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Wu Y, Lu Y, Kong L, Xie Y, Liu W, Yang A, Xin K, Yan X, Wu L, Liu Y, Zhu Q, Cao Y, Zhou Y, Jiang X, Tang Y, Wu F. Gender differences in plasma S100B levels of patients with major depressive disorder. BMC Psychiatry 2024; 24:387. [PMID: 38783266 PMCID: PMC11112965 DOI: 10.1186/s12888-024-05852-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2023] [Accepted: 05/15/2024] [Indexed: 05/25/2024] Open
Abstract
BACKGROUND Low concentrations of S100B have neurotrophic effects and can promote nerve growth and repair, which plays an essential role in the pathophysiological and histopathological alterations of major depressive disorder (MDD) during disease development. Studies have shown that plasma S100B levels are altered in patients with MDD. In this study, we investigated whether the plasma S100B levels in MDD differ between genders. METHODS We studied 235 healthy controls (HCs) (90 males and 145 females) and 185 MDD patients (65 males and 120 females). Plasma S100B levels were detected via multifactor assay. The Mahalanobis distance method was used to detect the outliers of plasma S100B levels in the HC and MDD groups. The Kolmogorov-Smirnov test was used to test the normality of six groups of S100B samples. The Mann-Whitney test and Scheirer-Ray-Hare test were used for the comparison of S100B between diagnoses and genders, and the presence of a relationship between plasma S100B levels and demographic details or clinical traits was assessed using Spearman correlation analysis. RESULTS All individuals in the HC group had plasma S100B levels that were significantly greater than those in the MDD group. In the MDD group, males presented significantly higher plasma S100B levels than females. In the male group, the plasma S100B levels in the HC group were significantly higher than those in the MDD group, while in the female group, no significant difference was found between the HC and MDD groups. In the male MDD subgroup, there was a positive correlation between plasma S100B levels and years of education. In the female MDD subgroup, there were negative correlations between plasma S100B levels and age and suicidal ideation. CONCLUSIONS In summary, plasma S100B levels vary with gender and are decreased in MDD patients, which may be related to pathological alterations in glial cells.
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Affiliation(s)
- Yifan Wu
- Department of Psychiatry, The First Hospital of China Medical University, 155 Nanjing North Street, 110001, Liaoning, P.R. China
| | - Yihui Lu
- Department of Psychiatry, The First Hospital of China Medical University, 155 Nanjing North Street, 110001, Liaoning, P.R. China
| | - Lingtao Kong
- Department of Psychiatry, The First Hospital of China Medical University, 155 Nanjing North Street, 110001, Liaoning, P.R. China
| | - Yu Xie
- Faculty of Public Health, China Medical University, 110001, Liaoning, P.R. China
| | - Wen Liu
- Department of Psychiatry, The First Hospital of China Medical University, 155 Nanjing North Street, 110001, Liaoning, P.R. China
| | - Anqi Yang
- Department of Psychiatry, The First Hospital of China Medical University, 155 Nanjing North Street, 110001, Liaoning, P.R. China
| | - Kaiqi Xin
- Department of Psychiatry, The First Hospital of China Medical University, 155 Nanjing North Street, 110001, Liaoning, P.R. China
| | - Xintong Yan
- Department of Psychiatry, The First Hospital of China Medical University, 155 Nanjing North Street, 110001, Liaoning, P.R. China
| | - Longhai Wu
- Department of Psychiatry, The First Hospital of China Medical University, 155 Nanjing North Street, 110001, Liaoning, P.R. China
| | - Yilin Liu
- Department of Psychiatry, The First Hospital of China Medical University, 155 Nanjing North Street, 110001, Liaoning, P.R. China
| | - Qianying Zhu
- Department of Psychiatry, The First Hospital of China Medical University, 155 Nanjing North Street, 110001, Liaoning, P.R. China
| | - Yang Cao
- Shenyang Mental Health Center, 110001, Liaoning, P.R. China
| | - Yifang Zhou
- Department of Psychiatry, The First Hospital of China Medical University, 155 Nanjing North Street, 110001, Liaoning, P.R. China
| | - Xiaowei Jiang
- Brain Function Research Section, Department of Radiology, The First Hospital of China Medical University, 110001, Liaoning, P.R. China
| | - Yanqing Tang
- Department of Psychiatry, The First Hospital of China Medical University, 155 Nanjing North Street, 110001, Liaoning, P.R. China
- Department of Geriatric Medicine, The First Hospital of China Medical University, 110001, Liaoning, P.R. China
| | - Feng Wu
- Department of Psychiatry, The First Hospital of China Medical University, 155 Nanjing North Street, 110001, Liaoning, P.R. China.
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Vandeloo KL, Burhunduli P, Bouix S, Owsia K, Cho KIK, Fang Z, Van Geel A, Pasternak O, Blier P, Phillips JL. Free-Water Diffusion Magnetic Resonance Imaging Differentiates Suicidal Ideation From Suicide Attempt in Treatment-Resistant Depression. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2023; 8:471-481. [PMID: 36906445 DOI: 10.1016/j.bpsc.2022.12.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 11/21/2022] [Accepted: 12/13/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND Suicide attempt is highly prevalent in treatment-resistant depression (TRD); however, the neurobiological profile of suicidal ideation versus suicide attempt is unclear. Neuroimaging methods including diffusion magnetic resonance imaging-based free-water imaging may identify neural correlates underlying suicidal ideation and attempts in individuals with TRD. METHODS Diffusion magnetic resonance imaging data were obtained from 64 male and female participants (mean age 44.5 ± 14.2 years), including 39 patients with TRD (n = 21 and lifetime history of suicidal ideation but no attempts [SI group]; n = 18 with lifetime history of suicide attempt [SA group]), and 25 age- and sex-matched healthy control participants. Depression and suicidal ideation severity were examined using clinician-rated and self-report measures. Whole-brain neuroimaging analysis was conducted using tract-based spatial statistics via FSL to identify differences in white matter microstructure in the SI versus SA groups and in patients versus control participants. RESULTS Free-water imaging revealed elevated axial diffusivity and extracellular free water in fronto-thalamo-limbic white matter tracts of the SA group compared with the SI group. In a separate comparison, patients with TRD had widespread reductions in fractional anisotropy and axial diffusivity, as well as elevated radial diffusivity compared with control participants (thresholded p < .05, familywise error corrected). CONCLUSIONS A unique neural signature consisting of elevated axial diffusivity and free water was identified in patients with TRD and suicide attempt history. Findings of reduced fractional anisotropy, axial diffusivity, and elevated radial diffusivity in patients versus control participants are consistent with previously published studies. Multimodal and prospective investigations are recommended to better understand biological correlates of suicide attempt in TRD.
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Affiliation(s)
- Katie L Vandeloo
- University of Ottawa Institute of Mental Health Research, Ottawa, Ontario, Canada; Department of Cellular and Molecular Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Patricia Burhunduli
- University of Ottawa Institute of Mental Health Research, Ottawa, Ontario, Canada; Department of Cellular and Molecular Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Sylvain Bouix
- Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Kimia Owsia
- University of Ottawa Institute of Mental Health Research, Ottawa, Ontario, Canada
| | - Kang Ik K Cho
- Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Zhuo Fang
- University of Ottawa Institute of Mental Health Research, Ottawa, Ontario, Canada
| | - Amanda Van Geel
- University of Ottawa Institute of Mental Health Research, Ottawa, Ontario, Canada; Department of Neuroscience, Carleton University, Ottawa, Ontario, Canada
| | - Ofer Pasternak
- Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts; Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Pierre Blier
- University of Ottawa Institute of Mental Health Research, Ottawa, Ontario, Canada; Department of Cellular and Molecular Medicine, University of Ottawa, Ottawa, Ontario, Canada; Department of Psychiatry, University of Ottawa, Ottawa, Ontario, Canada
| | - Jennifer L Phillips
- University of Ottawa Institute of Mental Health Research, Ottawa, Ontario, Canada; Department of Neuroscience, Carleton University, Ottawa, Ontario, Canada; Department of Psychiatry, University of Ottawa, Ottawa, Ontario, Canada; Department of Biochemistry, Microbiology and Immunology, University of Ottawa, Ottawa, Ontario, Canada.
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The Impact of Affective Temperaments on Suicidal Ideation and Behaviors: Results from an Observational Multicentric Study on Patients with Mood Disorders. Brain Sci 2023; 13:brainsci13010117. [PMID: 36672098 PMCID: PMC9856472 DOI: 10.3390/brainsci13010117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 01/02/2023] [Accepted: 01/04/2023] [Indexed: 01/11/2023] Open
Abstract
Suicide ideation and behaviors are major health issues in the field of mental health. Several psychological and psychosocial factors have been taken into account as possible predictors of suicidality. Only recently affective temperaments have been considered as possible factors linked to suicide. This study aims to investigate the relationship between affective temperaments and suicidality, including the lifetime onset of suicide ideation, lifetime presence of suicide attempts and the total number of lifetime suicide attempts. This is a naturalistic multicentric observational study, involving outpatient units of seven University sites in Italy. Patients were administered with the short version of TEMPS-M and the Columbia Suicide Severity Rating Scale. A total of 653 participants were recruited, with a diagnosis of bipolar (55.7%), unipolar (35.8%) and cyclothymic disorder (8.4%). Regression models showed that the presence of lifetime suicide behaviors was increased in patients presenting trait related impulsivity (p < 0.0001), poor free-interval functioning (p < 0.05), higher number of affective episodes (p < 0.01), higher number of hospitalizations (p < 0.0001), cyclothymic and irritable affective temperaments (p < 0.05 and p < 0.05, respectively). Conversely, the presence of hyperthymic affective disposition reduced the likelihood of having suicidal behaviors (p < 0.01). Lifetime suicidal ideation was associated with trait-related impulsivity (p < 0.001), poor free-interval functioning (p < 0.05), higher number of affective episodes (p < 0.001) and of hospitalizations (p < 0.001). Depressive temperaments increased the likelihood of presenting suicidal ideation (p < 0.05), along with irritable temperaments (p < 0.01), contrary to hyperthymic affective (p < 0.05). Results of the present study confirm that affective disposition has a significant impact on the onset of suicidal ideation and behaviors, and that affective dispositions should be assessed in clinical settings to identify people at risk of suicide. Moreover, a wider clinical evaluation, including different clinical psychopathological dimensions, should be taken into consideration to develop effective preventive interventions.
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Wong JCM, Chang CL, Shen L, Nyein N, Loh ASW, Yap NH, Kroneman LM, Feng L, Tan CH. Temperament, parenting, mental disorders, life stressors and help-seeking behavior of Asian adolescent suicide attempters: A case control study. Front Psychiatry 2022; 13:999089. [PMID: 36245865 PMCID: PMC9557074 DOI: 10.3389/fpsyt.2022.999089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 09/12/2022] [Indexed: 11/29/2022] Open
Abstract
PURPOSE The need to elucidate risk factors for adolescent suicide is urgent, as suicide consistently ranks among the top causes of death globally. Understanding suicide risk factors could inform more effective interventions. Previous studies have identified certain risk factors associated with suicide, but there is a paucity of research among adolescent and multi-ethnic Asian populations. MATERIALS AND METHODS This case-control study sampled 13-to-19-year-old Asian adolescents who had attempted suicide (N = 60) and controls (N = 58) matched by age, ethnicity and gender at group-level (73.7% female). Life stressors, temperament, parenting style, mental health conditions and help-seeking behavior were examined. RESULTS All domains of life stress apart from emerging adult responsibility were higher among cases than controls, especially home life, peer pressure and romantic relationships. Suicide attempters tended to avoid new situations, be less adaptable to changes, have a negative outlook and irregular sleep-wake cycle. Additionally, they perceived their parents to be significantly more aggressive, neglecting, rejecting and cold, while parents' perceptions of their own parenting were only significantly different in the domain of parental neglect. Cases were more likely to exhibit disorders of disruptive behavior, eating, mood, anxiety, symptoms of schizophrenia and experience of disturbing events. Significant differences were also found for 10 out of 12 Axis II disorders, particularly borderline, depressive, and avoidant personality disorder traits. No significant case-control differences were found regarding overall rates of help-seeking. CONCLUSION Findings from this study may help in suicide prevention efforts through more tailored interventions.
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Affiliation(s)
- John Chee Meng Wong
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.,Department of Psychological Medicine, National University Health System, Singapore, Singapore
| | - Christel Lynne Chang
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Liang Shen
- Biostatistics Unit, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Nyein Nyein
- Department of Psychological Medicine, National University Health System, Singapore, Singapore
| | - Adrian Seng Wei Loh
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Natalie Huijing Yap
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Leoniek Mirjam Kroneman
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Lei Feng
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.,Healthy Longevity Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.,Centre for Healthy Longevity, National University Health System, Singapore, Singapore
| | - Chay Hoon Tan
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.,Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
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5
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de Araújo RMF, Zanotto M, da Rosa LR, Mazzochi L, Lara DR. Sensitivity is the dimension of temperament most associated with the progression from ideation to suicide attempts. J Affect Disord 2021; 294:695-700. [PMID: 34343927 DOI: 10.1016/j.jad.2021.07.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 07/10/2021] [Accepted: 07/13/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND To analyze the association between temperament (emotional and affective) and scrutinize the progression from suicide ideation to attempt, by using data from a large internet-based sample. METHODS It is a cross-sectional study, based on the Brazilian Internet Study on Temperament and Psychopathology (BRAINSTEP). Temperament was assessed by the Affective and Emotional Composite Temperament Scale (AFECTS), and life-long suicidal behavior was determined by the adapted Suicidal Behaviors Questionnaire (SBQ-17). Odds ratios were obtained through multivariate logistic regression and a multiple linear regression were used in the analysis. According to the "ideation-to-action framework", we performed analyzes using two different reference groups: no suicidal ideation and suicidal ideation. RESULTS The affective temperaments that showed the greatest association with suicide attempts were depressive, cyclothymic, and volatile. The temperaments that reflected higher associations for progression from ideation to suicide attempt were cyclothymic, depressive, and euphoric. Sensitivity was manifested as the emotional temperament with the strongest positive association with the severity of suicidal behavior, followed by desire and control. Stability was estimated as the emotional trait with the strongest negative association with the severity of suicidal behavior. LIMITATIONS It is not a population based sample. BRAINSTEP is a self-selected sample whose participants are mostly women, who are highly educated and young. CONCLUSIONS Our results suggest that temperament assessment using AFECT model may be relevant to assess the risk for the progression from ideation to suicide attempts. These results strengthen the "ideation-to-action" framework that risk factors to suicide ideators can differ from suicide attempters.
