1
|
Maydom JK, Blackwell C, O'Connor DB. Childhood trauma and suicide risk: Investigating the role of adult attachment. J Affect Disord 2024; 365:295-302. [PMID: 39134153 DOI: 10.1016/j.jad.2024.08.005] [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: 09/22/2023] [Revised: 06/21/2024] [Accepted: 08/09/2024] [Indexed: 08/26/2024]
Abstract
BACKGROUND Suicide is a leading cause of death globally and a serious public health concern. Childhood trauma has been found to be associated with adult suicide vulnerability. Recent research has turned attention to investigating the role of attachment in the context of the childhood trauma-adult suicide relationship. The current study investigated for the first time whether attachment influences and moderates the childhood trauma-suicidality relationship, using a daily diary design, in the general population. METHODS 481 participants completed questionnaires assessing experiences of childhood trauma, attachment patterns, and history of suicidality. 243 participants continued to a daily diary phase where measures of daily stress, defeat and entrapment were completed for 7 consecutive days. RESULTS Higher levels of childhood trauma were associated with a history of suicide ideation and attempt and also higher levels of daily defeat, entrapment and stress during the 7 day study. Similarly, higher levels of attachment anxiety and avoidance were associated with a history of suicide ideation and attempt together with higher levels of daily defeat, entrapment and stress. However, the effects of childhood trauma on suicide history and on daily suicide vulnerability factors were not moderated by attachment anxiety or avoidance. LIMITATIONS The measure of childhood trauma was a retrospective self-report tool that may be influenced by memory biases. CONCLUSIONS Childhood trauma and insecure attachment are implicated in adult suicide risk. Interventions aimed at mitigating the negative effects of childhood trauma and insecure attachment should also incorporate components that target modifiable risk factors such as defeat, entrapment and stress.
Collapse
Affiliation(s)
- Jasmine K Maydom
- School of Medicine, Division of Psychological and Social Medicine, University of Leeds, UK
| | - Charley Blackwell
- School of Medicine, Division of Psychological and Social Medicine, University of Leeds, UK
| | | |
Collapse
|
2
|
Zartaloudi AE. Adolescent suicide: a major mental health issue in pediatric care. Minerva Pediatr (Torino) 2024; 76:660-678. [PMID: 37947773 DOI: 10.23736/s2724-5276.23.06682-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2023]
Abstract
Adolescent suicide is a major public health problem, as suicide is one of the leading causes of death for adolescents. Predicting and preventing suicide represent very difficult challenges for clinicians. Youth suicide might be prevented by identifying risk factors for adolescent suicidal behavior. Diagnostic assessment involves identification of multiple factors including gender differences, psychopathology, comorbidity, interpersonal problems, family discord, family psychopathology, accessibility of lethal suicide methods, exposure to suicide, previous attempt, social support, life stressors, and protective factors. The literature clearly indicates a need for suicide awareness and prevention programs and for early identification of adolescents at risk for suicidal behaviors. However, many health care professionals who have frequent contact with adolescents are not sufficiently trained in suicide evaluation techniques and approaches to adolescents with suicidal behavior. Pediatricians and other health professionals involved in adolescents' care need more in-depth information about the characteristics and the warning signs for suicide.
Collapse
|
3
|
Salloum A, Boedeker P, Morris C, Storch EA. Suicidal Ideation, Clinical Worsening and Outcomes among Child Participants in Trauma-Focused Treatment. Res Child Adolesc Psychopathol 2024:10.1007/s10802-024-01242-5. [PMID: 39325087 DOI: 10.1007/s10802-024-01242-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/21/2024] [Indexed: 09/27/2024]
Abstract
Research on clinical trajectories of children with suicidal ideation (SI) and clinical worsening (CW) during cognitive behavioral therapy (CBT) for childhood trauma is limited. The current study utilized secondary data from a randomized clinical trial comparing Trauma-Focused CBT versus Stepped care CBT to examine (1) clinical profile and outcomes of children with SI, recurrent thoughts of death/dying, and past attempts; and (2) clinical worsening during treatment and difference in outcomes. Children (ages 4-12) and their parents (N = 183) participated and 132 completed treatment. Interviews assessing SI, thoughts of death/dying, past attempts, and number/type of trauma were conducted with children (ages 7-12) and parents. Outcome measures (baseline and post-treatment) completed by parents included child posttraumatic stress symptoms, impairment, and internalizing and externalizing problems and an independent evaluator rated overall severity. Children (ages 7-12), parents and therapists completed ratings during treatment that indicated CW. Results did not differ by treatment group; thus, the pooled sample was used. Children with SI at baseline had higher severity than children without. For completers, no children (n = 14) with SI at baseline had SI at post-treatment. Child (n = 3) and therapist (n = 5) ratings of CW were low. Eighteen children (13.64%) were rated as CW by parents. Most ratings occurred at the beginning of treatment. Children with therapist ratings of CW had higher internalizing problems. Findings suggest that children with SI and CW can improve from trauma-focused CBT. More research is needed on the clinical trajectory of children with SI and trauma, and on clinical tools to monitor CW. Clinical trial registration information: https://clinicaltrials.gov : NCT02537678.
Collapse
Affiliation(s)
- Alison Salloum
- School of Social Work, University of South Florida, 13301 Bruce B Downs Blvd, Tampa, FL, MHC 1400, USA.
| | - Peter Boedeker
- Department of Education, Innovation and Technology, Baylor College of Medicine, Houston, TX, USA
| | - Cleo Morris
- College of Behavioral and Community Sciences, Cleo Morris, University of South Florida, Tampa, FL, USA
| | - Eric A Storch
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| |
Collapse
|
4
|
Kim S, Dunn N, Moon K, Casement MD, Nam Y, Yeom JW, Cho CH, Lee HJ. Childhood maltreatment and suicide attempts in major depression and bipolar disorders in South Korea: A prospective nationwide cohort study. J Affect Disord 2024; 361:120-127. [PMID: 38851432 DOI: 10.1016/j.jad.2024.06.012] [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: 03/09/2024] [Revised: 05/27/2024] [Accepted: 06/03/2024] [Indexed: 06/10/2024]
Abstract
BACKGROUND Childhood maltreatment (CM) is prevalent among patients with mood disorders and considered an important risk factor for suicide in the general population. Despite mood disorders being implicated in up to 60 % of completed suicides, the predictive role of CM on suicide attempt (SA) among early mood disorder patients remains poorly understood. METHODS We enrolled 480 participants diagnosed with early-onset major depressive disorder (MDD), bipolar I disorder (BD I), and bipolar II disorder (BD II). Over an average of 60 weeks, participants underwent follow-up assessments at 12-week intervals. Using multivariate logistic regression, we examined the association between CM and SA history at baseline. Further, the Cox proportional hazard model assessed the predictive role of childhood maltreatment in SA during follow-up. RESULTS At baseline, 38 % of the total participants reported SA history, with a follow-up prevalence of 10 %. Childhood maltreatment was significantly associated with past SAs and was a robust predictor of future SA, adjusting for relevant clinical risk factors. Emotional abuse and sexual abuse related to SA history, and physical abuse increased future SA risk. LIMITATIONS Potential biases in reporting SA and childhood maltreatment, along with unexplored factors such as additional environmental and familial risks, may affect the study's findings. CONCLUSIONS Childhood maltreatment emerged as a robust predictor of SA among early-onset mood disorder patients. Systematic evaluation of CM early in the clinical process may be crucial for effective risk management. Additionally, our findings highlight the importance of implementing proactive interventions for CM to prevent the onset of adverse psychological trajectories.
Collapse
Affiliation(s)
- Sojeong Kim
- Department of Psychology, University of Oregon, Eugene, USA
| | - Natalie Dunn
- Department of Psychology, University of Oregon, Eugene, USA
| | - Kibum Moon
- Department of Psychology, Georgetown University, Washington, DC, USA
| | | | - Yaerim Nam
- Department of Psychiatry, Korea University College of Medicine, Seoul, Republic of Korea; Korea University Chronobiology Institute, Seoul, Republic of Korea
| | - Ji Won Yeom
- Department of Psychiatry, Korea University College of Medicine, Seoul, Republic of Korea; Korea University Chronobiology Institute, Seoul, Republic of Korea
| | - Chul-Hyun Cho
- Department of Psychiatry, Korea University College of Medicine, Seoul, Republic of Korea; Korea University Chronobiology Institute, Seoul, Republic of Korea; Department of Biomedical Informatics, Korea University College of Medicine, Seoul, Republic of Korea
| | - Heon-Jeong Lee
- Department of Psychiatry, Korea University College of Medicine, Seoul, Republic of Korea; Korea University Chronobiology Institute, Seoul, Republic of Korea.
| |
Collapse
|
5
|
Sheehan AE, Bounoua N, Rose RE, Sadeh N, Javdani S. Profiles of Risk for Self-injurious Thoughts and Behaviors Among System-Impacted Girls of Color. J Am Acad Child Adolesc Psychiatry 2024; 63:898-907. [PMID: 37442206 PMCID: PMC10748794 DOI: 10.1016/j.jaac.2023.06.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 02/11/2023] [Accepted: 06/15/2023] [Indexed: 07/15/2023]
Abstract
OBJECTIVE Suicide is a leading cause of death among youth in custodial settings. Prior research investigating risk factors for suicide among system-impacted youth fail to incorporate an intersectional framework to contextualize suicide risk among system-impacted girls of color. METHOD Profiles of risk for self-injurious thoughts and behaviors (SITBs) were investigated in a sample of 240 racially and ethnically diverse system-impacted girls (mean [SD] age = 14.5 [1.7] years, Hispanic/Latinx 49.6%, Black 37.1%). Participants completed self-report measures evaluating traditional risk factors for suicide (mental health symptoms, trauma exposure) as well as assessments of minority stress (eg, daily discrimination) and recent engagement in SITBs at baseline and 3-month follow-up. RESULTS Latent profile analysis revealed 3 distinct profiles: low-risk, characterized by relatively low levels of suicide risk indicators (n = 102); high-risk internalizing, characterized by elevations in internalizing symptom indicators (n = 96); and high-risk comorbid, characterized by relatively high levels of suicide risk indicators (n = 42). Girls in the high-risk profiles reported more SITBs at baseline and 3-month follow-up than girls in the low-risk profile. CONCLUSION Results suggest that indicators of suicide risk can be used to classify system-impacted girls into profiles that differ concurrently and prospectively on SITBs. Findings could be used to inform more accurate risk and referral assessments for system-impacted girls of color, whose SITB-related challenges may be overlooked or framed as criminal. These findings highlight the continued need for assessments evaluating multiple indicators of risk for SITBs in the juvenile legal system. PLAIN LANGUAGE SUMMARY System-impacted girls of color represent an understudied subset of youth at elevated risk for engagement in self-injurious thoughts and behaviors (SITBs). This study investigated profiles of risk for SITBs in a sample of 240 racially and ethnically diverse system-impacted girls of color (mean age = 14.5 years) utilizing frequently studied factors associated with SITBs, including mental health symptoms and trauma experiences along with understudied risk factors such as minority stress. The authors found that three distinct profiles of risk for SITBs: "Low-Risk," characterized by relatively low levels of suicide risk indicators (n = 102); "High-Risk Internalizing," distinguished by elevations in internalizing symptoms (n = 96); and "High-Risk Comorbid," defined by relatively high levels of internalizing and externalizing symptoms (n = 42). Participants in both high-risk groups had high levels of trauma, minority stress, and were more likely to identify as a member of a sexually minoritized group. DIVERSITY & INCLUSION STATEMENT We worked to ensure race, ethnic, and/or other types of diversity in the recruitment of human participants. We worked to ensure that the study questionnaires were prepared in an inclusive way. One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented racial and/or ethnic groups in science. We actively worked to promote inclusion of historically underrepresented racial and/or ethnic groups in science in our author group.
Collapse
|
6
|
Gruev-Vintila A, Muresan-Vintila L. [Coercive control: Health, victims' rights and the ethics of care]. SOINS; LA REVUE DE REFERENCE INFIRMIERE 2024; 69:16-24. [PMID: 39218516 DOI: 10.1016/j.soin.2024.07.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/04/2024]
Abstract
This article provides healthcare professionals with an overview of research on coercive control, a paramount concept for understanding domestic violence, primarily targeting women and children. It aims to foster interdisciplinary dialogue and integrate advances into professional practices and (psycho)education. To this end, we present the conceptual evolution of coercive control and the perpetrators' behavioral patterns, their risks for victims and professionals, their devastating impact on the rights and biopsychosocial health of adult and child victims, and the challenges posed by technology, particularly generative artificial intelligence.
Collapse
Affiliation(s)
- Andreea Gruev-Vintila
- Laboratoire parisien de psychologie sociale LAPPS, Centre de recherches en éducation et formation, équipe Éducation familiale et interventions sociales, Université Paris Nanterre, 200 avenue de la République, 92001 Nanterre cedex, France.
| | - Laura Muresan-Vintila
- Faculté d'Odontologie, Université Claude-Bernard Lyon 1, Hospices Civils de Lyon, rue Guillaume-Paradin, 69008 Lyon, France
| |
Collapse
|
7
|
Zheng Q, Feng Y, Du J, Xu S, Ma Z, Wang Y. Specific effects of cumulative childhood trauma on suicidality among youths. J Affect Disord 2024; 358:260-269. [PMID: 38705526 DOI: 10.1016/j.jad.2024.05.027] [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: 12/14/2023] [Revised: 02/28/2024] [Accepted: 05/02/2024] [Indexed: 05/07/2024]
Abstract
BACKGROUND Suicidality was very high among individuals who suffered from childhood trauma. The distribution of cumulative childhood trauma among youths remains unclear, as well as the specific effects of cumulative childhood trauma on suicidality. This study attempted to explore the distribution of cumulative childhood trauma and examine the specific effects of cumulative childhood trauma on suicidality. METHODS A cross-sectional design was employed in this study, with 117,769 college students recruited from 63 universities in Jilin Province, China. All variables were measured by corresponding self-report questionnaires. The Venn diagram was used to represent the distribution of single and cumulative childhood trauma. ANOVA and chi-square tests were conducted to identify the high-risk suicide groups. Multiple linear regression analysis was performed to examine risk factors for suicidality for overlapping subtypes. RESULTS 27,671 (23.5%) participants reported suffering from childhood trauma, of which 49.5% were male (Mage = 19.59, SD = 1.76). The "physical neglect" group accounted for the largest proportion (31.5%). Suicidality was the highest in the "overlap of childhood neglect, emotional abuse, and physical abuse" group (2.0%). Depression, obsessive-compulsive disorder, and post-traumatic stress disorder were common risk factors for suicidality. LIMITATIONS This study was limited by cross-sectional studies and self-report bias. CONCLUSIONS The childhood trauma subtype group with the largest proportion was not necessarily the highest suicidality. Both the largest group and the highest-risk suicide group require special attention to their respective risk factors.
