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Yöyen E, Keleş M. First- and Second-Generation Psychological Theories of Suicidal Behaviour. Behav Sci (Basel) 2024; 14:710. [PMID: 39199106 PMCID: PMC11351948 DOI: 10.3390/bs14080710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2024] [Revised: 08/06/2024] [Accepted: 08/13/2024] [Indexed: 09/01/2024] Open
Abstract
Suicidal behaviour is defined as taking actions with the intention of killing oneself and thinking of performing these actions. Suicide is a serious public health problem with complex biological, social and psychological risk factors and a multidimensional clinical appearance, occurring all over the world and ranking among the leading causes of death. In this study, psychological approaches explaining suicide were evaluated under the headings of first-generation and second-generation suicide theories, the different aspects of these theories were put forward, and previously published studies and recent evidence were reviewed. A literature review on the theoretical foundations of suicide is presented. First-generation suicide theories were developed before the 2000s and second-generation suicide theories were developed after the 2000s. While Psychodynamic Theory, Social Learning Theory, Hopelessness Theory, Shneidman's Suicide Theory and Escape Theory are included under the title of first-generation suicide theories, Interpersonal Psychological Suicide Theory, Three Stage Suicide Theory, Complementary Motivational-Demotivational Theory and Variable Predisposition Theory are examined as second-generation suicide theories. The approaches of the theories provide important evidence in understanding suicidal behaviour and recognising various risk factors in the transition from suicidal ideation to suicidal action. Controlling the risk factors may contribute both in terms of preventive community mental health and in the development of health policies.
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Affiliation(s)
- Elif Yöyen
- Department of Psychology, Faculty of Humanities and Social Sciences, Sakarya University, Sakarya 54050, Türkiye
| | - Merve Keleş
- Department of Educational Psychology, College of Education, Texas Tech University, Lubbock, TX 79416, USA
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Kendler KS, Ohlsson H, Mościcki EK, Sundquist J, Edwards AC, Sundquist K. Genetic liability to suicide attempt, suicide death, and psychiatric and substance use disorders on the risk for suicide attempt and suicide death: a Swedish national study. Psychol Med 2023; 53:1639-1648. [PMID: 37010214 PMCID: PMC10916711 DOI: 10.1017/s0033291721003354] [Citation(s) in RCA: 15] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND How does genetic liability to suicide attempt (SA), suicide death (SD), major depression (MD), bipolar disorder (BD), schizophrenia (SZ), alcohol use disorder (AUD), and drug use disorder (DUD) impact on risk for SA and SD? METHODS In the Swedish general population born 1932-1995 and followed through 2017 (n = 7 661 519), we calculate family genetic risk scores (FGRS) for SA, SD, MD, BD, SZ, AUD, and DUD. Registration for SA and SD was assessed from Swedish national registers. RESULTS In univariate and multivariate models predicting SA, FGRS were highest for SA, AUD, DUD, and MD. In univariate models predicting SD, the strongest FGRS were AUD, DUD, SA, and SD. In multivariate models, the FGRS for SA and AUD were higher in predicting SA while the FGRS for SD, BD, and SZ were higher in predicting SD. Higher FGRS for all disorders significantly predicted both younger age at first SA and frequency of attempts. For SD, higher FGRS for MD, AUD, and SD predicted later age at SD. Mediation of FGRS effects on SA and SD was more pronounced for SD than SA, strongest for AUD, DUD, and SZ FGRS and weakest for MD. CONCLUSIONS FGRS for both SA and SD and for our five psychiatric disorders impact on risk for SA and SD in a complex manner. While some of the impact of genetic risk factors for psychiatric disorders on risk for SA and SD is mediated through developing the disorders, these risks also predispose directly to suicidal behaviors.
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Affiliation(s)
- Kenneth S. Kendler
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA, USA
- Department of Psychiatry, Virginia Commonwealth University, Richmond, VA, USA
| | - Henrik Ohlsson
- Center for Primary Health Care Research, Lund University, Malmö, Sweden
| | | | - Jan Sundquist
- Center for Primary Health Care Research, Lund University, Malmö, Sweden
- Department of Family Medicine and Community Health, Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Alexis C. Edwards
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA, USA
- Department of Psychiatry, Virginia Commonwealth University, Richmond, VA, USA
| | - Kristina Sundquist
- Center for Primary Health Care Research, Lund University, Malmö, Sweden
- Department of Family Medicine and Community Health, Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, USA
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Kamdar NP, Horning ML, Geraci JC, Uzdavines AW, Helmer DA, Hundt NE. Risk for depression and suicidal ideation among food insecure US veterans: data from the National Health and Nutrition Examination Study. Soc Psychiatry Psychiatr Epidemiol 2021; 56:2175-2184. [PMID: 33770225 DOI: 10.1007/s00127-021-02071-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Accepted: 03/11/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Suicide and food insecurity (i.e., lack of access to food) are two major issues that affect US Veterans. PURPOSE Using a US-based sample, we evaluated the association between food insecurity and suicidal ideation among Veterans. Because depression often precedes suicide, we also examined the association between food insecurity and depression. METHODS Using data from 2630 Veterans who participated in the National Health and Nutrition Examination Survey 2007-2016, we conducted an adjusted linear regression model to evaluate the association between food insecurity (measured using 18-item Household Food Security Survey) and depression (measured using PHQ-9) and an adjusted binary logistic regression model to evaluate the association between food insecurity and suicidal ideation (measured using PHQ-9 Question 9). Models were adjusted for gender, age, income-to-poverty ratio, race/ethnicity, and education level. RESULTS Of the sample, 11.5% were food insecure, depression scores averaged 2.86 (SD = 4.28), and 3.7% endorsed suicidal ideation. Veterans with marginal (β = 0.68, 95%CI [0.09,1.28]), low (β = 1.38, 95%CI [0.70,2.05]) or very low food security (β = 3.08, 95%CI [2.34, 3.83]) had significantly increased depression scores compared to food secure Veterans. Veterans with low (OR = 2.15, 95%CI [1.08, 4.27]) or very low food security (OR = 3.84, 95%CI [2.05, 7.20]) had significantly increased odds for suicidal ideation compared to food secure Veterans. CONCLUSION Food insecurity in Veterans is associated with increased depression symptoms and suicidal ideation. This association strengthens as food insecurity worsens. Veterans with food insecurity should be screened for depression and suicidal ideation. Simultaneously, depression treatment plans and suicide prevention programs should consider basic needs like food security.