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Affiliation(s)
- Rafael M F de Araújo
- Universidade do Vale do Taquari, Lajeado, RS, Brazil; Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brazil.
| | | | | | - Leonardo Mazzochi
- Universidade do Vale do Taquari, Lajeado, RS, Brazil; Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Diogo R Lara
- Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brazil
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6
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Kassem M, Haddad C, Hallit S, Kazour F. Impact of spirituality and religiosity on suicidal risk among a sample of lebanese psychiatric in-patients. Int J Psychiatry Clin Pract 2021; 25:336-343. [PMID: 32644837 DOI: 10.1080/13651501.2020.1787453] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVES To evaluate the prevalence of suicidality among the psychiatric inpatients community in Lebanon, and to elucidate the effect of religiosity and spirituality on suicidal thoughts or behaviours. METHODS A total sample of 159 patient consecutively admitted to a psychiatric hospital was interviewed. The Ask Suicide-screening Questionnaire (ASQ) was used to assess suicidal risk; the Mature Religiosity Scale (MRS) and the Spirituality Index for Well Being (SIWB) scales were used to assess religiosity and spirituality. RESULTS We found that 45.6% of the participants screened positively on the ASQ, including 37.5% with acute suicidal ideation. A backward logistic regression, taking the negative/positive screening ASQ as the dependent variable, showed that a positive family history of suicide and depression were significantly associated with higher positive suicidal screening, whereas higher spirituality was significantly associated with lower positive suicidal screening. When forcing the mature religiosity scale as an independent variable, the results remained the same. CONCLUSION Spiritual well-being might be considered an important factor to explore among psychiatric patients. Psychiatric inpatients have a high risk for suicide; the challenge remains for clinicians to identify upon admission patients that are most likely to die from suicide.Key pointsA positive family history of suicide and depression was significantly associated with higher suicidality.Higher spirituality, but not religiosity, was significantly associated with lower suicidality.Spiritual well-being might be considered an important factor to explore among psychiatric patients.The challenge remains for clinicians to identify patients that are most likely to die from suicide upon admission.
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Affiliation(s)
- Maha Kassem
- Faculty of Sciences, Lebanese University, Fanar, Lebanon
| | - Chadia Haddad
- Psychiatric Hospital of the Cross, Jal Eddib, Lebanon.,Univ. Limoges, UMR 1094, Neuroépidémiologie Tropicale, Institut d'Epidémiologie et de Neurologie Tropicale, GEIST, Limoges, France
| | - Souheil Hallit
- Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon.,INSPECT-LB, Institut National de Sante Publique, Epidemiologie Clinique et Toxicologie, Beirut, Lebanon
| | - Francois Kazour
- Faculty of Sciences, Lebanese University, Fanar, Lebanon.,Psychiatric Hospital of the Cross, Jal Eddib, Lebanon.,Faculty of Arts and Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon.,Faculty of Medicine, Saint-Joseph University, Beirut, Lebanon
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Mirkovic B, Delvenne V, Robin M, Pham-Scottez A, Corcos M, Speranza M. Borderline personality disorder and adolescent suicide attempt: the mediating role of emotional dysregulation. BMC Psychiatry 2021; 21:393. [PMID: 34372810 PMCID: PMC8351432 DOI: 10.1186/s12888-021-03377-x] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Accepted: 07/15/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Emotional dysregulation seems to be a core feature of Borderline Personality Disorders (BPD). In addition, recent research in the adolescent population has shown that suicidal behaviours have been associated with maladaptive strategies of emotion regulation. METHODS This study examined the relative contributions of emotional dysregulation to suicide attempt history in a clinical sample of borderline adolescents. Data were analyzed from 85 participants of the Collaborative European Research Network on Borderline Personality Disorder. Participants completed measures of BPD traits and symptoms, suicide behaviours, emotional dysregulation, attachment styles and lifetime depressive disorders. RESULTS In an SEM model, lifetime depressive disorders and insecure attachment styles have a significant direct effect on lifetime suicide attempt, but only lifetime depressive disorders have an indirect effect through emotion dysregulation. The results suggest that emotional dysregulation has a mediating role in suicide attempts among BPD adolescents. CONCLUSIONS These findings call for the development of interventions targeting the role of emotion dysregulation in effectively predicting and preventing suicidality in borderline adolescents.
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Affiliation(s)
- Bojan Mirkovic
- Université Paris-Saclay, UVSQ, Inserm U1018, CESP, "DevPsy", 94807, Villejuif, France. .,Pôle de psychiatrie de l'enfant et de l'adolescent, Nouvel Hôpital de Navarre, Université de Normandie, Nouvel Hôpital de Navarre, route de Conches, 27000, Évreux, France.
| | - Véronique Delvenne
- grid.412209.c0000 0004 0578 1002Service de Pédopsychiatrie, Hôpital Universitaire des Enfants Reine Fabiola, Brussels, Belgium
| | - Marion Robin
- grid.418120.e0000 0001 0626 5681Département de Psychiatrie de l’Adolescent et du Jeune Adulte, Institut Mutualiste Montsouris, Paris, France
| | - Alexandra Pham-Scottez
- grid.414435.30000 0001 2200 9055GHT Paris Psychiatrie et Neurosciences, Centre Hospitalier Sainte Anne, Paris, France
| | - Maurice Corcos
- grid.418120.e0000 0001 0626 5681Département de Psychiatrie de l’Adolescent et du Jeune Adulte, Institut Mutualiste Montsouris, Paris, France
| | - Mario Speranza
- grid.463845.80000 0004 0638 6872Université Paris-Saclay, UVSQ, Inserm U1018, CESP, “DevPsy”, 94807 Villejuif, France ,grid.418080.50000 0001 2177 7052Service Universitaire de Psychiatrie de l’Enfant et de l’Adolescent, Centre Hospitalier de Versailles, Versailles, France
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Wu H, Zheng Y, Zhan Q, Dong J, Peng H, Zhai J, Zhao J, She S, Wu C. Covariation between spontaneous neural activity in the insula and affective temperaments is related to sleep disturbance in individuals with major depressive disorder. Psychol Med 2021; 51:731-740. [PMID: 31839025 DOI: 10.1017/s0033291719003647] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
BACKGROUND Affective temperaments have been considered antecedents of major depressive disorder (MDD). However, little is known about how the covariation between alterations in brain activity and distinct affective temperaments work collaboratively to contribute to MDD. Here, we focus on the insular cortex, a critical hub for the integration of subjective feelings, emotions, and motivations, to examine the neural correlates of affective temperaments and their relationship to depressive symptom dimensions. METHODS Twenty-nine medication-free patients with MDD and 58 healthy controls underwent magnetic resonance imaging scanning and completed the Temperament Evaluation of Memphis, Pisa, Paris and San Diego (TEMPS). Patients also received assessments of the Hamilton Depression Rating Scale (HDRS). We used multivariate analyses of partial least squares regression and partial correlation analyses to explore the associations among the insular activity, affective temperaments, and depressive symptom dimensions. RESULTS A profile (linear combination) of increased fractional amplitude of low-frequency fluctuations (fALFF) of the anterior insular subregions (left dorsal agranular-dysgranular insula and right ventral agranuar insula) was positively associated with an affective-temperament (depressive, irritable, anxious, and less hyperthymic) profile. The covariation between the insula-fALFF profile and the affective-temperament profile was significantly correlated with the sleep disturbance dimension (especially the middle and late insomnia scores) in the medication-free MDD patients. CONCLUSIONS The resting-state spontaneous activity of the anterior insula and affective temperaments collaboratively contribute to sleep disturbances in medication-free MDD patients. The approach used in this study provides a practical way to explore the relationship of multivariate measures in investigating the etiology of mental disorders.
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Affiliation(s)
- Huawang Wu
- The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou510370, China
| | - Yingjun Zheng
- The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou510370, China
| | - Qianqian Zhan
- The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou510370, China
| | - Jie Dong
- The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou510370, China
| | - Hongjun Peng
- The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou510370, China
| | - Jinguo Zhai
- School of Mental Health, Jining Medical University, Jining272067, China
| | - Jingping Zhao
- The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou510370, China
| | - Shenglin She
- The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou510370, China
| | - Chao Wu
- School of Nursing, Peking University Health Science Center, Beijing100191, China
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9
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Belteczki Z, Rihmer Z, Rozsa S, Ujvari J, Pompili M, Gonda X, Dome P. Affective Temperaments, Panic Disorder and Their Bipolar Connections. ACTA ACUST UNITED AC 2021; 57:medicina57030289. [PMID: 33808711 PMCID: PMC8003512 DOI: 10.3390/medicina57030289] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 03/15/2021] [Accepted: 03/17/2021] [Indexed: 01/21/2023]
Abstract
Background and Objectives: The role of affective temperament in the genesis and outcome of major mood disorders is well studied, but there are only a few reports on the relationship between panic disorder (PD) and affective temperaments. Accordingly, we aimed to study the distribution of affective temperaments (depressive (DE); cyclothymic (CT); irritable (IRR); hyperthymic (HT) and anxious (ANX)) among outpatients with PD. Materials and Methods: Affective temperaments of 118 PD outpatients (80 females and 38 males) with or without agoraphobia but without any other psychiatric disorder at the time of inclusion were evaluated using the Temperament Evaluation of the Memphis, Pisa, Paris, and San Diego Autoquestionnaire (TEMPS-A) and compared with the affective temperament scores of control subjects. All patients were followed up for at least 1.5 years in order to detect the onset of any major affective disorders, substance use disorders and suicide attempts. Results: Among females, the dominant ANX and DE temperaments were four and three times as common as in a large normative Hungarian sample (for both cases p < 0.01). Among male PD patients, only the dominant DE temperament was slightly overrepresented in a non-significant manner. Females with PD obtained significantly higher scores on ANX, DE and CT subscales of the TEMPS-A, whereas males with PD showed significantly higher scores on ANX, DE and HT temperament subscales compared with the members of a large normative Hungarian sample and also with a gender- and age-matched control group. During the follow-up, newly developed unipolar major depression and bipolar spectrum (bipolar I or II and cyclothymic) disorders appeared in 64% and 22% of subjects, respectively. Conclusions: Our preliminary findings suggest that a specific, ANX-DE-CT affective temperament profile is characteristic primarily for female patients, and an ANX-DE-HT affective temperament profile is characteristic for male patients with PD, respectively. These findings are in line with expectations because PD is an anxiety disorder par excellence on the one hand, whereas, on the other hand, it is quite frequently comorbid with mood (including bipolar) disorders.
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Affiliation(s)
- Zsuzsanna Belteczki
- First Department of Psychiatry, University Hospital of Szabolcs-Szatmár-Bereg County, 4320 Nagykallo, Hungary; (Z.B.); (J.U.)
| | - Zoltan Rihmer
- Department of Psychiatry and Psychotherapy, Semmelweis University, 1085 Budapest, Hungary; (Z.R.); (X.G.)
- Nyiro Gyula National Institute of Psychiatry and Addictions, 1135 Budapest, Hungary
| | - Sandor Rozsa
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO 63110, USA;
| | - Julia Ujvari
- First Department of Psychiatry, University Hospital of Szabolcs-Szatmár-Bereg County, 4320 Nagykallo, Hungary; (Z.B.); (J.U.)
| | - Maurizio Pompili
- Department of Neurosciences, Mental Health and Sensory Organs, Suicide Prevention Center, Sant’Andrea Hospital, Sapienza University of Rome, 00189 Rome, Italy;
| | - Xenia Gonda
- Department of Psychiatry and Psychotherapy, Semmelweis University, 1085 Budapest, Hungary; (Z.R.); (X.G.)
- Nyiro Gyula National Institute of Psychiatry and Addictions, 1135 Budapest, Hungary
| | - Péter Dome
- Department of Psychiatry and Psychotherapy, Semmelweis University, 1085 Budapest, Hungary; (Z.R.); (X.G.)
