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Guo Z, Han X, Kong T, Wu Y, Kang Y, Liu Y, Wang F. The mediation effects of nightmares and depression between insomnia and suicidal ideation in young adults. Sci Rep 2024; 14:9577. [PMID: 38670978 PMCID: PMC11052998 DOI: 10.1038/s41598-024-58774-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Accepted: 04/03/2024] [Indexed: 04/28/2024] Open
Abstract
Suicide is prevalent among young adults, and epidemiological studies indicate that insomnia, nightmares, and depression are significantly associated with a high incidence of suicidal ideation (SI). However, the causal relationship between these factors and SI remains unclear. Therefore, the purpose of this study was to examine the association between nightmares and depression and insomnia and SI in young adults, as well as to develop a mediation model to investigate the causal relationship between insomnia, nightmare, depression, and SI. We assessed insomnia, nightmares, depression, and SI in 546 young adults using the Insomnia Severity Scale (ISI), Disturbing Dream and Nightmare Severity Scale (DDNSI), Depression Study Scale (CESD-20), and Columbia-Suicide Severity Rating Scale (C-SSRS). Using the Bootstrap method, the mediation effects of nightmares and depression between insomnia and SI were calculated. The results demonstrated that nightmares and depression fully mediated the relationship between insomnia and SI, including the chain-mediation of insomnia and SI between nightmare and depression with an effect value of 0.02, 95% CI 0.01-0.04, and depression as a mediator between insomnia and SI with an effect value of 0.22, 95% CI 0.15-0.29. This study found that depression and nightmares may be risk and predictive factors between insomnia and SI, which implies that the assessment and treatment of depression and the simple or linked effect of nightmares play crucial roles in preventing SI in young adults.
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Affiliation(s)
- Zixuan Guo
- Medical Neurobiology Lab, Inner Mongolia Medical University, Huhhot, 010110, China
- Beijing Hui-Long-Guan Hospital, Peking University, Beijing, 100096, China
| | - Xiaoli Han
- Clinical Nutrition Department, Friendship Hospital of Urumqi, Urumqi, 830049, China
| | - Tiantian Kong
- Xinjiang Key Laboratory of Neurological Disorder Research, The Second Affiliated Hospital of Xinjiang Medical University, Urumqi, 830063, China
| | - Yan Wu
- Beijing Hui-Long-Guan Hospital, Peking University, Beijing, 100096, China
| | - Yimin Kang
- Medical Neurobiology Lab, Inner Mongolia Medical University, Huhhot, 010110, China.
| | - Yanlong Liu
- School of Mental Health, Wenzhou Medical University, Wenzhou, 325035, China.
| | - Fan Wang
- Beijing Hui-Long-Guan Hospital, Peking University, Beijing, 100096, China.
- Xinjiang Key Laboratory of Neurological Disorder Research, The Second Affiliated Hospital of Xinjiang Medical University, Urumqi, 830063, China.
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Yu L, Zhao X, Long Q, Li S, Zhang H, Teng Z, Chen J, Zhang Y, You X, Guo Z, Zeng Y. Association between a changeable lifestyle, sedentary behavior, and suicide risk: A systematic review and meta-analysis. J Affect Disord 2024; 350:974-982. [PMID: 38266927 DOI: 10.1016/j.jad.2024.01.193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 01/17/2024] [Accepted: 01/19/2024] [Indexed: 01/26/2024]
Abstract
BACKGROUND Suicide and self-injury have become increasingly serious public health crises. Yet current evidence about the association between sedentary behavior (SB) and suicide is inconclusive. We explore the relationship between SB and suicide behavior to provide intervention measures to change the risk factors of the latter. METHODS We searched PubMed, Embase, Cochrane Library, and Web of Science from database inception to September 10, 2023. Adjusted odds ratios (ORs) with 95 % confidence intervals (CIs) were used as effect measures. Subgroup analysis was conducted based on gender, regions and countries, age, and study type. RESULTS A total of 13 studies were included. According to the meta-analysis of suicide type, compared with individuals without sedentary behavior, individuals with sedentary behavior have a higher risk of suicide attempt (OR = 1.23, 95%CI: 1.15-1.37, p < 0.001), suicide ideation (OR = 1.47, 95%CI:1.28-1.68, p < 0.001) and suicide plan (OR = 1.30, 95%CI:1.16-1.44, p < 0.001). We conducted multiple subgroup analyses for different suicidal behaviors. The analysis found that SB can increase the risk of suicide attempt in different subgroups of different genders, different research centers, Africa, and adolescents; SB can increase the risk of suicide ideation in the subgroups of different genders and ages, different research centers, Asia and Africa; SB can increase the risk of suicide plan in the subgroups of different genders, multi-center study, Africa, and adolescents. LIMITATIONS Future research should focus on objective SB measurement and explore its dose-response relation and time limit. CONCLUSION A sedentary lifestyle is associated with suicide behavior risk, with varying effects across age groups and regions, as evidenced in both single-center and multi-center studies.
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Affiliation(s)
- Ling Yu
- Department of Psychiatry, the Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan Province, China
| | - Xinling Zhao
- Department of Psychiatry, the Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan Province, China
| | - Qing Long
- Department of Psychiatry, the Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan Province, China
| | - Shujun Li
- Department of Student Affairs Office, Suizhou Vocational & Technical College, Suizhou City, Hubei Province, China
| | - Huaxia Zhang
- Department of Psychiatry, West China Hospital of Sichuan University, Chengdu, Sichuan Province, China
| | - Zhaowei Teng
- Department of Psychiatry, the Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan Province, China
| | - Jian Chen
- Department of Gastroenterology, Nanchong Central Hospital, Nanchong, Sichuan Province, China
| | - Yunqiao Zhang
- Department of Psychiatry, the Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan Province, China
| | - Xu You
- Department of Psychiatry, Honghe Second People's Hospital, Honghe, Yunnan Province, China
| | - Zeyi Guo
- Department of Psychiatry, the Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan Province, China.
| | - Yong Zeng
- Department of Psychiatry, the Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan Province, China.
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Ghafori SS, Yousefi Z, Bakhtiari E, mohammadi mahdiabadi hasani MH, Hassanzadeh G. Neutrophil-to-lymphocyte ratio as a predictive biomarker for early diagnosis of depression: A narrative review. Brain Behav Immun Health 2024; 36:100734. [PMID: 38362135 PMCID: PMC10867583 DOI: 10.1016/j.bbih.2024.100734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2023] [Revised: 01/23/2024] [Accepted: 02/04/2024] [Indexed: 02/17/2024] Open
Abstract
Depression is a mood disorder that causes persistent feelings of sadness, hopelessness, loss of interest, and decreased energy. Early diagnosis of depression can improve its negative impacts and be effective in its treatment. Previous studies have indicated that inflammation plays an important role in the initiation and development of depression, hence, various inflammatory biomarkers have been investigated for early diagnosis of depression, the most popular of which are blood biomarkers. The Neutrophil to lymphocyte ratio (NLR) may be more informative in the early diagnosis of depression than other widely used markers, such as other leukocyte characteristics or interleukins. Considering the importance of early diagnosis of depression and the role of NLR in early diagnosis of depression, our paper reviews the literature on NLR as a diagnostic biomarker of depression, which may be effective in its treatment. Various studies have shown that elevated NLR is associated with depression, suggesting that NLR may be a valuable, reproducible, easily accessible, and cost-effective method for the evaluation of depression and it may be used in outpatient clinic settings. Closer follow-up can be performed for these patients who have higher NLR levels. However, it seems that further studies on larger samples, taking into account important confounding factors, and assessing them together with other inflammatory markers are necessary to draw some conclusive statements.
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Affiliation(s)
- Sayed Soran Ghafori
- Department of Neuroscience and Addiction Studies, School of Advanced Technologies in Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Zahra Yousefi
- School of Allied Medical Sciences, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Elham Bakhtiari
- Department of Neuroscience and Addiction Studies, School of Advanced Technologies in Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Gholamreza Hassanzadeh
- Department of Neuroscience and Addiction Studies, School of Advanced Technologies in Medicine, Tehran University of Medical Sciences, Tehran, Iran
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Kim JM, Kang HJ, Kim JW, Choi W, Lee JY, Kim SW, Shin IS, Kim MG, Chun BJ, Stewart R. Multiple serum biomarkers for predicting suicidal behaviours in depressive patients receiving pharmacotherapy. Psychol Med 2023; 53:4385-4394. [PMID: 35578580 PMCID: PMC10388309 DOI: 10.1017/s0033291722001180] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2022] [Revised: 04/05/2022] [Accepted: 04/06/2022] [Indexed: 01/21/2023]
Abstract
BACKGROUND Predictive values of multiple serum biomarkers for suicidal behaviours (SBs) have rarely been tested. This study sought to evaluate and develop a panel of multiple serum biomarkers for predicting SBs in outpatients receiving a 12-month pharmacotherapy programme for depressive disorders. METHODS At baseline, 14 serum biomarkers and socio-demographic/clinical characteristics including previous suicidal attempt and present suicidal severity were evaluated in 1094 patients with depressive disorders without a bipolar diagnosis. Of these, 884 were followed for increased suicidal severity and fatal/non-fatal suicide attempt outcomes over a 12-month treatment period. Individual and combined effects of serum biomarkers on these two prospective SBs were estimated using logistic regression analysis after adjustment for relevant covariates. RESULTS Increased suicidal severity and fatal/non-fatal suicide attempt during the 12-month pharmacotherapy were present in 155 (17.5%) and 38 (4.3%) participants, respectively. Combined cortisol, total cholesterol, and folate serum biomarkers predicted fatal/non-fatal suicide attempt, and these with interleukin-1 beta and homocysteine additionally predicted increased suicidal severity, with clear gradients robust to adjustment (p values < 0.001). CONCLUSIONS Application of multiple serum biomarkers could considerably improve the predictability of SBs during the outpatient treatment of depressive disorders, potentially highlighting the need for more frequent monitoring and risk appraisal.
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Affiliation(s)
- Jae-Min Kim
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Korea
| | - Hee-Ju Kang
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Korea
| | - Ju-Wan Kim
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Korea
| | - Wonsuk Choi
- Department of Internal Medicine, Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Hwasun, Korea
| | - Ju-Yeon Lee
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Korea
| | - Sung-Wan Kim
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Korea
| | - Il-Seon Shin
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Korea
| | - Min-Gon Kim
- Department of Chemistry, School of Physics and Chemistry, Gwangju Institute of Science and Technology, Gwangju, South Korea
| | - Byung Jo Chun
- Department of Emergency Medicine, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Robert Stewart
- King's College London (Institute of Psychiatry, Psychology and Neuroscience), London, UK
- South London and Maudsley NHS Foundation Trust, London, UK
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Amitai M, Kaffman S, Kroizer E, Lebow M, Magen I, Benaroya-Milshtein N, Fennig S, Weizman A, Apter A, Chen A. Neutrophil to-lymphocyte and platelet-to-lymphocyte ratios as biomarkers for suicidal behavior in children and adolescents with depression or anxiety treated with selective serotonin reuptake inhibitors. Brain Behav Immun 2022; 104:31-38. [PMID: 35470013 DOI: 10.1016/j.bbi.2022.04.018] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 04/13/2022] [Accepted: 04/20/2022] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Both the neutrophil/lymphocyte ratio (NLR) and the platelet/lymphocyte ratio (PLR) have been proposed as biomarkers of suicidal risk in adults with depression. We examined whether these ratios may be considered biomarkers for suicidal behavior in young patients with major depressive or anxiety disorders before treatment with selective serotonin reuptake inhibitors (SSRIs), or as biomarkers for the adverse event of SSRI-associated suicidality. METHODS Children and adolescents meeting criteria for major depressive or anxiety disorder were recruited. Serum levels of three pro-inflammatory cytokines (TNF-α, IL-6, IL-1β) were assessed; and NLR and PLR calculated, from blood samples collected at baseline and after 8 weeks treatment with SSRI. A Mann-Whitney test was performed to evaluate differences in NLR and PLR between children with and without a history of a suicide attempt prior to treatment. We compared hematological parameters before and after treatment, and between children who developed SSRI-associated suicidality versus children without treatment emergent suicidality. RESULTS Among 91 children and adolescents (aged 13.9 ± 2.4 years), baseline NLR and PLR were significantly higher among those with a history of a suicide attempt versus those without such history. Statistically significant correlations were found for the suicide ideation subscale in the Columbia suicide severity rating scale with both baseline NLR and PLR. Baseline NLR and PLR were similar in children who did and did not develop SSRI-associated suicidality after 8 weeks. In the final logistic regression model (χ2 = 18.504, df = 4, p value = 0.001), after controlling for sex, depression severity and IL-6 levels, NLR was significantly associated with a past suicide attempt (β = 1.247, p = 0.019; OR [95% CI] = 3.478 [1.230-9.841]), with a NLR cut-off value of = 1.76 (area under the curve = 0.75 (95% CI = 0.63-0.88, sensitivity = 73%, and specificity = 71%, p value = 0.003). CONCLUSIONS High NLR and PLR values may be associated with suicidal behavior in depressed and anxious children and adolescents. NLR appears as a better predictor of suicide attempt than PLR, and thus may be a useful biomarker of suicidality in young patients with depression or anxiety.