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Affiliation(s)
- Nipa P Kamdar
- VA Health Services Research and Development Center of Excellence, Michael E. DeBakey VA Medical Center, 2450 Holcombe Blvd Suite 01Y, Houston, Texas, 77021, US.
| | - Melissa L Horning
- University of Minnesota School of Nursing, 5-140 Weaver-Densford Hall, 308 Harvard Street SE, Minneapolis, Minnesota, 55455, US
| | - Joseph C Geraci
- US Department of Veterans Affairs, VISN 2 Mental Illness, Research, Education, and Clinical Center, 130 W Kingsbridge Rd, The Bronx, New York City, 10468, US
| | - Alexander W Uzdavines
- VA Health Services Research and Development Center of Excellence, Michael E. DeBakey VA Medical Center, 2450 Holcombe Blvd Suite 01Y, Houston, Texas, 77021, US
| | - Drew A Helmer
- VA Health Services Research and Development Center of Excellence, Michael E. DeBakey VA Medical Center, 2450 Holcombe Blvd Suite 01Y, Houston, Texas, 77021, US
| | - Natalie E Hundt
- VA Health Services Research and Development Center of Excellence, Michael E. DeBakey VA Medical Center, 2450 Holcombe Blvd Suite 01Y, Houston, Texas, 77021, US.,Department of Psychiatry, Baylor College of Medicine, One Baylor Plaza, Houston, Texas, 77030, US
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Edwards AC, Ohlsson H, Mościcki E, Crump C, Sundquist J, Lichtenstein P, Kendler KS, Sundquist K. On the Genetic and Environmental Relationship Between Suicide Attempt and Death by Suicide. Am J Psychiatry 2021; 178:1060-1069. [PMID: 34256608 PMCID: PMC8570976 DOI: 10.1176/appi.ajp.2020.20121705] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The authors examined the extent to which the genetic and environmental etiology of suicide attempt and suicide death is shared or unique. METHODS The authors used Swedish national registry data for a large cohort of twins, full siblings, and half siblings (N=1,314,990) born between 1960 and 1990 and followed through 2015. They conducted twin-family modeling of suicide attempt and suicide death to estimate heritability for each outcome, along with genetic and environmental correlations between them. They further assessed the relationship between suicide attempt by young people compared with adults. RESULTS In bivariate models, suicide attempt and death were moderately heritable among both women (attempt: additive genetic variance component [A]=0.52, 95% CI=0.44, 0.56; death: A=0.45, 95% CI=0.39, 0.59) and men (attempt: A=0.41, 95% CI=0.38, 0.49; death: A=0.44, 95% CI=0.43, 0.44). The outcomes were substantially, but incompletely, genetically correlated (women: rA=0.67, 95% CI=0.55, 0.67; men: rA=0.74, 95% CI=0.63, 0.87). Environmental correlations were weaker (women: rE=0.36, 95% CI=0.29, 0.45; men: rE=0.21, 95% CI=0.19, 0.27). Heritability of suicide attempt was stronger among people ages 10-24 (A=0.55-0.62) than among those age 25 and older (A=0.36-0.38), and the genetic correlation between attempt during youth and during adulthood was stronger for women (rA=0.79, 95% CI=0.72, 0.79) than for men (rA=0.39, 95% CI=0.26, 0.47). CONCLUSIONS The genetic and environmental etiologies of suicide attempt and death are partially overlapping, exhibit modest sex differences, and shift across the life course. These differences must be considered when developing prevention efforts and risk prediction algorithms. Where feasible, suicide attempt and death should be considered separately rather than collapsed, including in the context of gene identification efforts.