- Nyiro Gyula National Institute of Psychiatry and Addictions, 1135 Budapest, Hungary
- Correspondence:
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Işik Ulusoy S, Colak E. Effects of Temperamental Characteristics on Depression-Anxiety Levels and the Quality of Life in Infertile Women. Medeni Med J 2020; 35:226-235. [PMID: 33110675 PMCID: PMC7584259 DOI: 10.5222/mmj.2020.96646] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Accepted: 09/12/2020] [Indexed: 11/05/2022] Open
Abstract
Objective It is known that the risk of anxiety disorders and depression in infertile women increases and their quality of life deteriorates. Temperamental characteristics are considered as predictors of mood disorders. The aim of this study was to investigate temperamental characteristics in infertile women and their effects on depression and anxiety levels, and the quality of life, and to reveal the differences and level of relationship compared to healthy women. Method Fourty-four female patients with primary infertility and 30 healthy female controls were included in this study. Temperamental characteristics of the participants were assessed with Temperament Evaluation of Memphis, Pisa, Paris and San Diego-Autoquestionnaire version (TEMPS-A). Depression and anxiety severity were evaluated with Beck Depression Inventory (BDI), and Beck Anxiety Inventory (BAI). To evaluate the quality of life, Short Form 36 (SF-36) health survey questionnaire was also applied. Results Hyperthymic temperament scores were higher in infertile women than the control group (p=0.001). BDI scores were positively correlated with depressive and cyclothymic temperament scores, and BAI scores were positively correlated with depressive and anxious temperament scores. A negative correlation was found between hyperthymic temperament and BAI and BDI scores. Hyperthymic temperament scores were positively correlated with both physical and mental subdimension scores of the quality of life scale. Conclusion In this study, hyperthymic temperament in infertile women was shown to be protective against anxiety and depression and it also improves the quality of life. Additional studies are needed to clarify the relationship between hyperthymic temperament and ovarian hormones or other biological parameters.
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Affiliation(s)
- Selen Işik Ulusoy
- Baskent University, Faculty of Medicine, Konya Research and Training Hospital, Department of Psychiatry, Konya, Turkey
| | - Eser Colak
- Baskent University, Faculty of Medicine, Konya Research and Training Hospital, Department of Obstetrics and Gynecology, Konya, Turkey
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A prospective longitudinal study searching for predictors of response to group psychoeducation in bipolar disorder. J Affect Disord 2020; 274:1113-1121. [PMID: 32663939 DOI: 10.1016/j.jad.2020.02.047] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Revised: 02/10/2020] [Accepted: 02/27/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND The efficacy of adjunctive group psychoeducation in bipolar disorder has been proven although treatment response differ among individuals. The aim of this study was to characterize responders and non-responders to group psychoeducation in order to identify baseline variables that could predict treatment response. METHODS The sample was composed of 103 medicated euthymic patients with bipolar disorder referred to 21 sessions of group psychoeducation (6 months). Sociodemographic and clinical variables, temperament, circadian rhythms, BDNF, cognitive and psychosocial functioning were collected. At the 18-month endpoint, the patients were split in two groups on the basis of having suffered any recurrence. Significant group differences were included in a logistic regression analysis. RESULTS Ninety patients out of 103 engaged in group psychoeducation, 47 of whom (52.2%) responded to psychoeducation and 43 (47.8%) did not. Recurrences occurred more often in the follow-up, the most common being depression. Responders and non-responders differed in gender, age at diagnosis, latency of diagnosis, temperament, attention composite score and BDNF. Lower age at diagnosis of bipolar disorder, lower cyclothimic temperament scores and being male -which was associated with bipolar type I and a trend to more previous manic episodes- were significantly related to a better response to psychoeducation in the regression analysis. LIMITATIONS No control group. CONCLUSIONS This study identifies age at diagnosis as a significant modifiable risk factor of treatment response, highlighting the need for early identification of bipolar disorder. Existing programs should be adjusted to the characteristics of specific subpopulations in the framework of a personalized approach.
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Taş Hİ, Altinbaş K. Comparison of the Emotion Regulation and Temperament Characteristics Between Depressive Patients With and Without Mixed Features. ACTA ACUST UNITED AC 2020; 57:27-32. [PMID: 32110147 DOI: 10.29399/npa.23610] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2019] [Accepted: 08/25/2019] [Indexed: 11/07/2022]
Abstract
Introduction "Depressive disorder with mixed features" has been included in the official classification in the latest version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Hypothesizing that difficulties in emotion regulation and affective temperament scores are higher in mixed depression comparing to pure depression, we aimed to evaluate the relationship between these phenomena and mixed symptoms. Methods Depressive patients diagnosed by a psychiatrist according to the DSM-5 and had not received any psychiatric treatment for the last 3 months, were included in the study. The Hamilton Rating Scale (HDRS), modified Hypomania Checklist (mHCL), Difficulties in Emotion Regulation Scale (DERS), and the TEMPS-A (Temperament Evaluation of Memphis, Pisa, Paris, San Diego Autoquestionaire) were applied to all participants. Results Of the 63 participants, 40 (63.5%) were women. The mean age was 37.8±12.4 years while mean duration of education was 10.8±4.3 years. The proportion of mixed-depression assessed by the mHCL was 23.8% (n=15). No significant difference was found between the groups concerning gender, age, family history, age at onset of illness, the total number of episodes and temperament scores. Depressive patients with mixed features had significantly higher DERS nonacceptance subscale scores. Multiple regression analysis demonstrated that the cyclothymic temperament scale scores significantly affected the total mHCL scores. Conclusion In mixed depression group, higher scores in nonacceptance subscale seems to reflect a tendency to fluctuations in the emotional reactions of a person to the stress. Association between mixed depression, DERS nonacceptance subscale and cyclothymic temperament support the spectrum view that mixed depression is placed between pure depression and bipolarity.
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Affiliation(s)
- Halil İbrahim Taş
- Department of Psychiatry, Çanakkale Onsekiz Mart University School of Medicine, Çanakkale, Turkey
| | - Kürşat Altinbaş
- Department of Psychiatry, Selçuk University School of Medicine, Konya, Turkey
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13
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Işık-Ulusoy S. Evaluation of affective temperament and anxiety-depression levels in fibromyalgia patients: a pilot study. ACTA ACUST UNITED AC 2019; 41:428-432. [PMID: 30994852 PMCID: PMC6796816 DOI: 10.1590/1516-4446-2018-0057] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2018] [Accepted: 08/10/2018] [Indexed: 01/08/2023]
Abstract
OBJECTIVE Fibromyalgia (FM) patients have higher rates of depression and anxiety disorders than healthy controls. Affective temperament features are subclinical manifestations of mood disorders. Our aim was to evaluate the affective temperaments of FM patients and investigate their association with depression and anxiety levels and clinical findings. METHODS This cross-sectional study included FM patients and healthy controls. The Hospital Anxiety and Depression Scale (HADS) was used to determine patient anxiety and depression levels, and the Temperament Scale of Memphis, Pisa and San Diego, self-administered version was applied to assess affective temperaments in all subjects. Disease severity was assessed in FM patients with the Fibromyalgia Criteria and Severity Scales and the Fibromyalgia Impact Questionnaire (FIQ). Differences between groups were evaluated using Student's t-tests. Correlations among parameters were performed. RESULTS This study involved 38 patients with FM (30 female) and 30 healthy controls (25 female). Depressive, anxious and cyclothymic temperaments were significantly higher in FM patients than healthy controls. Statistically significant positive correlations were found between HADS depression score and all temperaments except hyperthymic, as well as between HADS anxiety score and cyclothymic and anxious temperaments. HADS depression and anxiety scores were correlated with symptom severity. We found a higher risk of depression and anxiety among FM patients with higher FIQ scores. CONCLUSION This study is the first to evaluate affective temperament features of FM patients. Evaluating temperamental traits in FM patients may help clinicians determine which patients are at risk for depression and anxiety disorders.
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Affiliation(s)
- Selen Işık-Ulusoy
- Başkent University School of Medicine, Psychiatry Department, Konya, Turkey
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14
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Abstract
BACKGROUND Among risk factors for suicidal behavior, there is growing interest in associations with stable affective temperament types, particularly based on assessment with the TEMPS-A self-rating scale. AIM As research on this topic has not been reviewed systematically, we synthesized relevant, reported research findings. METHODS Systematic searching identified peer-reviewed reports pertaining to associations of suicidal behavior or ideation with affective temperament types evaluated with TEMPS-A. We summarized available findings and applied quantitative meta-analytic methods to compare scale scores in suicidal versus nonsuicidal subjects. RESULTS In 21 of 23 TEMPS-A studies meeting inclusion criteria, anxious, cyclothymic, depressive, or irritable temperament scores were significantly higher with previous or recent suicide attempts or ideation in both psychiatric and general population samples compared to nonsuicidal controls, whereas hyperthymic temperament scores were lower in 9 of 11 reports. These findings were synthesized by random-effects meta-analyses of standardized mean differences in TEMPS-A temperament scores in suicidal versus nonsuicidal subjects. Associations ranked: depressive ≥ irritable > cyclothymic > anxious > hyperthymic (negative). CONCLUSIONS Affective temperaments, especially depressive and irritable, were strongly associated with suicidal risk, whereas hyperthymic temperament appeared to be protective.
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15
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Solano P, Aguglia A, Caprino M, Conigliaro C, Giacomini G, Serafini G, Amore M. The personal experience of severe suicidal behaviour leads to negative attitudes towards self- and other's suicidal thoughts and behaviours: A study of temperaments, coping strategies, and attitudes towards suicide among medical students. Psychiatry Res 2019; 272:669-675. [PMID: 30616139 DOI: 10.1016/j.psychres.2018.12.116] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Revised: 12/22/2018] [Accepted: 12/22/2018] [Indexed: 10/27/2022]
Abstract
The attitudes individuals have towards suicidal behaviour, be it their own or others', and their capacity for developing specific coping strategies are influenced by affective temperaments that play a significant role in emotional regulation. However, few studies have investigated these specific patterns with a view to stratify them according to the severity of suicidal behaviours in medical students. The Pearson χ2 test for the comparison of categorical variables, the t-test for independent samples of continuous variables and logistic regression analysis were used to compare the association among temperaments, coping strategies, and attitudes towards suicide in a sample of medical students who attend the School of Medicine, Genoa. Severe suicidal thoughts and behaviours relative to those who were not at risk for suicide were also revealed. The severe suicidal thought and behaviour group had significantly more anxious and cyclothymic temperaments together with a higher use of dis-adaptive, lower emotional focus coping strategies, and higher self-reproaching, criticizing, and judgemental attitudes towards suicidality compared to the no severe suicidal thought and behaviour group. The identified pattern suggests the need for clinicians to carefully consider the complex interplay of clinical features which characterize severely at risk for suicide young adults in order to develop effective and comprehensive prevention strategies.
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Affiliation(s)
- Paola Solano
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, Italy; IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Andrea Aguglia
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, Italy; IRCCS Ospedale Policlinico San Martino, Genoa, Italy.
| | - Matilde Caprino
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, Italy; IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Claudia Conigliaro
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, Italy; IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Gabriele Giacomini
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, Italy; IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Gianluca Serafini
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, Italy; IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Mario Amore
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, Italy; IRCCS Ospedale Policlinico San Martino, Genoa, Italy
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Orri M, Perret LC, Turecki G, Geoffroy MC. Association between irritability and suicide-related outcomes across the life-course. Systematic review of both community and clinical studies. J Affect Disord 2018; 239:220-233. [PMID: 30025311 DOI: 10.1016/j.jad.2018.07.010] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2018] [Revised: 05/25/2018] [Accepted: 07/03/2018] [Indexed: 02/02/2023]
Abstract
BACKGROUND Irritability is gaining considerable attention as a risk factor for suicide-related outcomes (suicide mortality, attempt, and ideation). However, the evidence of this association is scant. We conducted a systematic review of the evidence regarding the associations between irritability and suicide-related outcomes across the life-course. METHODS We conducted a systematic search on Medline and PsycINFO (up to January 2018) for original articles published in English investigating the association between irritability and suicide-related outcomes. Two researchers independently screened the articles, assessed the quality of the evidence (New-Castle-Ottawa Scale) and extracted study characteristics. RESULTS Thirty-nine studies were retrieved, most were of low/medium quality. Twelve assessed irritability in childhood/adolescence (6 in community samples, 6 in clinical samples) and 27 in adulthood (7 in community samples, 20 in clinical samples). In both childhood/adolescence and adult samples, most community-based studies reported a positive association between irritability and suicidal ideation and/or attempt, while clinical studies reported mixed findings. More specifically, in clinical studies, the association of irritability with suicide-related outcomes (i) was not supported among adult depressed patients, (ii) findings were inconsistent in adult bipolar patients, (iii) for inpatients/outpatients with various psychiatric disorders/conditions, association was observed in adulthood but not in childhood/adolescence. LIMITATIONS Differences in methodology and definition/measurement of irritability limited the comparability of included studies. CONCLUSIONS Although irritability has been proposed as a promising transdiagnostic factor associated with suicide-related outcomes, the absence of consensus in the definition of irritability (vs anger or reactive/impulsive aggression), the poor methodological quality, and the lack of developmental considerations mitigate the conclusions.
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Affiliation(s)
- Massimiliano Orri
- McGill Group for Suicide Studies, Douglas Mental Health University Institute & Department of Psychiatry, McGill University, Montreal, Canada
| | - Lea C Perret
- McGill Group for Suicide Studies, Douglas Mental Health University Institute & Department of Psychiatry, McGill University, Montreal, Canada
| | - Gustavo Turecki
- McGill Group for Suicide Studies, Douglas Mental Health University Institute & Department of Psychiatry, McGill University, Montreal, Canada
| | - Marie-Claude Geoffroy
- Department of Educational and Counselling Psychology, McGill University, Montreal, Canada.