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Affiliation(s)
- Maya Amitai
- Department of Brain Sciences, Weizmann Institute of Science, Rehovot, Israel; Department of Molecular Neuroscience, Weizmann Institute of Science, Rehovot, Israel; Department of Stress Neurobiology and Neurogenetics, Max-Planck Institute of Psychiatry, Munich, Germany; Department of Psychiatry, Feinberg Child Study Center, Schneider Children's Medical Center of Israel, Petach Tikva, affiliated to Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
| | - Shaked Kaffman
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Eitan Kroizer
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Maya Lebow
- Department of Brain Sciences, Weizmann Institute of Science, Rehovot, Israel; Department of Molecular Neuroscience, Weizmann Institute of Science, Rehovot, Israel; Department of Stress Neurobiology and Neurogenetics, Max-Planck Institute of Psychiatry, Munich, Germany
| | - Iddo Magen
- Department of Molecular Neuroscience, Weizmann Institute of Science, Rehovot, Israel; Department of Molecular Genetics, Weizmann Institute of Science, Rehovot, Israel
| | - Noa Benaroya-Milshtein
- Department of Psychiatry, Feinberg Child Study Center, Schneider Children's Medical Center of Israel, Petach Tikva, affiliated to Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Silvana Fennig
- Department of Psychiatry, Feinberg Child Study Center, Schneider Children's Medical Center of Israel, Petach Tikva, affiliated to Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Abraham Weizman
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Laboratory of Biological Psychiatry, Felsenstein Medical Research Center, Petach Tikva, Israel; Research Unit, Geha Mental Health Center, Petach Tikva, Israel
| | - Alan Apter
- Department of Psychiatry, Feinberg Child Study Center, Schneider Children's Medical Center of Israel, Petach Tikva, affiliated to Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Alon Chen
- Department of Brain Sciences, Weizmann Institute of Science, Rehovot, Israel; Department of Molecular Neuroscience, Weizmann Institute of Science, Rehovot, Israel; Department of Stress Neurobiology and Neurogenetics, Max-Planck Institute of Psychiatry, Munich, Germany
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Bednarova A, Hlavacova N, Pecenak J. Analysis of Motives and Factors Connected to Suicidal Behavior in Patients Hospitalized in a Psychiatric Department. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19106283. [PMID: 35627820 PMCID: PMC9141087 DOI: 10.3390/ijerph19106283] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 05/15/2022] [Accepted: 05/20/2022] [Indexed: 11/30/2022]
Abstract
(1) Background: This study aimed to investigate the motives and factors connected to suicidal behavior in 121 hospitalized patients with intentional self-harm (diagnosis X 60-81 according to the ICD-10); (2) Methods: Suicidal behavior of the patient was assessed from data obtained by psychiatric examinations and by the Columbia Suicide Severity Rating Scale. Analysis of data to identify the patients’ reason and motives behind suicidal behavior in a group of patients with a suicide attempt (SA, n = 80) and patients with Non-Suicidal Self-Injurious Behavior (NSSIB, n = 41) was carried out; (3) Results: Results showed that patients with affective disorder have a 19-times higher rate of SA against other diagnoses. Patients with personality disorders have a 32-times higher rate of NSSIB than patients with other diagnoses. Living alone and the absence of social support increased the likelihood of SA. Qualitative data analysis of patients’ statements showed different themes in the justification of motives for suicidal behavior between SA and NSSIB cases. Significant differences were shown for non-communicated reasons, loneliness, social problems, extortion, and distress; (4) Conclusions: The evaluation of patients’ verbal statements by qualitative analysis during the psychiatric examination should be considered in clinical practice. It should be considered to include self-poisoning in the criteria of the Non-suicidal Self-Injury diagnostic categories.
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Affiliation(s)
- Aneta Bednarova
- 2nd Department of Psychiatry, Faculty of Medicine, University Hospital of L. Pasteur Kosice, Pavol Jozef Safarik University, 04011 Kosice, Slovakia;
| | - Natasa Hlavacova
- Institute of Experimental Endocrinology, Biomedical Research Center, Slovak Academy of Sciences, 84505 Bratislava, Slovakia
- Correspondence:
| | - Jan Pecenak
- Department of Psychiatry, Faculty of Medicine, University Hospital Bratislava, Comenius University, 81369 Bratislava, Slovakia;
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González-Castro TB, Genis-Mendoza AD, León-Escalante DI, Hernández-Díaz Y, Juárez-Rojop IE, Tovilla-Zárate CA, López-Narváez ML, Marín-Medina A, Nicolini H, Castillo-Avila RG, Ramos-Méndez MÁ. Possible Association of Cholesterol as a Biomarker in Suicide Behavior. Biomedicines 2021; 9:biomedicines9111559. [PMID: 34829788 PMCID: PMC8615563 DOI: 10.3390/biomedicines9111559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2021] [Revised: 10/19/2021] [Accepted: 10/26/2021] [Indexed: 11/25/2022] Open
Abstract
Suicides and suicidal behavior are major causes of mortality and morbidity in public health and are a global problem. Various authors have proposed changes in lipid metabolism (total cholesterol decrease) as a possible biological marker for suicidal behavior. The objective of this study was to review the studies that have demonstrated a relationship between serum cholesterol levels and suicidal behavior and to describe the possible pathophysiological mechanisms that associate changes in cholesterol concentration and suicidal behavior. Relevant literature related to serum cholesterol levels and suicidal behavior was identified through various database searches. The data from the existing literature present the findings that relate low cholesterol levels and possible pathophysiological mechanisms (neuroinflammation, serotonergic neurotransmission), genes related to cholesterol synthesis, pharmacological treatments that alter lipid metabolism and the possible participation in suicidal behavior. Nevertheless, future research is required to describe how serum cholesterol affects cholesterol metabolism in the CNS to establish and understand the role of cholesterol in suicidal behavior.
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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 86205, Tabasco, Mexico; (T.B.G.-C.); (Y.H.-D.)
| | - Alma Delia Genis-Mendoza
- Departamento de Genética Psiquiátrica, Instituto Nacional de Medicina Genómica, Ciudad de México 14610, Mexico;
| | - Dulce Ivannia León-Escalante
- División Académica Multidisciplinaria de Comalcalco, Universidad Juárez Autónoma de Tabasco, Comalcalco 86650, Tabasco, Mexico;
| | - Yazmín Hernández-Díaz
- División Académica Multidisciplinaria de Jalpa de Méndez, Universidad Juárez Autónoma de Tabasco, Jalpa de Méndez 86205, Tabasco, Mexico; (T.B.G.-C.); (Y.H.-D.)
| | - Isela Esther Juárez-Rojop
- División Académica de Ciencias de la Salud, Universidad Juárez Autónoma de Tabasco, Villahermosa 86100, Tabasco, Mexico; (I.E.J.-R.); (R.G.C.-A.); (M.Á.R.-M.)
| | - Carlos Alfonso Tovilla-Zárate
- División Académica Multidisciplinaria de Comalcalco, Universidad Juárez Autónoma de Tabasco, Comalcalco 86650, Tabasco, Mexico;
- Correspondence: (C.A.T.-Z.); (H.N.); Tel.: +52-9933581500 (ext. 6900) (C.A.T.-Z.); +52-53501900 (ext. 1197) (H.N.)
| | - María Lilia López-Narváez
- Secretaría de Salud de Chiapas, Hospital Chiapas Nos Une “Dr. Gilberto Gómez Maza”, Tuxtla Gutiérrez 29045, Chiapas, Mexico;
| | | | - Humberto Nicolini
- Departamento de Genética Psiquiátrica, Instituto Nacional de Medicina Genómica, Ciudad de México 14610, Mexico;
- Correspondence: (C.A.T.-Z.); (H.N.); Tel.: +52-9933581500 (ext. 6900) (C.A.T.-Z.); +52-53501900 (ext. 1197) (H.N.)
| | - Rosa Giannina Castillo-Avila
- División Académica de Ciencias de la Salud, Universidad Juárez Autónoma de Tabasco, Villahermosa 86100, Tabasco, Mexico; (I.E.J.-R.); (R.G.C.-A.); (M.Á.R.-M.)
| | - Miguel Ángel Ramos-Méndez
- División Académica de Ciencias de la Salud, Universidad Juárez Autónoma de Tabasco, Villahermosa 86100, Tabasco, Mexico; (I.E.J.-R.); (R.G.C.-A.); (M.Á.R.-M.)
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Guidara W, Messedi M, Maalej M, Naifar M, Khrouf W, Grayaa S, Maalej M, Bonnefont-Rousselot D, Lamari F, Ayadi F. Plasma oxysterols: Altered level of plasma 24-hydroxycholesterol in patients with bipolar disorder. J Steroid Biochem Mol Biol 2021; 211:105902. [PMID: 33901658 DOI: 10.1016/j.jsbmb.2021.105902] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Revised: 04/09/2021] [Accepted: 04/20/2021] [Indexed: 12/13/2022]
Abstract
Cholesterol and its oxygenated metabolites, including oxysterols, are intensively investigated as potential players in the pathophysiology of brain disorders. Altered oxysterol levels have been described in patients with numerous neuropsychiatric disorders. Recent studies have shown that Bipolar disorder (BD) is associated with the disruption of cholesterol metabolism. The present study was aimed at investigating the profile of oxysterols in plasma, their ratio to total cholesterol and their association with clinical parameters in patients with BD. Thirty three men diagnosed with BD and forty healthy controls matched for age and sex were included in the study. Oxysterol levels were measured by isotope-dilution ultra-performance liquid chromatography-tandem mass spectrometry. Significantly higher levels were observed for cholestane-3β,5α,6β-triol, 27-hydroxycholesterol (27-OHC) and Cholestanol in patients with BD. The concentration of 24-hydroxycholesterol (24-OHC) was significantly lower in patients compared to controls. 24-OHC was also negatively correlated to MAS subscale score (r =-0.343; p = 0.049). In patients, 24-OHC was inversely correlated with age (r = -0.240; p = 0.045). Multivariate analysis found that BD acute decompensation was independently related to the rise in plasma 24-OHC (p = 0.002; OR = 0.966, 95 % CI [0.945 - 0.987]). However, the 24-OHC assay relevance as a biomarker of this disease deserves further investigation in other studies.
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Affiliation(s)
- Wassim Guidara
- Laboratory of Research "Molecular Basis of Human Diseases", LR19ES13, Faculty of Medicine, University of Sfax, Sfax, Tunisia.
| | - Meriam Messedi
- Laboratory of Research "Molecular Basis of Human Diseases", LR19ES13, Faculty of Medicine, University of Sfax, Sfax, Tunisia
| | - Manel Maalej
- Psychiatry C-department, University of Sfax & Hédi Chaker Hospital, Sfax, Tunisia
| | - Manel Naifar
- Laboratory of Research "Molecular Basis of Human Diseases", LR19ES13, Faculty of Medicine, University of Sfax, Sfax, Tunisia; Laboratory of Biochemistry, University of Sfax & Habib Bourguiba Hospital, Sfax, Tunisia
| | - Walid Khrouf
- AP-HP, Sorbonne University, La Pitié-Salpêtrière University Hospital, Department of Metabolic Biochemistry, Paris, France
| | - Sahar Grayaa
- Laboratory of Research "Molecular Basis of Human Diseases", LR19ES13, Faculty of Medicine, University of Sfax, Sfax, Tunisia
| | - Mohamed Maalej
- Psychiatry C-department, University of Sfax & Hédi Chaker Hospital, Sfax, Tunisia
| | - Dominique Bonnefont-Rousselot
- AP-HP, Sorbonne University, La Pitié-Salpêtrière University Hospital, Department of Metabolic Biochemistry, Paris, France; UTCBS, U1267 Inserm, UMR 8258 CNRS, Université de Paris, Paris, France
| | - Foudil Lamari
- AP-HP, Sorbonne University, La Pitié-Salpêtrière University Hospital, Department of Metabolic Biochemistry, Paris, France
| | - Fatma Ayadi
- Laboratory of Research "Molecular Basis of Human Diseases", LR19ES13, Faculty of Medicine, University of Sfax, Sfax, Tunisia; Laboratory of Biochemistry, University of Sfax & Habib Bourguiba Hospital, Sfax, Tunisia
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9
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Association between serum lipid concentrations and attempted suicide in patients with major depressive disorder: A meta-analysis. PLoS One 2020; 15:e0243847. [PMID: 33301469 PMCID: PMC7728216 DOI: 10.1371/journal.pone.0243847] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2020] [Accepted: 11/30/2020] [Indexed: 11/19/2022] Open
Abstract
Background There is growing evidence that serum lipid concentrations may be associated with attempted suicide in patients with major depressive disorder (MDD), but these findings remain controversial. Thus, we performed a comprehensive meta-analysis to quantitatively assess the associations between serum lipid concentrations and attempted suicide in MDD patients. Materials and methods Electronic databases (PubMed, Embase, the Cochrane Library and the China National Knowledge Library) were searched for relevant literature up to 10 February 2020. We used a random-effects model based on heterogeneity amongst studies and generated pooled standardised mean differences (SMDs). Results Thirty-two studies comprising 7,068 subjects met the inclusion criteria. A pooled analysis showed that compared with non-attempters, MDD patients who had attempted suicide had significantly lower serum concentrations of total cholesterol (TC) (SMD: -0.63, 95% CI: -0.83 to -0.44) and low-density lipoprotein cholesterol (LDL-C) (SMD: -0.69, 95% CI: -1.04 to -0.34), but the serum concentrations of high-density lipoprotein cholesterol (HDL-C) (SMD: -0.12, 95% CI: -0.33 to 0.10) and triglycerides (TGs) (SMD: 0.00, 95% CI: -0.20 to 0.20) were not significantly different between the two groups. Subgroup and meta-regression analysis indicated that heterogeneity with respect to TC concentrations may be due to different ages (p = 0.041) and sample sizes (p = 0.016) of studies, and that heterogeneity with respect to HDL-C concentrations may be partly due to different settings of studies (p = 0.017). Conclusions This meta-analysis demonstrated that lower concentrations of TC and LDL-C, but not of HDL-C and TGs, were associated with attempted suicide in MDD patients. This indicates that TC and LDL-C may be useful as biological markers for predicting whether MDD patients may attempt to commit suicide.
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10
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Blasco-Fontecilla H, Herranz-Herrer J, Ponte-Lopez T, Gil-Benito E, Donoso-Navarro E, Hernandez-Alvarez E, Gil-Ligero M, Horrillo I, Meana JJ, Royuela A, Rosado-Garcia S, Sánchez-López AJ. Serum β-endorphin levels are associated with addiction to suicidal behavior: A pilot study. Eur Neuropsychopharmacol 2020; 40:38-51. [PMID: 32855024 DOI: 10.1016/j.euroneuro.2020.07.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Revised: 07/01/2020] [Accepted: 07/16/2020] [Indexed: 01/21/2023]
Abstract
The literature provides partial support for the hypothesis that some suicide attempters develop a behavioral addiction to suicidal behavior (SB). We hypothesized that major suicide repeaters (MR) (≥5 lifetime suicide attempts) are addicted to suicide attempts as measured by modified DSM-IV criteria for substance dependence. In this cross-sectional study with 13 psychiatric controls (PC), 55 non-major suicide attempters (NMR), and 9 MR we found that MR are characterized by emotional abuse and neglect, as well as higher scores on the Personality and Life Event scale (short version). The levels of 8 AM serum ACTH, cortisol and β-endorphin were elevated in all three groups. Serum β-endorphin (pg/mL) was particularly high in PC diagnosed with schizophrenia 220.34 (±56.30). The level of 8 AM serum β-endorphin rose with increased numbers of criteria met for addiction to SB from 130.31 (±88.16) (≥ 3 criteria met for addiction to SB) to 174.84 (±114.93) (≥ 6 criteria met for addiction to SB) whereas serum ACTH and cortisol did not change. SB addicts (≥ 6 criteria) displayed higher serum β-endorphin concentrations than non-addicts (174.84 ± 114.93 vs. 116.93 ± 61.70, FET p = 0.09). The present study brings some support to the addictive hypothesis of SB. Our results delineate β-endorphin as a promising biomarker of SB addiction, and offer a good basis for future studies that test whether buprenorphine can be used to prevent repetitive suicide attempts, non-suicidal-self-injury (NSSI), and the development of an addiction to SB.