Collapse
Affiliation(s)
- Qiaoqing Zheng
- Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, Guangzhou, China; and School of Psychology, Center for Studies of Psychological Application, and Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, China
| | - Yi Feng
- Mental Health Center, Central University of Finance and Economics, Beijing, China
| | - Jinmei Du
- Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, Guangzhou, China; and School of Psychology, Center for Studies of Psychological Application, and Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, China
| | - Shicun Xu
- Northeast Asian Research Center, Jilin University, Changchun, China
| | - Zhihao Ma
- Computational Communication Collaboratory, School of Journalism and Communication, Nanjing University, Nanjing, China
| | - Yuanyuan Wang
- Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, Guangzhou, China; and School of Psychology, Center for Studies of Psychological Application, and Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, China.
| |
Collapse
|
8
|
Zainal NH, Soh CP, Van Doren N. Daily stress reactivity and risk appraisal mediates childhood parental abuse predicting adulthood psychopathology severity: An 18-year longitudinal mediation analysis. J Affect Disord 2024; 358:138-149. [PMID: 38663555 PMCID: PMC11283637 DOI: 10.1016/j.jad.2024.04.068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Revised: 04/07/2024] [Accepted: 04/16/2024] [Indexed: 05/12/2024]
Abstract
Identifying mechanisms of childhood abuse-adulthood psychopathology relations could facilitate preventive efforts, but most prior studies used cross-sectional or two-wave designs and did not test the effects of childhood maternal and paternal abuse separately. Our 18-year three-wave study thus determined if Wave 2 daily stress reactivity and risk appraisal severity mediated Wave 1 retrospectively-reported childhood maternal and paternal abuse on Wave 3 generalized anxiety disorder (GAD), major depressive disorder (MDD), panic disorder (PD), alcohol (AUD), and substance use disorder (SUD) self-rated symptom severity. Longitudinal structural equation modeling was employed, adjusting for Wave 1 psychopathology severity. Higher childhood maternal and paternal abuse consistently predicted greater future daily stress reactivity and risk appraisal, and these mediators subsequently predicted increased GAD, MDD, and PD, but not AUD and SUD severity. Daily stress reactivity and risk appraisal consistently mediated the pathways between childhood maternal and paternal abuse predicting heightened adulthood GAD, MDD, and PD (Cohen's d = 0.333-0.888) but not AUD and SUD severity. Mediation effect sizes were stronger for childhood maternal (24.5-83.0%) than paternal (19.5-56.0%) abuse as the predictor. The latent interaction between Wave 1 childhood maternal and paternal abuse did not moderate the effect of Wave 1 maternal or paternal abuse on any Wave 3 adulthood psychopathology severity through Wave 2 daily stress reactivity and risk appraisal. Our research emphasizes the urgent requirement for continuous evaluation and intervention initiatives in trauma-informed care, both in inpatient and outpatient treatment settings.
Collapse
Affiliation(s)
- Nur Hani Zainal
- Harvard Medical School, Department of Health Care Policy, United States of America; National University of Singapore, Department of Psychology, Singapore.
| | - Chui Pin Soh
- National University of Singapore, Department of Psychology, Singapore
| | - Natalia Van Doren
- University of California at San Francisco, Department of Psychiatry and Behavioral Sciences, United States of America
| |
Collapse
|
9
|
Pemau A, Marin-Martin C, Diaz-Marsa M, de la Torre-Luque A, Ayad-Ahmed W, Gonzalez-Pinto A, Garrido-Torres N, Garrido-Sanchez L, Roberto N, Lopez-Peña P, Mar-Barrutia L, Grande I, Guinovart M, Hernandez-Calle D, Jimenez-Treviño L, Lopez-Sola C, Mediavilla R, Perez-Aranda A, Ruiz-Veguilla M, Seijo-Zazo E, Toll A, Elices M, Perez-Sola V, Ayuso-Mateos JL. Risk factors for suicide reattempt: a systematic review and meta-analysis. Psychol Med 2024; 54:1897-1904. [PMID: 38623694 DOI: 10.1017/s0033291724000904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/17/2024]
Abstract
BACKGROUND Suicide is one of the main external causes of death worldwide. People who have already attempted suicide are at high risk of new suicidal behavior. However, there is a lack of information on the risk factors that facilitate the appearance of reattempts. The aim of this study was to calculate the risk of suicide reattempt in the presence of suicidal history and psychosocial risk factors and to estimate the effect of each individual risk factor. METHODS This systematic review and meta-analysis were conducted following the PRISMA-2020 guidelines. Studies on suicide reattempt that measured risk factors were searched from inception to 2022. The risk factors studied were those directly related to suicide history: history of suicide prior to the index attempt, and those that mediate the transition from suicidal ideation to attempt (alcohol or drug misuse, impulsivity, trauma, and non-suicidal self-injury). RESULTS The initial search resulted in 11 905 articles. Of these, 34 articles were selected for this meta-analysis, jointly presenting 52 different effect sizes. The pooled effect size across the risk factors was significant (OR 2.16). Reattempt risk may be increased in presence of any of the following risk factors: previous history, active suicidal ideation, trauma, alcohol misuse, and drug misuse. However, impulsivity, and non-suicidal self-injury did not show a significant effect on reattempt. CONCLUSION Most of the risk factors traditionally associated with suicide are also relevant when talking about suicide reattempts. Knowing the traits that define reattempters can help develop better preventive and intervention plans.
Collapse
Affiliation(s)
- Andres Pemau
- Universidad Complutense de Madrid, Madrid, Spain
| | | | - Marina Diaz-Marsa
- San Carlos University Clinic Hospital, Madrid, Spain
- Araba University Hospital, Vitoria, Spain
| | - Alejandro de la Torre-Luque
- Universidad Complutense de Madrid, Madrid, Spain
- Centre for Biomedical Research in Mental Health (CIBERSAM), Madrid, Spain
| | | | - Ana Gonzalez-Pinto
- Centre for Biomedical Research in Mental Health (CIBERSAM), Madrid, Spain
- Araba University Hospital, Vitoria, Spain
- University of the Basque Country, Bilbao, Spain
| | - Nathalia Garrido-Torres
- Centre for Biomedical Research in Mental Health (CIBERSAM), Madrid, Spain
- Virgen del Rocio University Hospital, Seville, Spain
- Seville Biomedical Research Institute (IBiS), Seville, Spain
| | | | - Natalia Roberto
- Bipolar and Depressive Disorders Unit, Hospital Clinic de Barcelona, Barcelona, Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona (UB), Barcelona, Spain
| | - Purificación Lopez-Peña
- Centre for Biomedical Research in Mental Health (CIBERSAM), Madrid, Spain
- Araba University Hospital, Vitoria, Spain
- University of the Basque Country, Bilbao, Spain
- BIOARABA, Vitoria, Spain
| | - Lorea Mar-Barrutia
- Centre for Biomedical Research in Mental Health (CIBERSAM), Madrid, Spain
- Araba University Hospital, Vitoria, Spain
- University of the Basque Country, Bilbao, Spain
- BIOARABA, Vitoria, Spain
| | - Iria Grande
- Centre for Biomedical Research in Mental Health (CIBERSAM), Madrid, Spain
- Bipolar and Depressive Disorders Unit, Hospital Clinic de Barcelona, Barcelona, Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona (UB), Barcelona, Spain
| | - Marti Guinovart
- Institut d'Investigacio i Innovacio ParcTauli (I3PT), Barcelona, Spain
- Autonomous University of Barcelona, Barcelona, Spain
| | - Daniel Hernandez-Calle
- La Paz University Hospital, Madrid, Spain
- Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain
| | - Luis Jimenez-Treviño
- Centre for Biomedical Research in Mental Health (CIBERSAM), Madrid, Spain
- Servicio de Salud del Principado de Asturias (SESPA), Oviedo, Spain
- Principado de Asturias Health Research Institute (ISPA), Oviedo, Spain
- University of Oviedo, Oviedo, Spain
- Principado de Asturias Neuroscience Research Institute (INEUROPA), Oviedo, Spain
| | - Clara Lopez-Sola
- Centre for Biomedical Research in Mental Health (CIBERSAM), Madrid, Spain
- Bipolar and Depressive Disorders Unit, Hospital Clinic de Barcelona, Barcelona, Spain
| | - Roberto Mediavilla
- Centre for Biomedical Research in Mental Health (CIBERSAM), Madrid, Spain
- Autonomous University of Madrid, Madrid, Spain
| | | | - Miguel Ruiz-Veguilla
- Centre for Biomedical Research in Mental Health (CIBERSAM), Madrid, Spain
- Virgen del Rocio University Hospital, Seville, Spain
- Seville Biomedical Research Institute (IBiS), Seville, Spain
- University of Seville, Seville, Spain
| | - Elisa Seijo-Zazo
- Servicio de Salud del Principado de Asturias (SESPA), Oviedo, Spain
- Principado de Asturias Health Research Institute (ISPA), Oviedo, Spain
- University of Oviedo, Oviedo, Spain
- Principado de Asturias Neuroscience Research Institute (INEUROPA), Oviedo, Spain
| | - Alba Toll
- Autonomous University of Barcelona, Barcelona, Spain
- Neurosciences Research Unit, IMIM-Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain
| | - Matilde Elices
- Centre for Biomedical Research in Mental Health (CIBERSAM), Madrid, Spain
- Autonomous University of Barcelona, Barcelona, Spain
- Neurosciences Research Unit, IMIM-Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain
| | - Victor Perez-Sola
- Centre for Biomedical Research in Mental Health (CIBERSAM), Madrid, Spain
- Neurosciences Research Unit, IMIM-Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain
- Hospital de Mar, Mental Health Institute, Barcelona, Spain
- Department of Experimental and Health Sciences, Pompeu Fabra University, Barcelona, Spain
| | - Jose Luis Ayuso-Mateos
- Centre for Biomedical Research in Mental Health (CIBERSAM), Madrid, Spain
- Autonomous University of Madrid, Madrid, Spain
| |
Collapse
|
10
|
Schiff SJ, Meza J, Bath E, Lee SS. Commercially Sexually Exploited Adolescent Girls: The Association Between Externalizing Disorders and Parental Incarceration with Suicide Attempts. Child Psychiatry Hum Dev 2024:10.1007/s10578-024-01730-1. [PMID: 38935209 DOI: 10.1007/s10578-024-01730-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/12/2024] [Indexed: 06/28/2024]
Abstract
Commercial sexual exploitation (CSE) is a significant public health concern disproportionately affecting ethnoracially minoritized girls. Despite strong associations of CSE with suicide attempts, little is known about correlates of suicide among girls with CSE histories. Elevated rates of externalizing disorders (i.e., attention-deficit/hyperactivity disorder [ADHD], disruptive behavior disorders [DBD], conduct disorder [CD]) were observed among CSE youth, particularly in ethnoracially minoritized samples. Youth with CSE histories are frequently affected by parental incarceration, which is correlated with risk for suicide attempts. We tested cross-sectional simultaneous associations of externalizing disorders and parental incarceration with number of suicide attempts among 360 ethnoracially diverse girls affected by CSE (Mean age = 18.86). ADHD, DBD, and maternal incarceration were positively associated with number of suicide attempts. Findings implicate clinical/familial correlates of suicide attempts in this marginalized group, suggesting early suicide prevention efforts may improve traction on this problem by focusing on individual and family level factors.
Collapse
Affiliation(s)
- Sara J Schiff
- Department of Psychology, University of California Los Angeles, 502 Portola Plaza, Franz Hall, Los Angeles, CA, 90095-1563, USA.
| | - Jocelyn Meza
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Eraka Bath
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Steve S Lee
- Department of Psychology, University of California Los Angeles, 502 Portola Plaza, Franz Hall, Los Angeles, CA, 90095-1563, USA
| |
Collapse
|
11
|
Arango A, Brent D, Grupp-Phelan J, Barney BJ, Spirito A, Mroczkowski MM, Shenoi R, Mahabee-Gittens M, Casper TC, King C. Social connectedness and adolescent suicide risk. J Child Psychol Psychiatry 2024; 65:785-797. [PMID: 37926560 PMCID: PMC11069595 DOI: 10.1111/jcpp.13908] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/08/2023] [Indexed: 11/07/2023]
Abstract
BACKGROUND Despite evidence of the importance of interpersonal connectedness to our understanding of suicide risk, relatively little research has examined the protective and buffering effects of connectedness among adolescents. The aims of this study were to determine: (a) whether overall connectedness (composite of family, peer, and school) and specific domains of connectedness were related to a lower likelihood of suicide attempts, and (b) whether these factors buffer the prospective risk of suicide attempt for high-risk subgroups (i.e., recent suicidal ideation and/or lifetime history of suicide attempt, peer victimization, or sexual and gender minority status). METHODS Participants were 2,897 adolescents (64.7% biological female), ages 12 to 17 (M = 14.6, SD = 1.6), recruited in collaboration with the Pediatric Emergency Care Applied Research Network (PECARN) from 14 emergency departments for the Emergency Department Screen for Teens at Risk for Suicide Study (ED-STARS). Suicide risk and protective factors were assessed at baseline; 3- and 6-month follow-ups were completed (79.5% retention). Multivariable logistic regressions were conducted, adjusting for established suicide risk factors. RESULTS Higher overall connectedness and, specifically, school connectedness were associated with decreased likelihood of a suicide attempt across 6 months. Overall connectedness and connectedness domains did not function as buffers for future suicide attempts among certain high-risk subgroups. The protective effect of overall connectedness was lower for youth with recent suicidal ideation or a suicide attempt history than for those without this history. Similarly, overall connectedness was protective for youth without peer victimization but not those with this history. Regarding specific domains, family connectedness was protective for youth without recent suicidal ideation or a suicide attempt history and peer connectedness was protective for youth without peer victimization but not youth with these histories. CONCLUSIONS In this large and geographically diverse sample, overall and school connectedness were related prospectively to lower likelihood of suicide attempts, and connectedness was more protective for youth not in certain high-risk subgroups. Results inform preventive efforts aimed at improving youth connectedness and reducing suicide risk.
Collapse
Affiliation(s)
| | - David Brent
- Department of Psychiatry, University of Pittsburgh
| | | | | | - Anthony Spirito
- Department of Psychiatry and Human Behavior, Brown University
| | | | - Rohit Shenoi
- Department of Pediatrics, Baylor College of Medicine
| | | | | | - Cheryl King
- Department of Psychiatry, University of Michigan
| | | |
Collapse
|
12
|
Dong H, Wang Y, Jiang F, Yang F, Li J, Xiao Q, Ou J, Shen Y. Incidence and correlates of suicide attempts in adolescents with major depressive versus bipolar disorders: A cross-sectional study. J Affect Disord 2024; 354:247-252. [PMID: 38461897 DOI: 10.1016/j.jad.2024.03.021] [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: 10/26/2023] [Revised: 02/02/2024] [Accepted: 03/07/2024] [Indexed: 03/12/2024]
Abstract
BACKGROUND Major depressive disorders (MDD) and bipolar disorders (BD) are the most common psychiatric diagnoses of suicide attempts (SA) in adolescents. However, little is known regarding the differences in incidence and clinical-related features of SA between these two disorders. The study aims to examine the SA incidence and related factors in adolescents with MDD versus BD. METHOD A retrospective survey was conducted in outpatients. SA incidence, demographic characteristics and substance use history were collected. Symptom Checklist-90 was used to measure the severity of symptoms. The Revised Chinese internet addiction scale and Barratt Impulsiveness Scale-11 were utilized to assess the presence of internet addiction and impulsiveness. The Childhood Trauma Questionnaire was used to measure childhood maltreatment subtypes. RESULTS 295 MDD and 205 BD adolescents were recruited. The incidence of SA for MDD and BD were 52.5 % and 56.4 %, respectively. BD adolescents who attempted suicide showed worse symptoms, higher rates of nicotine and alcohol use, higher motor and non-planning impulsivity, and a more childhood physical abuse proportion than MDD adolescents with SA. Physical abuse in childhood was found to be associated with SA in both disorders (OR = 1.998 for MDD; OR = 2.275 for BD), while higher anxiety (OR = 1.705), and alcohol use (OR = 2.094) were only associated with SA in MDD. LIMITATIONS Retrospective, cross-sectional design cannot draw causality, and biases in self-report measurements cannot be ignored. CONCLUSIONS The findings revealed some difference between BD and MDD for adolescents with SA, and it emphasize significance of prompt identification and exact distinction between BD and MDD in adolescents.