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17
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Yazici E, Cimen Z, Akyollu IIU, Yazici AB, Turkmen BA, Erol A. Depressive Temperament in Relatives of Patients with Schizophrenia Is Associated with Suicidality in Patients with Schizophrenia. CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE 2018; 16:302-309. [PMID: 30121980 PMCID: PMC6124869 DOI: 10.9758/cpn.2018.16.3.302] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/16/2017] [Revised: 07/16/2017] [Accepted: 08/11/2017] [Indexed: 01/22/2023]
Abstract
Objective Suicide is a major cause of death in patients with schizophrenia; thus, predicting and preventing suicide in patients with schizophrenia is examined in various studies. Affective temperaments which are accepted as precursors of mood disorders may be an important factor in predicting suicidality. This study investigated the relationship between affective temperaments of relatives of schizophrenia patients and suicidal thoughts and other clinical correlates of patients with schizophrenia. Methods Patients with schizophrenia and their first degree relatives are included to the study. All of the participants were evaluated with Structured Clinical Interview for DSM-IV axis I disorders and relatives with active psychiatric diagnosis were excluded. Positive and Negative Symptom Scale, Clinical Global Impression Scale, Turkish version of cognitive assessment interview were administered congruently to the patients. Relatives of the patients were evaluated with Temperament Evaluation of Memphis, Pisa, Paris and San Diego-Auto-questionnaire. Results Depressive temperament scores of relatives of schizophrenic patients who had suicidal thoughts were higher than the scores of the relatives of the patients who did not have suicidal thoughts. Depressive temperament also predicted number of suicide attempts in regression analysis. Number of suicide attempts was also related with number of hospitalization and functionality of the patient. Conclusion Suicidality in schizophrenia is related with relatives’ affective temperaments and patients’ own positive symptom scores. The relationship between suicidal thoughts and depressive temperament is high lightened in this study
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Affiliation(s)
- Esra Yazici
- Department of Psychiatry, Faculty of Medicine, Sakarya University, Sakarya, Turkey
| | - Zerrin Cimen
- Department of Psychiatry, Sakarya University Training and Research Hospital, Sakarya, Turkey
| | | | - Ahmet Bulent Yazici
- Department of Psychiatry, Sakarya University Training and Research Hospital, Sakarya, Turkey
| | - Betul Aslan Turkmen
- Department of Psychiatry, Sakarya University Training and Research Hospital, Sakarya, Turkey
| | - Atila Erol
- Department of Psychiatry, Faculty of Medicine, Sakarya University, Sakarya, Turkey
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18
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Fornaro M, Grunebaum MF, Burke AK, Mann JJ, Oquendo MA. Comparison of familial and non-familial suicidal behaviors among people with major depressive disorder: Testing the discriminative predicting role of high-yield clinical variables. J Psychiatr Res 2018; 102:118-122. [PMID: 29635115 DOI: 10.1016/j.jpsychires.2018.02.021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2018] [Accepted: 02/22/2018] [Indexed: 11/25/2022]
Abstract
BACKGROUND Suicidal behavior in first-degree relatives of people diagnosed with major depressive disorder (MDD) increases the risk of suicidal behavior. Such an effect may be the result of genetic risk factors or environmental ones, including imitation, or both. Surprisingly few studies have examined this question and thus, there still is little known about the effect of first-degree family history of suicidal behavior on the type of suicidal behavior and profile of risk factors related to the diathesis for suicidal behavior. Even less is known about intra-familial risk transmission. METHODS Patients with MDD (n = 252) experiencing a current major depressive episode and who had a previous suicide attempt were studied. Those with and without a family history of first-degree relatives who had made a suicide attempt or died by suicide were compared across clinical and suicide-related characteristics. RESULTS Suicide attempters with (FDR+, n = 59) and without a first-degree relative with suicide attempt or suicide (FDR-, n = 193) were similar in terms of type or frequency of suicide attempts, level of lifetime aggression and impulsivity, age of onset of depression and age at first suicide attempt. LIMITATIONS Cross-Sectional study. Lack of additional external validators. CONCLUSIONS Contrary to our hypothesis and the concept of "genetic anticipation", a first-degree family history of suicide attempt or suicide in currently depressed attempters with MDD was not associated with a range of clinical and suicide-related characteristics. Longitudinal studies incorporating external validators and potential biological markers may advance this area of research.
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Affiliation(s)
- Michele Fornaro
- New York State Psychiatric Institute, Columbia University, NY, USA.
| | | | - Ainsley K Burke
- New York State Psychiatric Institute, Columbia University, NY, USA.
| | - J John Mann
- New York State Psychiatric Institute, Columbia University, NY, USA.
| | - Maria A Oquendo
- New York State Psychiatric Institute, Columbia University, NY, USA.
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Tondo L, Vázquez GH, Sani G, Pinna M, Baldessarini RJ. Association of suicidal risk with ratings of affective temperaments. J Affect Disord 2018; 229:322-327. [PMID: 29329066 DOI: 10.1016/j.jad.2017.12.061] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2017] [Accepted: 12/31/2017] [Indexed: 01/07/2023]
Abstract
BACKGROUND Ratings of particular temperament-types with the TEMPS-A autoquestionnaire have been associated with suicidal risk, and combinations of such ratings may enhance the association. However, the predictive value of scores for individual temperaments and combinations remains to be quantified. METHOD We evaluated associations of TEMPS-A ratings for anxious (anx), cyclothymic (cyc), dysthymic (dys), hyperthymic (hyp) and irritable (irr) temperaments, with a history of suicidal acts or reported suicidal ideation in 882 patients with bipolar (BD; n = 509), major depressive (MDD; n = 268) or anxiety (ANX; n = 105) disorders. RESULTS With BD, scores for cyc and irr were highest and anx lowest; with MDD, dys scored highest, hyp lowest; anx was highest with ANX and MDD. Women (n = 497) had higher anx and cyc scores than men; scores for irr and hyp decreased with age. Scores for dys, anx, and cyc, were higher, and hyp lower, with greater HDRS21 depression ratings. Among 347 suicidal subjects (112 with attempts), cyc, dys, and irr scores were higher, hyp lower. Pooled score [cyc+ dys+ irr - hyp] best distinguished subjects with suicide attempts versus nonsuicidal subjects, including in Receiver-Operating Characteristic (ROC) analysis (AUC for acts = 70.1% [64.9- 75.3]). Multivariable modeling associated suicidal acts with TEMPS-A [cyc+ dys+ irr - hyp] composite-score, depression severity, BD or MDD diagnosis, and older at illness-onset. CONCLUSIONS Subjects with suicidal acts or ideation were best distinguished by composite TEMPS-A score [cyc+ dys+ irr - hyp]. These factors should help to identify those at suicidal risk.
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Affiliation(s)
- Leonardo Tondo
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA; Lucio Bini Mood Disorders Center, Cagliari, Sardinia, Italy; International Consortium for Bipolar & Psychotic Disorders Research, McLean Hospital, Belmont, MA, USA.
| | - Gustavo H Vázquez
- International Consortium for Bipolar & Psychotic Disorders Research, McLean Hospital, Belmont, MA, USA; Department of Psychiatry, Queen's University, Kingston, Ontario, Canada
| | - Gabriele Sani
- NESMOS Department (Neurosciences, Mental Health, and Sensory Organs), Sapienza University of Rome, School of Medicine and Psychology, Sant'Andrea Hospital, Rome, Italy; Centro Lucio Bini, Rome, Italy
| | - Marco Pinna
- Lucio Bini Mood Disorders Center, Cagliari, Sardinia, Italy
| | - Ross J Baldessarini
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA; International Consortium for Bipolar & Psychotic Disorders Research, McLean Hospital, Belmont, MA, USA
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Perugi G, Hantouche E, Vannucchi G. Diagnosis and Treatment of Cyclothymia: The "Primacy" of Temperament. Curr Neuropharmacol 2018; 15:372-379. [PMID: 28503108 PMCID: PMC5405616 DOI: 10.2174/1570159x14666160616120157] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2015] [Revised: 04/25/2016] [Accepted: 05/24/2016] [Indexed: 01/30/2023] Open
Abstract
Background: Contrary to DSM-5 definition based on recurrence of low grade hypomanic and depressive symptoms, cyclothymia is better defined in a neurodevelopmental perspective as an exaggeration of cyclothymic temperament. Emotional dysregulation with extreme mood instability and reactivity is the core features of the complex symptomatology. Method: In the present article, we critically reviewed the literature on the diagnosis and treatment of cyclothymia, focusing on the temperamental and neurodevelopmental perspectives. Results: Current epidemiological and clinical research showed the high prevalence and the validity of cyclothymia as a distinct form of bipolarity, frequently associated with multiple comorbidities with anxiety, impulse control, substance use, and so called “personality” disorders. Many patients receive correct diagnosis and treatments after many years of illness, when the superposition of complications reduces the possibility of complete remission. A therapeutic model combining the focus on symptomatic presentations with a temperamental perspective seems to represent an effective approach for cyclothymic patients with complex clinical presentations. Conclusion: Cyclothymic mood instability is an understudied issue despite the evidence of its clinical relevance. Unresolved issues concern its diagnostic delimitation and the possible relationships with emotional dysregulation observed in other neurodevelopmental disorders. We need to confirm the specificity of the disorder and to improve its recognition in early phase of the life, especially in youth. Early recognition means avoiding unnecessary complications and establishing specific treatments and clinical management since the beginning.
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Affiliation(s)
- Giulio Perugi
- Department of Clinical and Experimental Medicine, University of Pisa, Italy.,Institute of Behavioural Science,
"G.De Lisio", Pisa, Italy
| | - Elie Hantouche
- Centre des Troubles Anxieux et de l'Humeur, Anxiety & Mood Center, 117, Rue de Rennes, Paris 75006, France
| | - Giulia Vannucchi
- Department of Clinical and Experimental Medicine, University of Pisa, Italy
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Masi G, Milone A, Montesanto AR, Valente E, Pisano S. Non suicidal self-injury in referred adolescents with mood disorders and its association with cyclothymic-hypersensitive temperament. J Affect Disord 2018; 227:477-482. [PMID: 29156361 DOI: 10.1016/j.jad.2017.11.049] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2017] [Revised: 09/24/2017] [Accepted: 11/11/2017] [Indexed: 10/18/2022]
Abstract
BACKGROUND Non suicidal self-injuries (NSSIs) are deliberate self-harm behaviors without suicidal intent, usually starting in adolescence, with increasing rates of occurrence both in epidemiological and clinical samples. Several studies associated cyclothymic-hypersensitive temperament (CHT) with self-harm behaviors and suicidal risk. Aim of this study is to explore the association between NSSIs and CHT in a clinical sample of adolescents. We hypothesized that CHT may differentiate NSSI from non-NSSI adolescents with mood disorders, when other psychopathological features are controlled for. METHODS A consecutive sample of 89 adolescents with mood disorders were assessed for presence and phenomenology of NSSIs, CHT, demographics, comorbid categorical psychiatric diagnoses, dimensional psychopathology, impairment and previous suicide attempts. RESULTS NSSIs were reported in 52% of the sample, with higher rates in females and in bipolar disorder. Regression analyses showed that CHT, but not age, gender, bipolar vs depression diagnosis, functional impairment, was associated with NSSIs. DISCUSSION CHT may be in close association with NSSIs in adolescents with mood disorders. An assessment of CHT in adolescents referred for mood disorder may help to detect specific psychological features of NSSIs, which may improve diagnostic and treatment strategies. LIMITATIONS Given the cross-sectional design, a developmental relation between CHT and NSSIs cannot be determined. The small sample size and the selection bias of severely impaired patients limit the generalization of the results. More sophisticated measures of CHT may consent to explore other dimensions of the cyclothymic construct (i.e., emotional intensity, emotional reactivity, emotional stability, positive vs. negative emotions, interpersonal sensitivity, impulsivity).
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Affiliation(s)
- Gabriele Masi
- IRCCS Stella Maris, Scientific Institute of Child Neurology and Psychiatry, Calambrone, Pisa, Italy
| | - Annarita Milone
- IRCCS Stella Maris, Scientific Institute of Child Neurology and Psychiatry, Calambrone, Pisa, Italy
| | - Anna Rita Montesanto
- IRCCS Stella Maris, Scientific Institute of Child Neurology and Psychiatry, Calambrone, Pisa, Italy
| | - Elena Valente
- IRCCS Stella Maris, Scientific Institute of Child Neurology and Psychiatry, Calambrone, Pisa, Italy
| | - Simone Pisano
- Clinic of Child and Adolescent Neuropsychiatry, Department of Medicine and Surgery, University of Salerno, Baronissi, Salerno, Italy.
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Pompili M, Baldessarini RJ, Innamorati M, Vázquez GH, Rihmer Z, Gonda X, Forte A, Lamis DA, Erbuto D, Serafini G, Fiorillo A, Amore M, Girardi P. Temperaments in psychotic and major affective disorders. J Affect Disord 2018; 225:195-200. [PMID: 28837953 DOI: 10.1016/j.jad.2017.08.026] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2017] [Revised: 06/06/2017] [Accepted: 08/10/2017] [Indexed: 11/26/2022]
Abstract
BACKGROUND Assessment of affective temperaments with the extensively validated, 110-item TEMPS-A autoquestionnaire has been used to characterize patients with mood disorders, and its scores have been associated consistently with suicidal behavior. Much less has been reported about comparisons of characteristics of such assessments in psychotic and other psychiatric disorders. METHODS We analyzed results of TEMPS-A assessments in 1081 psychiatrically hospitalized patients in Rome and compared subscale scores (anxious [anx], cyclothymic [cyc], depressive [dep], irritable [irr], hyperthymic [hyp]) and a composite score (anx+cyc+dep+irr - hyp) among diagnoses and subjects with vs. without a suicide attempt. RESULTS TEMPS-A subscale scores differed significantly among diagnoses and were higher with major affective than psychotic or other disorders. Suicide attempts were 1.5-times more frequent among women than men and with affective versus nonaffective disorders, ranking: bipolar-II > major depression > bipolar-I > other disorders > psychotic disorders. TEMPS-A subscores were significantly higher among suicidal subjects (ranking: anx ≥ cyc ≥ dep > irr) except hyp (lower), but the composite score differed most (1.37-fold higher). Multivariable logistic regression modeling indicated that suicide attempt was significantly and independently associated with: TEMPS-A composite score > female sex > affective disorder > older age. CONCLUSIONS TEMPS-A scores, particularly a composite score (anx+cyc+dep+irr - hyp) may help effectively evaluate suicidal risk in association with nonaffective as well as affective disorders.