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Affiliation(s)
- Hilario Blasco-Fontecilla
- Department of Psychiatry, Puerta de Hierro University Hospital, Health Research Institute Puerta de Hierro-Segovia de Arana (IDIPHISA), Majadahonda, Madrid, Spain; Autonoma University of Madrid, Madrid, Spain; Center of Biomedical Network Research on Mental Health (CIBERSAM), Madrid, Spain; CAS, ITA Salud Mental, Madrid, Spain.
| | - Javier Herranz-Herrer
- Department of Psychiatry, Puerta de Hierro University Hospital, Health Research Institute Puerta de Hierro-Segovia de Arana (IDIPHISA), Majadahonda, Madrid, Spain
| | - Teresa Ponte-Lopez
- Department of Psychiatry, Puerta de Hierro University Hospital, Health Research Institute Puerta de Hierro-Segovia de Arana (IDIPHISA), Majadahonda, Madrid, Spain
| | - Elena Gil-Benito
- Department of Psychiatry, Puerta de Hierro University Hospital, Health Research Institute Puerta de Hierro-Segovia de Arana (IDIPHISA), Majadahonda, Madrid, Spain
| | - Encarnación Donoso-Navarro
- Department of Clinical Biochemistry, Puerta de Hierro University Hospital, IDIPHISA, Majadahonda, Madrid, Spain
| | - Elena Hernandez-Alvarez
- Department of Clinical Biochemistry, Puerta de Hierro University Hospital, IDIPHISA, Majadahonda, Madrid, Spain
| | - Maria Gil-Ligero
- Biobank, Puerta de Hierro-Segovia de Arana Health Research Institute, Majadahonda, Madrid, Spain
| | - Igor Horrillo
- Center of Biomedical Network Research on Mental Health (CIBERSAM), Madrid, Spain; Department of Pharmacology, University of the Basque Country, Biocruces Bizkaia Health Research Institute, Spain
| | - J Javier Meana
- Center of Biomedical Network Research on Mental Health (CIBERSAM), Madrid, Spain; Department of Pharmacology, University of the Basque Country, Biocruces Bizkaia Health Research Institute, Spain
| | - Ana Royuela
- Clinical Biostatistics Unit, Health Research Institute Puerta de Hierro-Segovia de Arana, CIBERESP, Madrid, Spain
| | - Silvia Rosado-Garcia
- Biobank, Puerta de Hierro-Segovia de Arana Health Research Institute, Majadahonda, Madrid, Spain
| | - Antonio J Sánchez-López
- Biobank, Puerta de Hierro-Segovia de Arana Health Research Institute, Majadahonda, Madrid, Spain; Neuroimmunology Unit, Puerta de Hierro-Segovia de Arana Health Research Institute, Majadahonda, Madrid, Spain.
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11
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Kang W, Shin JH, Han KM, Kim A, Kang Y, Kang J, Tae WS, Paik JW, Lee HW, Seong JK, Ham BJ. Local shape volume alterations in subcortical structures of suicide attempters with major depressive disorder. Hum Brain Mapp 2020; 41:4925-4934. [PMID: 32804434 PMCID: PMC7643352 DOI: 10.1002/hbm.25168] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Revised: 07/14/2020] [Accepted: 08/01/2020] [Indexed: 01/18/2023] Open
Abstract
Suicide is among the most important global health concerns; accordingly, an increasing number of studies have shown the risks for suicide attempt(s) in terms of brain morphometric features and their clinical correlates. However, brain studies addressing suicidal vulnerability have been more focused on demonstrating impairments in cortical structures than in the subcortical structures. Using local shape volumes (LSV) analysis, we investigated subcortical structures with their clinical correlates in depressed patients who attempted suicide. Then we compared them with depressed patients without a suicidal history and age- and sex-matched healthy controls (HCs; i.e., 47 suicide attempters with depression, 47 non-suicide attempters with depression, and 109 HCs). Significant volumetric differences were found between suicidal and nonsuicidal depressed patients in several vertices: 16 in the left amygdala; 201 in the left hippocampus; 1,057 in the left putamen; and 140 in the left pallidum; 1 in the right pallidum; and 6 in the bilateral thalamus. These findings indicated subcortical alterations in LSV in components of the limbic-cortical-striatal-pallidal-thalamic circuits. Moreover, our results demonstrated that the basal ganglia was correlated with perceived stress levels, and the thalamus was correlated with suicidal ideation. We suggest that suicidality in major depressive disorder may involve subcortical volume alterations.
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Affiliation(s)
- Wooyoung Kang
- Department of Biomedical Sciences, Korea University College of Medicine, Seoul, Republic of Korea
| | - Jeong-Hyeon Shin
- Medical & Health Device Division, Korea Testing Laboratory, Seoul, Republic of Korea
| | - Kyu-Man Han
- Department of Psychiatry, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Aram Kim
- Department of Biomedical Sciences, Korea University College of Medicine, Seoul, Republic of Korea
| | - Youbin Kang
- Department of Biomedical Sciences, Korea University College of Medicine, Seoul, Republic of Korea
| | - June Kang
- Department of Brain and Cognitive Engineering, Korea University, Seoul, Republic of Korea
| | - Woo-Suk Tae
- Brain Convergence Research Center, Korea University Anam Hospital, Seoul, Republic of Korea
| | - Jong-Woo Paik
- Department of Neuropsychiatry, College of Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Hae-Woo Lee
- Department of Psychiatry, Seoul Medical Center, Seoul, Republic of Korea
| | - Joon-Kyung Seong
- School of Biomedical Engineering, Department of Artificial Intelligence, Korea University, Seoul, Republic of Korea
| | - Byung-Joo Ham
- Department of Psychiatry, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea
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12
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Orsolini L, Latini R, Pompili M, Serafini G, Volpe U, Vellante F, Fornaro M, Valchera A, Tomasetti C, Fraticelli S, Alessandrini M, La Rovere R, Trotta S, Martinotti G, Di Giannantonio M, De Berardis D. Understanding the Complex of Suicide in Depression: from Research to Clinics. Psychiatry Investig 2020; 17:207-221. [PMID: 32209966 PMCID: PMC7113180 DOI: 10.30773/pi.2019.0171] [Citation(s) in RCA: 162] [Impact Index Per Article: 40.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Accepted: 02/27/2020] [Indexed: 02/07/2023] Open
Abstract
OBJECTIVE Amongst psychiatric disorders, major depressive disorder (MDD) is the most prevalent, by affecting approximately 15-17% of the population and showing a high suicide risk rate equivalent to around 15%. The present comprehensive overview aims at evaluating main research studies in the field of MDD at suicide risk, by proposing as well as a schematic suicide risk stratification and useful flow-chart for planning suicide preventive and therapeutic interventions for clinicians. METHODS A broad and comprehensive overview has been here conducted by using PubMed/Medline, combining the search strategy of free text terms and exploded MESH headings for the topics of 'Major Depressive Disorder' and 'Suicide' as following: ((suicide [Title/Abstract]) AND (major depressive disorder [Title/Abstract])). All articles published in English through May 31, 2019 were summarized in a comprehensive way. RESULTS Despite possible pathophysiological factors which may explain the complexity of suicide in MDD, scientific evidence supposed the synergic role of genetics, exogenous and endogenous stressors (i.e., interpersonal, professional, financial, as well as psychiatric disorders), epigenetic, the hypothalamic-pituitary-adrenal stress-response system, the involvement of the monoaminergic neurotransmitter systems, particularly the serotonergic ones, the lipid profile, neuro-immunological biomarkers, the Brain-derived neurotrophic factor and other neuromodulators. CONCLUSION The present overview reported that suicide is a highly complex and multifaceted phenomenon in which a large plethora of mechanisms could be variable implicated, particularly amongst MDD subjects. Beyond these consideration, modern psychiatry needs a better interpretation of suicide risk with a more careful assessment of suicide risk stratification and planning of clinical and treatment interventions.
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Affiliation(s)
- Laura Orsolini
- Psychopharmacology, Drug Misuse and Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, UK.,Neomesia Mental Health, Villa Jolanda Hospital, Jesi, Italy.,Polyedra, Teramo, Italy
| | - Roberto Latini
- Neomesia Mental Health, Villa Jolanda Hospital, Jesi, Italy
| | - Maurizio Pompili
- Department of Neurosciences, Mental Health and Sensory Organs, Suicide Prevention Center, S. Andrea Hospital, Sapienza University, Rome, Italy
| | - Gianluca Serafini
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Umberto Volpe
- Department of Clinical Neurosciences/DIMSC, School of Medicine, Section of Psychiatry, Polytechnic University of Marche, Ancona, Italy
| | - Federica Vellante
- Department of Neuroscience, Imaging and Clinical Science, Chair of Psychiatry, University of "G. D'Annunzio", Chieti, Italy
| | - Michele Fornaro
- Polyedra, Teramo, Italy.,Department of Psychiatry, Federico II University, Naples, Italy
| | - Alessandro Valchera
- Polyedra, Teramo, Italy.,Villa S. Giuseppe Hospital, Hermanas Hospitalarias, Ascoli Piceno, Italy
| | - Carmine Tomasetti
- Department of Mental Health, National Health Service, Psychiatric Service of Diagnosis and Treatment, Hospital "SS. Annunziata" ASL 4, Giulianova, Italy
| | - Silvia Fraticelli
- Department of Neuroscience, Imaging and Clinical Science, Chair of Psychiatry, University of "G. D'Annunzio", Chieti, Italy
| | - Marco Alessandrini
- Department of Neuroscience, Imaging and Clinical Science, Chair of Psychiatry, University of "G. D'Annunzio", Chieti, Italy
| | - Raffaella La Rovere
- Department of Mental Health, National Health Service, Azienda Sanitaria Locale, Pescara, Italy
| | - Sabatino Trotta
- Department of Mental Health, National Health Service, Azienda Sanitaria Locale, Pescara, Italy
| | - Giovanni Martinotti
- Department of Neuroscience, Imaging and Clinical Science, Chair of Psychiatry, University of "G. D'Annunzio", Chieti, Italy
| | - Massimo Di Giannantonio
- Department of Neuroscience, Imaging and Clinical Science, Chair of Psychiatry, University of "G. D'Annunzio", Chieti, Italy
| | - Domenico De Berardis
- Department of Neuroscience, Imaging and Clinical Science, Chair of Psychiatry, University of "G. D'Annunzio", Chieti, Italy.,Department of Mental Health, National Health Service, Psychiatric Service of Diagnosis and Treatment, Hospital "G. Mazzini", ASL 4, Teramo, Italy
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13
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Khan MS, Wu GWY, Reus VI, Hough CM, Lindqvist D, Westrin Å, Nier BM, Wolkowitz OM, Mellon SH. Low serum brain-derived neurotrophic factor is associated with suicidal ideation in major depressive disorder. Psychiatry Res 2019; 273:108-113. [PMID: 30640051 PMCID: PMC6561801 DOI: 10.1016/j.psychres.2019.01.013] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Revised: 01/02/2019] [Accepted: 01/03/2019] [Indexed: 02/06/2023]
Abstract
The "neurotrophic hypothesis of depression" posits that low levels of brain-derived neurotrophic factor (BDNF) are associated with Major Depressive Disorder (MDD). Low levels of BDNF have also been found in individuals with suicide attempts, in MDD or other disorders, suggesting that low BDNF may also be associated with suicidality. We assessed serum BDNF in 68 physically healthy and unmedicated (for at least 6 weeks) MDD subjects, who expressed no suicidal ideation (NSI; N = 40) or endorsed suicidal ideation (SI; N = 28), but were not actively suicidal, and in healthy controls (HC; N = 76). Serum BDNF levels were significantly lower in MDD with SI compared to NSI MDD but were not significantly correlated with total Hamilton Depression Rating Scale (HDRS-17) severity or severity on any HDRS subscale. Covarying for age, sex, body mass index, platelets, perceived stress, smoking and physical activity did not alter the significant association between BDNF and SI. SI status was not significantly different between HC and MDD. Our findings show an association between low serum BDNF and SI in individuals with less than severe and non-active suicidal intent, suggesting that the individual symptom of suicidality may extend the neurotrophic hypothesis of depression to include suicidal ideation within MDD.
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Affiliation(s)
- Maryam S Khan
- Department of Psychiatry, School of Medicine, University of California, San Francisco (UCSF) , San Francisco, CA, USA
| | - Gwyneth W Y Wu
- Department of Psychiatry, School of Medicine, University of California, San Francisco (UCSF) , San Francisco, CA, USA
| | - Victor I Reus
- Department of Psychiatry, School of Medicine, University of California, San Francisco (UCSF) , San Francisco, CA, USA
| | - Christina M Hough
- Department of Psychiatry, School of Medicine, University of California, San Francisco (UCSF) , San Francisco, CA, USA; Department of Psychology, University of California, Los Angeles (UCLA), Los Angeles, CA, USA
| | - Daniel Lindqvist
- Department of Psychiatry, School of Medicine, University of California, San Francisco (UCSF) , San Francisco, CA, USA; Faculty of Medicine, Department of Clinical Studies, Lund University, Lund, Sweden
| | - Åsa Westrin
- Faculty of Medicine, Department of Clinical Studies, Lund University, Lund, Sweden
| | - Brenton M Nier
- Department of Psychiatry, School of Medicine, University of California, San Francisco (UCSF) , San Francisco, CA, USA
| | - Owen M Wolkowitz
- Department of Psychiatry, School of Medicine, University of California, San Francisco (UCSF) , San Francisco, CA, USA
| | - Synthia H Mellon
- Department of OB/GYN and Reproductive Sciences, School of Medicine, University of California, San Francisco (UCSF), Box 0556, 513 Parnassus Ave, 1464G, San Francisco, CA 94143, USA.