Collapse
Affiliation(s)
- Huixi Dong
- Mental Health Center of Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Ying Wang
- Mental Health Center of Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Furong Jiang
- Mental Health Center of Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Fangru Yang
- Mental Health Center of Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Jianling Li
- Mental Health Center of Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Qian Xiao
- Mental Health Center of Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Jianjun Ou
- Department of Psychiatry, and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Yidong Shen
- Department of Psychiatry, and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China.
| |
Collapse
|
13
|
Edwards AC, Ohlsson H, Salvatore JE, Stephenson ME, Crump C, Sundquist J, Sundquist K, Kendler KS. Divorce and risk of suicide attempt: a Swedish national study. Psychol Med 2024; 54:1620-1628. [PMID: 38084643 DOI: 10.1017/s0033291723003513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/26/2024]
Abstract
BACKGROUND Prior research has reported an association between divorce and suicide attempt. We aimed to clarify this complex relationship, considering sex differences, temporal factors, and underlying etiologic pathways. METHODS We used Swedish longitudinal national registry data for a cohort born 1960-1990 that was registered as married between 1978 and 2018 (N = 1 601 075). We used Cox proportional hazards models to estimate the association between divorce and suicide attempt. To assess whether observed associations were attributable to familial confounders or potentially causal in nature, we conducted co-relative analyses. RESULTS In the overall sample and in sex-stratified analyses, divorce was associated with increased risk of suicide attempt (adjusted hazard ratios [HRs] 1.66-1.77). Risk was highest in the year immediately following divorce (HRs 2.20-2.91) and declined thereafter, but remained elevated 5 or more years later (HRs 1.41-1.51). Divorcees from shorter marriages were at higher risk for suicide attempt than those from longer marriages (HRs 3.33-3.40 and 1.20-1.36, respectively). In general, HRs were higher for divorced females than for divorced males. Co-relative analyses suggested that familial confounders and a causal pathway contribute to the observed associations. CONCLUSIONS The association between divorce and risk of suicide attempt is complex, varying as a function of sex and time-related variables. Given evidence that the observed association is due in part to a causal pathway from divorce to suicide attempt, intervention or prevention efforts, such as behavioral therapy, could be most effective early in the divorce process, and in particular among females and those whose marriages were of short duration.
Collapse
Affiliation(s)
- Alexis C Edwards
- Department of Psychiatry, Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University School of Medicine, Richmond, VA, USA
| | - Henrik Ohlsson
- Center for Primary Health Care Research, Lund University, Malmö, Sweden
| | - Jessica E Salvatore
- Department of Psychiatry, Robert Wood Johnson Medical School, Rutgers University, Piscataway, NJ, USA
| | - Mallory E Stephenson
- Department of Psychiatry, Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University School of Medicine, Richmond, VA, USA
| | - Casey Crump
- Department of Family Medicine and Community Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Jan Sundquist
- Center for Primary Health Care Research, Lund University, Malmö, Sweden
- Department of Family Medicine and Community Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Kristina Sundquist
- Center for Primary Health Care Research, Lund University, Malmö, Sweden
- Department of Family Medicine and Community Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Kenneth S Kendler
- Department of Psychiatry, Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University School of Medicine, Richmond, VA, USA
| |
Collapse
|
14
|
Kim B, Royle M. Annual Research Review: Mapping the multifaceted approaches and impacts of adverse childhood experiences - an umbrella review of meta-analyses. J Child Psychol Psychiatry 2024. [PMID: 38772385 DOI: 10.1111/jcpp.14022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/07/2024] [Indexed: 05/23/2024]
Abstract
Adverse childhood experiences (ACEs) significantly impact lifelong health and well-being. Despite extensive research, a comprehensive understanding of ACEs' multifaceted impacts continues to be challenging to achieve. This study synthesizes meta-analytic evidence to provide a comprehensive view of ACEs' effects, addressing various approaches to conceptualizing ACEs and their diverse outcomes. Employing an umbrella synthesis methodology, this review integrated findings from 99 meta-analyses involving 592 effect sizes. We examined ACEs through specificity, lumping, dimensional, and child maltreatment-centric approaches, assessing their impact across six domains: biological system dysregulation, neuropsychological impairments, physical health complications, mental health conditions, social and behavioral challenges, and criminal justice involvement. The findings reveal a small to moderate overall effect size of ACEs across outcome domains. Specific ACE approaches exhibited varying impact levels, with notable differences in effects on mental health, social/behavioral issues, and criminal justice involvement. When ACEs were aggregated without distinguishing between different types, but with consideration of their cumulative effects, adverse outcomes were significantly exacerbated. The child maltreatment-centric approach consistently demonstrated substantial effects across all evaluated domains. This review underscores the heterogeneity in ACEs' impacts, influenced by the type of ACE and specific outcomes considered. It highlights the necessity for comprehensive approaches to understanding, preventing, and mitigating the effects of ACEs. These insights are vital for developing targeted interventions and informing policy-making, emphasizing the complexity and varied nature of ACEs' influence on individual development and societal well-being.
Collapse
Affiliation(s)
- Bitna Kim
- College of Criminal Justice, Sam Houston State University, Huntsville, TX, USA
| | - Meghan Royle
- College of Criminal Justice, Sam Houston State University, Huntsville, TX, USA
| |
Collapse
|
15
|
Gomes KD, Collette TL, Schlenk M, Judkins J, Sanchez-Cardona I, Channer B, Ross P, Fredrick G, Moore BA. Posttraumatic Stress Disorder, Suicidal ideation, and Stress: The Moderating Role of Dysfunctional and Recovery Cognitions. Arch Suicide Res 2024; 28:569-584. [PMID: 37073774 DOI: 10.1080/13811118.2023.2199798] [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] [Indexed: 04/20/2023]
Abstract
OBJECTIVE Trauma and stressor-related behavioral health conditions are prevalent in military populations and have become a major public health concern in recent years. Individuals who commonly report suicidal ideation often have comorbid mental health diagnoses (i.e., posttraumatic stress disorder; PTSD). However, the mechanisms associated with stress, suicidal ideation, and PTSD are unclear. METHOD The present study examined the moderating role of dysfunctional and recovery cognitions between (i) PTSD and suicidal ideation, and (ii) stress and suicidal ideation in two distinct samples. Sample 1 was composed of civilians and military personnel (N = 322). Sample 2 was composed of (N = 377) student service members and veterans (SSM/Vs). RESULTS In Study 1, we found that low recovery cognitions at higher and moderate levels of PTSD symptoms were significantly associated with increased suicidal ideation. High dysfunctional cognitions were significantly associated with suicidal ideation at higher levels of PTSD symptoms. In Study 2, we found no differences in any level of recovery cognitions at low and moderate stress levels with suicidal ideation. Higher levels of stress were associated with high dysfunctional cognitions and suicidal ideation. CONCLUSION Promoting higher levels of recovery cognitions and reducing dysfunctional cognitions are important in addressing stress, suicidal ideation, and comorbid conditions such as PTSD. Future research should focus on examining the clinical utility of the Dispositional Recovery and Dysfunction Inventory (DRDI) in other populations (i.e., firefighters and paramedics). This could contribute to efforts of suicide prevention and the promotion of the well-being of individuals experiencing suicidal ideation.
Collapse
|
16
|
Serbanescu I, Schramm E, Walter H, Schnell K, Zobel I, Drost S, Fangmeier T, Normann C, Schoepf D. Identifying subgroups with differential response to CBASP versus Escitalopram during the first eight weeks of treatment in outpatients with persistent depressive disorder. Eur Arch Psychiatry Clin Neurosci 2024; 274:723-737. [PMID: 37606728 PMCID: PMC10995028 DOI: 10.1007/s00406-023-01672-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Accepted: 08/08/2023] [Indexed: 08/23/2023]
Abstract
There exists little empirical evidence helping clinicians to select the most effective treatment for individual patients with persistent depressive disorder (PDD). This study identifies and characterizes subgroups of patients with PDD who are likely to benefit more from an acute treatment with psychotherapy than from pharmacotherapy and vice versa. Non-medicated outpatients with PDD were randomized to eight weeks of acute treatment with the Cognitive Behavioral Analysis System of Psychotherapy (CBASP; n = 29) or escitalopram plus clinical management (ESC/CM; n = 31). We combined several baseline variables to one composite moderator and identified two subgroups of patients: for 56.0%, ESC/CM was associated with a greater reduction in depression severity than CBASP, for the remaining 44.0%, it was the other way around. Patients likely to benefit more from ESC/CM were more often female, had higher rates of moderate-to-severe childhood trauma, more adverse life events and more previous suicide attempts. Patients likely to benefit more from CBASP were older, had more often an early illness onset and more previous treatments with antidepressants. Symptomatic response, remission, and reductions in symptom severity occurred more often in those patients treated with their likely more effective treatment condition. The findings suggest that the baseline phenotype of patients with PDD moderates their benefit from acute treatment with CBASP relative to ESC/CM. Once confirmed in an independent sample, these results could serve to guide the choice between primarily psychotherapeutic or pharmacological treatments for outpatients with PDD.
Collapse
Affiliation(s)
- Ilinca Serbanescu
- Institute of Psychology, Heidelberg University, Hauptstrasse 47-51, 69117, Heidelberg, Germany.
| | - Elisabeth Schramm
- Department of Psychiatry and Psychotherapy, Medical Center, Faculty of Medicine, University of Freiburg, Hauptstrasse 5, 79104, Freiburg, Germany
| | - Henrik Walter
- Department of Psychiatry and Psychotherapy, Charité-University Medicine Berlin, Charitéplatz 1, 10117, Berlin, Germany
| | - Knut Schnell
- Department of Psychiatry and Psychotherapy, University Medical Center Göttingen, Rosdorfer Weg 70, 37081, Göttingen, Germany
| | - Ingo Zobel
- Psychology School at the Fresenius University of Applied Sciences Berlin, Jägerstrasse 32, 10117, Berlin, Germany
| | - Sarah Drost
- Department of Psychiatry and Psychotherapy, CBASP Center of Competence, University Medical Center Bonn, Sigmund-Freud-Strasse 25, 53127, Bonn, Germany
| | - Thomas Fangmeier
- Department of Psychiatry and Psychotherapy, Medical Center, Faculty of Medicine, University of Freiburg, Hauptstrasse 5, 79104, Freiburg, Germany
| | - Claus Normann
- Department of Psychiatry and Psychotherapy, Medical Center, Faculty of Medicine, University of Freiburg, Hauptstrasse 5, 79104, Freiburg, Germany
| | - Dieter Schoepf
- Department of Psychiatry and Psychotherapy, CBASP Center of Competence, University Medical Center Bonn, Sigmund-Freud-Strasse 25, 53127, Bonn, Germany
| |
Collapse
|
17
|
Kisely S, Bull C, Trott M, Arnautovska U, Siskind D, Warren N, Najman JM. Emergency department presentations for deliberate self-harm and suicidal ideation in 25-39 years olds following agency-notified child maltreatment: results from the Childhood Adversity and Lifetime Morbidity (CALM) study. Epidemiol Psychiatr Sci 2024; 33:e18. [PMID: 38532726 PMCID: PMC11022258 DOI: 10.1017/s2045796024000192] [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: 11/14/2023] [Revised: 02/12/2024] [Accepted: 02/19/2024] [Indexed: 03/28/2024] Open
Abstract
AIMS To compare prospective reports of child maltreatment (CM) with emergency department (ED) presentations for deliberate self-harm (DSH) and suicidal ideation in individuals aged between 25 and 39 years old. METHODS Linked records between the Mater-University of Queensland Study of Pregnancy birth cohort and Queensland administrative health data were used, which included notifications to child protection agencies for CM. ED presentations for individuals aged between 25 and 39 years of age for suicidal ideation, suicidal behaviour or poisoning by paracetamol or psychotropic medications where the intention was unclear were examined using logistic regression analyses. RESULTS A total of 609 (10.1%) individuals were the subject of one or more CM notifications for neglect or physical, sexual or emotional abuse before the age of 15 years. Of these, 250 (4.1%) presented at least once to ED for DSH and/or suicidal ideation between 25 and 39 years of age. In adjusted analysis, any notification of CM was associated with significantly increased odds of presenting to ED for these reasons (aOR = 2.80; 95% CI = 2.04-3.84). In sensitivity analyses, any notification of CM increased the odds of the combined outcome of DSH and suicidal ideation by 275% (aOR = 2.75; 95% CI = 1.96-4.06) and increased the odds of DSH alone by 269% (aOR = 2.69; 95% CI = 1.65-4.41). CONCLUSIONS All CM types (including emotional abuse and neglect) were associated with ED presentations for DSH and suicidal ideation in individuals between 25 and 39 years of age. These findings have important implications for the prevention of DSH, suicidal ideation and other health outcomes. They also underscore the importance of trauma-informed care in ED for all individuals presenting with DSH and suicidal ideation.
Collapse
Affiliation(s)
- S. Kisely
- Princess Alexandra Hospital Southside Clinical Unit, Greater Brisbane Clinical School, Medical School, The University of Queensland, Woolloongabba, QLD, Australia
- Departments of Psychiatry, Community Health and Epidemiology, Dalhousie University, Halifax, NS, Canada
- Metro South Addiction and Mental Health Service, Brisbane, QLD, Australia
| | - C. Bull
- Princess Alexandra Hospital Southside Clinical Unit, Greater Brisbane Clinical School, Medical School, The University of Queensland, Woolloongabba, QLD, Australia
- Metro South Addiction and Mental Health Service, Brisbane, QLD, Australia
| | - M. Trott
- Princess Alexandra Hospital Southside Clinical Unit, Greater Brisbane Clinical School, Medical School, The University of Queensland, Woolloongabba, QLD, Australia
- Metro South Addiction and Mental Health Service, Brisbane, QLD, Australia
| | - U. Arnautovska
- Princess Alexandra Hospital Southside Clinical Unit, Greater Brisbane Clinical School, Medical School, The University of Queensland, Woolloongabba, QLD, Australia
- Metro South Addiction and Mental Health Service, Brisbane, QLD, Australia
| | - D. Siskind
- Princess Alexandra Hospital Southside Clinical Unit, Greater Brisbane Clinical School, Medical School, The University of Queensland, Woolloongabba, QLD, Australia
- Metro South Addiction and Mental Health Service, Brisbane, QLD, Australia
| | - N. Warren
- Princess Alexandra Hospital Southside Clinical Unit, Greater Brisbane Clinical School, Medical School, The University of Queensland, Woolloongabba, QLD, Australia
- Metro South Addiction and Mental Health Service, Brisbane, QLD, Australia
| | - J. Moses Najman
- School of Public Health, The University of Queensland, Herston, QLD, Australia
- School of Social Sciences, The University of Queensland, St Lucia, QLD, Australia
| |
Collapse
|
18
|
Shi X, Meng Y, Cheng B, Long L, Yin L, Ye A, Yi X, Ran M. Association between traumatic events with suicidality among adolescents: A large-scale cross-sectional study of 260,423 participants. Psychiatry Res 2024; 333:115762. [PMID: 38310687 DOI: 10.1016/j.psychres.2024.115762] [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: 07/23/2023] [Revised: 01/22/2024] [Accepted: 01/26/2024] [Indexed: 02/06/2024]
Abstract
Traumatic events have significant negative impacts throughout one's life. We aimed to comprehensively examine the early associations between traumatic events and suicidality among adolescents. In a cross-sectional sample of 260,423 adolescents in Deyang, China in September 2021, we assessed individual traumatic events, cumulative types, and patterns, alongside suicide risk scores and ideation, attempts, or plans. Linear and Poisson regression models adjusted for demographic confounders evaluated the association. Robust associations existed between interpersonal violence-related traumatic events and higher suicidality, with physical abuse demonstrating the strongest correlation. Moreover, suicide risk scores displayed a clear trend, indicating a progressively stronger association with suicidality as cumulative traumatic event types increased. Four distinct traumatic patterns emerged, including low traumas, high physical abuse, high death/serious injuries of a loved one, and multiple traumas, with the latter showing the strongest association with suicidality. Notably, the stratified analysis showed these associations were more pronounced in females, urban residents, only children, left-behind children, and those aged 13-15, while weaker in participants from families with intact parental relationships and middle socioeconomic status. Understanding the role of demographic factors and traumatic patterns in identifying at-risk youth can enable early detection and targeted interventions for suicide-related concerns.