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Affiliation(s)
- Maurizio Pompili
- Department of Neurosciences, Mental Health and Sensory Organs, Suicide Prevention Center, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy; International Consortium for Mood & Psychotic Disorders Research, Mailman Research Center, McLean Hospital, Belmont, MA, USA.
| | - Ross J Baldessarini
- International Consortium for Mood & Psychotic Disorders Research, Mailman Research Center, McLean Hospital, Belmont, MA, USA; Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Marco Innamorati
- Department of Human Sciences, European University of Rome, Rome, Italy
| | - Gustavo H Vázquez
- International Consortium for Mood & Psychotic Disorders Research, Mailman Research Center, McLean Hospital, Belmont, MA, USA; Department of Psychiatry, Queen's University, Kingston, Ontario, Canada
| | - Zoltan Rihmer
- Department of Psychiatry and Psychotherapy, Kútvölgyi Clinical Center, Semmelweis University, Budapest, Hungary; Laboratory of Suicide Prevention and Research, National Institute for Psychiatry and Addictology, Department of Pharmacology and Pharmacotherapy, Semmelweis University, Hungary
| | - Xenia Gonda
- Department of Psychiatry and Psychotherapy, Kútvölgyi Clinical Center, Semmelweis University, Budapest, Hungary; Laboratory of Suicide Prevention and Research, National Institute for Psychiatry and Addictology, Department of Pharmacology and Pharmacotherapy, Semmelweis University, Hungary; MTA-SE Neurochemistry and Neuropsychopharmacology Research Group, Hungarian Academy of Sciences, Semmelweis University, Budapest, Hungary
| | - Alberto Forte
- Department of Neurosciences, Mental Health and Sensory Organs, Suicide Prevention Center, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy; International Consortium for Mood & Psychotic Disorders Research, Mailman Research Center, McLean Hospital, Belmont, MA, USA
| | - Dorian A Lamis
- Department of Psychiatry & Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Denise Erbuto
- Department of Neurosciences, Mental Health and Sensory Organs, Suicide Prevention Center, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | - Gianluca Serafini
- Section of Psychiatry, Department of Neuroscience, Ophthalmology, Genetics, and Infant-Maternal Science, University of Genoa, Genoa, Italy
| | - Andrea Fiorillo
- Department of Psychiatry, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Mario Amore
- Section of Psychiatry, Department of Neuroscience, Ophthalmology, Genetics, and Infant-Maternal Science, University of Genoa, Genoa, Italy
| | - Paolo Girardi
- Department of Neurosciences, Mental Health and Sensory Organs, Suicide Prevention Center, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
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Association between suicide-related ideations and affective temperaments in the Japanese general adult population. PLoS One 2017. [PMID: 28640865 PMCID: PMC5481026 DOI: 10.1371/journal.pone.0179952] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Suicide rates are vastly higher in Japan than in many other countries, although the associations between affective temperaments and suicide-related ideations in the general adult population remain unclear. Therefore, we aimed to elucidate these associations in the present study. METHODS We analyzed data from 638 Japanese volunteers who completed both the Patient Health Questionnaire (PHQ-9) and the Temperament Evaluation of the Memphis, Pisa, Paris, and San Diego Auto-questionnaire (TEMPS-A). Participants were then divided into three groups based on PHQ-9 summary scores and responses to the suicide-related ideation item: non-depressive control group (NC; N = 469), depressive symptoms without suicide-related ideations group (non-SI; N = 135), and depressive symptoms with suicide-related ideations group (SI; N = 34). The depressive symptoms were defined for PHQ-9 summary scores ≥5, and the suicide-related ideations were defined for PHQ-9 #9 score ≥1. We then compared TEMPS-A scores among the groups using Kruskal-Wallis tests. Then the 95% confidence intervals of differences in TEMPS-A subscale scores between the NC and non-SI groups, or between NC and SI groups, were calculated. RESULTS Participants of the SI group exhibited significantly higher scores on the depressive, irritable, and anxious temperament subscales than those of the non-SI group. Similarly, women of the SI group exhibited significantly higher scores of the depressive and irritable temperament subscales than women of the non-SI group, while men of the SI group exhibited significantly higher depressive temperament scores than those of the non-SI group. Among all participants and only men, cyclothymic subscale scores were higher in those of the SI group than the non-SI group (not significant), although the 95% confidence intervals did not overlap. LIMITATIONS The cross-sectional study design was the main limitation. CONCLUSIONS Depressive, irritable, and anxious temperaments are significant risk factors for suicide-related ideations in the Japanese general adult population. Furthermore, irritable temperament in women and depressive temperament in men are associated with suicide-related ideations.
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Messaoud A, Mensi R, Mhalla A, Hallara I, Neffati F, Douki W, Najjar MF, Gaha L. [Dyslipidemia and suicidal risk in patients with psychiatric disorders]. Encephale 2017; 44:315-320. [PMID: 28583656 DOI: 10.1016/j.encep.2017.03.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2017] [Revised: 03/17/2017] [Accepted: 03/23/2017] [Indexed: 10/19/2022]
Abstract
The aim of this work is to study the association between dyslipidemia and suicidal risk in patients with psychiatric pathology. Our study has involved 155 patients suffering from major depressive disorder and 124 schizophrenic patients aged 40.58±12.16 and 43.43±10.60 years, respectively. Total cholesterol (TC), triglycerides (TG) and HDL-c were determined by enzymatic methods, LDL-c was calculated by the Friedewald formula. Plasma cholesterol level was significantly lower among suicidal schizophrenic or depressive patients. There were no significant differences in the others lipid levels. The results of our study suggest that total cholesterol values less than 3.59mmol/L could be an indicator of suicide vulnerability in patients with schizophrenia or major depressive disorder.
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Affiliation(s)
- A Messaoud
- Service de psychiatrie, laboratoire de recherche « vulnérabilité aux psychoses LR 05 ES 10 », hôpital universitaire de Monastir, Monastir, Tunisie; Laboratoire de biochimie-toxicologie, hôpital universitaire de Monastir, Monastir, Tunisie.
| | - R Mensi
- Service de psychiatrie, laboratoire de recherche « vulnérabilité aux psychoses LR 05 ES 10 », hôpital universitaire de Monastir, Monastir, Tunisie; Laboratoire de biochimie-toxicologie, hôpital universitaire de Monastir, Monastir, Tunisie
| | - A Mhalla
- Service de psychiatrie, laboratoire de recherche « vulnérabilité aux psychoses LR 05 ES 10 », hôpital universitaire de Monastir, Monastir, Tunisie
| | - I Hallara
- Laboratoire de biochimie-toxicologie, hôpital universitaire de Monastir, Monastir, Tunisie
| | - F Neffati
- Laboratoire de biochimie-toxicologie, hôpital universitaire de Monastir, Monastir, Tunisie
| | - W Douki
- Service de psychiatrie, laboratoire de recherche « vulnérabilité aux psychoses LR 05 ES 10 », hôpital universitaire de Monastir, Monastir, Tunisie; Laboratoire de biochimie-toxicologie, hôpital universitaire de Monastir, Monastir, Tunisie
| | - M F Najjar
- Laboratoire de biochimie-toxicologie, hôpital universitaire de Monastir, Monastir, Tunisie
| | - L Gaha
- Service de psychiatrie, laboratoire de recherche « vulnérabilité aux psychoses LR 05 ES 10 », hôpital universitaire de Monastir, Monastir, Tunisie
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Ardani AR, Hosseini FF, Asadpour Z, Hashemian AM, Dadpour B, Nahidi M. Affective temperaments, as measured by TEMPS-A, among self-poisoning nonlethal suicide attempters. Psychiatry Res 2017; 247:125-129. [PMID: 27888682 DOI: 10.1016/j.psychres.2016.10.086] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2016] [Revised: 10/26/2016] [Accepted: 10/30/2016] [Indexed: 10/20/2022]
Abstract
Suicidal behaviors are serious public health problems. The prominent association of mood disorders with suicide, along with the renaissance of the spectrum concept of psychiatric disorders in the recent decades, prioritizes the investigation of temperament variants in suicidal individuals. This study aimed to explore the relationship between affective temperaments and nonviolent suicide attempts. We administered Temperament Evaluation of the Memphis, Pisa, Paris, and San Diego Auto questionnaire (TEMPS-A) to 141 (27 males and 114 females) consecutive self-poisoning non-lethal suicide attempters at a Medical Toxicology Center and a sex and age matched group of healthy individuals (28 males, 112 females). Female suicide attempters scored significantly higher in depressive, cyclothymic, irritable, and anxious temperaments compared with female controls, whereas male cases' scores were significantly higher in depressive and anxious subscales compared with control males. Except for hyperthymic temperament which did not reveal any significant effects, depressive (OR: 11.5), cyclothymic (OR: 3.8), irritable (OR: 2.3), and anxious (OR: 8.8) temperaments were predictors for nonviolent suicide attempts. Therefore, this study replicated the evidence for the strong association of depressive temperament with suicide attempts. The hyperthymic temperament appeared to have neither protective nor predisposing influence. Further studies are needed to identify the role of this independent temperament.
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Affiliation(s)
- Amir Rezaei Ardani
- Psychiatry and Behavioural Sciences Research Centre, Mashhad University of Medical Sciences, Mashhad, Razavi Khorasan, Iran
| | - Farhad Farid Hosseini
- Psychiatry and Behavioural Sciences Research Centre, Mashhad University of Medical Sciences, Mashhad, Razavi Khorasan, Iran
| | - Zahra Asadpour
- Psychiatry and Behavioural Sciences Research Centre, Mashhad University of Medical Sciences, Mashhad, Razavi Khorasan, Iran
| | - Amir Masoud Hashemian
- Emergency Department, Faculty of medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Bita Dadpour
- Medical Toxicology Research Centre, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mahsa Nahidi
- Psychiatry and Behavioural Sciences Research Centre, Mashhad University of Medical Sciences, Mashhad, Razavi Khorasan, Iran.
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Baldessarini RJ, Vázquez GH, Tondo L. Affective temperaments and suicidal ideation and behavior in mood and anxiety disorder patients. J Affect Disord 2016; 198:78-82. [PMID: 27011363 DOI: 10.1016/j.jad.2016.03.002] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2015] [Revised: 02/29/2016] [Accepted: 03/05/2016] [Indexed: 10/22/2022]
Abstract
BACKGROUND Clinical characteristics proposed to be associated with suicidal risk include affective temperament types. We tested this proposal with two methods in a large sample of subjects with mood and anxiety disorders. METHODS We assessed consecutive, consenting subjects clinically for affective temperament types and by TEMPS-A self-ratings for associations of temperament with suicidal ideation and acts, using standard bivariate methods, and multivariate logistic regression models. RESULTS Among 2561 subjects (major depressive, 1171; bipolar, 919, anxiety disorders, 471), temperament-types and TEMPS-A (39-item Italian version) subscale scores differed by risk of suicidal acts or ideation. Suicidal acts and ideation were most associated with cyclothymic and dysthymic, and less with hyperthymic temperaments. These associations were sustained by multivariate modeling that included diagnosis, age, sex, and diagnosis. LIMITATIONS Not all subjects completed TEMPS-A self-ratings; clinical assessments of temperaments were not standardized, and long-term stability of temperament assessments was not tested. CONCLUSIONS The findings support and extend associations of cyclothymic-dysthymic temperaments with suicidal acts and ideation, whereas hyperthymic temperament may be protective.
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Affiliation(s)
- Ross J Baldessarini
- The International Consortium for Psychotic & Mood Disorders Research, McLean Hospital, Belmont, MA, United States; Department of Psychiatry, Harvard Medical School, Boston, MA, United States
| | - Gustavo H Vázquez
- The International Consortium for Psychotic & Mood Disorders Research, McLean Hospital, Belmont, MA, United States; Department of Neuroscience, Palermo University, Buenos Aires, Argentina
| | - Leonardo Tondo
- The International Consortium for Psychotic & Mood Disorders Research, McLean Hospital, Belmont, MA, United States; Department of Psychiatry, Harvard Medical School, Boston, MA, United States; Lucio Bini Mood Disorders Centers, Cagliari, Rome, Italy.