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14
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Wang L, Zhao Y, Edmiston EK, Womer FY, Zhang R, Zhao P, Jiang X, Wu F, Kong L, Zhou Y, Tang Y, Wei S. Structural and Functional Abnormities of Amygdala and Prefrontal Cortex in Major Depressive Disorder With Suicide Attempts. Front Psychiatry 2019; 10:923. [PMID: 31969839 PMCID: PMC6960126 DOI: 10.3389/fpsyt.2019.00923] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Accepted: 11/20/2019] [Indexed: 11/13/2022] Open
Abstract
Finding neural features of suicide attempts (SA) in major depressive disorder (MDD) may be helpful in preventing suicidal behavior. The ventral and medial prefrontal cortex (PFC), as well as the amygdala form a circuit implicated in emotion regulation and the pathogenesis of MDD. The aim of this study was to identify whether patients with MDD who had a history of SA show structural and functional connectivity abnormalities in the amygdala and PFC relative to MDD patients without a history of SA. We measured gray matter volume in the amygdala and PFC and amygdala-PFC functional connectivity using structural and functional magnetic resonance imaging (MRI) in 158 participants [38 MDD patients with a history of SA, 60 MDD patients without a history of SA, and 60 healthy control (HC)]. MDD patients with a history of SA had decreased gray matter volume in the right and left amygdala (F = 30.270, P = 0.000), ventral/medial/dorsal PFC (F = 15.349, P = 0.000), and diminished functional connectivity between the bilateral amygdala and ventral and medial PFC regions (F = 22.467, P = 0.000), compared with individuals who had MDD without a history of SA, and the HC group. These findings provide evidence that the amygdala and PFC may be closely related to the pathogenesis of suicidal behavior in MDD and implicate the amygdala-ventral/medial PFC circuit as a potential target for suicide intervention.
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Affiliation(s)
- Lifei Wang
- Department of Psychiatry, China Medical University, Shenyang, China.,Department of Psychiatry, First Affiliated Hospital, China Medical University, Shenyang, China.,Brain Function Research Section, First Affiliated Hospital, China Medical University, Shenyang, China
| | - Yimeng Zhao
- Department of Psychiatry, China Medical University, Shenyang, China.,Department of Psychiatry, First Affiliated Hospital, China Medical University, Shenyang, China.,Brain Function Research Section, First Affiliated Hospital, China Medical University, Shenyang, China
| | - Elliot K Edmiston
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
| | - Fay Y Womer
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, United States
| | - Ran Zhang
- Department of Psychiatry, First Affiliated Hospital, China Medical University, Shenyang, China
| | - Pengfei Zhao
- Department of Psychiatry, First Affiliated Hospital, China Medical University, Shenyang, China
| | - Xiaowei Jiang
- Brain Function Research Section, First Affiliated Hospital, China Medical University, Shenyang, China.,Department of Radiology, First Affiliated Hospital, China Medical University, Shenyang, China
| | - Feng Wu
- Department of Psychiatry, First Affiliated Hospital, China Medical University, Shenyang, China
| | - Lingtao Kong
- Department of Psychiatry, First Affiliated Hospital, China Medical University, Shenyang, China
| | - Yifang Zhou
- Department of Psychiatry, First Affiliated Hospital, China Medical University, Shenyang, China.,Department of Geriatric Medicine, First Affiliated Hospital, China Medical University, Shenyang, China
| | - Yanqing Tang
- Department of Psychiatry, First Affiliated Hospital, China Medical University, Shenyang, China.,Department of Geriatric Medicine, First Affiliated Hospital, China Medical University, Shenyang, China
| | - Shengnan Wei
- Brain Function Research Section, First Affiliated Hospital, China Medical University, Shenyang, China.,Department of Radiology, First Affiliated Hospital, China Medical University, Shenyang, China
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15
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Affiliation(s)
- Sangha Kim
- Department of Psychiatry, Uijeongbu St. Mary's Hospital, The Catholic University of Korea College of Medicine, Uijeongbu, Korea
| | - Kyoung-Uk Lee
- Department of Psychiatry, Uijeongbu St. Mary's Hospital, The Catholic University of Korea College of Medicine, Uijeongbu, Korea
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16
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Lee SM, Lee S, Kang WS, Jahng GH, Park HJ, Kim SK, Park JK. Gray Matter Volume Reductions Were Associated with TPH1 Polymorphisms in Depressive Disorder Patients with Suicidal Attempts. Psychiatry Investig 2018; 15:1174-1180. [PMID: 30602107 PMCID: PMC6318492 DOI: 10.30773/pi.2018.11.01] [Citation(s) in RCA: 3] [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: 06/09/2018] [Accepted: 11/01/2018] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVE Structural changes of brain areas have been reported in depressive disorder and suicidal behavior (SB), in which TPH1 also has been known as a promising candidate gene. We investigated gray matter volume (GMV) differences, TPH1 rs1800532 and rs1799913 polymorphisms previously found to be associated with depressive disorder and SB, and the relationship between the two markers. METHODS Thirteen depressive disorder patients with suicidal attempts (SA) and twenty healthy controls were included. We examined GMV differences using a voxel-based morphometry and regions of interest analysis. Direct sequencing was used for genotyping. RESULTS The patients showed significant GMV reduction in left cerebral region including middle frontal gyrus, inferior frontal gyrus, and anterior cingulate cortex; in right middle temporal gyrus; in left cerebellar tonsil; and in right cerebral region including precentral gyrus and postcentral gyrus (corrected p<0.005). The right precentral and postcentral gyri GMV values of AA and CA genotypes patients were significantly decreased compared to those of CC genotype subjects (corrected p=0.040). CONCLUSION These findings show the possibility that both GMV reductions and TPH1 rs1800532/rs1799913 A allele may be involved in the pathogenesis of depressive disorder patients with SA.
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Affiliation(s)
- Sang Min Lee
- Department of Psychiatry, School of Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Soyoen Lee
- Department of Medicine, Graduate School, Kyung Hee University, Seoul, Republic of Korea
| | - Won Sub Kang
- Department of Psychiatry, School of Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Geon-Ho Jahng
- Department of Radiology, Kyung Hee University Hospital at Gangdong, College of Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Hae Jeong Park
- Department of Pharmacology, School of Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Su Kang Kim
- Department of Biomedical Laboratory Science, Catholic Kwandong University, Gangneung, Republic of Korea
| | - Jin Kyung Park
- Department of Psychiatry, School of Medicine, Kyung Hee University, Seoul, Republic of Korea
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17
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Peng R, Dai W, Li Y. Low serum free thyroxine level is correlated with lipid profile in depressive patients with suicide attempt. Psychiatry Res 2018; 266:111-115. [PMID: 29859497 DOI: 10.1016/j.psychres.2018.05.059] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2017] [Revised: 05/04/2018] [Accepted: 05/23/2018] [Indexed: 12/31/2022]
Abstract
The present research was carried out to observe the relationships between serum free triiothyronine (FT3), free thyroxine (FT4), thyroid-stimulating hormone (TSH) levels and lipid profile and suicide risk in depressive subjects. Serum concentrations of albumin, total bilrubin, uric acid, total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL), low-density lipoprotein cholesterol (LDL), high-sensitivity C-reactive protein (hs-CRP), FT3, FT4 and TSH were measured in 271 patients meeting the DSM-IV criteria for major depressive disorder (202 subjects without suicidal behavior and 69 suicide attempters). A significant decrease in serum TC, TG and FT4 levels was found in suicide attempters with major depressive disorder compared with non-suicide attempters (all p < 0.0025). For the other biochemical factors levels (albumin, total bilrubin, uric acid, HDL, LDL, hs-CRP, FT3, and TSH), there were no significant differences between suicide attempters and non-suicide attempters. Relativity analysis suggested that FT4 is positively and significantly correlated with TC (p < 0.0025); TSH is positively associated with HDL (p < 0.0025). Univariate analysis showed that serum TC and FT4 abundances are correlated with the suicide attempts in major depressive subjects. This research demonstrated that the levels of serum TC, TG, and FT4 levels in suicidal patients were greatly decreased compared with patients without suicidal behavior. These findings support the hypothesis that low serum FT4 level affects lipid profile in major depressive patients with suicidal attempt.
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Affiliation(s)
- Rui Peng
- Department of Clinical Laboratory, Renmin Hospital of Wuhan University, Wuhan, China.
| | - Wen Dai
- Department of Clinical Laboratory, Renmin Hospital of Wuhan University, Wuhan, China
| | - Yan Li
- Department of Clinical Laboratory, Renmin Hospital of Wuhan University, Wuhan, China.
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18
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Segoviano-Mendoza M, Cárdenas-de la Cruz M, Salas-Pacheco J, Vázquez-Alaniz F, La Llave-León O, Castellanos-Juárez F, Méndez-Hernández J, Barraza-Salas M, Miranda-Morales E, Arias-Carrión O, Méndez-Hernández E. Hypocholesterolemia is an independent risk factor for depression disorder and suicide attempt in Northern Mexican population. BMC Psychiatry 2018; 18:7. [PMID: 29334911 PMCID: PMC5769344 DOI: 10.1186/s12888-018-1596-z] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Accepted: 01/08/2018] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Cholesterol has been associated as a risk factor for cardiovascular disease. Recently, however, there is growing evidence about crucial requirement of neuron membrane cholesterol in the organization and function of the 5-HT1A serotonin receptor. For this, low cholesterol level has been reported to be associated with depression and suicidality. However there have been inconsistent reports about this finding and the exact relationship between these factors remains controversial. Therefore, we investigated the link between serum cholesterol and its fractions with depression disorder and suicide attempt in 467 adult subjects in Mexican mestizo population. METHODS Plasma levels of total cholesterol, triglycerides, and high-density lipoprotein cholesterol (HDL-c) and low density lipoprotein cholesterol (LDL-c) were determined in 261 MDD patients meeting the DSM-5 criteria for major depressive disorder (MDD), 59 of whom had undergone an episode of suicide attempt, and 206 healthy controls. RESULTS A significant decrease in total cholesterol, LDL-cholesterol, VLDL-cholesterol and triglyceride serum levels was observed in the groups of MDD patients and suicide attempt compared to those without suicidal behavior (p < 0.05). After adjusting for covariates, lower cholesterol levels were significantly associated with MDD (OR 4.229 CI 95% 2.555 - 7.000, p<.001) and suicide attempt (OR 5.540 CI 95% 2.825 - 10.866, p<.001) CONCLUSIONS: These results support the hypothesis that lower levels of cholesterol are associated with mood disorders like MDD and suicidal behavior. More mechanistic studies are needed to further explain this association.
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Affiliation(s)
- Marcela Segoviano-Mendoza
- 0000 0000 8724 8383grid.412198.7Instituto de Investigación Científica, Universidad Juárez del Estado de Durango, Universidad S/N esquina Volantín Zona Centro CP 34000, Zip Code 34000 Av., Durango, Mexico
| | - Manuel Cárdenas-de la Cruz
- 0000 0000 8724 8383grid.412198.7Instituto de Investigación Científica, Universidad Juárez del Estado de Durango, Universidad S/N esquina Volantín Zona Centro CP 34000, Zip Code 34000 Av., Durango, Mexico
| | - José Salas-Pacheco
- 0000 0000 8724 8383grid.412198.7Instituto de Investigación Científica, Universidad Juárez del Estado de Durango, Universidad S/N esquina Volantín Zona Centro CP 34000, Zip Code 34000 Av., Durango, Mexico
| | | | - Osmel La Llave-León
- 0000 0000 8724 8383grid.412198.7Instituto de Investigación Científica, Universidad Juárez del Estado de Durango, Universidad S/N esquina Volantín Zona Centro CP 34000, Zip Code 34000 Av., Durango, Mexico
| | - Francisco Castellanos-Juárez
- 0000 0000 8724 8383grid.412198.7Instituto de Investigación Científica, Universidad Juárez del Estado de Durango, Universidad S/N esquina Volantín Zona Centro CP 34000, Zip Code 34000 Av., Durango, Mexico
| | - Jazmín Méndez-Hernández
- 0000 0001 2157 0393grid.7220.7Departamento de Biotecnología, Universidad Autónoma Metropolitana, Ciudad de México, México Zip Code 09340,
| | - Marcelo Barraza-Salas
- 0000 0000 8724 8383grid.412198.7Facultad de Ciencias Químicas, Universidad Juárez del Estado de Durango, Zip Code 34000, Durango, México
| | - Ernesto Miranda-Morales
- 0000 0000 8724 8383grid.412198.7Instituto de Investigación Científica, Universidad Juárez del Estado de Durango, Universidad S/N esquina Volantín Zona Centro CP 34000, Zip Code 34000 Av., Durango, Mexico
| | - Oscar Arias-Carrión
- grid.414754.7Unidad de Trastornos del Movimiento y Sueño (TMS), Hospital General Dr. Manuel Gea González, Zip Code 14080, Ciudad de México, México
| | - Edna Méndez-Hernández
- Instituto de Investigación Científica, Universidad Juárez del Estado de Durango, Universidad S/N esquina Volantín Zona Centro CP 34000, Zip Code 34000 Av., Durango, Mexico. .,Subdirección de Investigación en Salud, Servicios de Salud de Durango, Zip Code 34000., Durango, México.
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19
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Smith KA, Cipriani A. Lithium and suicide in mood disorders: Updated meta-review of the scientific literature. Bipolar Disord 2017; 19:575-586. [PMID: 28895269 DOI: 10.1111/bdi.12543] [Citation(s) in RCA: 131] [Impact Index Per Article: 18.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2017] [Revised: 07/16/2017] [Accepted: 07/24/2017] [Indexed: 02/02/2023]
Abstract
OBJECTIVES Suicide and suicidal behaviour are increased in mood disorders, particularly bipolar disorders. Observational studies and small randomized controlled trials (RCTs) support the idea that taking lithium is associated with a reduction in these rates. This paper aims to review the best evidence for the effect of lithium on rates of suicide and self harm. METHODS We searched PubMed, PsycINFO, and the Cochrane Library systematically for systematic reviews and meta-analyses of RCTs of lithium and suicide and self harm published between January 1980 and June 2017. In the case of multiple publications on the same topic, only the most recent or most comprehensive review was considered. RESULTS A large number of reviews were identified, but only 16 publications were systematic reviews. Of these, three systematic reviews of lithium and suicide rates and one of lithium and self harm confined only to RCTs were identified. Despite some methodological concerns and heterogeneity in terms of participants, diagnoses, comparators, durations, and phase of illness, the evidence to date is overwhelmingly in favour of lithium as an antisuicidal agent, even balanced against any potential disadvantages of its use in regular clinical practice. CONCLUSIONS The anti-suicidal effects of lithium have been consistently reported over the past 40 years. The most robust evidence comes from RCTs, but these results are also discussed in the context of the difficulties in conducting high quality studies in this area, and the supporting evidence that observational and non-randomized studies can also provide. Given this evidence, however, the use of lithium is still underrepresented in clinical practice and should be incorporated more assertively into current guidelines.
