Sensitivity, Pathological Worry and Cognitive Reactivity to sad mood over and above the personality traits neuroticism and extraversion. Symptomatic (N = 1,111) and remitted (N = 834) patients were selected from the 2,981 participants of the Netherlands Study of Depression and Anxiety (NESDA). Results revealed both specific and unique cognitive components of anxiety and depression. Across symptomatic and remitted groups, Anxiety Sensitivity was specific to social anxiety disorder and panic disorder, Aggression Reactivity was a unique component of dysthymia, and Rumination on Sadness was unique to major depressive disorder. We conclude that cognitive constructs have additional value in understanding anxiety and depressive disorders. Moreover, they prove to be more than mere epiphenomena of current disorders.
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Affiliation(s)
- J Drost
- Institute of Psychology, Leiden University, Wassenaarseweg 52, 2333 AK Leiden, The Netherlands
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Clinical and physiological correlates of irritability in depression: results from the Netherlands study of depression and anxiety. DEPRESSION RESEARCH AND TREATMENT 2011; 2011:126895. [PMID: 22110910 PMCID: PMC3205688 DOI: 10.1155/2011/126895] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/11/2011] [Revised: 08/18/2011] [Accepted: 08/18/2011] [Indexed: 11/18/2022]
Abstract
Objective. Irritable and nonirritable depressed patients differ on demographic and clinical characteristics. We investigated whether this extends to psychological and physiological measures. Method. We compared irritable and nonirritable unipolar depressed patients on symptomatology, personality, and (psycho)physiological measures (cortisol, cholesterol, and heart rate variability). Symptomatology was reassessed after one year, and we also compared depressed patients who were irritable or non-irritable at both time points (Irr++ versus Irr--). Results. Almost half (46%; N = 420) of the sample was classified as irritable. These patients scored higher on depression severity, anxiety, hypomanic symptoms, and psychological variables. No differences were observed on physiological markers after correction for depression severity. The same pattern was found when comparing Irr++ and Irr-- groups. Conclusion. Irritable and non-irritable depressed patients differ on clinical and psychological variables, but not on the currently investigated physiological markers. The clinical relevance of the distinction and the significance of the hypomanic symptoms remain to be demonstrated.
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Identifying tumor patients' depression. Support Care Cancer 2010; 19:1697-703. [DOI: 10.1007/s00520-010-1004-9] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2009] [Accepted: 09/06/2010] [Indexed: 11/26/2022]
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Barnhofer T, Chittka T. Cognitive reactivity mediates the relationship between neuroticism and depression. Behav Res Ther 2009; 48:275-81. [PMID: 20070952 PMCID: PMC2850390 DOI: 10.1016/j.brat.2009.12.005] [Citation(s) in RCA: 73] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2009] [Revised: 12/08/2009] [Accepted: 12/09/2009] [Indexed: 11/20/2022]
Abstract
Although neuroticism has long been established as an important risk factor for depression, the mechanisms through which this temperamental predisposition translates into the occurrence of symptoms are still relatively unclear. This study investigated cognitive reactivity, i.e. the ease with which particular patterns of negative thinking are reactivated in response to mild low mood, as a potential mediator. Individuals with (N = 98) and without a previous history of depression (N = 83) who had provided neuroticism scores six years previously were assessed for cognitive reactivity and current symptoms of depression using self-report questionnaires. Tendencies to respond to mild low mood with ruminative thinking mediated the relation between neuroticism and current symptoms of depression in both groups. Reactivation of hopelessness and suicidal thinking occurred as an additional mediator only in those with a history of previous depression. The results suggest that neuroticism predisposes individuals to depression by generally increasing the likelihood of ruminative responses to low mood. In those with a history of depression in the past, neuroticism additionally increases risk of recurrence by facilitating reactivation of previously associated patterns such as suicidal thinking and hopelessness. These findings suggest potential targets for interventions to help preventing the occurrence, or recurrence of depression in those who due to their temperamental predisposition are at an increased risk.
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Affiliation(s)
- Thorsten Barnhofer
- University of Oxford, Department of Psychiatry, Warneford Hospital, Oxford OX37JX, United Kingdom.
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Perlis RH, Ostacher MJ, Uher R, Nierenberg AA, Casamassima F, Kansky C, Calabrese JR, Thase M, Sachs GS. Stability of symptoms across major depressive episodes in bipolar disorder. Bipolar Disord 2009; 11:867-75. [PMID: 19922555 PMCID: PMC3566555 DOI: 10.1111/j.1399-5618.2009.00764.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Some studies suggest that depressive subtypes, defined by groups of symptoms, have predictive or diagnostic utility. These studies make the implicit assumption of stability of symptoms across episodes in mood disorders, which has rarely been investigated. METHODS We examined prospective data from a cohort of 3,750 individuals with bipolar I or II disorder participating in the Systematic Treatment Enhancement Program for Bipolar Disorder study, selecting a subset of individuals who experienced two depressive episodes during up to two years of follow-up. Across-episode association of individual depressive or hypomanic/mixed symptoms was examined using the weighted kappa measure of agreement as well as logistic regression. RESULTS A total of 583 subjects experienced two prospectively observed depressive episodes, with 149 of those subjects experiencing a third. Greatest evidence of stability was observed for neurovegetative features, suicidality, and guilt/rumination. Loss of interest and fatigue were not consistent across episodes. Structural equation modeling suggested that the dimensional structure of symptoms was not invariant across episodes. CONCLUSION While the overall dimensional structure of depressive symptoms lacks temporal stability, individual symptoms including suicidality, mood, psychomotor, and neurovegetative symptoms are stable across major depressive episodes in bipolar disorder and should be considered in future investigations of course and pathophysiology in bipolar disorder.
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Affiliation(s)
- Roy H Perlis
- Bipolar Clinic and Research Program, Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA.
| | - Michael J Ostacher
- Bipolar Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Rudolf Uher
- Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, King’s College London, London, UK
| | - Andrew A Nierenberg
- Bipolar Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Francesco Casamassima
- Bipolar Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Christine Kansky
- Bipolar Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Joseph R Calabrese
- Department of Psychiatry, Case Western Reserve University, Cleveland, OH
| | - Michael Thase
- Department of Psychiatry, University of Pennsylvania School of Medicine, Philadelphia, PA, USA
| | - Gary S Sachs
- Bipolar Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
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