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27
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Baker AW, Goetter EM, Bui E, Shah R, Charney ME, Mauro C, Shear MK, Simon NM. The Influence of Anxiety Sensitivity on a Wish to Die in Complicated Grief. J Nerv Ment Dis 2016; 204:314-6. [PMID: 27015394 PMCID: PMC4808517 DOI: 10.1097/nmd.0000000000000465] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Individuals with complicated grief are at elevated risk of suicidal thoughts. Anxiety sensitivity has recently emerged as a risk factor of suicide. This study aimed to investigate a possible association between anxiety sensitivity and a wish to die in individuals with complicated grief. Participants were evaluated for participation in a treatment study and completed an ancillary questionnaire-based study. Participants were 51 bereaved adults evaluated (age: mean, 54 [SD, 13.6] years; 78% [n = 40] women). Logistic regression was used to examine the relationship between anxiety sensitivity and a wish to die. Overall, anxiety sensitivity was associated with a wish to die at the level of a medium effect size, although it did not reach statistical significance. The anxiety sensitivity social concerns subscale was significantly associated with a wish to die. These findings add to a growing literature implicating anxiety sensitivity in reporting a wish to die.
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Mensi R, Messaoud A, Mhallah A, Azizi I, Salah WH, Douki W, Najjar MF, Gaha L. The association between altered lipid profile and suicide attempt among Tunisian patients with schizophrenia. Ann Gen Psychiatry 2016; 15:36. [PMID: 28018476 PMCID: PMC5162100 DOI: 10.1186/s12991-016-0123-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2016] [Accepted: 12/02/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND There have been many studies on psychiatric disorders, but very little is known about the biology of suicide with schizophrenia. In the present study, we are looking for a possible connection between altered lipid profile and suicidal behavior in schizophrenic Tunisian patients. METHODS Assay of total cholesterol (TC), high-density lipoprotein cholesterol (HDL-c), low-density lipoprotein cholesterol (LDL-c), and triglycerides (TG) has been done for 126 schizophrenic patients with and without suicide attempts and 131 healthy controls recruited in the University Hospital of Monastir. RESULTS TC and LDL-c levels were significantly higher in schizophrenic patients compared to controls. TC was significantly lower in schizophrenic patients with suicide attempt compared to those without suicide attempt. Depending to the sonority of suicide attempt, TC was significantly lower in patients with recent suicide attempt compared to those with lifetime suicide attempt and without suicide attempt (p < 0.001), and no significant differences between TG, LDL-c, and HDL-c were noted. CONCLUSIONS Results of this study showed that TC levels in schizophrenic patients after a recent suicide attempt are significantly lower than in patients without suicide attempt and with lifetime suicide attempts. TC can be one of biological markers defined suicidal risk for schizophrenic patients.
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Affiliation(s)
- Rym Mensi
- Research Laboratory "Vulnerability to Psychotic Disorders LR05ES10", Faculty of Medicine, University of Monastir, 5012 Monastir, Tunisia ; Clinical Biochemistry and Toxicology Laboratory, University Hospital in Monastir, Monastir, Tunisia
| | - Amal Messaoud
- Research Laboratory "Vulnerability to Psychotic Disorders LR05ES10", Faculty of Medicine, University of Monastir, 5012 Monastir, Tunisia ; Clinical Biochemistry and Toxicology Laboratory, University Hospital in Monastir, Monastir, Tunisia
| | - Ahmed Mhallah
- Research Laboratory "Vulnerability to Psychotic Disorders LR05ES10", Faculty of Medicine, University of Monastir, 5012 Monastir, Tunisia ; Department of Psychiatry, University Hospital in Monastir, Monastir, Tunisia
| | - Islem Azizi
- Research Laboratory "Vulnerability to Psychotic Disorders LR05ES10", Faculty of Medicine, University of Monastir, 5012 Monastir, Tunisia ; Clinical Biochemistry and Toxicology Laboratory, University Hospital in Monastir, Monastir, Tunisia
| | - Walid Haj Salah
- Research Laboratory "Vulnerability to Psychotic Disorders LR05ES10", Faculty of Medicine, University of Monastir, 5012 Monastir, Tunisia ; Department of Psychiatry, University Hospital in Monastir, Monastir, Tunisia
| | - Wahiba Douki
- Research Laboratory "Vulnerability to Psychotic Disorders LR05ES10", Faculty of Medicine, University of Monastir, 5012 Monastir, Tunisia ; Clinical Biochemistry and Toxicology Laboratory, University Hospital in Monastir, Monastir, Tunisia
| | - Mohamed Fadhel Najjar
- Clinical Biochemistry and Toxicology Laboratory, University Hospital in Monastir, Monastir, Tunisia
| | - Lotfi Gaha
- Research Laboratory "Vulnerability to Psychotic Disorders LR05ES10", Faculty of Medicine, University of Monastir, 5012 Monastir, Tunisia ; Department of Psychiatry, University Hospital in Monastir, Monastir, Tunisia
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Abstract
BACKGROUND AND AIMS Treatment adherence is one of the most important factors that may determine treatment response in patients with bipolar disorders (BD). Many factors have been described to be associated with treatment adherence in BD. Temperament that can influence the course of BD will have an impact on treatment adherence. The aim of this study is to investigate temperament effect on treatment adherence in euthymic patients with BD-I. METHODS Eighty patients with BD-I participated in the study. A psychiatrist used the Structured Clinical Interview for DSM-IV Axis-I Disorders to determine the diagnosis and co-morbidities. Hamilton Depression and Young Mania Rating Scale were used to detect the remission. We used the Temperament Evaluation of Memphis, Pisa, Paris, San Diego Autoquestionnaire and the 4-item Morisky Medication Adherence Scale to evaluate temperament and treatment adherence, respectively. The study group was divided into two groups as "treatment adherent" and "treatment non-adherent". RESULTS The cyclothymic and anxious temperament scores of the treatment non-adherent patients with BD-I were significantly higher than those of the treatment adherent group (p < 0.001, p = 0.006, respectively). Multiple linear regression analysis determined that cyclothymic temperament predicted treatment non-adherence (p = 0.009). CONCLUSION It should be kept in mind that BD-I patients with cyclothymic temperament may be treatment non-adherent and future studies should explore whether temperament characteristics deteriorate BD-I course by disrupting treatment adherence.
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Affiliation(s)
- Sadiye Visal Buturak
- a Sadiye Visal Buturak, Department of Psychiatry , Faculty of Medicine, Kirikkale University , Kirikkale , Turkey
| | - Erdogan Bakar Emel
- b Emel Erdogan Bakar, Department of Psychology , Faculty of Science and Literature, Ufuk University , Ankara , Turkey
| | - Orhan Murat Koçak
- c Orhan Murat Koçak, Department of Psychiatry , Faculty of Medicine, Kirikkale University , Kirikkale , Turkey
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Asik M, Altinbas K, Eroglu M, Karaahmet E, Erbag G, Ertekin H, Sen H. Evaluation of affective temperament and anxiety-depression levels of patients with polycystic ovary syndrome. J Affect Disord 2015; 185:214-8. [PMID: 26241866 DOI: 10.1016/j.jad.2015.06.043] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2015] [Accepted: 06/26/2015] [Indexed: 02/04/2023]
Abstract
BACKGROUND Women with polycystic ovary syndrome (PCOS) are reported to experience depressive episodes at a higher rate than healthy controls (HC). Affective temperament features are psychiatric markers that may help to predict and identify vulnerability to depression in women with PCOS. Our aim was to evaluate the affective temperaments of women with PCOS and to investigate the association with depression and anxiety levels and laboratory variables in comparison with HC. METHODS The study included 71 women with PCOS and 50 HC. Hormonal evaluations were performed for women with PCOS. Physical examination, clinical history, Hospital Anxiety and Depression Scale (HADS) and TEMPS-A were performed for all subjects. Differences between groups were evaluated using Student's t-tests and Mann-Whitney U tests. Correlations and logistic regression tests were performed. RESULTS All temperament subtype scores, except hyperthymic, and HADS anxiety, depression, and total scores were significantly higher in patients with PCOS compared to HC. A statistically significant positive correlation was found between BMI and irritable temperament, and insulin and HADS depression scores in patients with PCOS. Additionally, hirsutism score and menstrual irregularity were correlated with HADS depression, anxiety and total scores in PCOS patients. In logistic regression analysis, depression was not affected by PCOS, hirsutism score or menstrual irregularity. However, HADS anxiety score was associated with hirsutism score. CONCLUSIONS Our study is the first to evaluate the affective temperament features of women with PCOS. Consequently, establishing affective temperament properties for women with PCOS may help clinicians predict those patients with PCOS who are at risk for depressive and anxiety disorders.
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Affiliation(s)
- Mehmet Asik
- Departments of Endocrinology and Metabolism, Faculty of Medicine, Çanakkale Onsekiz Mart University, Çanakkale, Turkey.
| | - Kursat Altinbas
- Department of Psychiatry, Faculty of Medicine, Çanakkale Onsekiz Mart University, Çanakkale, Turkey
| | - Mustafa Eroglu
- Departments of Endocrinology and Metabolism, Faculty of Medicine, Çanakkale Onsekiz Mart University, Çanakkale, Turkey
| | - Elif Karaahmet
- Department of Psychiatry, Faculty of Medicine, Çanakkale Onsekiz Mart University, Çanakkale, Turkey
| | - Gokhan Erbag
- General Medicine, Faculty of Medicine, Çanakkale Onsekiz Mart University, Çanakkale, Turkey
| | - Hulya Ertekin
- Department of Psychiatry, Faculty of Medicine, Çanakkale Onsekiz Mart University, Çanakkale, Turkey
| | - Hacer Sen
- General Medicine, Faculty of Medicine, Çanakkale Onsekiz Mart University, Çanakkale, Turkey
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Cyclothymia reloaded: A reappraisal of the most misconceived affective disorder. J Affect Disord 2015; 183:119-33. [PMID: 26005206 DOI: 10.1016/j.jad.2015.05.004] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2015] [Revised: 05/04/2015] [Accepted: 05/04/2015] [Indexed: 12/16/2022]
Abstract
Data emerging from both academic centers and from public and private outpatient facilities indicate that from 20% to 50% of all subjects that seek help for mood, anxiety, impulsive and addictive disorders turn out, after careful screening, to be affected by cyclothymia. The proportion of patients who can be classified as cyclothymic rises significantly if the diagnostic rules proposed by the DSM-5 are reconsidered and a broader approach is adopted. Unlike the DSM-5 definition based on the recurrence of low-grade hypomanic and depressive symptoms, cyclothymia is best identified as an exaggeration of cyclothymic temperament (basic mood and emotional instability) with early onset and extreme mood reactivity linked with interpersonal and separation sensitivity, frequent mixed features during depressive states, the dark side of hypomanic symptoms, multiple comorbidities, and a high risk of impulsive and suicidal behavior. Epidemiological and clinical research have shown the high prevalence of cyclothymia and the validity of the concept that it should be seen as a distinct form of bipolarity, not simply as a softer form. Misdiagnosis and consequent mistreatment are associated with a high risk of transforming cyclothymia into severe complex borderline-like bipolarity, especially with chronic and repetitive exposure to antidepressants and sedatives. The early detection and treatment of cyclothymia can guarantee a significant change in the long-term prognosis, when appropriate mood-stabilizing pharmacotherapy and specific psychological approaches and psychoeducation are adopted. The authors present and discuss clinical research in the field and their own expertise in the understanding and medical management of cyclothymia and its complex comorbidities.
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Hardt J, Bernert S, Matschinger H, Angermeier MC, Vilagut G, Bruffaerts R, de Girolamo G, de Graaf R, Haro JM, Kovess V, Alonso J. Suicidality and its relationship with depression, alcohol disorders and childhood experiences of violence: results from the ESEMeD study. J Affect Disord 2015; 175:168-74. [PMID: 25618003 DOI: 10.1016/j.jad.2014.12.044] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2014] [Revised: 12/16/2014] [Accepted: 12/16/2014] [Indexed: 10/24/2022]
Abstract
BACKGROUND Suicidality constitutes a major health concern in many countries. The aim of the present paper was to analyse 10 of its risk factors and their interdependence. METHODS Data on suicidality, mental disorders and experience of childhood violence was collected from 8796 respondents in the European Study of the Epidemiology of Mental Disorders (ESEMeD). The CIDI was used to assess mental disorders. Individuals were randomly divided into two subgroups. In one, a Graphical Markov model to predict suicidality was constructed, in the second, predictors were cross-validated. RESULTS Lifetime suicidality was predicted mainly by lifetime depression and early experiences of violence, with a pseudo R-square of 12.8%. In addition, alcohol disorders predicted suicidality, but played a minor role compared with the other risk factors in this sample. CONCLUSION In addition to depression, early experience of violence constitutes an important risk factor of suicidality. LIMITATIONS This is a cross-sectional and retrospective study assessing risk factors for suicidality, not for suicide itself.