Collapse
Affiliation(s)
- Xinyi Shi
- Mental Health Center, West China Hospital of Sichuan University, Chengdu, Sichuan, PR China
| | - Yajing Meng
- Mental Health Center, West China Hospital of Sichuan University, Chengdu, Sichuan, PR China.
| | - Bochao Cheng
- Department of Radiology, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, PR China
| | - Lu Long
- Department of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, PR China
| | - Li Yin
- Mental Health Center, West China Hospital of Sichuan University, Chengdu, Sichuan, PR China
| | - Anhong Ye
- Mental Health Center, Zigong Hospital Affiliated to Southwest Medical University, Zigong, Sichuan, PR China
| | - Xingjian Yi
- Department of Psychosomatic Medicine, Dazhou Yuanda United Hospital, Dazhou, Sichuan, PR China
| | - Maosheng Ran
- Mental Health Center, West China Hospital of Sichuan University, Chengdu, Sichuan, PR China
| |
Collapse
|
19
|
Zhong W, Liang Q, Yang A, Yan R. Why emotional neglect brings suicidal ideation? The mediating effect of meaning in life and the moderating effect of post-stress growth. CHILD ABUSE & NEGLECT 2024; 149:106700. [PMID: 38382400 DOI: 10.1016/j.chiabu.2024.106700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 02/05/2024] [Accepted: 02/09/2024] [Indexed: 02/23/2024]
Abstract
BACKGROUND Emotional neglect during childhood has long-lasting negative effects on individuals, and it is often hidden and unrecognized. Previous research has not fully understood its unique effects on mental health outcomes, especially when considering the co-occurrence with other forms of maltreatment. The meaning-making coping and growth model suggests that individuals achieve positive psychological outcomes by constructively integrating negative experiences into their self-concept, which may be a protective mechanism against the detrimental effects of emotional neglect. OBJECTIVE This study aimed to examine the relationship between emotional neglect and suicidal ideation among undergraduates, accounting for the presence of emotional abuse and physical neglect, and to investigate the mediating role of meaning in life and the moderating role of post-stress growth in this relationship. METHODS A self-reported survey was conducted with 3132 undergraduate students from a university in South China. The survey assessed emotional neglect, emotional abuse, physical neglect, suicidal ideation, post-stress growth, and meaning in life. RESULTS Meaning in life partially mediated the relationship between emotional neglect and suicidal ideation. Post-stress growth moderated the association between emotional neglect and the sense of meaning in life, in particular the moderation effect was stronger when emotional abuse was weaker. CONCLUSIONS Meaning in life mediated the relationship between emotional neglect and suicide ideation. Post-stress growth moderated the mediation effect such that it was weakened among individual with a higher level of post-stress growth. This study contributes to the understanding of the psychopathological processes following emotional neglect and the development of positive personal changes thereafter.
Collapse
Affiliation(s)
- Weiwei Zhong
- Mental Health Education and Consultation Center, Guangdong University of Foreign Studies, Guangzhou, Guangdong 510420, China
| | - Qianrong Liang
- School of Finance, Guangdong University of Foreign Studies, Guangzhou, Guangdong 510420, China; Institute of Analytical Psychology, Faculty of Humanities and Social Sciences, City University of Macau, Macau 999078, China
| | - An Yang
- Department of Applied Psychology, Guangdong University of Foreign Studies, Guangzhou, Guangdong 510420, China.
| | - Ru Yan
- Mental Health Education and Consultation Center, Guangdong University of Foreign Studies, Guangzhou, Guangdong 510420, China.
| |
Collapse
|
20
|
Sánchez-Carro Y, de la Torre-Luque A, Díaz-Marsá M, Aguayo-Estremera R, Andreo-Jover J, Ayad-Ahmed W, Bobes J, Bobes-Bascarán T, Bravo-Ortiz MF, Canal-Rivero M, Cebrià AI, Crespo-Facorro B, Elices M, Fernández-Rodrigues V, Lopez-Peña P, Grande I, Palao-Tarrero Á, Pemau A, Roberto N, Ruiz-Veguilla M, Pérez-Solà V. Psychiatric profiles in suicidal attempters: Relationships with suicide behaviour features. SPANISH JOURNAL OF PSYCHIATRY AND MENTAL HEALTH 2024:S2950-2853(24)00011-5. [PMID: 38331321 DOI: 10.1016/j.sjpmh.2024.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 01/17/2024] [Accepted: 01/22/2024] [Indexed: 02/10/2024]
Abstract
BACKGROUND Suicide constitutes a major health concern worldwide, being a significant contributor of death, globally. The diagnosis of a mental disorder has been extensively linked to the varying forms of suicidal ideation and behaviour. The aim of our study was to identify the varying diagnostic profiles in a sample of suicide attempters. METHODS A sample of 683 adults (71.3% females, 40.10±15.74 years) admitted at a hospital emergency department due to a suicide attempt was recruited. Latent class analysis was used to identify diagnostic profiles and logistic regression to study the relationship between comorbidity profile membership and sociodemographic and clinical variables. RESULTS Two comorbidity profiles were identified (Class I: low comorbidity class, 71.3% of attempters; Class II: high comorbidity class, 28.7% of attempters). Class I members were featured by the diagnosis of depression and general anxiety disorder, and low comorbidity; by contrast, the high comorbidity profile was characterized by a higher probability of presenting two or more coexisting psychiatric disorders. Class II included more females, younger, with more depressive symptoms and with higher impulsivity levels. Moreover, Class II members showed more severe suicidal ideation, higher number of suicide behaviours and a greater number of previous suicide attempts (p<.01, for all the outcomes), compared to Class I members. CONCLUSIONS Psychiatric profiles may be considered for treatment provision and personalized psychiatric treatment in suicidal attempters as well as tackle suicide risk.
Collapse
Affiliation(s)
- Yolanda Sánchez-Carro
- Department of Psychiatry, Universidad Autónoma de Madrid, Madrid, Spain; CIBERSAM ISCIII, Madrid, Spain
| | | | - Marina Díaz-Marsá
- CIBERSAM ISCIII, Madrid, Spain; Universidad Complutense de Madrid, Madrid, Spain; Hospital Clinico San Carlos, Madrid, Spain.
| | | | - Jorge Andreo-Jover
- Department of Psychiatry, Universidad Autónoma de Madrid, Madrid, Spain; Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain
| | | | | | - Teresa Bobes-Bascarán
- CIBERSAM ISCIII, Madrid, Spain; Universidad de Oviedo, Spain; Instituto de Investigación Sanitaria del Principado de Asturias, Spain; Instituto de Neurocias del Principado de Asturias, Spain
| | - María Fé Bravo-Ortiz
- Department of Psychiatry, Universidad Autónoma de Madrid, Madrid, Spain; Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain; Department of Psychiatry, Clinical Psychology and Mental Health, La Paz University Hospital, Madrid, Spain
| | - Manuel Canal-Rivero
- CIBERSAM ISCIII, Madrid, Spain; UGC-Salud Mental de Hospital Virgen del Rocío/IBIS Sevilla, Spain; Universidad de Sevilla, Spain
| | | | - Benedicto Crespo-Facorro
- CIBERSAM ISCIII, Madrid, Spain; UGC-Salud Mental de Hospital Virgen del Rocío/IBIS Sevilla, Spain; Universidad de Sevilla, Spain
| | - Matilde Elices
- Institut Hospital del Mar d'Investigacions Mediques (IMIM), Barcelona, Spain
| | | | - Purificacion Lopez-Peña
- CIBERSAM ISCIII, Madrid, Spain; Department Psychiatry, Hospital Universitario Alava, Bioaraba, UPV/EHU, Osakidetza, Spain
| | - Iría Grande
- CIBERSAM ISCIII, Madrid, Spain; Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona (UB), Barcelona, Spain; Bipolar and Depressive Disorders Unit, Hospìtal Clinic de Barcelona, Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Institute of Neurosciences (UBNeuro), Spain
| | - Ángela Palao-Tarrero
- Department of Psychiatry, Universidad Autónoma de Madrid, Madrid, Spain; Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain; Department of Psychiatry, Clinical Psychology and Mental Health, La Paz University Hospital, Madrid, Spain
| | - Andrés Pemau
- Universidad Complutense de Madrid, Madrid, Spain
| | - Natalia Roberto
- CIBERSAM ISCIII, Madrid, Spain; Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona (UB), Barcelona, Spain; Bipolar and Depressive Disorders Unit, Hospìtal Clinic de Barcelona, Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Institute of Neurosciences (UBNeuro), Spain
| | - Miguel Ruiz-Veguilla
- CIBERSAM ISCIII, Madrid, Spain; UGC-Salud Mental de Hospital Virgen del Rocío/IBIS Sevilla, Spain; Universidad de Sevilla, Spain
| | - Víctor Pérez-Solà
- CIBERSAM ISCIII, Madrid, Spain; Institut Hospital del Mar d'Investigacions Mediques (IMIM), Barcelona, Spain
| |
Collapse
|
21
|
Kisely S, Strathearn L, Najman JM. Self-Reported and Agency-Notified Child Abuse as Contributors to Suicidal Behaviour in a Population-Based Birth Cohort Study at 30-Year-Follow-Up. CHILD MALTREATMENT 2024; 29:155-164. [PMID: 36127307 DOI: 10.1177/10775595221127923] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
This was a record-linkage analysis of a birth cohort to examine the association between self-reported self-harm in adulthood and childhood maltreatment (CM) as prospectively notified to authorities and self-reported on the Child Trauma Questionnaire. There were 2507 participants at 30-year follow-up with data on both CM and self-reported self-harm including an intent to die. Of the participants, 304 (12.1%) had self-harmed at some time in their lives while 150 (4.2%) had wanted to die. The prevalence of self- and agency-reported maltreatment was 513 (20.5%) and 143 (5.7%) respectively. On adjusted analyses, CM irrespective of reporting source showed significant associations with both suicidal outcomes. Physical and emotional abuse showed the strongest associations while findings for neglect were mixed. The only association for sexual abuse was for self-reported maltreatment and intent to die but numbers may have been under-powered.
Collapse
Affiliation(s)
- Steve Kisely
- School of Medicine, University of Queensland, Princess Alexandra Hospital, Woolloongabb, Queensland, Australia
- Departments of Psychiatry, Community Health and Epidemiology, Dalhousie University, Canada
| | - Lane Strathearn
- Stead Family Department of Paediatrics, Developmental and Behavioural Paediatrics, University of Iowa, Iowa, USA
- Center for Disabilities and Development, University of Iowa Stead Family Children's Hospital, Iowa City, Iowa, USA
| | - Jake Moses Najman
- School of Public Health, The University of Queensland, Public Health Building, Herston, , Queensland, Australia
| |
Collapse
|
22
|
Traetta ME, Chaves Filho AM, Akinluyi ET, Tremblay MÈ. Neurodevelopmental and Neuropsychiatric Disorders. ADVANCES IN NEUROBIOLOGY 2024; 37:457-495. [PMID: 39207708 DOI: 10.1007/978-3-031-55529-9_26] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/04/2024]
Abstract
This chapter will focus on microglial involvement in neurodevelopmental and neuropsychiatric disorders, particularly autism spectrum disorder (ASD), schizophrenia and major depressive disorder (MDD). We will describe the neuroimmune risk factors that contribute to the etiopathology of these disorders across the lifespan, including both in early life and adulthood. Microglia, being the resident immune cells of the central nervous system, could play a key role in triggering and determining the outcome of these disorders. This chapter will review preclinical and clinical findings where microglial morphology and function were examined in the contexts of ASD, schizophrenia and MDD. Clinical evidence points out to altered microglial morphology and reactivity, as well as increased expression of pro-inflammatory cytokines, supporting the idea that microglial abnormalities are involved in these disorders. Indeed, animal models for these disorders found altered microglial morphology and homeostatic functions which resulted in behaviours related to these disorders. Additionally, as microglia have emerged as promising therapeutic targets, we will also address in this chapter therapies involving microglial mechanisms for the treatment of neurodevelopmental and neuropsychiatric disorders.
Collapse
Affiliation(s)
| | | | - Elizabeth Toyin Akinluyi
- Division of Medical Sciences, University of Victoria, Victoria, BC, Canada
- Department of Pharmacology and Therapeutics, Afe Babalola University, Ado-Ekiti, Nigeria
| | - Marie-Ève Tremblay
- Division of Medical Sciences, University of Victoria, Victoria, BC, Canada.
- Département de Médecine Moléculaire, Université Laval, Quebec City, QC, Canada.
- Axe Neurosciences, Center de Recherche du CHU de Québec, Université Laval, Quebec City, QC, Canada.
- Neurology and Neurosurgery Department, McGill University, Montréal, QC, Canada.
- Department of Biochemistry and Molecular Biology, University of British Columbia, Vancouver, BC, Canada.
- Center for Advanced Materials and Related Technology (CAMTEC), University of Victoria, Victoria, BC, Canada.
- Institute on Aging and Lifelong Health (IALH), University of Victoria, Victoria, BC, Canada.
| |
Collapse
|
23
|
Zhu B, Xiao C, Ding C, Yan H, Wang L, Jiang Q, Tian J, Wei L. Adverse childhood experiences and depressive symptoms among lesbian and bisexual women in China. BMC Womens Health 2023; 23:679. [PMID: 38114972 PMCID: PMC10731884 DOI: 10.1186/s12905-023-02686-5] [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: 10/08/2021] [Accepted: 10/04/2023] [Indexed: 12/21/2023] Open
Abstract
BACKGROUND Despite the relationship between Adverse childhood experiences (ACEs) and depressive symptoms, which has been well researched in general populations, little is known about homosexual and bisexual populations, especially lesbian and bisexual women in China. This study aims to investigate the prevalence of ACEs and depressive symptoms and to analyze the relationship between them among lesbian and bisexual women in China. METHODS The eligible participants were aged 16 years or older who report their sexual orientation as homosexual or bisexual. The data was collected through anonymous questionnaires with the help of Lespark in Beijing from July 18 to December 29, 2018, and all participants had informed consent to this study. Univariate analysis and multiple linear regression analyses were performed to explore the relationship between ACEs and depressive symptoms among lesbian and bisexual women. All statistical analyses were conducted by the software of SPSS 22.0. RESULTS Among 301 lesbian and bisexual women, 81.4% were lesbian, 18.4% were bisexual women, and the majority were 21-30 years. As for ACEs, 51.5% reported at least one ACE, in which emotional neglect (22.6%) and emotional abuse (22.3%) were common ACEs. As for depressive symptoms of lesbian and bisexual women, the detection rate was 56.1%. The multiple linear regression analyses showed that abuse (β = 2.95, 95%CI:1.07-4.83) and neglect (β = 3.21, 95%CI:1.09-5.31) were positively associated with depressive symptoms and lesbian and bisexual women with three (β = 4.11, 95%CI: 0.99-7.22) or more (β = 6.02, 95%CI: 3.23-8.78) ACEs suffered from more depressive symptoms than others. CONCLUSION Adverse childhood experiences (ACEs) and depressive symptoms were at high prevalence among lesbian and bisexual women in China. ACEs were associated with depressive symptoms, especially childhood abuse and neglect experiences that have a significant effect on lesbian and bisexual women mental health.