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Affiliation(s)
- Alexis C. Edwards
- Department of Psychiatry, Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University School of Medicine, Richmond, VA, US
| | - Henrik Ohlsson
- Center for Primary Health Care Research, Lund University, Malmö, Sweden
| | | | - Casey Crump
- Department of Family Medicine and Community Health, Icahn School of Medicine at Mount Sinai, New York, NY, US,Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, US
| | - Jan Sundquist
- Center for Primary Health Care Research, Lund University, Malmö, Sweden,Department of Family Medicine and Community Health, Icahn School of Medicine at Mount Sinai, New York, NY, US,Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, US
| | - Paul Lichtenstein
- Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden
| | - Kenneth S. Kendler
- Department of Psychiatry, Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University School of Medicine, Richmond, VA, US
| | - Kristina Sundquist
- Center for Primary Health Care Research, Lund University, Malmö, Sweden,Department of Family Medicine and Community Health, Icahn School of Medicine at Mount Sinai, New York, NY, US,Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, US
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Hjern A, Palacios J, Vinnerljung B, Manhica H, Lindblad F. Increased risk of suicidal behaviour in non-European international adoptees decreases with age - A Swedish national cohort study. EClinicalMedicine 2020; 29-30:100643. [PMID: 33305197 PMCID: PMC7710634 DOI: 10.1016/j.eclinm.2020.100643] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 11/03/2020] [Accepted: 11/06/2020] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Non-European international adoptees in Sweden were shown to have a three-to fourfold higher risk of suicidal behaviour in youth during 1986-1995 compared with the general population. The aim of this study was to investigate whether this high risk persists beyond youth and in later cohorts. METHODS A register study of Swedish national cohorts born 1972-86 including 20 625 non-European international adoptees, and comparison populations of 10 915 non-European immigrants and 1 435 167 Swedish born was performed. The study population was followed from age 18 between 1991 and 2016, with suicide and hospital admissions due to suicide attempt as outcomes. Poisson regression models of person time in the study, adjusted for gender and household income at age 17, were fitted to calculate relative risks (RR). FINDINGS Adjusted RR for suicide in non-European international adoptees was high at age 18-22, 2·74 (95% C.I. 1·95-3·86), but decreased gradually to age 33-43 when the risk was similar to Swedish-born. Adjusted RR for suicide attempts in international adoptees was 2·33 (2·15-2·52) at age 18-22, decreased slightly with older age, but remained higher than Swedish born in all age-classes. Risks for both outcomes were greatest, around three times higher compared with the Swedish-born in the oldest birth cohorts of non-European international adoptees, born 1972-76. Risks for both suicidal outcomes increased with higher age at adoption. INTERPRETATION The risk of suicidal behaviour in non-European international adoptees in Sweden decreases with age and is lower in later birth cohorts and in infant adoptions.
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Affiliation(s)
- Anders Hjern
- Centre for Health Equity Studies (CHESS), Karolinska Institutet/Stockholm University, and Clinical Epidemiology/Department of Medicine, Karolinska Institutet, S 171 77 Stockholm, Sweden
- Corresponding author.
| | - Jesús Palacios
- Department of Developmental Psychology, University of Seville, Seville, Spain
| | - Bo Vinnerljung
- Department of Social Work, Stockholm University, S 106 91 Stockholm, Sweden
| | - Helio Manhica
- Department of Public Health, Karolinska Institutet, S 171 77 Stockholm, Sweden
| | - Frank Lindblad
- Department of Neuroscience, Uppsala University, Uppsala, Sweden
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Kendler KS, Ohlsson H, Sundquist J, Sundquist K, Edwards AC. The Sources of Parent-Child Transmission of Risk for Suicide Attempt and Deaths by Suicide in Swedish National Samples. Am J Psychiatry 2020; 177:928-935. [PMID: 32854532 PMCID: PMC8957060 DOI: 10.1176/appi.ajp.2020.20010017] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The authors aimed to clarify the sources of parent-child transmission for suicide attempt and death by suicide. METHODS Three sources of parent-child resemblance (genes plus rearing, genes only, and rearing only) were examined in parents and offspring from four family types from Swedish national samples: intact nuclear families, families with a not-lived-with biological father, families with a stepfather, and adoptees and their biological and adoptive parents. Parent-child resemblance was assessed primarily by tetrachoric correlation. RESULTS For suicide attempt to suicide attempt transmission, best-estimate tetrachoric correlations for genes plus rearing, genes only, and rearing only were 0.23 (95% CI=0.23, 0.24), 0.13 (95% CI=0.11, 0.15), and 0.14 (95% CI=0.11, 0.16), respectively. Suicide attempt was more strongly transmitted to male offspring compared with female offspring. Parental psychiatric disorders accounted for 40% of the genetic transmission but had no impact on rearing effects. For suicide death to suicide death transmission, best estimates of tetrachoric correlations for genes plus rearing, genes only, and rearing only were 0.16 (95% CI=0.15, 0.18), 0.07 (95% CI=0.02, 0.12), and -0.05 (95% CI=-0.17, 0.07), respectively. Although the suicide attempt-suicide death genetic correlation was high (0.84), the hypothesis that they reflect behaviors only differing in severity on the same continuum of genetic liability could be rejected. CONCLUSIONS The transmission of suicide attempt across generations is moderately strong and arises equally from genetic and rearing effects. Parental psychiatric illness explains almost half of the genetic transmission of suicide attempt but none of the rearing effect. Suicide death is modestly transmitted across generations, probably via genetic effects, although rearing may play a role. While suicide attempt and suicide death share a substantial proportion of their hereditary risk, they do not, from a genetic perspective, simply reflect milder and more severe forms of the same diathesis.