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Affiliation(s)
- J Hardt
- Medizinische Psychologie und Medizinische Soziologie, Klinik für Psycho-somatische Medizin und Psychotherapie, Universitätsmedizin Mainz, Germany.
| | - S Bernert
- Institute of Medical Sociology, Department of Rehabilitation Research, Charité - University Medicine Berlin
| | - H Matschinger
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), Medical Faculty, University of Leipzig
| | - M C Angermeier
- Center for Public Mental Health, Gösing am Wagram, Austria; Department of Public Health, University of Cagliari, Italy
| | - G Vilagut
- Health Services Research Unit, IMIM- Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain; CIBER en Epidemiología y Salud Pública (CIBERESP), Spain
| | - R Bruffaerts
- Department of Psychiatry, University Hospital Gasthuisberg; Leuven, Belgium
| | - G de Girolamo
- IRCCS St John of God Fatebenefratelli, Via Pilastroni, 4, 25125, Brescia, Italy
| | - R de Graaf
- Netherlands Institute of Mental Health and Addiction (Trimbos-Instituut), Utrecht, Nl; Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain
| | - J M Haro
- CIBER en Salud Mental (CIBERSAM), Spain
| | - V Kovess
- EA4069, Paris Descartes University, Ecole des Hautes Etudes en Santé Publique (EHESP), Paris, France
| | - J Alonso
- Health Services Research Unit, IMIM- Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain; CIBER en Epidemiología y Salud Pública (CIBERESP), Spain
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da Graça Cantarelli M, Nardin P, Buffon A, Eidt MC, Antônio Godoy L, Fernandes BS, Gonçalves CA. Serum triglycerides, but not cholesterol or leptin, are decreased in suicide attempters with mood disorders. J Affect Disord 2015; 172:403-9. [PMID: 25451444 DOI: 10.1016/j.jad.2014.10.033] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2014] [Accepted: 10/14/2014] [Indexed: 12/22/2022]
Abstract
BACKGROUND Many peripheral biomarkers, including low cholesterol and its fractions, have been examined to identify suicidal behavior. Herein, we assessed serum lipid profile and some proteins putatively associated with suicidal behavior in subjects with mood disorder (bipolar disorder or major depressive disorder) with a recent suicide attempt and with no lifetime history of suicide attempts. METHODS Fifty subjects had presented an episode of attempted suicide during the last 15 days, and 36 subjects had no history of any suicide attempt. We measured total cholesterol, HDL, LDL and triglycerides as well as serum leptin, brain-derived neurotrophic factor (BDNF), S100B and C-reactive protein (CRP). RESULTS Individuals that had attempted suicide presented decreased body mass index (BMI) and waist circumference. After adjusting for these confounders, we found that triglycerides were decreased in attempted suicide subjects. We found no differences among total cholesterol, LDL, and HDL or leptin, S100B, CRP and BDNF. LIMITATIONS This is a cross-sectional study, and we cannot therefore assess whether a decrease in triglycerides caused a mood episode with suicidal ideation that led to a suicide attempt or if the presence of a mood episode originated a loss of appetite and consequent loss of weight, therefore decreasing triglyceride levels. CONCLUSIONS These results do not support the hypothesis that lower levels of cholesterol are associated with suicidal behavior in a mood disorder sample. However, our data support the idea that adiposity is differentiated in these patients (reduced BMI, waist circumference and serum triglycerides), which could lead to an altered communication between the adipose tissue and brain.
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Affiliation(s)
| | - Patrícia Nardin
- Laboratory of Calcium Binding Proteins in the Central Nervous System, Post Graduate Program in Biochemistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Andréia Buffon
- Faculty of Pharmacy, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | | | | | - Brisa S Fernandes
- Laboratory of Calcium Binding Proteins in the Central Nervous System, Post Graduate Program in Biochemistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Carlos-Alberto Gonçalves
- Post Graduate Program in Neuroscience, Federal University of Rio Grande do Sul,Porto Alegre, Brazil; Laboratory of Calcium Binding Proteins in the Central Nervous System, Post Graduate Program in Biochemistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil.
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Costa LDS, Alencar ÁP, Nascimento Neto PJ, dos Santos MDSV, da Silva CGL, Pinheiro SDFL, Silveira RT, Bianco BAV, Pinheiro RFF, de Lima MAP, Reis AOA, Rolim Neto ML. Risk factors for suicide in bipolar disorder: a systematic review. J Affect Disord 2015; 170:237-54. [PMID: 25261630 DOI: 10.1016/j.jad.2014.09.003] [Citation(s) in RCA: 81] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2014] [Revised: 08/18/2014] [Accepted: 09/02/2014] [Indexed: 01/27/2023]
Abstract
BACKGROUND Bipolar disorder confers the highest risk of suicide among major psychological disorders. The risk factors associated with bipolar disorder and suicide exist and are relevant to clinicians and researchers. OBJECTIVE The aim of the present study was to conduct a systematic review of articles regarding the suicide risk factors in bipolar disorder. METHODS A systematic review of articles on suicide risk factors in bipolar disorder, published from January 1, 2010 to April 05, 2014, on SCOPUS and PUBMED databases was carried out. Search terms were "Suicide" (medical subject headings [MeSH]), "Risk factors" (MeSH), and "Bipolar" (keyword). Of the 220 retrieved studies, 42 met the eligibility criteria. RESULTS Bipolar disorder is associated with an increased rate death by suicide which contributes to overall mortality rates. Studies covered a wide range of aspects regarding suicide risk factors in bipolar disorder, such as risk factors associated to Sociodemographic conditions, Biological characteristics, Drugs Relationships, Psychological Factors, Genetic Compound, Religious and Spirituals conditions. Recent scientific literature regarding the suicide risk factors in bipolar disorder converge to, directly or indirectly, highlight the negative impacts of risk factors to the affected population quality of life. CONCLUSION This review demonstrated that Bipolar disorders commonly leads to other psychiatric disorders and co-morbidities involving risk of suicide. Thus the risk factors are relevant to have a better diagnosis and prognosis of BD cases involving risk of suicide.
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Affiliation(s)
- Lucas da Silva Costa
- Laboratório de Escrita Científica, Faculdade de Medicina, Universidade Federal do Cariri, UFCA, Barbalha, Ceará, Brazil.
| | - Átila Pereira Alencar
- Laboratório de Escrita Científica, Faculdade de Medicina, Universidade Federal do Cariri, UFCA, Barbalha, Ceará, Brazil
| | | | | | | | | | - Regiane Teixeira Silveira
- Programa de Pós-Graduação em Ciências da Saúde, Faculdade de Medicina do ABC, Santo André, São Paulo, Brazil
| | - Bianca Alves Vieira Bianco
- Programa de Pós-Graduação em Ciências da Saúde, Faculdade de Medicina do ABC, Santo André, São Paulo, Brazil
| | | | | | - Alberto Olavo Advincula Reis
- Programa de Pós-Graduação em Saúde Pública, Faculdade de Saúde Pública, Universidade de São Paulo, USP, São Paulo, São Paulo, Brazil
| | - Modesto Leite Rolim Neto
- Líder de Grupo de Pesquisa em Suicidologia, Universidade Federal do Ceará, UFC/Conselho Nacional de Desenvolvimento Científico e Tecnológico, CNPq, Faculdade de Medicina, Universidade Federal do Cariri, UFCA, Barbalha, Ceará, Brazil
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Cyclothymic temperament rather than polarity is associated with hopelessness and suicidality in hospitalized patients with mood disorders. J Affect Disord 2015; 170:161-5. [PMID: 25240844 DOI: 10.1016/j.jad.2014.08.042] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2014] [Revised: 08/11/2014] [Accepted: 08/14/2014] [Indexed: 11/23/2022]
Abstract
BACKGROUND The aim of the present study was to assess sociodemographic and clinical differences between inpatients with major mood disorders (bipolar disorder - BD - and major depression - MDD) and the cyclothymic phenotype (CYC), and pure BDs or MDDs. METHODS Participants were 281 adult inpatients (134 men and 147 women) consecutively admitted to the Department of Psychiatry of the Sant׳Andrea University Hospital in Rome, Italy, between January 2008 and June 2010. The patients completed the Hamilton Scale for Depression (HAMD17), the Young Mania Rating Scale, the TEMPS-A (Temperament Evaluation of the Memphis, Pisa, Paris and San Diego-Autoquestionnaire), and the Beck Hopelessness Scale. RESULTS 38.7% of the MDD patients and 48.3% of the BD patients satisfied criteria to be included in the cyclothymic groups. Above 92% of the patients with the cyclothymic phenotype reported suicidal ideation at the item #3 of the HAMD17. Furthermore, patients with the cyclothymic phenotype reported higher hopelessness than other patients. LIMITATIONS Our results are potentially limited by the small number of MDD-CYC patients included in the sample. CONCLUSIONS Our results support the clinical usefulness of the concept of soft bipolar spectrum. Patients with the cyclothymic phenotype differ from pure MDD patients and BD patients for temperamental profile and clinical variables.
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Eory A, Rozsa S, Torzsa P, Kalabay L, Gonda X, Rihmer Z. Affective temperaments contribute to cardiac complications in hypertension independently of depression. PSYCHOTHERAPY AND PSYCHOSOMATICS 2014; 83:187-9. [PMID: 24752132 DOI: 10.1159/000357364] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/04/2013] [Accepted: 11/15/2013] [Indexed: 11/19/2022]
Affiliation(s)
- Ajandek Eory
- Department of Family Medicine, Semmelweis University, Budapest, Hungary
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Lian Q, Zuo X, Lou C, Gao E, Cheng Y. Sexual orientation and risk factors for suicidal ideation and suicide attempts: a multi-centre cross-sectional study in three Asian cities. J Epidemiol 2014; 25:155-61. [PMID: 25446798 PMCID: PMC4310877 DOI: 10.2188/jea.je20140084] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Purpose Despite robust empirical and theoretical evidence for higher rates of suicide among lesbian, gay, and bisexual (LGB) youths, little is known about the relationship between suicide and sexual orientation among Asian youths. This study examined differences in prevalence of suicidal ideation and suicide attempts between LGB and heterosexual youths in the cities of Hanoi, Shanghai, and Taipei, China. Methods The data are from a community-based multi-centre cross-sectional study conducted from 2006 to 2007, with a sample of 17 016 youths aged 15–24 years from Hanoi, Shanghai, and Taipei. Chi-square test and logistic regression were used to evaluate correlates of suicidal ideation and suicide attempts. Results The overall prevalence of suicidal ideation and suicide attempts in the preceding 12 months in LGB youths were both higher than in heterosexual youth (12.8% vs. 8.1% and 4.0% vs. 2.4%, respectively). Stratified by city, the prevalence of suicidal ideation was lowest in Hanoi (2.2%), followed by Shanghai (8.0%) and Taipei (17.0%). Similar trends were observed in the prevalence of suicide attempts, which was lowest in Hanoi (0.3%), followed by Shanghai (1.2%) and Taipei (2.5%). Of note, however, multivariate logistic regression results revealed that LGB youth were at a higher risk for suicidal ideation than heterosexual youth only in Taipei (odds ratio 1.65). Conclusions Suicidality is common among Asian youth, with higher prevalence observed in urbanized cities. LGB youths are at greater risk of suicidal ideation than their heterosexual counterparts in Taipei than in the other two examined cities.
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Affiliation(s)
- Qiguo Lian
- Department of Epidemiology and Social Science, Shanghai Institute of Planned Parenthood Research
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Rybakowski JK, Kaminska K, Charytonik J, Akiskal KK, Akiskal HS. Temperamental dimensions of the TEMPS-A in females with co-morbid bipolar disorder and bulimia. J Affect Disord 2014; 164:90-3. [PMID: 24856559 DOI: 10.1016/j.jad.2014.04.016] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2014] [Revised: 04/09/2014] [Accepted: 04/10/2014] [Indexed: 10/25/2022]
Abstract
OBJECTIVES We investigated the effect of co-morbid bipolar disorder and bulimia on temperamental dimensions measured by TEMPS-A, relative to "pure" bulimia and "pure" bipolar disorder, in female patients. METHODS The study was performed on 47 patients with bipolar disorder (BD) with a mean age of 36±10 years, 96 patients with bulimia or bulimic type of anorexia, mean age 26±9 years and 50 control healthy females (HC), mean age 29±6 years. Among bulimic patients, a group of 68 subjects with co-morbid bulimia with bipolarity (BD+B) was identified, based on positive score of the Mood Disorder Questionnaire (MDQ). The TEMPS-A questionnaire, 110 questions version, has been used, evaluating five temperament domains: depressive, cyclothymic, hyperthymic, irritable and anxious. Parametric analysis was performed for 4 groups (BD, "pure" bulimia (PB), BD+B and HC), with 28 subjects randomly chosen from each group, using analysis of variance and cluster analysis. RESULTS All clinical groups significantly differed from control group by having higher scores of depressive, cyclothymic, irritable and anxious temperaments and lower of hyperthymic one. Among patients, significantly higher scores of cyclothymic and irritable temperaments were found in BD+B compared to both PB and BD. These differences were also reflected in cluster analysis, where two clusters were identified. LIMITATIONS Bipolarity in bulimic patients assessed only by the MDQ. CONCLUSIONS These results show that co-morbid bulimia and bipolar disorder is characterized by extreme dimensions of both cyclothymic and irritable temperaments, significantly higher than each single diagnosis. Possible clinical implications of such fact are discussed.