Collapse
Affiliation(s)
- Biao Zhu
- School of Public Health, Wuhan University, Wuhan, China
- Anhui Provincial Center for Disease Control and Prevention, Hefei, China
| | | | - Changmian Ding
- Department of Medical Record, The People's Hospital of Dehong, Dehong, China
| | - Hong Yan
- School of Public Health, Wuhan University, Wuhan, China.
| | - Liyin Wang
- School of Public Health, Wuhan University, Wuhan, China
| | | | - Jiawei Tian
- School of Public Health, Wuhan University, Wuhan, China
| | - Liqing Wei
- School of Public Health, Wuhan University, Wuhan, China
| |
Collapse
|
24
|
Wolf J, Reinhard MA, Goerigk S, Barton BB, Burkhardt G, Tang J, Eder J, Amann BL, Bertsch K, Jobst A, Musil R, Padberg F. Suicidal behaviors and adverse childhood experiences: A cross-diagnostic study in persistent depressive disorder and borderline personality disorder. Psychiatry Res 2023; 330:115562. [PMID: 37918208 DOI: 10.1016/j.psychres.2023.115562] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 10/23/2023] [Accepted: 10/25/2023] [Indexed: 11/04/2023]
Abstract
Adverse childhood experiences (ACE) constitute a known risk factor for suicidality. There is a research gap regarding differential patterns of associations between variants of suicidal ideations and behaviors (SIB) and characteristics of ACE in severe mental disorders. This cross-diagnostic study investigates whether SIB are related to ACE subtypes in two high-risk conditions, i.e., persistent depressive disorder (PDD) and borderline personality disorder (BPD). Inpatients with PDD (n = 117; age 40.2 years ± 12.3) and BPD (n = 74; age 26.2 ± 7.9) were assessed with the Columbia-Suicide Severity Rating Scale for suicidal ideations (SI), suicidal behaviors (SB) and actual suicide attempts (SA); ACE were recorded with the Childhood Trauma Questionnaire. In PDD, SI and SA were associated with childhood physical abuse (ORs 7.2 and 2.3, respectively). In BPD, SA were associated with severe experiences of physical abuse (OR 6.5). Weaker yet significant associations were found for childhood emotional abuse in PDD with SB (including SA), and in BPD with SA. Recall of childhood physical abuse may be clinically relevant information for identifying particular risks of SIB. Future studies should investigate these differential patterns in more depth and in terms of causality.
Collapse
Affiliation(s)
- Johannes Wolf
- Department of Psychiatry and Psychotherapy, LMU University Hospital, Munich, Germany.
| | - Matthias A Reinhard
- Department of Psychiatry and Psychotherapy, LMU University Hospital, Munich, Germany
| | - Stephan Goerigk
- Department of Psychiatry and Psychotherapy, LMU University Hospital, Munich, Germany; Charlotte Fresenius Hochschule, Munich, Germany
| | - Barbara B Barton
- Department of Psychiatry and Psychotherapy, LMU University Hospital, Munich, Germany
| | - Gerrit Burkhardt
- Department of Psychiatry and Psychotherapy, LMU University Hospital, Munich, Germany
| | - Jeni Tang
- Department of Psychiatry and Psychotherapy, LMU University Hospital, Munich, Germany
| | - Julia Eder
- Department of Psychiatry and Psychotherapy, LMU University Hospital, Munich, Germany
| | - Benedikt L Amann
- Centro Fórum Research Unit, Institute of Neuropsychiatry and Addictions (INAD), Hospital del Mar Medical Research Institute (IMIM), Parc de Salut Mar, Barcelona, Spain; Pompeu Fabra University Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto Carlos III, Madrid, Spain
| | - Katja Bertsch
- Department of Psychology, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Andrea Jobst
- Department of Psychiatry and Psychotherapy, LMU University Hospital, Munich, Germany
| | - Richard Musil
- Department of Psychiatry and Psychotherapy, LMU University Hospital, Munich, Germany
| | - Frank Padberg
- Department of Psychiatry and Psychotherapy, LMU University Hospital, Munich, Germany
| |
Collapse
|
25
|
McEvoy D, Brannigan R, Cooke L, Butler E, Walsh C, Arensman E, Clarke M. Risk and protective factors for self-harm in adolescents and young adults: An umbrella review of systematic reviews. J Psychiatr Res 2023; 168:353-380. [PMID: 37972513 DOI: 10.1016/j.jpsychires.2023.10.017] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 09/13/2023] [Accepted: 10/13/2023] [Indexed: 11/19/2023]
Abstract
We conducted an umbrella review to synthesise the evidence from systematic reviews and meta-analyses that examined the risk and protective factors for self-harm in young people. We searched six different databases and used the AMSTAR-2 checklist for quality assessment. The importance of each risk and protective factor was determined based on (1) the number of times it was identified by general reviews examining any risk or protective factor, and (2) the effect sizes from meta-analyses. There were 61 systematic reviews included in this review. The most frequently identified risk factors for self-harm in young people included childhood abuse, depression/anxiety, bullying, trauma, psychiatric illnesses, substance use/abuse, parental divorce, poor family relationships, lack of friends, and exposure to self-harm behaviour in others. The risk factors with the strongest evidence for an association with self-harm were behavioural disorders, personality disorders and depression or anxiety. There was a dearth of systematic reviews examining protective factors but good family/friend relationships were most frequently identified. There was also evidence to show that non-suicidal and suicidal self-harm shared many of the same risk factors. Clinicians and other professionals who work with young people should be particularly cognisant of the psychiatric and adverse life event risk factors as well as the substance use, education-related and individual-level (e.g. being LGB) risk factors for self-harm. Knowledge of risk factors for self-harm can potentially be used to inform the design and implementation of prevention measures and further research is needed on the protective factors for self-harm.
Collapse
Affiliation(s)
- David McEvoy
- School of Population Health, Royal College of Surgeons Ireland (RCSI), Beaux Lane House, Mercer Street Lower, Dublin, 2, Ireland.
| | - Ross Brannigan
- School of Population Health, Royal College of Surgeons Ireland (RCSI), Beaux Lane House, Mercer Street Lower, Dublin, 2, Ireland.
| | - Lorcan Cooke
- School of Medicine, Royal College of Surgeons Ireland (RCSI), Dublin, 2, Ireland.
| | - Emma Butler
- School of Population Health, Royal College of Surgeons Ireland (RCSI), Beaux Lane House, Mercer Street Lower, Dublin, 2, Ireland.
| | - Cathal Walsh
- Health Research Institute, University of Limerick, Limerick, Ireland.
| | - Ella Arensman
- School of Public Health, University College Cork, 4th Floor, Western Gateway Building, Western Road, Cork, Ireland; National Suicide Research Foundation (NSRF), Western Gateway Building, University College Cork, Ireland.
| | - Mary Clarke
- School of Population Health, Royal College of Surgeons Ireland (RCSI), Beaux Lane House, Mercer Street Lower, Dublin, 2, Ireland; Department of Psychiatry, Royal College of Surgeons in Ireland (RCSI), Dublin, Ireland.
| |
Collapse
|
26
|
Barrett NM, Michaels NL, Kistamgari S, Smith GA, Brink FW. Child maltreatment among victims of violent death: an analysis of national violent death reporting system data, 2014-2018. Inj Epidemiol 2023; 10:63. [PMID: 38031196 PMCID: PMC10685529 DOI: 10.1186/s40621-023-00474-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 11/20/2023] [Indexed: 12/01/2023] Open
Abstract
BACKGROUND Limited information is known about the impact of childhood maltreatment on lifetime risk of violent death. This study aimed to compare manner of death, demographics, age at time of death, and the presence of a mental health or substance use disorder among decedents of violent deaths with a history of child maltreatment to those without. METHODS This cross-sectional study compared characteristics of pediatric and adult violent deaths with and without a history of child maltreatment that were captured in the National Violent Death Reporting System from 2014 through 2018. RESULTS Decedents who were male, multiracial, and had adulthood substance or mental health disorders were more likely to have a history of maltreatment. All-age decedents with a history of maltreatment were more likely to die by homicide. Adult decedents with a history of maltreatment were more likely to die by suicide. Maltreated decedents died significantly younger than non-maltreated decedents. CONCLUSIONS Among victims of violent deaths, an identified history of child maltreatment was associated with increased risk of homicide across the lifespan, adult suicide, and earlier death. A history of child maltreatment was also associated with mental health and substance use disorders, which may reflect one of the pathways through which the child maltreatment-to-death association functions.
Collapse
Affiliation(s)
- Nicole M Barrett
- Pediatric Resource Center at Atrium Health Levine Children's Hospital, 901 East Blvd., Charlotte, NC, 28203, USA
- Wake Forest University School of Medicine, 475 Vine St., Winston-Salem, NC, 27101, USA
| | - Nichole L Michaels
- The Ohio State University College of Medicine, 370 W 9th Ave, Columbus, OH, 43210, USA
- The Center for Injury Research and Policy, The Abigail Wexner Research Institute at Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH, 43215, USA
| | - Sandhya Kistamgari
- The Center for Injury Research and Policy, The Abigail Wexner Research Institute at Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH, 43215, USA
| | - Gary A Smith
- The Ohio State University College of Medicine, 370 W 9th Ave, Columbus, OH, 43210, USA
- The Center for Injury Research and Policy, The Abigail Wexner Research Institute at Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH, 43215, USA
| | - Farah W Brink
- The Ohio State University College of Medicine, 370 W 9th Ave, Columbus, OH, 43210, USA.
- The Center for Family Safety and Healing at Nationwide Children's Hospital, 655 E. Livingston Ave., Columbus, OH, 43205, USA.
| |
Collapse
|
27
|
Navarro D, Marín-Mayor M, Gasparyan A, García-Gutiérrez MS, Rubio G, Manzanares J. Molecular Changes Associated with Suicide. Int J Mol Sci 2023; 24:16726. [PMID: 38069051 PMCID: PMC10706600 DOI: 10.3390/ijms242316726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Revised: 11/20/2023] [Accepted: 11/21/2023] [Indexed: 12/18/2023] Open
Abstract
Suicide is a serious global public health problem, with a worrying recent increase in suicide rates in both adolescent and adult populations. However, it is essential to recognize that suicide is preventable. A myriad of factors contributes to an individual's vulnerability to suicide. These factors include various potential causes, from psychiatric disorders to genetic and epigenetic alterations. These changes can induce dysfunctions in crucial systems such as the serotonergic, cannabinoid, and hypothalamic-pituitary-adrenal axes. In addition, early life experiences of abuse can profoundly impact an individual's ability to cope with stress, ultimately leading to changes in the inflammatory system, which is a significant risk factor for suicidal behavior. Thus, it is clear that suicidal behavior may result from a confluence of multiple factors. This review examines the primary risk factors associated with suicidal behavior, including psychiatric disorders, early life adversities, and epigenetic modifications. Our goal is to elucidate the molecular changes at the genetic, epigenetic, and molecular levels in the brains of individuals who have taken their own lives and in the plasma and peripheral mononuclear cells of suicide attempters and how these changes may serve as predisposing factors for suicidal tendencies.
Collapse
Affiliation(s)
- Daniela Navarro
- Instituto de Neurociencias, Universidad Miguel Hernández-CSIC, Avda de Ramón y Cajal s/n, San Juan de Alicante, 03550 Alicante, Spain; (D.N.); (A.G.); (M.S.G.-G.)
- Redes de Investigación Cooperativa Orientada a Resultados en Salud (RICORS), Red de Investigación en Atención Primaria de Adicciones (RIAPAd), Instituto de Salud Carlos III, MICINN and FEDER, 28029 Madrid, Spain;
- Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), 03010 Alicante, Spain
| | - Marta Marín-Mayor
- Instituto de Investigación i+12, Hospital Universitario 12 de Octubre, 28041 Madrid, Spain;
- Department of Psychiatry, Complutense University of Madrid, 28040 Madrid, Spain
| | - Ani Gasparyan
- Instituto de Neurociencias, Universidad Miguel Hernández-CSIC, Avda de Ramón y Cajal s/n, San Juan de Alicante, 03550 Alicante, Spain; (D.N.); (A.G.); (M.S.G.-G.)
- Redes de Investigación Cooperativa Orientada a Resultados en Salud (RICORS), Red de Investigación en Atención Primaria de Adicciones (RIAPAd), Instituto de Salud Carlos III, MICINN and FEDER, 28029 Madrid, Spain;
- Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), 03010 Alicante, Spain
| | - María Salud García-Gutiérrez
- Instituto de Neurociencias, Universidad Miguel Hernández-CSIC, Avda de Ramón y Cajal s/n, San Juan de Alicante, 03550 Alicante, Spain; (D.N.); (A.G.); (M.S.G.-G.)
- Redes de Investigación Cooperativa Orientada a Resultados en Salud (RICORS), Red de Investigación en Atención Primaria de Adicciones (RIAPAd), Instituto de Salud Carlos III, MICINN and FEDER, 28029 Madrid, Spain;
- Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), 03010 Alicante, Spain
| | - Gabriel Rubio
- Redes de Investigación Cooperativa Orientada a Resultados en Salud (RICORS), Red de Investigación en Atención Primaria de Adicciones (RIAPAd), Instituto de Salud Carlos III, MICINN and FEDER, 28029 Madrid, Spain;
- Instituto de Investigación i+12, Hospital Universitario 12 de Octubre, 28041 Madrid, Spain;
- Department of Psychiatry, Complutense University of Madrid, 28040 Madrid, Spain
| | - Jorge Manzanares
- Instituto de Neurociencias, Universidad Miguel Hernández-CSIC, Avda de Ramón y Cajal s/n, San Juan de Alicante, 03550 Alicante, Spain; (D.N.); (A.G.); (M.S.G.-G.)