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Affiliation(s)
- Katharine A Smith
- Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, UK.,Oxford Health NHS Foundation Trust, Warneford Hospital, Oxford, UK
| | - Andrea Cipriani
- Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, UK.,Oxford Health NHS Foundation Trust, Warneford Hospital, Oxford, UK
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20
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Ekinci O, Ekinci A. The connections among suicidal behavior, lipid profile and low-grade inflammation in patients with major depressive disorder: a specific relationship with the neutrophil-to-lymphocyte ratio. Nord J Psychiatry 2017; 71:574-580. [PMID: 28800269 DOI: 10.1080/08039488.2017.1363285] [Citation(s) in RCA: 66] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
OBJECTIVES The role of inflammation and lipid metabolism in the pathophysiology of suicidal behavior has received particular attention in recent years. The neutrophil-to-lymphocyte ratio (NLR) has been suggested as a new and more reliable indicator of low-grade inflammation. NLR has been found to be altered in major depressive disorder (MDD) and has been related to various factors, including chronic stress and impulsivity that were previously reported to be related to suicidal behavior. We aimed to explore the roles of NLR, C-reactive protein (CRP) and serum lipid levels on suicidal behavior in patients with MDD. METHODS The study group consisted of 139 inpatients diagnosed with MDD [37 suicide attempters (SA); 102 suicide non-attempters (NSA)], 50 healthy controls and matched according to age, gender and education. NLR, PLR, CRP and lipid values were obtained from digital inpatient records. RESULTS CRP levels and NLR were substantially higher in patients with SA than in subjects with NSA and healthy comparison subjects after adjusting the confounding factors. The logistic regression included two predictive variables for suicide status in patients with depressive disorder (A) previous suicidal history; (B) NLR. CONCLUSIONS This is the first study suggesting that NLR may be a trait marker for suicidal vulnerability via a relationship between NLR and a recent suicide attempt in depressed inpatients. Future prospective studies are needed to determine the exact roles of NLR, and other inflammatory markers on suicidality in MDD.
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Affiliation(s)
- Okan Ekinci
- a Department of Psychiatry , Usak University Medical Faculty, Education and Training Hospital , Usak , Turkey
| | - Asli Ekinci
- a Department of Psychiatry , Usak University Medical Faculty, Education and Training Hospital , Usak , Turkey
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21
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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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22
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Suicidal Ideation vs. Suicide Attempts: Clinical and Psychosocial Profile Differences Among Depressed Patients: A Study on Personality Traits, Psychopathological Variables, and Sociodemographic Factors in 228 Patients. J Nerv Ment Dis 2017; 205:361-371. [PMID: 28225508 DOI: 10.1097/nmd.0000000000000667] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
This study investigated whether personality traits, psychopathological characteristics, and sociodemographic factors in depressed patients differentiate patients with only suicidal thoughts from those who have attempted suicide. We investigated two groups of patients with an affective disorder: 198 patients with a suicide attempt within the last 3 months (sex ratio male to female, 1:1.3; mean age male to female, 44.8/44.7 years) and 30 patients without a suicide attempt but with suicidal thoughts (sex ratio male to female, 1:2; mean age male to female, 39.4/42.6 years) using a comprehensive measurement (Mini-International Neuropsychiatric Interview, Structured Clinical Interview for DSM-4 Axis II disorders, Hamilton Depression Scale, Beck Depression Inventory, State-Trait Anxiety Inventory, Hamilton Anxiety Scale, Brief Psychiatric Rating Scale, Clinical Global Impression Scale, Beck-Hopelessness Scale, Scale for Suicide Ideation, Impulsivity Rating Scale, Barratt Impulsivity Scale, Inventory for the Assessment of Aggression Factors, State-Trait Anger Expression Inventory, Ways of Coping Checklist). Several differences distinguished the two groups, namely, in personality traits such as anxiety or coping strategies and sociodemographics (e.g., education level). Personality traits, psychopathological characteristics, and sociodemographic factors are useful tools for assessing suicidal risk. Our findings encourage us to suggest that clinicians pay particular attention to sociodemographic variables such as separation/divorce and a lower education level when conducting risk assessments on suicidal patients.
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23
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Association between total serum cholesterol and suicide attempts in subjects with major depressive disorder: Exploring the role of clinical and biochemical confounding factors. Clin Biochem 2017; 50:274-278. [DOI: 10.1016/j.clinbiochem.2016.11.035] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2016] [Revised: 11/30/2016] [Accepted: 11/30/2016] [Indexed: 01/06/2023]
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24
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Messaoud A, Mensi R, Mrad A, Mhalla A, Azizi I, Amemou B, Trabelsi I, Grissa MH, Salem NH, Chadly A, Douki W, Najjar MF, Gaha L. Is low total cholesterol levels associated with suicide attempt in depressive patients? Ann Gen Psychiatry 2017; 16:20. [PMID: 28428806 PMCID: PMC5392998 DOI: 10.1186/s12991-017-0144-4] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2016] [Accepted: 04/05/2017] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Patients with major depressive disorder (MDD) have a high risk of suicide. Many pathophysiological factors involved in MDD and suicide such us a low cholesterol levels have been associated with MDD and increased vulnerability to suicide. In this study, we investigate the relation between lipid parameters and suicide risk in patients with MDD. METHODS Plasma levels of total cholesterol, triglycerides, and high-density lipoprotein cholesterol (HDL-c) and low-density lipoprotein cholesterol (LDL-c) were determined in 160 patients meeting the DSM-IV-TR criteria for MDD (110 patients without suicidal behavior and 52 suicidal attempters) and 151 healthy controls. RESULTS A significant decrease in plasma cholesterol levels was observed in the group of suicidal depressive patients compared to those without suicidal behavior (p < 0.001). For the other lipid levels (triglycerides, HDL cholesterol, and LDL cholesterol), there were no significant differences between suicidal and non-suicidal patients. CONCLUSIONS Our study showed a significant decrease in plasma cholesterol levels in suicidal patients. This result support the hypothesis of the association of low plasma cholesterol level and suicidal behavior in patients with major depressive disorder.
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Affiliation(s)
- A Messaoud
- Research Laboratory 'Vulnerability to psychotic disorders LR 05 ES 10', Department of Psychiatry, Monastir University Hospital, University of Monastir, Monastir, Tunisia
| | - R Mensi
- Research Laboratory 'Vulnerability to psychotic disorders LR 05 ES 10', Department of Psychiatry, Monastir University Hospital, University of Monastir, Monastir, Tunisia.,Laboratory of Biochemistry-Toxicology, Monastir University Hospital, University of Monastir, Monastir, Tunisia
| | - A Mrad
- Research Laboratory 'Vulnerability to psychotic disorders LR 05 ES 10', Department of Psychiatry, Monastir University Hospital, University of Monastir, Monastir, Tunisia
| | - A Mhalla
- Research Laboratory 'Vulnerability to psychotic disorders LR 05 ES 10', Department of Psychiatry, Monastir University Hospital, University of Monastir, Monastir, Tunisia
| | - I Azizi
- Research Laboratory 'Vulnerability to psychotic disorders LR 05 ES 10', Department of Psychiatry, Monastir University Hospital, University of Monastir, Monastir, Tunisia.,Laboratory of Biochemistry-Toxicology, Monastir University Hospital, University of Monastir, Monastir, Tunisia
| | - B Amemou
- Research Laboratory 'Vulnerability to psychotic disorders LR 05 ES 10', Department of Psychiatry, Monastir University Hospital, University of Monastir, Monastir, Tunisia
| | - I Trabelsi
- Department of Emergency, Monastir University Hospital, University of Monastir, Monastir, Tunisia
| | - M H Grissa
- Department of Emergency, Monastir University Hospital, University of Monastir, Monastir, Tunisia
| | - N Haj Salem
- Department of Forensic Medicine, Monastir University Hospital, University of Monastir, Monastir, Tunisia
| | - A Chadly
- Department of Forensic Medicine, Monastir University Hospital, University of Monastir, Monastir, Tunisia
| | - W Douki
- Research Laboratory 'Vulnerability to psychotic disorders LR 05 ES 10', Department of Psychiatry, Monastir University Hospital, University of Monastir, Monastir, Tunisia.,Laboratory of Biochemistry-Toxicology, Monastir University Hospital, University of Monastir, Monastir, Tunisia
| | - M F Najjar
- Laboratory of Biochemistry-Toxicology, Monastir University Hospital, University of Monastir, Monastir, Tunisia
| | - L Gaha
- Research Laboratory 'Vulnerability to psychotic disorders LR 05 ES 10', Department of Psychiatry, Monastir University Hospital, University of Monastir, Monastir, Tunisia
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25
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Luykx JJ, Olde Loohuis LM, Neeleman M, Strengman E, Bakker SC, Lentjes E, Borgdorff P, van Dongen EPA, Bruins P, Kahn RS, Horvath S, de Jong S, Ophoff RA. Peripheral blood gene expression profiles linked to monoamine metabolite levels in cerebrospinal fluid. Transl Psychiatry 2016; 6:e983. [PMID: 27959337 PMCID: PMC5290339 DOI: 10.1038/tp.2016.245] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2016] [Accepted: 10/15/2016] [Indexed: 01/07/2023] Open
Abstract
The blood-brain barrier separates circulating blood from the central nervous system (CNS). The scope of this barrier is not fully understood which limits our ability to relate biological measurements from peripheral to central phenotypes. For example, it is unknown to what extent gene expression levels in peripheral blood are reflective of CNS metabolism. In this study, we examine links between central monoamine metabolite levels and whole-blood gene expression to better understand the connection between peripheral systems and the CNS. To that end, we correlated the prime monoamine metabolites in cerebrospinal fluid (CSF) with whole-genome gene expression microarray data from blood (N=240 human subjects). We additionally applied gene-enrichment analysis and weighted gene co-expression network analyses (WGCNA) to identify modules of co-expressed genes in blood that may be involved with monoamine metabolite levels in CSF. Transcript levels of two genes were significantly associated with CSF serotonin metabolite levels after Bonferroni correction for multiple testing: THAP7 (P=2.8 × 10-8, β=0.08) and DDX6 (P=2.9 × 10-7, β=0.07). Differentially expressed genes were significantly enriched for genes expressed in the brain tissue (P=6.0 × 10-52). WGCNA revealed significant correlations between serotonin metabolism and hub genes with known functions in serotonin metabolism, for example, HTR2A and COMT. We conclude that gene expression levels in whole blood are associated with monoamine metabolite levels in the human CSF. Our results, including the strong enrichment of brain-expressed genes, illustrate that gene expression profiles in peripheral blood can be relevant for quantitative metabolic phenotypes in the CNS.
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Affiliation(s)
- J J Luykx
- Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands,Department of Translational Neuroscience Human Neurogenetics Unit, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands,Department of Psychiatry, ZNA Hospitals, Antwerp, Belgium
| | - L M Olde Loohuis
- Center for Neurobehavioral Genetics, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, USA
| | - M Neeleman
- Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - E Strengman
- Department of Pathology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - S C Bakker
- Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - E Lentjes
- Department of Clinical Chemistry and Hematology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - P Borgdorff
- Department of Anesthesiology, Intensive Care and Pain Management, Diakonessenhuis Hospital, Utrecht, The Netherlands
| | - E P A van Dongen
- Department of Anesthesiology, Intensive Care and Pain Management, University Medical Center Utrecht, Utrecht, The Netherlands
| | - P Bruins
- Department of Anesthesiology, Intensive Care and Pain Management, University Medical Center Utrecht, Utrecht, The Netherlands
| | - R S Kahn
- Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - S Horvath
- Department of Human Genetics, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA,Department of Biostatistics, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, USA
| | - S de Jong
- Center for Neurobehavioral Genetics, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, USA
| | - R A Ophoff
- Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands,Center for Neurobehavioral Genetics, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, USA,Department of Human Genetics, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA,Department of Human Genetics, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA 90095 USA. E-mail:
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26
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Gelaye B, Kajeepeta S, Williams MA. Suicidal ideation in pregnancy: an epidemiologic review. Arch Womens Ment Health 2016; 19:741-51. [PMID: 27324912 PMCID: PMC5023474 DOI: 10.1007/s00737-016-0646-0] [Citation(s) in RCA: 91] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2015] [Accepted: 06/02/2016] [Indexed: 10/21/2022]
Abstract
Suicidal behaviors are the leading causes of injury and death worldwide, and are leading causes of maternal deaths in some countries. One of the strongest risk factors, suicidal ideation, is considered a harbinger and distal predictor of later suicide attempt and completion, and also presents an opportunity for interventions prior to physical self-harm. The purpose of this systematic epidemiologic review is to synthesize available research on antepartum suicidal ideation. Original publications were identified through searches of the electronic databases using the search terms pregnancy, pregnant women, suicidal ideation, and pregnan* and suicid* as root searches. We also reviewed references of published articles. We identified a total of 2626 articles through the electronic database search. After irrelevant and redundant articles were excluded, 57 articles were selected. The selected articles were original articles that focused on pregnancy and suicidal ideation. Of the 57 included articles, 20 reported prevalence, 26 reported risk factors, 21 reported consequences of antepartum suicidal ideation, and 5 reported on screening measures. Available evidence indicates that pregnant women are more likely than the general population to endorse suicidal ideation. Additionally, a number of risk factors for antepartum suicidal ideation were identified including intimate partner violence, <12-year education, and major depressive disorder. There is a need for enhanced screening for antepartum suicidal ideation. The few screening instruments that exist are limited as they were primarily developed to measure antepartum and postpartum depression. Given a substantial proportion of women with suicidal ideation that does not meet clinical thresholds of depression and given the stress-diathesis model that shows susceptibility to suicidal behavior independent of depressive disorders, innovative approaches to improve screening and detection of antepartum suicidal ideation are urgently needed.
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Affiliation(s)
- Bizu Gelaye
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, 677 Huntington Ave, K505F, Boston, MA, 02115, USA.
| | - Sandhya Kajeepeta
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA
| | - Michelle A. Williams
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA
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27
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Lewitzka U, Denzin S, Sauer C, Bauer M, Jabs B. Personality differences in early versus late suicide attempters. BMC Psychiatry 2016; 16:282. [PMID: 27506387 PMCID: PMC4979154 DOI: 10.1186/s12888-016-0991-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2015] [Accepted: 08/02/2016] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Suicidality is an individual behaviour caused by a complex framework of internal and external factors. The predictive values of personality traits for a suicide attempt have been demonstrated, especially in conjunction with Cloninger's TCI and impulsivity. Two issues remain unsolved, namely whether these traits alter over time after a suicide attempt, and how they may be influenced by depressive symptoms. METHODS We studied two patient cohorts: one sample of 81 patients after a suicide attempt no longer than 3 months previously (SA early) and another sample of 32 patients whose attempt had taken place more than 6 months previously (SA late). We carried out structured interviews with these subjects addressing diagnosis (MINI), suicidality (Scale for suicide ideation), depression (HAMD-17), temperament and character inventory (TCI), and impulsivity (BIS-10). Data analysis was done using SPSS 16.0. RESULTS Our two groups did not differ significantly in sociodemographics or suicidality. However, patients in the SA early group were significantly more depressed (p < 0.001), and scored lower in reward dependence (p < 0.001) and persistence (p = 0.005) but higher in harm avoidance (p < 0.001); they did not differ significantly in impulsivity (p < 0.01). Reward dependence, persistence, and harm avoidance remained significantly different between the two groups after controlling for depressive symptoms. CONCLUSIONS Our findings suggest that some personality traits vary after a suicide attempt. Further investigations are necessary to verify our results, ideally in longitudinal studies with larger, carefully-described cohorts. It would be also clinically important to investigate the influence of therapeutic strategies on the variability of personality traits and their impact on suicidal behavior.