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Affiliation(s)
- Kenneth S. Kendler
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA, USA.,Department of Psychiatry, Virginia Commonwealth University, Richmond VA, USA
| | - Henrik Ohlsson
- Center for Primary Health Care Research, Lund University, Malmö, Sweden
| | - Jan Sundquist
- Center for Primary Health Care Research, Lund University, Malmö, Sweden.,Department of Family Medicine and Community Health, Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Kristina Sundquist
- Center for Primary Health Care Research, Lund University, Malmö, Sweden.,Department of Family Medicine and Community Health, Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Alexis C. Edwards
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA, USA.,Department of Psychiatry, Virginia Commonwealth University, Richmond VA, USA
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de Souza ALP, Segolin BW, Pessanha PB, Abreu TQDA, Mino YEE, de Freitas FAC, Botti NCL. Characterization of suicidal behavior among children in a depressive episode: case series study. TRENDS IN PSYCHIATRY AND PSYCHOTHERAPY 2020; 41:394-400. [PMID: 31967198 DOI: 10.1590/2237-6089-2018-0111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Accepted: 04/07/2019] [Indexed: 11/21/2022]
Abstract
INTRODUCTION Child suicidal behavior is related to specific childhood variations, constituting risk factors, including predisposing factors, internal factors, and environmental factors. OBJECTIVE To characterize suicidal behavior among children aged 5 to 12 years diagnosed with a depressive episode. METHODS Fifteen participants, aged 5 to 12, were assessed at a child and adolescent mental health center in Belo Horizonte, state of Minas Gerais, Brazil. All participants had a history of suicide attempt and were in a depressive episode at the time of assessment. RESULTS Vulnerabilities related to the children themselves were self-harm, aggression, loss of an important family figure, sexual abuse, sexuality disorders, use of alcohol or other drugs, and ill-treatment. Factors of family structure and dynamics found were psychiatric illness in family members, family conflict or violence, abandonment or rejection, history of suicidal behavior in family, parents users of alcohol and other drugs, and separated parents. Factors related to school were bullying, school difficulties/delays, high school performance, bad behavior, physical aggression, school dropout, and aggressiveness. The main methods used in suicide attempts were injury by sharp or blunt objects and intentional self-poisoning. CONCLUSIONS Psychiatric comorbidities and a previous history of disturbances in the family and at school are important factors to consider with relation to suicidal behavior by children with depressive episodes.
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Affiliation(s)
| | | | - Paula Bedim Pessanha
- Faculdade de Medicina, Universidade Federal de São João del Rei (UFSJ), Divinópolis, MG, Brazil
| | | | - Yasmin Emi Enemu Mino
- Faculdade de Medicina, Universidade Federal de São João del Rei (UFSJ), Divinópolis, MG, Brazil
| | - Filipe Augusto Cursino de Freitas
- Programa de Residência Médica em Psiquiatria da Infância e Adolescência, Centro Psíquico da Adolescência e Infância (CEPAI/FHEMIG), Belo Horizonte, MG, Brazil
| | - Nadja Cristiane Lappann Botti
- Programa de Pós-Graduação Mestrado e Residência Multiprofissional em Saúde do Adolescente, UFSJ, Divinópolis, MG, Brazil
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Lengvenyte A, Conejero I, Courtet P, Olié E. Biological bases of suicidal behaviours: A narrative review. Eur J Neurosci 2019; 53:330-351. [PMID: 31793103 DOI: 10.1111/ejn.14635] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Revised: 11/05/2019] [Accepted: 11/28/2019] [Indexed: 12/13/2022]
Abstract
Suicidal behaviour is a multifaceted phenomenon that concerns all human populations. It has been suggested that a complex interaction between the individual genetic profile and environmental factors throughout life underlies the pathophysiology of suicidal behaviour. Although epidemiological and genetic studies suggest the existence of a genetic component, exposure to biological and psychosocial adversities, especially during critical developmental periods, also contributes to altering the biological responses to threat and pleasure. This results in amplified maladaptive cognitive and behavioural traits and states associated with suicidal behaviours. Alterations in the cognitive inhibition and decision-making capacity have been implicated in suicidal behaviours. Structural and functional changes in key brain regions and networks, such as prefrontal cortex, insula and default mode network, may underlie this relationship. Furthermore, the shift from health to suicidal behaviour incorporates complex and dynamic changes in the immune and stress responses, monoaminergic system, gonadal system and neuroplasticity. In this review, we describe the major findings of epidemiological, genetic, neuroanatomical, neuropsychological, immunological and neuroendocrinological studies on suicide behaviours to provide a solid background for future research in this field. This broad overview of the biological bases of suicide should promote neuroscience research on suicidal behaviours. This might lead to improved biological models and to the identification of evidence-based biomarkers, treatment options and preventive strategies.
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Affiliation(s)
- Aiste Lengvenyte
- Department of Emergency Psychiatry & Acute Care, CHU Montpellier, University of Montpellier, Montpellier, France.,Faculty of Medicine, Institute of Clinical Medicine, Psychiatric Clinic, Vilnius University, Vilnius, Lithuania
| | - Ismael Conejero
- Neuropsychiatry: Epidemiological and Clinical Research, Inserm Unit 1061, Montpellier, France.,Department of Psychiatry, CHU Nimes, University of Montpellier, Montpellier, France
| | - Philippe Courtet
- Department of Emergency Psychiatry & Acute Care, CHU Montpellier, University of Montpellier, Montpellier, France.,Neuropsychiatry: Epidemiological and Clinical Research, Inserm Unit 1061, Montpellier, France
| | - Emilie Olié
- Department of Emergency Psychiatry & Acute Care, CHU Montpellier, University of Montpellier, Montpellier, France.,Neuropsychiatry: Epidemiological and Clinical Research, Inserm Unit 1061, Montpellier, France
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Musci RJ, Augustinavicius JL, Volk H. Gene-Environment Interactions in Psychiatry: Recent Evidence and Clinical Implications. Curr Psychiatry Rep 2019; 21:81. [PMID: 31410638 PMCID: PMC7340157 DOI: 10.1007/s11920-019-1065-5] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
PURPOSE OF REVIEW We identify the recent evidence for gene-by-environment interaction studies in relation to psychiatric disorders. We focus on the key genotypic data as well as environmental exposures and how they interact to predict psychiatric disorders and psychiatric symptomatology. We direct our focus on the psychiatric outcomes that were focused on by the Psychiatric Genetics Consortium. RECENT FINDINGS Many of the studies focus on candidate gene approaches, with most of the studies drawing upon previous literature to decide the genes of interest. Other studies used a genome-wide approach. While some studies demonstrated positive replication of previous findings, replication is still an issue within gene-by-environment interaction studies. Gene-by-environment interaction research in psychiatry globally suggests some susceptibility to environmental exposures based on genotype; however, greater clarity is needed around the idea that genetic risk may not be disorder specific.