- Redes de Investigación Cooperativa Orientada a Resultados en Salud (RICORS), Red de Investigación en Atención Primaria de Adicciones (RIAPAd), Instituto de Salud Carlos III, MICINN and FEDER, 28029 Madrid, Spain;
- Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), 03010 Alicante, Spain
| |
Collapse
|
28
|
O'Connor DB, Branley-Bell D, Green JA, Ferguson E, O'Carroll RE, O'Connor RC. Effects of childhood trauma on sleep quality and stress-related variables in adulthood: evidence from two multilevel studies. Psychol Health 2023:1-22. [PMID: 37975565 DOI: 10.1080/08870446.2023.2281712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 11/05/2023] [Indexed: 11/19/2023]
Abstract
Childhood trauma has been found to have serious negative consequences for mental and physical health. However, the precise mechanisms through which trauma influences health outcomes are unclear. Childhood trauma-related disruptions to sleep in adulthood represent an important potential mechanism. Two 7-day multilevel studies investigated the effects of childhood trauma on daily sleep outcomes and stress-related variables and whether the effects of trauma on sleep outcomes were mediated through these stress-related variables (or vice versa). Participants completed the Childhood Trauma Questionnaire before a 7-day online daily diary study. Measures of daily stress, perseverative cognition, and sleep were completed daily. Multi-level modelling found that higher levels of childhood neglect were associated with poorer daily sleep quality, shorter sleep duration, longer sleep onset latency, and higher daily stress and rumination levels. Higher childhood abuse was associated with shorter sleep duration, greater morning tiredness, and higher levels of daily stress, rumination, and worry. Childhood trauma was found also to have bidirectional, indirect effects on sleep quality and morning tiredness through daily stress-related variables. The current findings suggest that interventions aimed at mitigating the negative effects of childhood trauma should also incorporate components that target modifiable risk factors, such as sleep, stress, worry, and rumination.
Collapse
Affiliation(s)
| | - Dawn Branley-Bell
- Department of Psychology, Northumbria University, Newcastle upon Tyne, UK
| | | | - Eamonn Ferguson
- School of Psychology, University of Nottingham, Nottingham, UK
| | | | - Rory C O'Connor
- Suicidal Behavior Research Laboratory, Institute of Health & Wellbeing, University of Glasgow, Glasgow, UK
| |
Collapse
|
29
|
Stephan NM, van Sprang ED, Wiebenga JXM, Dickhoff J, Schirmbeck F, de Haan L, van Amelsvoort T, Veling W, Alizadeh BZ, Simons CJP, Heering HD. Risk factors for suicidality across psychosis vulnerability spectrum. Schizophr Res 2023; 261:152-160. [PMID: 37769453 DOI: 10.1016/j.schres.2023.09.021] [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: 09/28/2022] [Revised: 06/14/2023] [Accepted: 09/09/2023] [Indexed: 09/30/2023]
Abstract
BACKGROUND Suicide is a leading cause of death in individuals with psychotic disorders. Risk factors for suicidality across the psychosis vulnerability spectrum are insufficiently known. METHODS For patients (n = 830), siblings (n = 664) and controls (n = 444), suicidality was assessed by the use of a clinical interview. Multilevel modelling was used to investigate risk factors of suicidality. Lastly, risk factor × familial risk interaction effects were examined. RESULTS Multivariable models revealed a significant relation between suicidality and depressive symptoms across all three groups, and childhood trauma in patients and siblings. The association between suicidality and psychotic-like experiences is more pronounced in siblings compared to controls. CONCLUSION Across the psychosis vulnerability spectrum, depressive symptoms and childhood trauma have been associated with suicidality. Clinicians should pay attention to suicidality in individuals at high familial risk for psychosis with psychotic-like experiences.
Collapse
Affiliation(s)
| | - Eleonore Dorothée van Sprang
- Amsterdam UMC, Location VUMC, Psychiatry, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
| | - Jasper Xiao Ming Wiebenga
- Amsterdam UMC, Location VUMC, Psychiatry, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands; Amsterdam UMC, Location AMC, Department of Psychiatry, University of Amsterdam, Amsterdam, the Netherlands
| | - Justine Dickhoff
- University of Groningen, University Medical Center Groningen, Department of Biomedical Sciences of Cells and Systems, Cognitive Neuroscience Center, Groningen, the Netherlands
| | - Frederike Schirmbeck
- Amsterdam UMC, Location AMC, Department of Psychiatry, University of Amsterdam, Amsterdam, the Netherlands; Department of Public Mental Health, Central Institute of Mental Health, Faculty Medicine Mannheim, Heidelberg University Mannheim, Germany
| | - Lieuwe de Haan
- Amsterdam UMC, Location AMC, Department of Psychiatry, University of Amsterdam, Amsterdam, the Netherlands; Arkin Mental Health Care, Amsterdam, the Netherlands
| | - Therese van Amelsvoort
- Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, the Netherlands
| | - Wim Veling
- Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Behrooz Z Alizadeh
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands; Department of Psychiatry, Rob Giel Research Center, University Medical Center Groningen, University Center for Psychiatry, University of Groningen, Groningen, the Netherlands
| | - Claudia J P Simons
- Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, the Netherlands
| | - Henriëtte Dorothée Heering
- GGZ inGeest Specialized Mental Health Care, Amsterdam, the Netherlands; Department of Research, 113 Suicide Prevention, the Netherlands.
| |
Collapse
|
30
|
González-Ortega I, Diaz-Marsa M, López-Peña P, Fernández-Sevillano J, Andreo-Jover J, Bobes J, Bravo-Ortiz MF, Cebria AI, Crespo-Facorro B, de la Torre-Luque A, Elices M, Fernández-Rodrigues V, Garrido-Torres N, Grande I, Palao-Tarrero Á, Pemau A, Roberto N, Ruiz-Veguilla M, Seijo-Zazo E, Alberich S, González-Pinto A, Pérez V. Clinical predictors and psychosocial risk factors of suicide attempt severity. SPANISH JOURNAL OF PSYCHIATRY AND MENTAL HEALTH 2023:S2950-2853(23)00034-0. [PMID: 38591830 DOI: 10.1016/j.sjpmh.2023.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 06/06/2023] [Accepted: 07/09/2023] [Indexed: 04/10/2024]
Abstract
BACKGROUND Suicide attempts are an important predictor of completed suicide and may differ in terms of severity of medical consequences or medical lethality. There is little evidence on serious suicide attempt (SSA) and very few studies have compared SSA with non-SSA. OBJECTIVE The aim of this multisite, coordinated, cohort study was to analyze the role of clinical variables and the sociodemographic and psychological risk factors of SSA. METHOD In this multisite, coordinated, cohort study, 684 participants (222 for the mild suicide attempt group, 371 for the moderate suicide attempt group and 91 for the SSA group) were included in the study. Ordinal regression models were performed to analyze the predictor variables of SSA. RESULTS Early physical abuse (OR=1.231) and impulsivity (OR=1.036) were predictors of SSA, while depressive symptoms were associated with a lower risk of SSA. CONCLUSION Environmental and psychological factors as physical abuse and impulsivity are related with severe suicide severity. These findings will help to develop strategies to prevent suicide and may be considered for the treatment and management of suicide.
Collapse
Affiliation(s)
- Itxaso González-Ortega
- Centre for Biomedical Research in the Mental Health Network (CIBERSAM), Madrid, Spain; Department of Psychiatry, Araba University Hospital, Bioaraba Research Institute, Vitoria, Spain; Department of Personality, Assessment and Psychological Treatment, National University of Distance Education (UNED), Vitoria, Spain
| | - Marina Diaz-Marsa
- Centre for Biomedical Research in the Mental Health Network (CIBERSAM), Madrid, Spain; Hospital Clínico San Carlos, Madrid, Spain; Complutense University of Madrid, Madrid, Spain
| | - Purificación López-Peña
- Centre for Biomedical Research in the Mental Health Network (CIBERSAM), Madrid, Spain; Department of Psychiatry, Araba University Hospital, Bioaraba Research Institute, Vitoria, Spain; Department of Neurosciences, University of the Basque Country, Leioa, Spain
| | - Jessica Fernández-Sevillano
- Centre for Biomedical Research in the Mental Health Network (CIBERSAM), Madrid, Spain; Department of Psychiatry, Araba University Hospital, Bioaraba Research Institute, Vitoria, Spain
| | - Jorge Andreo-Jover
- Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain; Department of Psychiatry, Universidad Autónoma de Madrid, Madrid, Spain
| | - Julio Bobes
- Centre for Biomedical Research in the Mental Health Network (CIBERSAM), Madrid, Spain; Department of Psychiatry, University of Oviedo, Oviedo, Spain; Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Spain; Instituto de Neurociencias del Principado de Asturias (INEUROPA), Spain; Mental Health Services of the Principality of Asturias (SESPA), Oviedo, Spain
| | - María Fe Bravo-Ortiz
- Centre for Biomedical Research in the Mental Health Network (CIBERSAM), Madrid, Spain; Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain; Department of Psychiatry, Universidad Autónoma de Madrid, Madrid, Spain; Department of Psychiatry, Clinical Psychology and Mental Health, La Paz University Hospital, Madrid, Spain
| | - Ana Isabel Cebria
- Centre for Biomedical Research in the Mental Health Network (CIBERSAM), Madrid, Spain; Mental Health Service, Hospital Universitari Parc Taulí, Unitat Mixta de Neurociència Traslacional I3PT-INc-UAB, Barcelona, Spain; Department of Clinical and Health Psychology, Faculty of Psychology, Universitat Autònoma of Barcelona, Cerdanyola del Vallès, Spain
| | - Benedicto Crespo-Facorro
- Centre for Biomedical Research in the Mental Health Network (CIBERSAM), Madrid, Spain; Hospital Virgen del Rocío, Instituto de Biomedicina de Sevilla (IBIS), Sevilla, Spain; Department of Psychiatry, University of Sevilla, Sevilla, Spain
| | - Alejandro de la Torre-Luque
- Centre for Biomedical Research in the Mental Health Network (CIBERSAM), Madrid, Spain; Complutense University of Madrid, Madrid, Spain
| | - Matilde Elices
- Centre for Biomedical Research in the Mental Health Network (CIBERSAM), Madrid, Spain; Mar Institute of Medical Research (IMIM), Parc de Salut Mar, Barcelona, Spain
| | | | - Nathalia Garrido-Torres
- Centre for Biomedical Research in the Mental Health Network (CIBERSAM), Madrid, Spain; Hospital Virgen del Rocío, Instituto de Biomedicina de Sevilla (IBIS), Sevilla, Spain
| | - Iria Grande
- Centre for Biomedical Research in the Mental Health Network (CIBERSAM), Madrid, Spain; Bipolar and Depressive Disorders Unit, Hospital Clinic of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Institute of Neurosciences (UBNeuro) P. de la Vall d'Hebron, Barcelona, Spain; Department de Medicina, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona (UB), Barcelona, Spain
| | - Ángela Palao-Tarrero
- Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain; Department of Psychiatry, Universidad Autónoma de Madrid, Madrid, Spain; Department of Psychiatry, Clinical Psychology and Mental Health, La Paz University Hospital, Madrid, Spain
| | | | - Natalia Roberto
- Bipolar and Depressive Disorders Unit, Hospital Clinic of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Institute of Neurosciences (UBNeuro) P. de la Vall d'Hebron, Barcelona, Spain
| | - Miguel Ruiz-Veguilla
- Centre for Biomedical Research in the Mental Health Network (CIBERSAM), Madrid, Spain; Hospital Virgen del Rocío, Instituto de Biomedicina de Sevilla (IBIS), Sevilla, Spain; Department of Psychiatry, University of Sevilla, Sevilla, Spain
| | - Elisa Seijo-Zazo
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Spain; Instituto de Neurociencias del Principado de Asturias (INEUROPA), Spain; Mental Health Services of the Principality of Asturias (SESPA), Oviedo, Spain
| | - Susana Alberich
- Centre for Biomedical Research in the Mental Health Network (CIBERSAM), Madrid, Spain; Department of Psychiatry, Araba University Hospital, Bioaraba Research Institute, Vitoria, Spain; Department of Personality, Assessment and Psychological Treatment, National University of Distance Education (UNED), Vitoria, Spain
| | - Ana González-Pinto
- Centre for Biomedical Research in the Mental Health Network (CIBERSAM), Madrid, Spain; Department of Psychiatry, Araba University Hospital, Bioaraba Research Institute, Vitoria, Spain; Department of Neurosciences, University of the Basque Country, Leioa, Spain; Department of Pathophysiology and Transplantation, University of Milan, 20122 Milan, Italy; Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; Department of Psychiatry and Forensic Medicine, Faculty of Medicine, Universitat Autònoma de Barcelona, 08193 Cerdanyola del Vallès, Spain.
| | - Víctor Pérez
- Centre for Biomedical Research in the Mental Health Network (CIBERSAM), Madrid, Spain; Mar Institute of Medical Research (IMIM), Parc de Salut Mar, Barcelona, Spain; Institute of Neuropsychiatry and Addictions (INAD), Parc de Salut Mar, Barcelona, Spain; Universitat Pompeu Fabra, UPF, Barcelona, Spain
| |
Collapse
|
31
|
Ochi S, Roy B, Prall K, Shelton RC, Dwivedi Y. Strong associations of telomere length and mitochondrial copy number with suicidality and abuse history in adolescent depressed individuals. Mol Psychiatry 2023; 28:3920-3929. [PMID: 37735501 PMCID: PMC10730407 DOI: 10.1038/s41380-023-02263-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 08/30/2023] [Accepted: 09/08/2023] [Indexed: 09/23/2023]
Abstract
Major depressive disorder (MDD) is highly prevalent in adolescents and is a major risk factor for suicidality. Recent evidence shows that accelerated cellular senescence/aging is associated with psychiatric illness, including depression, in adults. The present study examined if the relationships of telomere length (TL) and mitochondrial DNA copy number (mtDNAcn), two critical indicators of cellular senescence/aging, are altered in depressed adolescents and whether these alterations are associated with suicidality, early-life adversities, and other co-occuring factors. In genomic DNA isolated from 53 adolescents (ages 16-19, 19 MDD with suicide attempt/suicidal ideation [MDD + SI/SA], 14 MDD without SA/SI [MDD-SI/SA], and 20 healthy controls [HC]), TL and mtDNAcn were measured as the ratio between the number of telomere repeats and that of a single-copy nuclear-hemoglobin [HBG] gene or the amount of mtDNA (NADH dehydrogenase, subunit 1) relative to HBG. Our data show that TL was significantly lower, and mtDNAcn was significantly higher in the total MDD group than HC. TL was significantly lower and mtDNAcn was significantly higher in the MDD + SA/SI group than in the HC, whereas there were no differences in the MDD-SI/SA group. TL was positively correlated with mtDNAcn in both HC and MDD-SA/SI groups; however, TL was negatively correlated with mtDNAcn in MDD + SA/SI. Furthermore, TL was negatively correlated with the severity of both depression and anxiety, while mtDNAcn was positively correlated with the severity of prior emotional abuse. Our study indicates that cellular senescence is more advanced in depressed adolescents with suicidal ideation and that childhood emotional abuse may participate in such a process.
Collapse
Affiliation(s)
- Shinichiro Ochi
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham, AL, 35294, USA
- Department of Neuropsychiatry, Molecules and Function, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime, 791-0295, Japan
| | - Bhaskar Roy
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham, AL, 35294, USA
| | - Kevin Prall
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham, AL, 35294, USA
| | - Richard C Shelton
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham, AL, 35294, USA
| | - Yogesh Dwivedi
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham, AL, 35294, USA.
| |
Collapse
|
32
|
Szymanski K, Hartmann V, Springer C, Bornstein R. Suicidality and Implicit Dependency in Child and Adolescent Inpatients With Histories of Trauma: Moderating Effect of Gender. J Nerv Ment Dis 2023; 211:496-503. [PMID: 37192011 DOI: 10.1097/nmd.0000000000001662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/18/2023]
Abstract
ABSTRACT There is lack of empirical findings on a direct link between suicidality and dependency in youth. This is particularly relevant for children and adolescents with a trauma history, since traumatization is a well-established risk factor for suicidality in this population. Research on dependency predominantly uses self-report assessments, which may be susceptible to biases. In this study, performance-based interpersonal dependency scores in inpatient children and adolescents with trauma history were compared with patients' suicidal behavior (suicidal ideation and suicidal attempts) as derived from chart records. The results showed a gender effect. High dependency scores were associated with higher suicidal ideation for girls and with lower suicidal attempts for boys. These findings demonstrate that a relationship between dependency and suicidality for hospitalized traumatized youth is impacted by gender.