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Affiliation(s)
- Ute Lewitzka
- Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Technische Universität Dresden, Fetscherstr. 74, D-01307, Dresden, Germany.
| | | | - Cathrin Sauer
- Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Technische Universität Dresden, Fetscherstr. 74, D-01307 Dresden, Germany
| | - Michael Bauer
- Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Technische Universität Dresden, Fetscherstr. 74, D-01307 Dresden, Germany
| | - Burkhard Jabs
- Psychiatric Department of the Municipal Hospital Dresden-Neustadt, Dresden, Germany
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28
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Soavi C, Marušič U, Sanz JM, Morieri ML, Dalla Nora E, Šimunič B, Pišot R, Zuliani G, Passaro A. Age-related differences in plasma BDNF levels after prolonged bed rest. J Appl Physiol (1985) 2016; 120:1118-23. [DOI: 10.1152/japplphysiol.01111.2015] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2016] [Accepted: 03/01/2016] [Indexed: 01/22/2023] Open
Abstract
Brain-derived neurotrophic factor (BDNF) is a member of the family of neurotrophins and has been implicated in brain resistance to insults. Murine studies have demonstrated increased hippocampal concentration after acute immobilization and decreased concentration after chronic immobilization. In humans, chronic stress and sedentary lifestyle result in decreased plasma BDNF levels, but there no data exist regarding acute immobilization. The aim of our study was to evaluate age-related responses [comparing 7 younger subjects (age 23 ± 3 yr) and 8 older subjects (age 60 ± 4 yr)] of plasma BDNF before (baseline data collection, BDC) and after 14 days (BR14) of horizontal bed rest (BR). At BDC, BDNF levels were not different between the two groups ( P = 0.101), although at BR14, BDNF levels were higher in older subjects (62.02 ± 18.31) than in younger subjects (34.36 ± 15.24 pg/ml) ( P = 0.002). A general linear model for repeated measures showed a significant effect of BR on BDNF ( P = 0.002). The BDC BDNF levels correlated with fat-free mass in both populations (ALL) ( R = 0.628, P = 0.012), (older, R = 0.753, P = 0.031; younger, R = 0.772, P = 0.042), and with total cholesterol in ALL ( R = 0.647, P = 0.009) and older study subjects ( R = 0.805, P = 0.016). At BR14, BDNF correlated with total cholesterol ( R = 0.579, P = 0.024) and age ( R = 0.647, P = 0.009) in ALL. With an increase in age, the brain could become naturally less resistant to acute stressors, including the detrimental effects of prolonged bed rest, and thus the increase in BDNF in the older study group might reflect a protective overshooting of the brain to counteract the negative effects in such conditions.
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Affiliation(s)
- Cecilia Soavi
- Medical Science Department, University of Ferrara, Ferrara, Italy; and
| | - Uroš Marušič
- Science and Research Centre, University of Primorska, Capodistria, Slovenia
| | - Juana Maria Sanz
- Medical Science Department, University of Ferrara, Ferrara, Italy; and
| | | | | | - Bostjan Šimunič
- Science and Research Centre, University of Primorska, Capodistria, Slovenia
| | - Rado Pišot
- Science and Research Centre, University of Primorska, Capodistria, Slovenia
| | - Giovanni Zuliani
- Medical Science Department, University of Ferrara, Ferrara, Italy; and
| | - Angelina Passaro
- Medical Science Department, University of Ferrara, Ferrara, Italy; and
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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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Shin HY, Kang G, Kang HJ, Kim SW, Shin IS, Yoon JS, Kim JM. Associations between serum lipid levels and suicidal ideation among Korean older people. J Affect Disord 2016; 189:192-8. [PMID: 26451502 DOI: 10.1016/j.jad.2015.09.047] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2015] [Revised: 08/24/2015] [Accepted: 09/25/2015] [Indexed: 01/08/2023]
Abstract
INTRODUCTION There have been inconsistent reports on the relationships between lipids and suicidality, and studies conducted in older adults are rare. This study examined associations between serum lipid levels and suicidal ideation in an older population. METHODS This study used data obtained from a representative Korean sample of 4265 people age 65 years or older who completed a self-administered questionnaire about suicidal ideation over the last year. The fasting serum concentrations of total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, and triglycerides were measured and categorized into lower, intermediate (reference), and upper quartiles. A complex sample logistic regression stratified by gender was performed to determine the associations between serum lipid levels and suicidal ideation after controlling for covariates including age, education, marital status, current smoking, alcohol drinking, body mass index, hypertension, diabetes, diagnosed depression, antidepressant use, and lipid-lowering therapies. RESULTS In this study, the prevalence of suicidal ideation in an older Korean population was 22.9% (SE=0.9%). The prevalence was significantly higher in women than in men, 27.7% (1.2%) vs. 15.9% (1.1%) respectively. After adjusting for covariates, lower triglyceride levels were significantly associated with a decreased risk of suicidal ideation (OR=0.65; 95% CI=0.43-0.99) among men but no significant associations were observed among women. Additionally, there were no significant associations between any other measure of cholesterol levels and suicidal ideation in either men or women. LIMITATIONS Cross-sectional design cannot infer temporality or the effects of changes in variables. CONCLUSIONS These results support the association between lower triglyceride levels and a reduced risk of suicidal ideation among Korean men over 65. Further studies are necessary to investigate gender difference and the biological mechanism.
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Affiliation(s)
- Hee-Young Shin
- Department of Biomedical Science, Chonnam National University Medical School, 42 Jebongro, Dong-gu, Gwangju 501-746, Republic of Korea
| | - Gaeun Kang
- Division of Clinical Pharmacology, Chonnam National University Hospital, Gwangju, Republic of Korea
| | - Hee-Ju Kang
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Sung-Wan Kim
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Il-Seon Shin
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Jin-Sang Yoon
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Jae-Min Kim
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea.
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Lopez-Castroman J, Blasco-Fontecilla H, Courtet P, Baca-Garcia E, Oquendo MA. Are we studying the right populations to understand suicide? World Psychiatry 2015; 14:368-9. [PMID: 26407798 PMCID: PMC4592665 DOI: 10.1002/wps.20261] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Affiliation(s)
- Jorge Lopez-Castroman
- Centre Hospitalier Universitaire Régional Montpellier and University of Montpellier, Montpellier, France
| | | | - Philippe Courtet
- Centre Hospitalier Universitaire Régional Montpellier and University of Montpellier, Montpellier, France
| | - Enrique Baca-Garcia
- Department of Psychiatry, IIS-Jimenez Diaz Foundation, CIBERSAM, Madrid, Spain
- Department of Psychiatry, Columbia University/New York State Psychiatric Institute, New York, NY, USA
| | - Maria A Oquendo
- Department of Psychiatry, Columbia University/New York State Psychiatric Institute, New York, NY, USA
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Assessing measures of suicidal ideation in clinical trials with a rapid-acting antidepressant. J Psychiatr Res 2015; 68:68-73. [PMID: 26228403 PMCID: PMC4522045 DOI: 10.1016/j.jpsychires.2015.06.003] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2015] [Revised: 05/21/2015] [Accepted: 06/05/2015] [Indexed: 12/14/2022]
Abstract
Rapid reduction of suicidal thoughts is critical for treating suicidal patients. Clinical trials evaluating these treatments require appropriate measurement. Key methodological issues include: 1) the use of single or multi-item assessments, and 2) evaluating whether suicidal ideation measures can track rapid change over time. The current study presents data from two randomized, placebo-controlled, crossover clinical trials evaluating ketamine in individuals with treatment-resistant depression (n = 60). Participants were assessed for suicidal thoughts using the Hamilton Depression Rating Scale (HAM-D), Montgomery-Asberg Depression Rating Scale (MADRS), Beck Depression Inventory (BDI), and Scale for Suicidal Ideation (SSI) at eight time points over three days. Assessments were compared using correlational analyses and effect sizes at 230 min and three days after ketamine infusion. Linear mixed models evaluated change in ideation across all time points. The HAM-D and MADRS suicide items demonstrated correlations of r > .80 with the first five items of the SSI (SSI5). On linear mixed models, an effect for ketamine was found for the HAM-D, MADRS, BDI items, and SSI5 (p < .001), but not for the full SSI (p = .88), which suggests a limited ability to assess change over time in patients with low levels of suicidal thoughts. Taken together, the results suggest that repeated suicidal assessments over minutes to days appear to detect improvement in suicidal thoughts after ketamine infusion compared to placebo. The MADRS suicide item, BDI suicide item, and SSI5 may be particularly sensitive to rapid changes in suicidal thoughts.
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Lewitzka U, Severus E, Bauer R, Ritter P, Müller-Oerlinghausen B, Bauer M. The suicide prevention effect of lithium: more than 20 years of evidence-a narrative review. Int J Bipolar Disord 2015; 3:32. [PMID: 26183461 PMCID: PMC4504869 DOI: 10.1186/s40345-015-0032-2] [Citation(s) in RCA: 89] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2015] [Accepted: 06/29/2015] [Indexed: 11/21/2022] Open
Abstract
The management and treatment of patients with suicidal behavior is one of the most challenging tasks for health-care professionals. Patients with affective disorders are at high risk for suicidal behavior, therefore, should be a target for prevention. Numerous international studies of lithium use have documented anti-suicidal effects since the 1970s. Despite the unambiguous evidence of lithium’s anti-suicidal effects and recommendations in national and international guidelines for its use in acute and maintenance therapy of affective disorders, the use of lithium is still underrepresented. The following article provides a comprehensive review of studies investigating the anti-suicidal effect of lithium in patients with affective disorders.
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Affiliation(s)
- U Lewitzka
- Department of Psychiatry and Psychotherapy, Universitätsklinikum Carl Gustav Carus Dresden, Technische Universität Dresden, Fetscherstr. 74, 01307, Dresden, Germany,
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Misiak B, Kiejna A, Frydecka D. Higher total cholesterol level is associated with suicidal ideation in first-episode schizophrenia females. Psychiatry Res 2015; 226:383-8. [PMID: 25618471 DOI: 10.1016/j.psychres.2014.12.030] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2014] [Revised: 12/06/2014] [Accepted: 12/19/2014] [Indexed: 01/08/2023]
Abstract
There are inconsistent reports showing that the relationship between total cholesterol (TC) level and suicidality might be gender-specific. We compared 30 first-episode schizophrenia (FES) patients reporting suicidal ideation based on the Operational Criteria for Psychotic Illness (OPCRIT) checklist with 70 FES patients, who have never experienced suicidal ideation. After controlling for potential confounders, higher TC was associated with suicidal ideation only in FES females. Future studies should disentangle biological underpinnings of this gender-specific association.
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Affiliation(s)
- Błażej Misiak
- Department of Psychiatry, Wroclaw Medical University, 10 Pasteur Street, 50-367 Wroclaw, Poland; Department of Genetics, Wroclaw Medical University, 1 Marcinkowski Street, 50-368 Wroclaw, Poland.
| | - Andrzej Kiejna
- Department of Psychiatry, Wroclaw Medical University, 10 Pasteur Street, 50-367 Wroclaw, Poland
| | - Dorota Frydecka
- Department of Psychiatry, Wroclaw Medical University, 10 Pasteur Street, 50-367 Wroclaw, Poland
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Hubers AAM, van der Mast RC, Pereira AM, Roos RAC, Veen LJ, Cobbaert CM, van Duijn E, Giltay EJ. Hypothalamic-pituitary-adrenal axis functioning in Huntington's disease and its association with depressive symptoms and suicidality. J Neuroendocrinol 2015; 27:234-44. [PMID: 25565388 DOI: 10.1111/jne.12255] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2014] [Revised: 12/10/2014] [Accepted: 01/04/2015] [Indexed: 12/27/2022]
Abstract
Hyperactivity of the hypothalamic-pituitary-adrenal (HPA) axis has been reported in Huntington's disease (HD). In non-HD populations, alterations in HPA axis activity have been associated with depression and suicidality. The present study aims to compare HPA axis activity between HD mutation carriers and controls, and examine its association with depressive symptoms and suicidality. To this end, salivary cortisol concentrations at seven time points, as well as depressive symptoms and suicidality, were assessed in 49 pre-motor, 102 motor symptomatic mutation carriers and 55 controls, at baseline and follow-up combined. Differences in parameters of HPA axis activity between these three groups, and their associations with depressive symptoms and suicidality in HD mutation carriers, were analysed using multilevel regression analyses. There were no differences in parameters of HPA axis activity between mutation carriers and controls, whereas pre-motor symptomatic mutation carriers had a significantly higher area under the curve to the increase (AUCi ) compared to motor symptomatic mutation carriers. In the entire HD cohort, HPA axis activity was not associated with depressive symptoms or suicidality. After stratifying mutation carriers into pre-motor, early and advanced disease stages, β values differed between these groups. Remarkably, a higher AUCi was significantly associated with depressive symptoms in pre-motor and early disease stage mutation carriers, with a reverse nonsignificant association in advanced disease stage mutation carriers. The lower AUCi in motor symptomatic mutation carriers and the varying associations with depressive symptoms and suicidality in pre-motor, early and advanced disease stages could possibly be explained by exhaustion of the HPA axis after prolonged stress-induced HPA axis hyperactivity and deserves further longitudinal study.