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Affiliation(s)
- Rashelle J. Musci
- Department of Mental Health, Johns Hopkins University Bloomberg School of Public Health, 624 North Broadway, Baltimore, MD 21205, USA
| | - Jura L. Augustinavicius
- Department of Mental Health, Johns Hopkins University Bloomberg School of Public Health, 624 North Broadway, Baltimore, MD 21205, USA
| | - Heather Volk
- Department of Mental Health, Johns Hopkins University Bloomberg School of Public Health, 624 North Broadway, Baltimore, MD 21205, USA
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Ballard ED, Cui L, Vandeleur C, Castelao E, Zarate CA, Preisig M, Merikangas KR. Familial Aggregation and Coaggregation of Suicide Attempts and Comorbid Mental Disorders in Adults. JAMA Psychiatry 2019; 76:826-833. [PMID: 30916728 PMCID: PMC6583867 DOI: 10.1001/jamapsychiatry.2019.0248] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
IMPORTANCE Clarification of the joint influence of familial patterns of suicide attempts and comorbid mental disorders can enhance the understanding and prevention of suicide attempts. OBJECTIVE To investigate the familial patterns of suicide attempts and comorbid mental disorders and their associations in a 2-site family study of mood and anxiety disorders. DESIGN, SETTING, AND PARTICIPANTS Data were obtained from 2 parallel community-based family studies conducted in the United States (National Institute of Mental Health [NIMH] study) and in Lausanne, Switzerland (PsyCoLaus study), on the comorbidity of mood and anxiety disorders. The study sample comprised 1119 adult probands and 5355 first-degree relatives. Data were collected and analyzed from October 2004 to December 2016. MAIN OUTCOMES AND MEASURES Lifetime suicide attempt and mental disorders in first-degree relatives, obtained through direct interviews or family history reports. RESULTS The study included 1119 adult probands (675 female [60.3%] and a mean [SD] age of 50 [12.0] years) and 5355 first-degree relatives (2752 female [51.4%] and a mean [SD] age of 52 [1.5] years). Of these participants, 90 (8.0%) of 1119 probands and 199 (3.7%) of 5355 relatives had a lifetime history of suicide attempt. Those with such a history had higher rates of all mental disorders, a greater number of disorders, and statistically significantly poorer current and lifetime global functioning. After adjustment for age and sex, a statistically significant association between suicide attempts in probands and in relatives was found at the NIMH site (OR, 2.6; 95% CI, 1.5-4.7), at the Lausanne site (OR, 3.1; 95% CI, 1.6-6.0), and in the combined data (OR, 2.9; 95% CI, 1.9-4.5). All mood disorder subtypes and substance use disorders were statistically significantly associated with suicide attempts. The familial association between lifetime suicide attempts in probands and relatives was not statistically significant for the combined sample (OR, 1.6; 95% CI, 1.0-2.7) after adjustment for comorbid conditions in probands and relatives. Social anxiety disorder in probands was associated with suicide attempts in relatives (OR, 2.4; 95% CI, 1.7-3.5) after controlling for comorbid mood, anxiety, and substance use disorders. CONCLUSIONS AND RELEVANCE Familiality of suicide attempts appears to be explained by a history of mental disorders among those with suicide attempts; the novel finding of a common familial diathesis for suicide attempts and social anxiety, particularly in combination with mood disorders, has heuristic value for future research and may be a risk marker that can inform prevention efforts.
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Affiliation(s)
- Elizabeth D. Ballard
- Experimental Therapeutics & Pathophysiology Branch, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland
| | - Lihong Cui
- Genetic Epidemiology Research Branch, Intramural Research Program, National Institute of Mental Health, Bethesda, Maryland
| | - Caroline Vandeleur
- Department of Psychiatry, University Hospital of Lausanne, Lausanne, Switzerland
| | - Enrique Castelao
- Department of Psychiatry, University Hospital of Lausanne, Lausanne, Switzerland
| | - Carlos A. Zarate
- Experimental Therapeutics & Pathophysiology Branch, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland
| | - Martin Preisig
- Department of Psychiatry, University Hospital of Lausanne, Lausanne, Switzerland
| | - Kathleen Ries Merikangas
- Genetic Epidemiology Research Branch, Intramural Research Program, National Institute of Mental Health, Bethesda, Maryland
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González-Castro TB, Genis-Mendoza AD, Tovilla-Zárate CA, Martínez-Magaña JJ, Juárez-Rojop IE, Sarmiento E, Nicolini H. Genome-wide association study of suicide attempt in a Mexican population: a study protocol. BMJ Open 2019; 9:e025335. [PMID: 30975676 PMCID: PMC6500275 DOI: 10.1136/bmjopen-2018-025335] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
INTRODUCTION Suicidality is a complex behaviour and a major health problem; the specific features that could predispose to suicidal behaviour have been extensively investigated, most frequently in European and Asian populations. Therefore, our aim is to present a protocol that will explore suicide attempt in Mexican individuals diagnosed with psychiatric disorders, through a genome-wide association study (GWAS). METHOD AND ANALYSIS We will perform a GWAS by comparing 700 individuals who have suicide attempt history, with control subjects without suicide attempt history (n=500). The genotyping will be conducted using the Infinium PsychArray BeadChip and quality controls will be applied to single nucleotides (SNPs) genotyped. After that, we will perform the imputation using reference panels provided by the Haplotype Reference Consortium. We will perform two different workflows: (A) the classic GWAS analysis applying the same weight to all the variants and (B) an algorithm with prediction of deleteriousness of variants. ETHICS AND DISSEMINATION This study was approved by the ethics and investigation committees of the National Institute of Genomic Medicine on 22 July 2015, No CEI 215/13. We plan to disseminate research findings in scientific conferences and as a manuscript in peer-reviewed journals. TRIAL REGISTRATION NUMBER CEI 215/13.