Collapse
Affiliation(s)
- Kate Szymanski
- Derner School of Psychology, Adelphi University, Garden City, New York
| | | | | | | |
Collapse
|
33
|
Wang Y, Chen X, Zhou K, Zhang H. A Meta-Analysis of the Effects of Childhood Maltreatment on Elderly Depression. TRAUMA, VIOLENCE & ABUSE 2023; 24:1593-1607. [PMID: 35232293 DOI: 10.1177/15248380211073838] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Background: The present study aimed to synthesize the effects of five types of child maltreatment (physical abuse, emotional abuse, sexual abuse, physical neglect and emotional neglect) on late-life depression.Method: Four English-language databases (Web of Science, PsycINFO and PsycARTICLES, PubMed, and Cochrane Library) and three Chinese databases (China National Knowledge Infrastructure, Wanfang Database, and Weipu Database) were systematically reviewed, and data related to the association between child maltreatment and late-life depression were extracted. Ten studies involving 30,308 older adults were included, and the effect sizes were pooled using random-effect models.Findings: Except for sexual abuse, four types of child maltreatment were found to be positively associated with late-life depression. Physical abuse, emotional abuse and physical neglect were associated with elderly depression (PA: OR = 1.73, 95% CI = 1.55-1.95, p < .001; EA: OR = 1.92, 95% CI = 1.73-2.12, p < .001; PN: OR = 2.05, 95% CI = 1.15-3.67, p < .01) at a small level, and emotional neglect was associated with elderly depression (OR = 3.25, 95% CI = 1.43-7.39, p < .001) at an approximately moderate level. Gender moderated the relationship between physical neglect, emotional neglect, and late-life depression.Conclusion: Our findings highlight the significance of child maltreatment in the development of late-life depression, and underscore the need for future research and practice to explore potential ways to address late-life depression among older adults who suffered child maltreatment.
Collapse
Affiliation(s)
- Yang Wang
- Department of Social Work and Social Policy, Renmin University of China, Beijing, China
| | - Xiaoxuan Chen
- Department of Social Work and Social Policy, Renmin University of China, Beijing, China
| | - Ke Zhou
- Department of Social Work and Social Policy, Renmin University of China, Beijing, China
| | - Huiping Zhang
- Department of Social Work and Social Policy, Renmin University of China, Beijing, China
- Center for Studies of Sociological Theory and Method, Renmin University of China, Beijing, China
| |
Collapse
|
34
|
Yates K, Lång U, Peters EM, Wigman JTW, Boyda D, McNicholas F, Cannon M, Alderson-Day B, Bloomfield M, Ramsay H, Kelleher I. Hallucinations as a risk marker for suicidal behaviour in individuals with a history of sexual assault: a general population study with instant replication. Psychol Med 2023; 53:4627-4633. [PMID: 35698850 PMCID: PMC10388314 DOI: 10.1017/s0033291722001532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 05/04/2022] [Accepted: 05/09/2022] [Indexed: 11/05/2022]
Abstract
BACKGROUND Research has shown a strong relationship between hallucinations and suicidal behaviour in general population samples. Whether hallucinations also index suicidal behaviour risk in groups at elevated risk of suicidal behaviour, namely in individuals with a sexual assault history, remains to be seen. AIMS We assessed whether hallucinations were markers of risk for suicidal behaviour among individuals with a sexual assault history. METHODS Using the cross-sectional 2007 (N = 7403) and 2014 (N = 7546) Adult Psychiatric Morbidity Surveys, we assessed for an interaction between sexual assault and hallucinations in terms of the odds of suicide attempt, as well as directly comparing the prevalence of suicide attempt in individuals with a sexual assault history with v. without hallucinations. RESULTS Individuals with a sexual assault history had increased odds of hallucinations and suicide attempt compared to individuals without a sexual assault history in both samples. There was a significant interaction between sexual assault and hallucinations in terms of the odds of suicide attempt. In total, 14-19% of individuals with a sexual assault history who did not report hallucinations had one or more suicide attempt. This increased to 33-52% of individuals with a sexual assault history who did report hallucinations (2007, aOR = 2.85, 1.71-4.75; 2014, aOR = 4.52, 2.78-7.35). CONCLUSIONS Hallucinations are a risk marker for suicide attempt even among individuals with an elevated risk of suicidal behaviour, specifically individuals with a sexual assault history. This finding highlights the clinical significance of hallucinations with regard to suicidal behaviour risk, even among high-risk populations.
Collapse
Affiliation(s)
- Kathryn Yates
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin 2, Ireland
| | - Ulla Lång
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin 2, Ireland
| | - Evyn M. Peters
- Department of Psychiatry, University of Saskatchewan, Saskatoon SK, Canada
| | - Johanna T. W. Wigman
- Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion regulation (ICPE), University of Groningen, Groningen, The Netherlands
| | - David Boyda
- School of Psychology, University of Wolverhampton, Wolverhampton, UK
| | - Fiona McNicholas
- School of Medicine, University College Dublin, Belfield, Dublin, Ireland
- Lucena Clinic, St John of God Hospitaller Services, Dublin, Ireland
- Department of Child Psychiatry, Our Lady's Hospital for Sick Children, Dublin, Ireland
| | - Mary Cannon
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin 2, Ireland
| | - Ben Alderson-Day
- Department of Psychology, Science Laboratories, Durham University, South Road, Durham, UK
| | - Michael Bloomfield
- Division of Psychiatry, University College London, London, UK
- Traumatic Stress Clinic, Camden & Islington NHS Foundation Trust, London, UK
- National Institute for Health Research, University College London Hospitals Biomedical Research Centre, London, UK
- University College London Hospitals NHS Foundation Trust, London, UK
| | - Hugh Ramsay
- School of Medicine, University College Dublin, Belfield, Dublin, Ireland
- Department of Psychiatry, Research Unit of Clinical Neuroscience, University of Oulu, Oulu, Finland
| | - Ian Kelleher
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin 2, Ireland
- School of Medicine, University College Dublin, Belfield, Dublin, Ireland
- Lucena Clinic, St John of God Hospitaller Services, Dublin, Ireland
| |
Collapse
|
35
|
Yıldız M, Orak U, Aydoğdu R. Enduring Effects of Early Life Traumas on Adult Suicidal Ideation. JOURNAL OF CHILD & ADOLESCENT TRAUMA 2023; 16:297-307. [PMID: 37234841 PMCID: PMC10205958 DOI: 10.1007/s40653-022-00482-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/15/2022] [Indexed: 05/28/2023]
Abstract
Exposure to traumas early in life has been found to have a range of negative health effects later in adulthood, including a higher risk for suicidal behavior. Using data from the Waves I (1994/95) and IV (2008) of the National Longitudinal Study of Adolescent to Adult Health (N = 14,385; 49.35% female; Mage in Wave IV = 29), this study examines the effects of exposure to three different types of early life traumas-emotional abuse, physical abuse, and sexual abuse before the age of 18-on adult suicidal ideation. Guided by the stress process model incorporated with a life-course perspective, potential mediating roles of psychological distress, subjective powerlessness, and perceived social rejection were also investigated. A series of regression and Karlson-Holm-Breen (KHB) mediation analyses were performed using Stata 14 to assess the total, direct, and indirect effects. All three early life trauma measures were found to be significantly and independently associated with a higher risk of suicidal ideation in adulthood. A substantive portion (between 30 and 50%) of the effects was mediated by psychological distress (i.e., depression and anxiety), subjective powerlessness, and perceived social rejection. The general policy implications of this study include evaluating suicidal individuals for prior childhood abuse experiences and assessing abuse survivors for suicidality.
Collapse
Affiliation(s)
- Muhammed Yıldız
- Applied Sociology and Criminal Justice Department, Utah Tech University, 232 McDonald Center, 84770 St. George, UT USA
| | - Uğur Orak
- Department of Sociology and Anthropology, Middle Tennessee State University, Murfreesboro, TN USA
| | - Ramazan Aydoğdu
- General Education & Health Sciences Department, Baptist Health Sciences University, Memphis, TN USA
| |
Collapse
|
36
|
Richardson C, Robb KA, McManus S, O'Connor RC. Psychosocial factors that distinguish between men and women who have suicidal thoughts and attempt suicide: findings from a national probability sample of adults. Psychol Med 2023; 53:3133-3141. [PMID: 35012702 PMCID: PMC10235670 DOI: 10.1017/s0033291721005195] [Citation(s) in RCA: 18] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 11/26/2021] [Accepted: 11/30/2021] [Indexed: 11/05/2022]
Abstract
BACKGROUND Previous research has highlighted the importance of understanding which psychosocial factors distinguish between those with suicide thoughts compared to those who attempt suicide. This study aims to investigate these distinguishing factors further within an ideation-to-action framework and to explore sex differences in suicide risk. METHODS Participants (n = 7546, aged 16+) were from the cross-sectional Adult Psychiatric Morbidity Survey (APMS; 2014) of England. Face-to-face and self-completion questionnaires assessed lifetime suicidal ideation, lifetime suicide attempts, demographic characteristics, life experiences, social support, health and mental illness. Multinomial logistic regression examined factors differentiating between those with suicidal ideation only and suicide attempt histories (with or without suicidal ideation) in men and women. RESULTS Overall men were less likely to report suicidal thoughts and attempts, compared to females. More factors differentiated between suicidal thoughts and attempts in women compared to in men; these included hospital admission for mental illness, below degree level qualifications, being single and childhood adversity. In men, factors which significantly differentiated between suicidal thoughts and attempts included self-report of professional diagnosis of mental illness and childhood adversity. Higher levels of social support were associated with being in the suicidal thoughts group v. in the attempts group in men. CONCLUSION This study identified some key differences between men and women in factors associated with suicide attempts compared to suicidal thoughts. The findings support the use of the ideation-to-action framework to investigate sex differences in suicidal behaviour. Future research should examine the extent to which these factors are associated with suicide risk over time.
Collapse
Affiliation(s)
- Cara Richardson
- Suicidal Behaviour Research Laboratory, Institute of Health & Wellbeing, University of Glasgow, Glasgow, UK
| | - Kathryn A. Robb
- Institute of Health & Wellbeing, University of Glasgow, Glasgow, UK
| | - Sally McManus
- School of Health Sciences, City, University of London, UK
| | - Rory C. O'Connor
- Suicidal Behaviour Research Laboratory, Institute of Health & Wellbeing, University of Glasgow, Glasgow, UK
| |
Collapse
|
37
|
Iwatate E, Atem FD, Jones EC, Hughes JL, Yokoo T, Messiah SE. Association of Obesity, Suicide Behaviors, and Psychosocial Wellness Among Adolescents in the United States. J Adolesc Health 2023; 72:526-534. [PMID: 36646564 DOI: 10.1016/j.jadohealth.2022.11.240] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Revised: 11/14/2022] [Accepted: 11/21/2022] [Indexed: 01/15/2023]
Abstract
BACKGROUND Adolescents with obesity are more likely to exhibit suicide behaviors, but this association may be confounded by psychosocial stigma related to obesity. We examined whether the obesity is independently associated with suicide behaviors among United States adolescents, after adjusting for the psychosocial factors. METHODS We analyzed data from 2019 Youth Risk Behavior Survey data (N = 13,871 United States adolescents) on recent (past year) suicide behavior (attempt, ideation, and plan); demographics (age, sex, and race/ethnicity); and psychosocial factors (feeling sad/hopeless, alcohol and illegal drug use, being bullied, and sexually abused). Participants were classified as having obesity (Y/N) per standardized percentiles. Logistic regression was employed to examine the association between obesity and suicide attempt, ideation, and plan, while adjusting for psychosocial covariates. RESULTS The prevalence of suicide attempt, ideation, and plan was 8.90%, 18.75%, and 15.71%, respectively. Obesity prevalence was 15.5%. The odds of suicide attempt, ideation, and plan were 1.65 (1.30-2.11), 1.31 (0.89-1.61), and 1.27 (1.02-1.57), respectively, among those with obesity versus without obesity. DISCUSSION Obesity is significantly associated with a suicide attempt, ideation, and plan among United States adolescents, even after adjusting for confounding psychosocial factors. Further research on the temporality and causality of this association is needed.
Collapse
Affiliation(s)
- Eriko Iwatate
- Department of Epidemiology, Human Genetics & Environmental Sciences, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Dallas, Texas.
| | - Folefac D Atem
- Department of Biostatistics and Data Science, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Dallas, Texas; Center for Pediatric Population Health, Children's Health System of Texas and UTHealth School of Public Health, Dallas, Texas
| | - Eric C Jones
- Department of Epidemiology, Human Genetics & Environmental Sciences, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Dallas, Texas
| | - Jennifer L Hughes
- Department of Psychiatry and Behavioral Health, Big Lots Behavioral Health Services, College of Medicine, Nationwide Children's Hospital, Columbus, Ohio; Division of Health Behavior and Health Promotion, College of Public Health, The Ohio State University, Columbus, Ohio
| | - Takeshi Yokoo
- Department of Radiology, University of Texas Southwestern, Dallas, Texas
| | - Sarah E Messiah
- Department of Epidemiology, Human Genetics & Environmental Sciences, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Dallas, Texas; Center for Pediatric Population Health, Children's Health System of Texas and UTHealth School of Public Health, Dallas, Texas
| |
Collapse
|
38
|
Gomes-da-Costa S, Solé E, Williams E, Giménez A, Garriga M, Pacchiarotti I, Vázquez M, Cavero M, Blanch J, Pérez V, Palao D, Vieta E, Verdolini N. The impact of the Catalonia Suicide Risk Code (CSRC) in a tertiary hospital: Reduction in hospitalizations and emergency room visits for any reason but not for suicide attempt. SPANISH JOURNAL OF PSYCHIATRY AND MENTAL HEALTH 2023; 16:68-75. [PMID: 34111603 DOI: 10.1016/j.rpsm.2021.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 05/11/2021] [Accepted: 05/23/2021] [Indexed: 11/15/2022]
Abstract
INTRODUCTION Suicide attempts represent a public health concern. The objective of this study is to describe the clinical characteristics of patients visiting an emergency room for a suicide attempt and included in a suicide prevention program, the Catalonia Suicide Risk Code (CSRC), particularly focusing on the follow-up evaluations. MATERIALS AND METHODS The CSRC program is divided in 3 phases: (1) alert and activation, (2) proactive telephone and face-to-face follow-up and (3) comprehensive preventive health monitoring. This is the analysis of the sample of patients attempting or intending suicide who were seen at a tertiary hospital in Barcelona, and their 1-year follow-up outcome. RESULTS Three hundred and sixty-five patients were included. In 15% of the cases, there was no previous psychiatric history but in the majority of cases, a previous psychiatric diagnosis was present. The most common type of suicide attempt was by drug overdose (84%). Up to 66.6% of the patients attended the scheduled follow-up visit in the CSRC program. A significant reduction in the proportion of patients visiting the emergency room for any reason (but not specifically for a suicide attempt) and being hospitalized in the first semester in comparison with the second six months after the CSRC activation (30.1% versus 19.9%, p=0.006; 14.1% versus 5.8%, p=0.002) was observed. CONCLUSIONS The clinical risk factors and the findings of the CSRC helped in the characterization of suicide attempters. The CSRC may contribute to reduce hospitalizations and the use of mental health care resources, at least in the short-term.