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Affiliation(s)
- A A M Hubers
- Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands
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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: 61] [Impact Index Per Article: 6.8] [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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Colle R, Chupin M, Cury C, Vandendrie C, Gressier F, Hardy P, Falissard B, Colliot O, Ducreux D, Corruble E. Depressed suicide attempters have smaller hippocampus than depressed patients without suicide attempts. J Psychiatr Res 2015; 61:13-8. [PMID: 25555305 DOI: 10.1016/j.jpsychires.2014.12.010] [Citation(s) in RCA: 56] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2014] [Revised: 12/11/2014] [Accepted: 12/15/2014] [Indexed: 02/04/2023]
Abstract
BACKGROUND Despite known relationship between hippocampal volumes and major depressive episodes (MDE) and the increased suicidality in MDE, the links between hippocampal volumes and suicidality remain unclear in major depressive disorders (MDD). If the hippocampus could be a biomarker of suicide attempts in depression, it could be useful for prevention matters. This study assessed the association between hippocampal volumes and suicide attempts in MDD. METHODS Hippocampal volumes assessed with automatic segmentation were compared in 63 patients with MDD, with (n = 24) or without (n = 39) suicide attempts. Acute (<one month) and past (>one month) suicide attempts were studied. RESULTS Although not different in terms of socio-demographic, MDD and MDE clinical features, suicide attempters had lower total hippocampus volumes than non-attempters (4.61 (± 1.15) cm(3) vs 5.22 (± 0.99) cm(3); w = 625.5; p = 0.03), especially for acute suicide attempts (4.19 (± 0.81) cm(3) vs 5.22 (± 0.99) cm(3); w = 334; p = 0.005), even after adjustment on brain volumes, sex, age, Hamilton Depression Rating Scale (HDRS) scores and MDD duration. A ROC analysis showed that a total hippocampal volume threshold of 5.00 cm(3) had a 98.2% negative predictive value for acute suicide attempts. CONCLUSION Depressed suicide attempters have smaller hippocampus than depressed patients without suicide attempts, independently from socio-demographics and MDD characteristics. This difference is related to acute suicide attempts but neither to past suicide attempts nor to duration since the first suicide attempt, suggesting that hippocampal volume could be a suicidal state marker in MDE. Further studies are required to better understand this association.
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Affiliation(s)
- Romain Colle
- INSERM UMR 1178, Team "Depression and Antidepressants", Univ Paris Sud, Service de Psychiatrie, Hôpital Bicêtre, Assistance Publique Hôpitaux de Paris, 94275 Le Kremlin Bicêtre, France.
| | - Marie Chupin
- INSERM, U1127, F-75013 Paris, France; CNRS, UMR 7225 ICM, 75013 Paris, France; Sorbonne Universités, UPMC Univ Paris 06, UMR S 1127, F-75013 Paris, France; Institut du Cerveau et de la Moelle épinière, ICM, F-75013 Paris, France; Inria, Aramis Team, Centre de Recherche Paris, Rocquencourt, France
| | - Claire Cury
- INSERM, U1127, F-75013 Paris, France; CNRS, UMR 7225 ICM, 75013 Paris, France; Sorbonne Universités, UPMC Univ Paris 06, UMR S 1127, F-75013 Paris, France; Institut du Cerveau et de la Moelle épinière, ICM, F-75013 Paris, France; Inria, Aramis Team, Centre de Recherche Paris, Rocquencourt, France
| | - Christophe Vandendrie
- CNRS IR4M, UMR 8081, Neuroradiology Hôpital Bicêtre, Assistance Publique Hôpitaux de Paris, 94275 Le Kremlin Bicêtre, France
| | - Florence Gressier
- INSERM UMR 1178, Team "Depression and Antidepressants", Univ Paris Sud, Service de Psychiatrie, Hôpital Bicêtre, Assistance Publique Hôpitaux de Paris, 94275 Le Kremlin Bicêtre, France
| | - Patrick Hardy
- INSERM UMR 1178, Team "Depression and Antidepressants", Univ Paris Sud, Service de Psychiatrie, Hôpital Bicêtre, Assistance Publique Hôpitaux de Paris, 94275 Le Kremlin Bicêtre, France
| | - Bruno Falissard
- INSERM UMR 1178, Département de Biostatistiques, Univ Paris Sud, Hôpital Paul Brousse, Assistance Publique Hôpitaux de Paris, 94400 Villejuif, France
| | - Olivier Colliot
- INSERM, U1127, F-75013 Paris, France; CNRS, UMR 7225 ICM, 75013 Paris, France; Sorbonne Universités, UPMC Univ Paris 06, UMR S 1127, F-75013 Paris, France; Institut du Cerveau et de la Moelle épinière, ICM, F-75013 Paris, France; Inria, Aramis Team, Centre de Recherche Paris, Rocquencourt, France
| | - Denis Ducreux
- CNRS IR4M, UMR 8081, Neuroradiology Hôpital Bicêtre, Assistance Publique Hôpitaux de Paris, 94275 Le Kremlin Bicêtre, France
| | - Emmanuelle Corruble
- INSERM UMR 1178, Team "Depression and Antidepressants", Univ Paris Sud, Service de Psychiatrie, Hôpital Bicêtre, Assistance Publique Hôpitaux de Paris, 94275 Le Kremlin Bicêtre, France
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Cantarelli MDG, Tramontina AC, Leite MC, Gonçalves CA. Potential neurochemical links between cholesterol and suicidal behavior. Psychiatry Res 2014; 220:745-51. [PMID: 25457283 DOI: 10.1016/j.psychres.2014.10.017] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2013] [Revised: 10/07/2014] [Accepted: 10/16/2014] [Indexed: 12/16/2022]
Abstract
The role of cholesterol in psychiatric diseases has aroused the interest of the medical community, particularly in association with violent and suicidal behavior. Herein, we discuss some aspects of brain cholesterol metabolism, exploring possible mechanisms underlying the findings and reviewing the available literature on the possible neurochemical link between suicide and low or reduced levels of serum cholesterol. Most of the current hypotheses suggest a decreased serotonergic activity due to a decrease in cholesterol in the lipid rafts of synaptic membranes. Some aspects and limitations of this assumption are emphasized. In addition to serotonin hypofunction, other mechanisms have been proposed to explain increased impulsivity in suicidal individuals, including steroid modulation and brain-derived neurotrophic factor decrease, which could also be related to changes in lipid rafts. Other putative markers of suicidal behavior (e.g. protein S100B) are discussed in connection with cholesterol metabolism in the brain tissue.
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Dysfunction of neural circuitry in depressive patients with suicidal behaviors: a review of structural and functional neuroimaging studies. Prog Neuropsychopharmacol Biol Psychiatry 2014; 53:61-6. [PMID: 24632395 DOI: 10.1016/j.pnpbp.2014.03.002] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2014] [Revised: 03/06/2014] [Accepted: 03/06/2014] [Indexed: 01/13/2023]
Abstract
Suicide is an important public problem. Understanding the neurobiological mechanisms of suicidal behavior in depression will facilitate the development of more effective prevention strategies for suicide. There are several reviews of imaging studies of suicidal behavior, but none of these reviews have focused only on suicide in depression. We reviewed neuroimaging studies of suicide in depression in recent years. The majority of studies found structural and functional alterations in the orbital frontal cortex, anterior cingulate cortex and striatum in depressive patients with suicidal behaviors. The evidence suggests that the frontal-striatal circuitry, which includes the striatum, orbital frontal and anterior cingulate cortices, is involved in the neurobiology of suicide in depressive patients. These findings also indicate that not all suicides have the same underlying neuropathology. Future studies require larger samples and more accurate subtypes of suicide. Furthermore, combining neuroimaging and other new technologies in molecular biology will be helpful to reveal the pathogenesis of suicidal behavior in depression.
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Peng H, Wu K, Li J, Qi H, Guo S, Chi M, Wu X, Guo Y, Yang Y, Ning Y. Increased suicide attempts in young depressed patients with abnormal temporal-parietal-limbic gray matter volume. J Affect Disord 2014; 165:69-73. [PMID: 24882180 DOI: 10.1016/j.jad.2014.04.046] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2013] [Revised: 03/18/2014] [Accepted: 04/17/2014] [Indexed: 11/15/2022]
Abstract
BACKGROUND Suicide is a major cause of death throughout the world. Approximately 60% of all suicides have a history of depression. Previous studies of structural brain imaging have shown that suicide is often associated with abnormal fronto-limbic networks. However, the mechanism underlying suicide in depression remains poorly understood. METHOD Twenty sex- and age-matched suicidal unipolar patients were compared with 18 non-suicidal unipolar patients and 28 healthy controls. High-resolution T1-weighted 3T magnetic resonance imaging (MRI) scans were acquired. Hamilton Depressive Rating Scale (HAMD) and Self-Rating Depression scale (SDS) were evaluated. The criterion for suicidality was one or more documented lifetime suicide attempts. A whole-brain optimized voxel-based morphometry (VBM) approach was applied. The Dysfunctional Attitude Scale (DAS) was used to measure cognitive scheme in depressive patients. RESULTS Compared with controls, patients without suicide history showed significant decreased gray matter volume in the left insula lobe [-35 18 9], whereas patients with suicide history showed significantly decreased gray matter volume in the right middle temporal gyrus [60 -53 -8] and increased gray matter volume in the right parietal lobe [39 -39 60]. Compared with the non-suicidal depressed patient group, the suicidal group showed significant decreased gray matter volume in left limbic cingulated gyrus [-2 -21 28]. Moreover, the gray matter volume values in this significantly different brain region were negatively correlated with dysfunctional attitude scores in suicidal depressed patients. LIMITATIONS This study needs replication and further clarification in a larger patient population. CONCLUSIONS Suicide attempts in young depressed patients may be related to abnormal gray matter volumes in temporal-parietal-limbic networks. Specifically, small left limbic cingulate gyrus volumes may be a candidate for the prediction of suicide in young depressed patients.
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Affiliation(s)
- Hongjun Peng
- Guangzhou Psychiatric Hospital, Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.
| | - Kai Wu
- Department of Biomedical Engineering, School of Materials Science and Engineering, South China University of Technology, Guangzhou, China.
| | - Jie Li
- Guangzhou Psychiatric Hospital, Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Haochen Qi
- Department of Biomedical Engineering, School of Materials Science and Engineering, South China University of Technology, Guangzhou, China
| | - Shengwen Guo
- Department of Biomedical Engineering, School of Materials Science and Engineering, South China University of Technology, Guangzhou, China
| | - Minyue Chi
- Department of Biomedical Engineering, School of Materials Science and Engineering, South China University of Technology, Guangzhou, China
| | - Xiaoming Wu
- Department of Biomedical Engineering, School of Materials Science and Engineering, South China University of Technology, Guangzhou, China
| | - Yangbo Guo
- Guangzhou Psychiatric Hospital, Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Yuling Yang
- Guangzhou Psychiatric Hospital, Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Yuping Ning
- Guangzhou Psychiatric Hospital, Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
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Baek JH, Kang ES, Fava M, Mischoulon D, Nierenberg AA, Yu BH, Lee D, Jeon HJ. Serum lipids, recent suicide attempt and recent suicide status in patients with major depressive disorder. Prog Neuropsychopharmacol Biol Psychiatry 2014; 51:113-8. [PMID: 24495778 DOI: 10.1016/j.pnpbp.2014.01.018] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2013] [Revised: 01/28/2014] [Accepted: 01/28/2014] [Indexed: 01/31/2023]
Abstract
OBJECTIVE Major depressive disorder (MDD) is associated with suicide. Although several studies have reported its association with low serum lipid, few studies have investigated relationships between current suicidality and lipid profiles, comparing with other blood measures in MDD patients. METHODS The study population consisted of 555 subjects with MDD who were ≥ 18 years old, evaluated by the Mini International Neuropsychiatric Interview (MINI) with the suicidality module. At the evaluation visit, we measured serum lipid profiles including total cholesterol, triglycerides (TG), low-density lipoprotein (LDL), high-density lipoprotein (HDL), and very low-density lipoprotein (VLDL), and blood measures such as fasting glucose, total protein, albumin, blood urea nitrogen, creatinine, thyroid hormones, red and white blood cells, platelet count, hemoglobin, and hematocrit. RESULTS Recent attempters who had attempted suicide within the past month showed significantly lower TG and higher HDL levels than lifetime and never attempters, using Tukey's post-hoc analysis. Recent attempters exhibited lower TG and higher HDL than those with recent suicide ideation and wish to self-harm and those without previous attempt. Linear regression analysis revealed that TG was negatively associated with current suicidality scores (β = -0.187, p = 0.039), whereas VLDL was positively associated with the recent suicide status (β = 0.198, p = 0.032) after controlling for age and sex. There were no significant differences between the groups in terms of other serum lipid profiles and blood measures. CONCLUSIONS Low serum TG, high HDL and VLDL levels are associated with recent suicide attempt or recent suicide status in patients with MDD.
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Affiliation(s)
- Ji Hyun Baek
- Department of Psychiatry, Depression Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea; Bipolar Clinic and Research Program, Massachusetts General Hospital, Harvard Medical School, Boston, USA
| | - Eun-Suk Kang
- Department of Laboratory Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Maurizio Fava
- Depression Clinical and Research Program, Massachusetts General Hospital, Harvard Medical School, Boston, USA
| | - David Mischoulon
- Depression Clinical and Research Program, Massachusetts General Hospital, Harvard Medical School, Boston, USA
| | - Andrew A Nierenberg
- Depression Clinical and Research Program, Massachusetts General Hospital, Harvard Medical School, Boston, USA; Bipolar Clinic and Research Program, Massachusetts General Hospital, Harvard Medical School, Boston, USA
| | - Bum-Hee Yu
- Department of Psychiatry, Depression Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Dongsoo Lee
- Department of Psychiatry, Depression Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Hong Jin Jeon
- Department of Psychiatry, Depression Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea; Samsung Advanced Institute for Health Sciences & Technology (SAIHST), South Korea; Depression Clinical and Research Program, Massachusetts General Hospital, Harvard Medical School, Boston, USA.
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Predicting suicidal behavior: are we really that far along? Comment on "Discovery and validation of blood biomarkers for suicidality". Curr Psychiatry Rep 2013; 15:424. [PMID: 24254200 PMCID: PMC3967238 DOI: 10.1007/s11920-013-0424-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
A recent publication focused on biomarkers of future suicidal behaviors identifies several genes expressed in high-risk states among four samples. We discuss the implications of this study as well as the current state of research regarding biomarkers of suicidal behavior.
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Kim YK, Na KS, Hwang JA, Yoon HK, Lee HJ, Hahn SW, Lee BH, Jung HY. High insulin-like growth factor-1 in patients with bipolar I disorder: a trait marker? J Affect Disord 2013; 151:738-743. [PMID: 24012102 DOI: 10.1016/j.jad.2013.07.041] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2013] [Revised: 07/28/2013] [Accepted: 07/30/2013] [Indexed: 01/21/2023]
Abstract
OBJECTIVES Neurotrophic factors exert substantial effects on the central nervous system. The present study investigates the roles of insulin-like growth factor-1 (IGF-1), β-nerve growth factor (β-NGF), and brain-derived neurotrophic factor (BDNF) in bipolar disorder. METHODS Baseline levels of culture-stimulated IGF-1, β-NGF, and BDNF were compared in 116 patients with bipolar I disorder and 123 healthy controls. Neurotrophic factors were also compared in patients before and after 6 weeks of pharmacotherapy. A multivariate logistic regression analysis was used to investigate the influence of the neurotrophic factors analyzed in quartile form, in relation to confounding variables, such as age, sex, and body mass index. RESULTS IGF-1 was significantly higher in patients (mean=514.57, SD=259.78) than in healthy controls (mean=316.82, SD=270.00, p<0.0001) at baseline. Furthermore, higher levels of IGF-1 substantially increased the risk for bipolar I disorder. IGF-1 level was not significantly changed at 6-weeks (mean=506.41, SD=313.66). No changes in BDNF or β-NGF-1 levels were found following the 6-week treatment period. IGF-1 and β-NGF were negatively correlated in healthy controls, but not in patients. Severity of manic symptoms was not associated with any of the neurotrophic factors. LIMITATIONS We did not measure cortisol, growth hormone, or IGF-1 receptors. This study is cross-sectional in design. CONCLUSIONS Elevated IGF-1 levels may be a trait marker for bipolar disorder. Further studies are needed to thoroughly investigate the role of IGF-1 in relation to other neuroendocrine factors and biological markers for bipolar disorder.