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Affiliation(s)
- Thelma Beatriz González-Castro
- División Académica Multidisciplinaria de Jalpa de Méndez, Universidad Juárez Autónoma de Tabasco, Jalpa de Méndez, Mexico
| | - Alma Delia Genis-Mendoza
- Laboratorio de Genomica de Enfermedades Psiquiatrica y Neurodegenerativas, Instituto Nacional de Medicina Genomica, Mexico, Mexico
| | - Carlos Alfonso Tovilla-Zárate
- División Académica Multidisciplinaria de Comalcalco, Universidad Juárez Autónoma de Tabasco, División Multidisciplinaria de Comalcalco, Comalcalco, Mexico
| | - José Jaime Martínez-Magaña
- Laboratorio de Genomica de Enfermedades Psiquiatrica y Neurodegenerativas, Instituto Nacional de Medicina Genomica, Mexico, Mexico
- División Académica de Ciencias de la Salud, Universidad Juárez Autónoma de Tabasco, Villahermosa, Mexico
| | - Isela Esther Juárez-Rojop
- División Académica de Ciencias de la Salud, Universidad Juárez Autónoma de Tabasco, Villahermosa, Mexico
| | - Emmanuel Sarmiento
- Urgencias y Pre-consulta, Hospital Psiquiátrico Infantil Dr. Juan N. Navarro, Ciudad de Mexico, Mexico
| | - Humberto Nicolini
- Laboratorio de Genomica de Enfermedades Psiquiatrica y Neurodegenerativas, Instituto Nacional de Medicina Genomica, Mexico, Mexico
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Abstract
Suicide is a serious public health problem in many countries and has always been a source of apprehension and quest to human mankind, which can be resolved with due diligence. Suicide is a hidden and silent epidemic, with many causative factors. Studying and researching on various causative factors have always been the subject of significance for the researchers. Psychiatric illnesses happen to be the primary reasons for the majority of suicide mortality cases. Not only this, there has been a consistent increase in the no. of cases of mental disorders as well as attempted and completed suicide cases. If one looks at global scenario, an approximate 70,000 people commit suicide, and further alarming is the fact that the rate of suicide attempt cases has gone up to 250% during last 18 years in conflict zones. Poisoning, hanging and self-immolation are some of the common methods to commit suicide. Physical and mental illness, disturbed emotional relationships and economic difficulties were the major reasons for suicide with the predisposed population being women, student and farmers. As per WHO's approximation, there is one suicide every minute and an attempted suicide every third second. It implies that the number of killed due to suicide is greater than that of the ones killed due to the armed conflict.
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13
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Kendler KS, Ohlsson H, Sundquist K, Sundquist J. Sources of Parent-Offspring Resemblance for Major Depression in a National Swedish Extended Adoption Study. JAMA Psychiatry 2018; 75:194-200. [PMID: 29238796 PMCID: PMC5838567 DOI: 10.1001/jamapsychiatry.2017.3828] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
IMPORTANCE Twin studies have assessed sibling resemblance for major depression (MD) but cannot address sources of resemblance across generations. OBJECTIVE To clarify the relative importance of genetic and rearing effects on the parent-offspring resemblance for MD. DESIGN This Swedish population register-based study examined parents and children from the following 5 family types: intact (2 041 816 offspring), adoptive (14 104 offspring), not-lived-with (NLW) father (116 601 offspring), stepfather (67 826 offspring), and triparental (29 205 offspring). The 5 family types permitted quantification of parent-offspring resemblance for genes plus rearing, genes-only, and rearing-only associations. Treated MD was assessed from national primary care, specialist care, and inpatient registries. Data were collected from January 1, 1960, through December 31, 2016. EXPOSURE Diagnosis of MD vs no diagnosis in parents. MAIN OUTCOMES AND MEASURES Registration for MD. RESULTS The study population included 2 269 552 offspring (51.5% male and 48.5% female; median age, 42; range, 26-56 years). The weighted tetrachoric correlations for MD across family types and across mothers and fathers were r = 0.17 (95% CI, 0.16-0.17) for genes plus rearing, r = 0.08 (95% CI, 0.06-0.09) for genes-only, and r = 0.08 (95% CI, 0.07-0.09) for rearing-only parent-child associations. Only the genes plus rearing association differed significantly between mothers (weighted tetrachoric correlation, r = 0.18; 95% CI, 0.18-0.18) and fathers (weighted tetrachoric correlation, r = 0.15; 95% CI, 0.15-0.16). In triparental families, the parent-offspring correlations for MD were estimated at r = 0.19 (95% CI, 0.17-0.22) for mothers in the genes plus rearing association, r = 0.10 (95% CI, 0.07-0.13) for NLW fathers in the genes-only association, and r = 0.08 (95% CI, 0.05-0.11) for stepfathers in the rearing-only association. In adoptive families, the effect of affected biological and affected adoptive parents on adoptee risk for MD was additive. In intact families, parental MD diagnosed by specialists in hospital or outpatient settings and primary care physicians affected equally the risk for MD in offspring. CONCLUSIONS AND RELEVANCE The parent-offspring resemblance for treated MD arises from genetic factors and rearing experiences to an approximately equal extent. Both forms of cross-generational transmission act additively on the risk for MD in the offspring.