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Affiliation(s)
- Janusz K Rybakowski
- Department of Adult Psychiatry, Poznan University of Medical Sciences, ul.Szpitalna 27/33, 60-572 Poznan, Poland.
| | - Katarzyna Kaminska
- Department of Adult Psychiatry, Poznan University of Medical Sciences, ul.Szpitalna 27/33, 60-572 Poznan, Poland
| | | | - Kareen K Akiskal
- International Mood Center, Paris, France; International Mood Center, La Jolla, CA, USA
| | - Hagop S Akiskal
- International Mood Center, Paris, France; International Mood Center, La Jolla, CA, USA
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Cyprien F, Guillaume S, Jaussent I, Lopez-Castroman J, Mercier G, Olie E, Courtet P. Impact of axis-I comorbidity and suicidal behavior disorders on sensitivity and specificity of the Mood Disorder Questionnaire in complex depressed inpatients. Compr Psychiatry 2014; 55:876-82. [PMID: 24625765 DOI: 10.1016/j.comppsych.2014.02.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2013] [Revised: 02/05/2014] [Accepted: 02/06/2014] [Indexed: 10/25/2022] Open
Abstract
OBJECTIVE This study assessed the psychometric performance of the Mood Disorder Questionnaire (MDQ) and its modified MDQ7 version, to screen for bipolar disorders (BD) in depressive inpatients according to depression severity, number of current axis I psychiatric comorbidities and suicidal behavior disorders. METHODS Depressed adult inpatients (n=195) were consecutively enrolled. Psychiatric diagnoses were made using the standardized DSM-IV-TR structured interview MINI 5.0.0 and medical case notes. Depression severity was assessed with the Beck Depression Inventory and the Hamilton Depression Scale. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of each MDQ version were evaluated in the whole sample and according to depression severity, current axis I psychiatric comorbidities and suicidal behavior. RESULTS The occurrence and the number of axis I disorders affected performance of both versions. Among depressed patients with two or more comorbidities, PPV and NPV of the MDQ were 65% and 80%, respectively, and they were respectively 56.2% and 87.9% with MDQ7. Current suicidal behavior disorders also dramatically reduced the PPV of MDQ (from 81.2% to 63.3%) and MDQ7 (from 72.2% to 52.6%) but the NPV remained above 80%. The performance of both versions of the MDQ tended to improve with the severity of depression. CONCLUSION The MDQ is not a suitable screening instrument to diagnose BD in subjects with a complex major depressive episode and/or a current history of suicidal behavior. Nevertheless MDQ particularly in its modified version may be useful for ruling out the presence of BD among these complex patients.
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Affiliation(s)
- Fabienne Cyprien
- Psychiatric Department, CHU Nîmes, Hopital Carémeau, Nîmes, France; Inserm U1061 Montpellier, France; University of Montpellier 1, Montpellier, France
| | - Sébastien Guillaume
- Inserm U1061 Montpellier, France; Psychiatric Emergency and Post Emergency Department, CHU Montpellier, Hôpital Lapeyronie, Pole Urgence, Montpellier, France; University of Montpellier 1, Montpellier, France.
| | - Isabelle Jaussent
- Inserm U1061 Montpellier, France; University of Montpellier 1, Montpellier, France
| | - Jorge Lopez-Castroman
- Inserm U1061 Montpellier, France; Psychiatric Emergency and Post Emergency Department, CHU Montpellier, Hôpital Lapeyronie, Pole Urgence, Montpellier, France; University of Montpellier 1, Montpellier, France; Department of Psychiatry, IIS-Fundacion Jimenez Diaz, CIBERSAM, Madrid, Spain
| | - Grégoire Mercier
- CHU Montpellier, Information Medical Department, Montpellier, France
| | - Emilie Olie
- Inserm U1061 Montpellier, France; Psychiatric Emergency and Post Emergency Department, CHU Montpellier, Hôpital Lapeyronie, Pole Urgence, Montpellier, France; University of Montpellier 1, Montpellier, France
| | - Philippe Courtet
- Inserm U1061 Montpellier, France; Psychiatric Emergency and Post Emergency Department, CHU Montpellier, Hôpital Lapeyronie, Pole Urgence, Montpellier, France; University of Montpellier 1, Montpellier, France
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de Aguiar Ferreira A, Vasconcelos AG, Neves FS, Correa H. Affective temperaments and antidepressant response in the clinical management of mood disorders. J Affect Disord 2014; 155:138-41. [PMID: 24215897 DOI: 10.1016/j.jad.2013.10.038] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2013] [Accepted: 10/22/2013] [Indexed: 10/26/2022]
Abstract
BACKGROUND The aim of this study was to investigate the presence of a relationship between affective temperament and antidepressant treatment response in mood disorder patients. METHODS The lifetime history of antidepressant response of 90 bipolar disorder patients and 88 major depressive disorder patients were retrospectively evaluated and then assigned to one of four subgroups: complete response (CR), partial response (PR), no response (NR), and antidepressant associated mania response (AAMR). Using TEMPS-Rio de Janeiro - the brief Brazilian version of TEMPS-A - we compared affective temperament subscale scores across these groups. RESULTS We observed a statistically significant relationship between depressive and anxious affective temperaments and no antidepressant response. In bipolar disorder patients, cyclothymic temperament (p<0.01) and hyperthymic temperament (p<0.05) were associated with antidepressant-associated mania. Hyperthymic temperament was associated with complete antidepressant responses in major depressive disorder patients. LIMITATIONS The evaluation of antidepressant response was retrospective. CONCLUSIONS Our data are consistent with the theory that affective temperament traits are factors that can influence the antidepressant response and the recovery from depressive episodes, but more longitudinal studies are needed to confirm this theory and our findings.
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Affiliation(s)
- Alexandre de Aguiar Ferreira
- Neuroscience Program, Federal University, Minas Gerais (UFMG), Belo Horizonte, MG, Brazil; Raul Soares Institute - FHEMIG, Belo Horizonte, MG, Brazil; Faculty of Medical Sciences of Minas Gerais - FCMMG, Belo Horizonte, MG, Brazil
| | | | - Fernando Silva Neves
- Neuroscience Program, Federal University, Minas Gerais (UFMG), Belo Horizonte, MG, Brazil; Department of Mental Health, Faculty of Medicine, Federal University, Minas Gerais, Av. Alfredo Balena, 190, Belo Horizonte, MG 30130-100, Brazil
| | - Humberto Correa
- Neuroscience Program, Federal University, Minas Gerais (UFMG), Belo Horizonte, MG, Brazil; Department of Mental Health, Faculty of Medicine, Federal University, Minas Gerais, Av. Alfredo Balena, 190, Belo Horizonte, MG 30130-100, Brazil.
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Abstract
AIM There are many studies on the mood disorders that occur during pregnancy, but no studies that question how affective temperaments, which are the antecedents of the mood disorders, are influenced by pregnancy. This study aims to examine the affective temperaments in women without any psychiatric diagnoses during the pregnancy period. METHOD The study included 100 pregnant women at the third trimester of their pregnancy (pregnant group) and 75 non-pregnant women (control group). Structured Clinical Interview for DSM Axis-I Disorders (SCID-I) was used for the evaluation of psychiatric disorders; Temperament Evaluation of Memphis, Pisa, Paris and San Diego Auto-questionnaire (TEMPS-A) was used for the evaluation of affective temperaments. RESULTS The cyclothymic, irritable and anxious temperament scores of the pregnant women were significantly lower than that of the non-pregnant women (p < 0.05). Pregnancy predicted lower scores of cyclothymic, irritable and anxious temperaments. Younger age and lower levels of education were predictors of higher cyclothymic, anxious and depressive temperament scores. Younger age also predicted higher irritable temperament scores. CONCLUSION The third trimester of pregnancy is associated with significantly lower affective temperament. Future studies may help to understand the biological background of the present findings.
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Affiliation(s)
- Esra Yazici
- a Department of Psychiatry Medical Faculty, Sakarya University Training and Research Hospital Turkey
| | - Hasan Terzi
- b Derince Training and Research Hospital Kocaeli Turkey
| | | | - Ahmet Bulent Yazici
- a Department of Psychiatry Medical Faculty, Sakarya University Training and Research Hospital Turkey
| | | | - Ahmet Kale
- b Derince Training and Research Hospital Kocaeli Turkey
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Preti A, Vellante M, Gabbrielli M, Lai V, Muratore T, Pintus E, Pintus M, Sanna S, Scanu R, Tronci D, Corrias I, Petretto DR, Carta MG. Confirmatory factor analysis and measurement invariance by gender, age and levels of psychological distress of the short TEMPS-A. J Affect Disord 2013; 151:995-1002. [PMID: 24054919 DOI: 10.1016/j.jad.2013.08.025] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2013] [Revised: 08/27/2013] [Accepted: 08/27/2013] [Indexed: 10/26/2022]
Abstract
BACKGROUND The Temperament Evaluation of Memphis, Pisa, Paris and San Diego - Autoquestionnaire (TEMPS-A) is a widely used self-reported tool aimed at measuring the affective temperaments that define the bipolar spectrum, with cyclothymic, depressive, irritable, hyperthymic, and anxious subscales. Confirmatory factor analysis (CFA) was rarely used to confirm the expected five-factor model. Measurement invariance was never tested. METHODS Cross-sectional, survey design involving 649 Italian college students (males: 47%). The short 39-item TEMPS-A and the 12-item General Health Questionnaire (GHQ-12) were used as measures of the affective temperaments and of psychological distress, respectively. CFA was applied to the TEMPS-A. Measurement invariance by gender, age and levels of psychological distress on the GHQ-12 was calculated with the establishment of subsequent equivalence constraints in the model parameters across groups. RESULTS The expected five-factor model had the best fit for all CFA indexes. Configural, metric and scalar invariance of the five-factor model of the TEMPS-A was proved across gender, age and levels of psychological distress of the participants. The hyperthymic temperament subscale has low or no links with the other affective temperament subscales, which were interrelated with medium to large effect sizes. LIMITATIONS College students might be not representative of the general population. No information on the clinical status of the students was available beyond self-report data. CONCLUSION The study proved the measurement invariance of the (short) TEMPS-A, which is a pre-requisite to compare groups or individuals in cross-sectional and longitudinal surveys. Generalizability cannot be assumed without replication of the findings in clinical samples.
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Affiliation(s)
- Antonio Preti
- Center of Liaison Psychiatry and Psychosomatics, University Hospital, University of Cagliari, Italy; Section on Clinical Psychology, Department of Education, Psychology, Philosophy, University of Cagliari, Italy; Genneruxi Medical Center, Cagliari, Italy.
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Iasevoli F, Valchera A, Di Giovambattista E, Marconi M, Rapagnani MP, De Berardis D, Martinotti G, Fornaro M, Mazza M, Tomasetti C, Buonaguro EF, Di Giannantonio M, Perugi G, de Bartolomeis A. Affective temperaments are associated with specific clusters of symptoms and psychopathology: a cross-sectional study on bipolar disorder inpatients in acute manic, mixed, or depressive relapse. J Affect Disord 2013; 151:540-550. [PMID: 23856282 DOI: 10.1016/j.jad.2013.06.041] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2013] [Revised: 06/17/2013] [Accepted: 06/17/2013] [Indexed: 12/12/2022]
Abstract
BACKGROUND The aim of this study was to assess whether different affective temperaments could be related to a specific mood disorder diagnosis and/or to different therapeutic choices in inpatients admitted for an acute relapse of their primary mood disorder. METHOD Hundred and twenty-nine inpatients were consecutively assessed by means of the Structured and Clinical Interview for axis-I disorders/Patient edition and by the Temperament Evaluation of Memphis, Pisa, Paris, and San Diego auto-questionnaire, Young Mania Rating Scale, Hamilton Scale for Depression and for Anxiety, Brief Psychiatry Rating Scale, Clinical Global impression, Drug Attitude Inventory, Barratt Impulsiveness Scale, Toronto Alexithymia Scale, and Symptoms Checklist-90 items version, along with records of clinical and demographic data. RESULTS The following prevalence rates for axis-I mood diagnoses were detected: bipolar disorder type I (BD-I, 28%), type II (31%), type not otherwise specified (BD-NOS, 33%), major depressive disorder (4%), and schizoaffective disorder (4%). Mean scores on the hyperthymic temperament scale were significantly higher in BD-I and BD-NOS, and in mixed and manic acute states. Hyperthymic temperament was significantly more frequent in BD-I and BD-NOS patients, whereas depressive temperament in BD-II ones. Hyperthymic and irritable temperaments were found more frequently in mixed episodes, while patients with depressive and mixed episodes more frequently exhibited anxious and depressive temperaments. Affective temperaments were associated with specific symptom and psychopathology clusters, with an orthogonal subdivision between hyperthymic temperament and anxious/cyclothymic/depressive/irritable temperaments. Therapeutic choices were often poorly differentiated among temperaments and mood states. LIMITS Cross-sectional design; sample size. CONCLUSIONS Although replication studies are needed, current results suggest that temperament-specific clusters of symptoms severity and psychopathology domains could be described.
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Affiliation(s)
- Felice Iasevoli
- Department of Neuroscience, Reproductive Sciences and Odontostomatology-University "Federico II" of Naples, Italy.
| | - Alessandro Valchera
- Hermanas Hospitalarias, Villa San Giuseppe Hospital, Ascoli Piceno, Italy; FoRiPsi, Rome, Italy
| | | | - Massimo Marconi
- Hermanas Hospitalarias, Villa San Giuseppe Hospital, Ascoli Piceno, Italy
| | | | - Domenico De Berardis
- NHS, Department of Mental Health, Psychiatric Service of Diagnosis and Treatment, Hospital "G. Mazzini", Asl 4, Teramo, Italy; Department of Neurosciences and Imaging, Chair of Psychiatry, University "G. d'Annunzio" of Chieti, Italy
| | - Giovanni Martinotti
- Department of Neurosciences and Imaging, Chair of Psychiatry, University "G. d'Annunzio" of Chieti, Italy
| | - Michele Fornaro
- Department of Education Science, University of Catania, Catania, Italy
| | - Monica Mazza
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
| | - Carmine Tomasetti
- Department of Neuroscience, Reproductive Sciences and Odontostomatology-University "Federico II" of Naples, Italy
| | - Elisabetta F Buonaguro
- Department of Neuroscience, Reproductive Sciences and Odontostomatology-University "Federico II" of Naples, Italy
| | - Massimo Di Giannantonio
- Department of Neurosciences and Imaging, Chair of Psychiatry, University "G. d'Annunzio" of Chieti, Italy
| | - Giulio Perugi
- Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, Pisa, Italy
| | - Andrea de Bartolomeis
- Department of Neuroscience, Reproductive Sciences and Odontostomatology-University "Federico II" of Naples, Italy
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