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Affiliation(s)
- Yong-Ku Kim
- Department of Psychiatry, College of Medicine, Korea University, Seoul, Republic of Korea
| | - Kyoung-Sae Na
- Department of Psychiatry, Gachon University Gil Medical Center, 1198, Guwol-dong, Namdong-Gu, Incheon, Republic of Korea.
| | - Jung-A Hwang
- Department of Psychiatry, College of Medicine, Korea University, Seoul, Republic of Korea
| | - Ho-Kyoung Yoon
- Department of Psychiatry, College of Medicine, Korea University, Seoul, Republic of Korea
| | - Heon-Jeong Lee
- Department of Psychiatry, College of Medicine, Korea University, Seoul, Republic of Korea
| | - Sang-Woo Hahn
- Department of Psychiatry, College of Medicine, Soonchunhyang University, Seoul, Republic of Korea
| | - Bun-Hee Lee
- Department of Psychiatry, Gangnam Eulji Hospital, Eulji University, Seoul, Republic of Korea
| | - Han-Yong Jung
- Department of Psychiatry, College of Medicine, Soonchunhyang University, Seoul, Republic of Korea
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TNF-alpha -308G>A polymorphism is associated with suicide attempts in major depressive disorder. J Affect Disord 2013; 150:668-72. [PMID: 23608119 DOI: 10.1016/j.jad.2013.03.019] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2012] [Revised: 03/18/2013] [Accepted: 03/19/2013] [Indexed: 01/22/2023]
Abstract
BACKGROUND Despite the substantial role of the cytokine network in depression and suicide, few studies have investigated the role of genetic polymorphisms of pro- and anti-inflammatory cytokines in suicide in major depressive disorder (MDD). The aim of this study was to investigate whether tumor necrosis factor-alpha (TNF-alpha) -308G>A, interferon-gamma (IFN-gamma) +874A>T, and interleukin-10 (IL-10) -1082A>G are associated with increased risk for suicide attempts in MDD. METHODS Among patients with MDD, 204 patients who had attempted suicide and 97 control patients who had not attempted suicide were recruited. A chi-square test was used to identify a possible risk genotype or allele type for suicide. A subsequent multivariate logistic regression analysis was conducted to investigate the influence of a risk genotype or allele type adjusted for other environmental factors. The lethality of the suicide attempt was also tested between genotype and allele types among suicidal patients with MDD. RESULTS The GG genotype of the TNF-alpha -308G>A polymorphism was found to significantly increase risk for suicide attempt (adjusted OR=2.630, 95% CI=1.206 to 5.734). IFN-gamma +874A>T and IL-10 -1082A>G were not associated with risk for suicide. Lethality of the suicide attempt was not associated with any of the three cytokine genotypes or allele types. LIMITATIONS Limitations include a relatively small sample size and a cross-sectional design. CONCLUSIONS TNF-alpha -308G>A polymorphism is an independent risk factor for suicide attempts in MDD. Future studies should clarify the neural mechanisms by which the GG genotype of TNF-alpha -308G>A influences suicide in MDD.
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Abstract
OBJECTIVE Suicide is a major public health concern as each year 30000 people die by suicide in the USA alone. In the teenage population, it is the second leading cause of death. There have been extensive studies of psychosocial factors associated with suicide and suicidal behavior. However, very little is known about the neurobiology of suicide. Recent research has provided some understanding of the neurobiology of suicide, which is the topic of this review. METHODS Neurobiology of suicide has been studied using peripheral tissues such as platelets, lymphocytes, and cerebrospinal fluid obtained from suicidal patients or from the postmortem brains of suicide victims. RESULTS These studies have provided encouraging information with regard to the neurobiology of suicide. They show an abnormality of the serotonergic mechanism, such as increased serotonin receptor subtypes and decreased serotonin metabolites (e.g. 5-hydroxyindoleacetic acid). These studies also suggest abnormalities of receptor-linked signaling mechanisms such as phosphoinositide and adenylyl cyclase. Other biological systems that appear to be dysregulated in suicide involve the hypothalamic-pituitary-adrenal axis, and neurotrophins and neurotrophin receptors. More recently, several studies have also indicated abnormalities of neuroimmune functions in suicide. CONCLUSIONS Some encouraging information emerged from the present review, primarily related to some of the neurobiological mechanisms mentioned above. It is hoped that neurobiological studies may eventually result in the identification of appropriate biomarkers for suicidal behavior as well as appropriate therapeutic targets for its treatment.
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Affiliation(s)
- Ghanshyam N Pandey
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL 60612, USA.
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Papadopoulou A, Markianos M, Christodoulou C, Lykouras L. Plasma total cholesterol in psychiatric patients after a suicide attempt and in follow-up. J Affect Disord 2013; 148:440-3. [PMID: 23237826 DOI: 10.1016/j.jad.2012.11.032] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2012] [Revised: 11/18/2012] [Accepted: 11/19/2012] [Indexed: 11/19/2022]
Abstract
BACKGROUND Low plasma total cholesterol (TC) levels have been found in subjects after a suicide attempt in most studies. Other studies question these results because of possible influences on TC of somatic effects due to the attempt (drugs, somatic trauma, hospitalization), or nutritional habits and physical activity before attempt, especially in patients with depression. METHODS To address this issue, TC levels were estimated in 51 subjects on admission to psychiatric clinic after a suicide attempt, as well as later in follow-up when patients were back in their normal activities. Patients were evaluated for suicide intent (SIS), aggression, and severity of depression (BDI). RESULTS A small (7% in the mean) but statistically significant increase in plasma cholesterol levels was observed in samples taken in follow-up compared to samples after attempt. However, TC levels of patients were significantly lower than controls in both assessments. There were no differences in TC between violent and non-violent attempters, either after attempt or in follow-up. In the subgroup of patients with major affective disorder, TC levels were lower compared to age-matched controls in both assessments, although patients showed significant reductions in BDI score in follow-up. In this subgroup, TC levels after attempt correlated negatively to SIS score. CONCLUSIONS TC levels in psychiatric patients after a suicide attempt are lower than healthy controls and remain low in follow-up, independently from the severity of psychopathology. The results support the role of plasma total cholesterol as a biological risk factor in suicidal behavior, especially in affective patients.
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Affiliation(s)
- Athanassia Papadopoulou
- Department of Psychiatry, Attikon General Hospital, Athens University Medical School, Greece.
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Abstract
Suicide and bipolar disorder (BD) are challenging, complex, and intertwined areas of study in contemporary psychiatry. Indeed, BD is associated with the highest lifetime risk for suicide attempt and completion of all the psychiatric conditions. Given that several clinical risk factors for both suicide and BD have been well noted in the literature, exploring the neurobiological aspects of suicide in BD may provide insights into both preventive measures and future novel treatments. This review synthesizes findings regarding the neurobiological aspects of suicide and, when applicable, their link to BD. Neurochemical findings, genes/epigenetics, and potential molecular targets for current or future treatments are discussed. The role of endophenotypes and related proximal and distal risk factors underlying suicidal behavior are also explored. Lastly, we discuss the manner in which preclinical work on aggression and impulsivity may provide additional insights for the future development of novel treatments.
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Thompson PM, Cruz DA, Olukotun DY, Delgado PL. Serotonin receptor, SERT mRNA and correlations with symptoms in males with alcohol dependence and suicide. Acta Psychiatr Scand 2012; 126:165-74. [PMID: 22176604 DOI: 10.1111/j.1600-0447.2011.01816.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVE This study tested the hypothesis that abnormalities in components of the serotonin (5HT) system in the prefrontal cortex are associated with suicide in alcohol-dependent subjects. Second, we assessed the relationship of lifetime impulsivity and mood symptoms with prefrontal cortex 5-HT measures. METHOD Tissue was obtained from Brodmann's areas (BA) 9 and 24 in postmortem samples of individuals who were alcohol dependent with suicide (n = 5), alcohol dependent without suicide (n = 9) and normal controls (n = 5). Serotonin receptor (5HT) and serotonin reuptake transporter (SERT) mRNA were measured. Interviews with next of kin estimated lifetime impulsivity and mood symptoms in the last week of life. RESULTS Serotonin receptor 1A (5HT1A) mRNA in BA 9 was elevated in the alcohol dependence without suicide group compared with controls. In the alcohol dependence with suicide group, anxiety symptoms were associated with decreased BA 24 SERT mRNA and depressive symptoms with BA 9 5HT1A mRNA expression. In the alcohol dependent only group impulsivity is correlated with increased BA 9, and BA 24 serotonin receptor 2A mRNA. CONCLUSION Our data suggest region-specific change, rather than global serotonin blunting is involved in alcohol dependence and suicide. It also suggests that symptoms are differentially influenced by prefrontal cortex serotonin receptor mRNA levels.
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Affiliation(s)
- P M Thompson
- Department of Psychiatry, University of Texas Health Science Center San Antonio Southwest Brain Bank, USA.
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Pinheiro RT, Pinheiro KAT, da Cunha Coelho FM, de Ávila Quevedo L, Gazal M, da Silva RA, Giovenardi M, Lucion AB, de Souza DO, Portela LV, Oses JP. Brain-derived neurotrophic factor levels in women with postpartum affective disorder and suicidality. Neurochem Res 2012; 37:2229-34. [PMID: 22851352 DOI: 10.1007/s11064-012-0851-9] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2012] [Revised: 07/16/2012] [Accepted: 07/20/2012] [Indexed: 01/05/2023]
Abstract
Our aim was to investigate serum brain-derived neurotrophic factor (BDNF) levels in postpartum women, according to the presence of postpartum affective disorder (PPAD) and suicidality. A cross-sectional study was carried out with women between 45 and 90 days after delivery. PPAD (depression, manic and mixed episode) and suicide risk were assessed using the Mini International Neuropsychiatric Interview. BDNF was assessed using a commercial ELISA kit. Linear regression was used for multivariate analyses. A hundred ninety women participated in the study, 15.3 % had PPAD, 7.4 % showed PPAD with suicide risk. BDNF levels were lower in subjects with three or more Stressful Life Events (P = 0.01). The serum BDNF levels of women with PPAD presenting suicide risk were significantly lower than those of women without suicide risk (1.50 ± 1.38 and 2.33 ± 1.28 ng/ml, P = 0.02). Clinicians should enquire postpartum women about their history of stressful life events, PPAD, and suicidality. This study shows the potential role of BDNF in the neurobiology of the association of PPAD and suicidality.
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Affiliation(s)
- Ricardo Tavares Pinheiro
- Programa de Pós-Graduação em Saúde & Comportamento, Centro de Ciências da Vida e da Saúde, Universidade Católica de Pelotas, Rua Gonçalves Chaves, 373 sala 411C, Pelotas, RS CEP 96015-560, Brazil
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Indic P, Murray G, Maggini C, Amore M, Meschi T, Borghi L, Baldessarini RJ, Salvatore P. Multi-scale motility amplitude associated with suicidal thoughts in major depression. PLoS One 2012; 7:e38761. [PMID: 22701706 PMCID: PMC3373552 DOI: 10.1371/journal.pone.0038761] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2012] [Accepted: 05/13/2012] [Indexed: 11/18/2022] Open
Abstract
Major depression occurs at high prevalence in the general population, often starts in juvenile years, recurs over a lifetime, and is strongly associated with disability and suicide. Searches for biological markers in depression may have been hindered by assuming that depression is a unitary and relatively homogeneous disorder, mainly of mood, rather than addressing particular, clinically crucial features or diagnostic subtypes. Many studies have implicated quantitative alterations of motility rhythms in depressed human subjects. Since a candidate feature of great public-health significance is the unusually high risk of suicidal behavior in depressive disorders, we studied correlations between a measure (vulnerability index [VI]) derived from multi-scale characteristics of daily-motility rhythms in depressed subjects (n = 36) monitored with noninvasive, wrist-worn, electronic actigraphs and their self-assessed level of suicidal thinking operationalized as a wish to die. Patient-subjects had a stable clinical diagnosis of bipolar-I, bipolar-II, or unipolar major depression (n = 12 of each type). VI was associated inversely with suicidal thinking (r = –0.61 with all subjects and r = –0.73 with bipolar disorder subjects; both p<0.0001) and distinguished patients with bipolar versus unipolar major depression with a sensitivity of 91.7% and a specificity of 79.2%. VI may be a useful biomarker of characteristic features of major depression, contribute to differentiating bipolar and unipolar depression, and help to detect risk of suicide. An objective biomarker of suicide-risk could be advantageous when patients are unwilling or unable to share suicidal thinking with clinicians.
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Affiliation(s)
- Premananda Indic
- Department of Neurology, University of Massachusetts Medical School, Worcester, Massachusetts, United States of America
| | - Greg Murray
- Faculty of Life and Social Sciences, Swinburne University of Technology, Hawthorn, Victoria, Australia
| | - Carlo Maggini
- Section of Psychiatry, Department of Neuroscience, University of Parma, Parma, Italy
| | - Mario Amore
- Section of Psychiatry, Department of Neuroscience, University of Parma, Parma, Italy
| | - Tiziana Meschi
- Section of Internal Medicine, Department of Clinical Sciences, University of Parma, Parma, Italy
| | - Loris Borghi
- Section of Internal Medicine, Department of Clinical Sciences, University of Parma, Parma, Italy
| | - Ross J. Baldessarini
- International Consortium for Psychotic and Bipolar Disorders Research, McLean Hospital, Belmont, Massachusetts, United States of America
- Department of Psychiatry, Harvard Medical School and McLean Hospital, Boston, Massachusetts, United States of America
| | - Paola Salvatore
- Section of Psychiatry, Department of Neuroscience, University of Parma, Parma, Italy
- International Consortium for Psychotic and Bipolar Disorders Research, McLean Hospital, Belmont, Massachusetts, United States of America
- Department of Psychiatry, Harvard Medical School and McLean Hospital, Boston, Massachusetts, United States of America
- * E-mail:
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