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Affiliation(s)
- Kenneth S. Kendler
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond,Department of Psychiatry, Virginia Commonwealth University, Richmond,Department of Human and Molecular Genetics, Virginia Commonwealth University, Richmond
| | - Henrik Ohlsson
- Center for Primary Health Care Research, Lund University, Malmö, Sweden
| | - Kristina Sundquist
- Center for Primary Health Care Research, Lund University, Malmö, Sweden,Department of Family Medicine and Community Health, Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Jan Sundquist
- Center for Primary Health Care Research, Lund University, Malmö, Sweden,Department of Family Medicine and Community Health, Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, New York
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14
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Wang YG, Chen S, Xu ZM, Shen ZH, Wang YQ, He XY, Cao RF, Roberts DL, Shi JF, Wang YQ. Family history of suicide and high motor impulsivity distinguish suicide attempters from suicide ideators among college students. J Psychiatr Res 2017; 90:21-25. [PMID: 28214643 DOI: 10.1016/j.jpsychires.2017.02.006] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2016] [Revised: 02/06/2017] [Accepted: 02/07/2017] [Indexed: 12/01/2022]
Abstract
Suicide in college students has become an important public health issue in China. The aim of this study was to identify the differences between suicide attempters and suicide ideators based on a cross-sectional survey. Our results indicate that although female gender, positive screening for psychiatric illness, positive family history of suicide, elevated overall impulsivity, and elevated motor impulsivity were correlated with suicidal ideation, only positive family history of suicide and high motor impulsivity could differentiate suicide attempters from suicidal ideators. Future research with a longitudinal and prospective study design should be conducted to confirm these findings.
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Affiliation(s)
- Yong-Guang Wang
- Department of Brain Functioning Research, The Seventh Hospital of Hangzhou, 305 Tianmushan Road, Hangzhou, 310013, Zhejiang Province, China; Clinical Institute of Mental Health in Hangzhou, Anhui Medical University, Hangzhou, Zhejiang Province, China; Mental Health Center, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China; Institute of Film & Television Animation, China Academy of Art, Hangzhou, Zhejiang Province, China.
| | - Shen Chen
- Institute of Film & Television Animation, China Academy of Art, Hangzhou, Zhejiang Province, China
| | - Zhi-Ming Xu
- Department of Brain Functioning Research, The Seventh Hospital of Hangzhou, 305 Tianmushan Road, Hangzhou, 310013, Zhejiang Province, China
| | - Zhi-Hua Shen
- Department of Brain Functioning Research, The Seventh Hospital of Hangzhou, 305 Tianmushan Road, Hangzhou, 310013, Zhejiang Province, China
| | - Yi-Quan Wang
- Department of Brain Functioning Research, The Seventh Hospital of Hangzhou, 305 Tianmushan Road, Hangzhou, 310013, Zhejiang Province, China
| | - Xiao-Yan He
- Department of Health Education, The Center of Disease Control and Prevention of Hangzhou, Hangzhou, Zhejiang Province, China
| | - Ri-Fang Cao
- Department of Brain Functioning Research, The Seventh Hospital of Hangzhou, 305 Tianmushan Road, Hangzhou, 310013, Zhejiang Province, China
| | - David L Roberts
- Department of Psychiatry, University of Texas Health Science, San Antonio, USA
| | - Jian-Fei Shi
- Department of Brain Functioning Research, The Seventh Hospital of Hangzhou, 305 Tianmushan Road, Hangzhou, 310013, Zhejiang Province, China; Clinical Institute of Mental Health in Hangzhou, Anhui Medical University, Hangzhou, Zhejiang Province, China; Mental Health Center, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China.
| | - Yi-Qiang Wang
- Department of Brain Functioning Research, The Seventh Hospital of Hangzhou, 305 Tianmushan Road, Hangzhou, 310013, Zhejiang Province, China; Clinical Institute of Mental Health in Hangzhou, Anhui Medical University, Hangzhou, Zhejiang Province, China; Mental Health Center, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China
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Hughes ND, Locock L, Simkin S, Stewart A, Ferrey AE, Gunnell D, Kapur N, Hawton K. Making Sense of an Unknown Terrain: How Parents Understand Self-Harm in Young People. QUALITATIVE HEALTH RESEARCH 2017; 27:215-225. [PMID: 26369673 DOI: 10.1177/1049732315603032] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Self-harm is common in young people, and can have profound effects on parents and other family members. We conducted narrative interviews with 41 parents and other family members of 38 young people, aged up to 25, who had self-harmed. Most of the participants were parents but included one sibling and one spouse. This article reports experiences of the parent participants. A cross-case thematic analysis showed that most participants were bewildered by self-harm. The disruption to their worldview brought about by self-harm prompted many to undergo a process of "sense-making"-by ruminative introspection, looking for information, and building a new way of seeing-to understand and come to terms with self-harm. Most participants appeared to have been successful in making sense of self-harm, though not without considerable effort and emotional struggle. Our findings provide grounds for a deeper socio-cultural understanding of the impact of self-harm on parents.
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16
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Pulay AJ, Réthelyi JM. Multimarker analysis suggests the involvement of BDNF signaling and microRNA biosynthesis in suicidal behavior. Am J Med Genet B Neuropsychiatr Genet 2016; 171:763-76. [PMID: 26921221 DOI: 10.1002/ajmg.b.32433] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2015] [Accepted: 02/04/2016] [Indexed: 12/22/2022]
Abstract
Despite moderate heritability estimates the genetics of suicidal behavior remains unclear, genome-wide association and candidate gene studies focusing on single nucleotide associations reported inconsistent findings. Our study explored biologically informed, multimarker candidate gene associations with suicidal behavior in mood disorders. We analyzed the GAIN Whole Genome Association Study of Bipolar Disorder version 3 (n = 999, suicidal n = 358) and the GAIN Major Depression: Stage 1 Genomewide Association in Population-Based Samples (n = 1,753, suicidal n = 245) datasets. Suicidal behavior was defined as severe suicidal ideation or attempt. Candidate genes were selected based on literature search (Geneset1, n = 35), gene expression data of microRNA genes, (Geneset2, n = 68) and their target genes (Geneset3, n = 11,259). Quality control, dosage analyses were carried out with PLINK. Gene-based associations of Geneset1 were analyzed with KGG. Polygenic profile scores of suicidal behavior were computed in the major depression dataset both with PRSice and LDpred and validated in the bipolar disorder data. Several nominally significant gene-based associations were detected, but only DICER1 associated with suicidal behavior in both samples, while only the associations of NTRK2 in the depression sample reached family wise and experiment wise significance. Polygenic profile scores negatively predicted suicidal behavior in the bipolar sample for only Geneset2, with the strongest prediction by PRSice at Pt < 0.03 (Nagelkerke R(2) = 0.01, P < 0.007). Gene-based association results confirmed the potential involvement of the BDNF-NTRK2-CREB pathway in the pathogenesis of suicide and the cross-disorder association of DICER1. Polygenic risk prediction of the selected miRNA genes indicates that the miRNA system may play a mediating role, but with considerable pleiotropy. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Attila J Pulay
- Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary
| | - János M Réthelyi
- Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary.,Molecular Psychiatry Research Group, MTA-SE NAP-B, Hungarian Academy of Sciences and Semmelweis University, Budapest, Hungary
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Bazrafshan MR, Sharif F, Molazem Z, Mani A. Exploring the risk factors contributing to suicide attempt among adolescents: A qualitative study. IRANIAN JOURNAL OF NURSING AND MIDWIFERY RESEARCH 2016; 21:93-9. [PMID: 26985229 PMCID: PMC4776568 DOI: 10.4103/1735-9066.174747] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND Since suicide attempt among adolescents is a major challenge and the reasons why this age group attempt suicide are complex, the aim of this study was to investigate the risk factors that contribute to suicide attempt among adolescents. MATERIALS AND METHODS In this qualitative content analysis, 14 adolescents (12-19 years old) who were admitted in two hospitals in Shiraz, Iran, were interviewed. Participants who tried attempt suicide with medication were selected by purposive sampling and the data were gathered by semi-structured interviews. Data analysis was guided by the conventional approach of qualitative content analysis. RESULTS Three major themes and 13 subthemes emerged from data analysis. The main themes were: (a) Individual factors and experiences (psycho-emotional problems, puberty, religious beliefs, stress management strategies, marriage and love, field and level of education); (b) family factors (family structure, family relationship, family economic features, family health conditions); and (c) social factors (suicidal behavior in others, media influence, professional support). CONCLUSIONS This study identified three major themes related to suicide attempt among adolescents in the context. As a result, suicide prevention and care provision should formulate a comprehensive method, considering the interaction of medical besides individual, familiar, and social factors in their assessment and care provision.
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Affiliation(s)
- Mohammad-Rafi Bazrafshan
- Department of Nursing, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Farkhondeh Sharif
- Department of Nursing, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Zahra Molazem
- Department of Nursing, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Arash Mani
- Research Centre for Psychiatry and Behavioral Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
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18
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Brandt WA, Stadtmüller G, Bielitz CJ, Georgi A. [Third case of attempted suicide by snakebite]. DER NERVENARZT 2015; 87:552-5. [PMID: 26334351 DOI: 10.1007/s00115-015-4410-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- W A Brandt
- Fachkrankenhaus für Psychiatrie, Psychotherapie und Psychosomatische Medizin, Sigma-Zentrum für Akutmedizin, Tagesklinik, Hüssyweg 2, 79713, Bad Säckingen, Deutschland
| | - G Stadtmüller
- Klinik für Psychosomatik und Psychotherapie, Adula Klinik, Oberstdorf, Deutschland
| | - C J Bielitz
- Fachkrankenhaus für Psychiatrie, Psychotherapie und Psychosomatische Medizin, Sigma-Zentrum für Akutmedizin, Tagesklinik, Hüssyweg 2, 79713, Bad Säckingen, Deutschland
| | - A Georgi
- Fachkrankenhaus für Psychiatrie, Psychotherapie und Psychosomatische Medizin, Sigma-Zentrum für Akutmedizin, Tagesklinik, Hüssyweg 2, 79713, Bad Säckingen, Deutschland.
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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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