Collapse
Affiliation(s)
- Susana Gomes-da-Costa
- Bipolar and Depressive Disorders Unit, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Institute of Neuroscience, Barcelona, Catalonia, Spain
| | - Eva Solé
- Bipolar and Depressive Disorders Unit, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Institute of Neuroscience, Barcelona, Catalonia, Spain; Perinatal Mental Health Unit, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Institute of Neuroscience, Barcelona, Catalonia, Spain
| | - Evelyn Williams
- Bipolar and Depressive Disorders Unit, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Institute of Neuroscience, Barcelona, Catalonia, Spain
| | - Anna Giménez
- Bipolar and Depressive Disorders Unit, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Institute of Neuroscience, Barcelona, Catalonia, Spain
| | - Marina Garriga
- Bipolar and Depressive Disorders Unit, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Institute of Neuroscience, Barcelona, Catalonia, Spain
| | - Isabella Pacchiarotti
- Bipolar and Depressive Disorders Unit, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Institute of Neuroscience, Barcelona, Catalonia, Spain
| | - Mireia Vázquez
- Psychiatry Emergency Service, Hospital Clinic, Institute of Neuroscience, Barcelona, Catalonia, Spain
| | - Myriam Cavero
- Bipolar and Depressive Disorders Unit, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Institute of Neuroscience, Barcelona, Catalonia, Spain
| | - Jordi Blanch
- Psychiatry and Psychology Department, Hospital Clinic, University of Barcelona, CIBERSAM, Institute of Neuroscience, Barcelona, Catalonia, Spain; Chair of the Mental Health and Addictions Program, Department of Health, Generalitat de Catalunya, Barcelona, Catalonia, Spain
| | - Víctor Pérez
- Institute of Neuropsychiatry and Addictions, Department of Psychiatry, Hospital del Mar, IMIM (Hospital del Mar Medical Research Institute), CIBERSAM, Autonomous University of Barcelona, Barcelona, Catalonia, Spain
| | - Diego Palao
- Department of Mental Health, Parc Taulí-University Hospital of Sabadell, Department of Psychiatry and Forensic Medicine, Autonomous University of Barcelona, CIBERSAM, Barcelona, Catalonia, Spain
| | - Eduard Vieta
- Bipolar and Depressive Disorders Unit, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Institute of Neuroscience, Barcelona, Catalonia, Spain.
| | - Norma Verdolini
- Bipolar and Depressive Disorders Unit, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Institute of Neuroscience, Barcelona, Catalonia, Spain
| |
Collapse
|
39
|
Raza F, Yeh HW, Goggin K, Connelly M, Sullivant S. Rates of Positive Suicide Screens in the Emergency Department and Outpatient Clinics at a Tertiary Care Children's Hospital. J Adolesc Health 2023; 72:629-632. [PMID: 36646562 DOI: 10.1016/j.jadohealth.2022.11.245] [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: 02/28/2022] [Revised: 11/18/2022] [Accepted: 11/21/2022] [Indexed: 01/16/2023]
Abstract
PURPOSE To provide guidance to hospitals that are developing suicide screening programs, we identified rates of positive screens across outpatient visits within a tertiary care children's hospital. METHODS Suicide screening results from healthcare encounters occurring between February 2019 and January 2020 were estimated for ambulatory clinics (OP), urgent care (UC) clinics, and the emergency department (ED). RESULTS Positive screens (95% confidence interval [CI]) occurred in 10.8% (10.6, 11.0)%) of visits overall. Rates of positive screens were 14.5 (14.1, 14.9)%, 9.9 (9.7, 10.1)%, and 9.3 (8.9, 9.7)% in the ED, OP, and UC, respectively. Rates of positive screens in outpatient clinics were highest in child abuse (33.4 (28.0, 39.2) %) and adolescent specialty (19.2 (17.3, 21.1) %). DISCUSSION Some outpatient clinics had rates of positive suicide screens that surpass those seen in the ED. These findings could inform targeted suicide screening in hospital systems with limited resources to do universal screening.
Collapse
Affiliation(s)
- Fajar Raza
- Bioethics Center, Children's Mercy Hospital, Kansas City, Missouri.
| | - Hung-Wen Yeh
- Health Services and Outcome Research, Children's Mercy Hospital, Kansas City, Missouri
| | - Kathy Goggin
- Health Services and Outcome Research, Children's Mercy Hospital, Kansas City, Missouri
| | - Mark Connelly
- Developmental and Behavioral Research, Children's Mercy Hospital, Kansas City, Missouri
| | - Shayla Sullivant
- Developmental and Behavioral Research, Children's Mercy Hospital, Kansas City, Missouri
| |
Collapse
|
40
|
Alqueza KL, Pagliaccio D, Durham K, Srinivasan A, Stewart JG, Auerbach RP. Suicidal Thoughts and Behaviors Among Adolescent Psychiatric Inpatients. Arch Suicide Res 2023; 27:353-366. [PMID: 34761728 PMCID: PMC9675401 DOI: 10.1080/13811118.2021.1999874] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND Given low base rates of suicidal thoughts and behaviors (STBs) in national samples of adolescents, clarifying the sociodemographic and clinical correlates among psychiatric inpatients may afford insights into potential risk factors that predict STBs onset. METHOD Adolescents (N = 970; ages 12-19 years) admitted for acute, psychiatric inpatient care completed baseline clinical interviews and self-report measures assessing demographics and early life adversity. Lifetime and 12-month STBs prevalence were obtained, allowing for the estimate of STBs persistence (i.e., rates of those with both current and past STBs) and transition rates (i.e., proportion of ideators that transition to plans or attempts). Univariate and multivariate logistic regression tested sociodemographic and clinical correlates of STBs. RESULTS Age-of-onset for STBs occurred in early adolescence. Most patients reported suicide ideation with nearly half of patients making a plan and one-third a suicide attempt. Although relatively modest, the strongest correlates of lifetime attempts were depressive disorders, physical abuse, and non-suicidal self-injury. Knowing a peer that had attempted suicide also increased the likelihood of a suicide attempt, especially among attempters who transitioned from ideation to planned attempts. CONCLUSION STBs are highly prevalent among adolescents admitted for acute psychiatric inpatient treatment. The modest effects suggest that correlates, particularly those related to suicide attempts, are widely distributed. As a history of physical abuse and knowing a peer with a suicide attempt history are related to transitioning from ideation to action, these may be critical factors to target in the deployment of future suicide prevention and treatment programs. HIGHLIGHTSOne-third of adolescent inpatients report a lifetime history of suicide attempts.Approximately 65% of adolescent inpatients with a lifetime plan attempt suicide.Knowing peers who attempt suicide may facilitate the transition from ideation to action.
Collapse
Affiliation(s)
- Kira L. Alqueza
- Department of Psychiatry, Columbia University, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
| | - David Pagliaccio
- Department of Psychiatry, Columbia University, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
| | - Katherine Durham
- Department of Psychiatry, Columbia University, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
| | - Apoorva Srinivasan
- Department of Psychiatry, Columbia University, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
| | - Jeremy G. Stewart
- Department of Psychology and Centre for Neuroscience Studies, Queen’s University, Kingston, ON, Canada
| | - Randy P. Auerbach
- Department of Psychiatry, Columbia University, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
- Division of Clinical Developmental Neuroscience, Sackler Institute, New York, NY, USA
| |
Collapse
|
41
|
Szlyk HS, Li X, Filiatreau LM, Bierut LJ, Banks D, Cavazos-Rehg P. Principal component regression analysis of familial psychiatric histories and suicide risk factors among adults with opioid use disorder. J Psychiatr Res 2023; 159:6-13. [PMID: 36652753 PMCID: PMC10084714 DOI: 10.1016/j.jpsychires.2023.01.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 12/21/2022] [Accepted: 01/10/2023] [Indexed: 01/13/2023]
Abstract
This study explores familial psychiatric risk factors that are closely linked to suicide risk among patients with opioid use disorder (OUD) as measured by the Family History Assessment Module (FHAM). Data was derived from adults diagnosed with OUD (N = 389). To analyze the covariance between the 11 items of the FHAM, principal component analysis was applied to infer principal components (PC) scores. Log-binominal regression was conducted to quantify the associations between PC scores and mental health symptoms (e.g., lifetime suicidal attempt, P30D suicidal ideation, depression, and anxiety). Analyses revealed that the first 3 three PCs could account for 56% of the total variance of the FHAM items within the data. Family history of substance misuse (PC1) was positively associated with lifetime suicide attempts and severe anxiety. Family history of serious mental illness (PC2) and of suicidal behavior (PC3) were not significantly associated with any outcomes. Our findings suggest current suicide risk is associated with an array of familial psychiatric issues among people with OUD. However, family history of suicide attempts and death by suicide has less bearing on current suicide risk in OUD patients whereas family history of substance use confers significant risk. Findings underscore suicide-related preventive interventions as necessary components of treatment plans among people with OUD, who commonly report family histories of substance misuse.
Collapse
Affiliation(s)
- Hannah S Szlyk
- Department of Psychiatry, Washington University School of Medicine, 660 S Euclid Ave, Campus Box 8314, St. Louis, MO, 63130, USA.
| | - Xiao Li
- Department of Psychiatry, Washington University School of Medicine, 660 S Euclid Ave, Campus Box 8314, St. Louis, MO, 63130, USA
| | - Lindsey M Filiatreau
- Department of Psychiatry, Washington University School of Medicine, 660 S Euclid Ave, Campus Box 8314, St. Louis, MO, 63130, USA
| | - Laura J Bierut
- Department of Psychiatry, Washington University School of Medicine, 660 S Euclid Ave, Campus Box 8314, St. Louis, MO, 63130, USA
| | - Devin Banks
- Department of Psychological Sciences, University of Missouri - St. Louis, One University Blvd, Louis, MO, USA
| | - Patricia Cavazos-Rehg
- Department of Psychiatry, Washington University School of Medicine, 660 S Euclid Ave, Campus Box 8314, St. Louis, MO, 63130, USA
| |
Collapse
|
42
|
Gracia-Liso R, Portella MJ, Puntí-Vidal J, Pujals-Altés E, Torralbas-Ortega J, Llorens M, Pamias M, Fradera-Jiménez M, Montalvo-Aguirrezabala I, Palao DJ. COVID-19 Pandemic Has Changed the Psychiatric Profile of Adolescents Attempting Suicide: A Cross-Sectional Comparison. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2952. [PMID: 36833651 PMCID: PMC9956974 DOI: 10.3390/ijerph20042952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 02/01/2023] [Accepted: 02/05/2023] [Indexed: 06/18/2023]
Abstract
The COVID-19 pandemic is having a major impact on the mental health of adolescents, leading to suicidal behaviors. However, it remains to be clarified whether the COVID-19 pandemic has changed the psychiatric profile of adolescent suicide attempters. METHODS a retrospective observational analytical study was conducted to assess age, gender and clinical characteristics of adolescents attempting suicide during the year before and the year after the global lockdown. RESULTS ninety adolescents (12-17 y.o.) were recruited consecutively from February 2019 to March 2021 at the emergency ward for having attempted suicide. Fifty-two (57.8%) attended before the lockdown (pre-pandemic group) and thirty-eight (42.2%) the year after (pandemic group). There were significant differences in diagnostic categories between the periods (p = 0.003). Adjustment and conduct disorders were more frequent in the pre-pandemic group, while anxiety and depressive disorders were more prevalent during the pandemic. Although the severity of suicide attempts did not show significant differences between the two study periods (0.7), the generalized linear model showed that the suicide attempt severity was significantly associated with current diagnosis (p = 0.01). CONCLUSIONS the psychiatric profile of adolescents attempting suicide was different before and during the COVID-19 pandemic. During the pandemic, the proportion of adolescents with a prior psychiatric history was lower, and most of them were diagnosed with depressive and anxiety disorders. These diagnoses were also associated with a greater severity in the intentionality of suicide attempt, regardless of the study period.
Collapse
Affiliation(s)
- Rebeca Gracia-Liso
- Department of Mental Health, Parc Taulí-University Hospital of Sabadell, 08208 Barcelona, Spain
- Department of Psychiatry and Forensic Medicine, Unitat de Neurociència Traslacional I3PT-Inc., Autonomous University of Barcelona (UAB), 08193 Barcelona, Spain
| | - Maria J. Portella
- Sant Pau Mental Health Research Group, Sant Pau Biomedical Research Institute (IIB Sant Pau), 08041 Barcelona, Spain
- Department of Psychiatry, Hospital de la Santa Creu i Sant Pau, 08041 Barcelona, Spain
- Department of Psychiatry and Forensic Medicine, Autonomous University of Barcelona (UAB), 08193 Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), 28029 Madrid, Spain
| | - Joaquim Puntí-Vidal
- Department of Mental Health, Parc Taulí-University Hospital of Sabadell, 08208 Barcelona, Spain
- Department of Psychiatry and Forensic Medicine, Unitat de Neurociència Traslacional I3PT-Inc., Autonomous University of Barcelona (UAB), 08193 Barcelona, Spain
- Department of Psychiatry, Hospital de la Santa Creu i Sant Pau, 08041 Barcelona, Spain
- Department of Psychiatry and Forensic Medicine, Autonomous University of Barcelona (UAB), 08193 Barcelona, Spain
| | - Elena Pujals-Altés
- Department of Mental Health, Parc Taulí-University Hospital of Sabadell, 08208 Barcelona, Spain
- Department of Psychiatry and Forensic Medicine, Unitat de Neurociència Traslacional I3PT-Inc., Autonomous University of Barcelona (UAB), 08193 Barcelona, Spain
- Department of Psychiatry, Hospital de la Santa Creu i Sant Pau, 08041 Barcelona, Spain
- Department of Psychiatry and Forensic Medicine, Autonomous University of Barcelona (UAB), 08193 Barcelona, Spain
| | | | - Marta Llorens
- Department of Psychiatry and Forensic Medicine, Autonomous University of Barcelona (UAB), 08193 Barcelona, Spain
- Child and Adolescent Psychiatry and Psychology Department, Hospital Sant Joan de Déu of Barcelona, 08950 Barcelona, Spain
| | - Montserrat Pamias
- Department of Mental Health, Parc Taulí-University Hospital of Sabadell, 08208 Barcelona, Spain
- Department of Psychiatry and Forensic Medicine, Unitat de Neurociència Traslacional I3PT-Inc., Autonomous University of Barcelona (UAB), 08193 Barcelona, Spain
- Department of Psychiatry, Hospital de la Santa Creu i Sant Pau, 08041 Barcelona, Spain
- Department of Psychiatry and Forensic Medicine, Autonomous University of Barcelona (UAB), 08193 Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), 28029 Madrid, Spain
- Institut d’Investigació i Innovació Parc Taulí I3PT-CERCA, 08208 Sabadell, Spain
| | - Marc Fradera-Jiménez
- Department of Mental Health, Parc Taulí-University Hospital of Sabadell, 08208 Barcelona, Spain
- Department of Psychiatry and Forensic Medicine, Unitat de Neurociència Traslacional I3PT-Inc., Autonomous University of Barcelona (UAB), 08193 Barcelona, Spain
- Department of Psychiatry, Hospital de la Santa Creu i Sant Pau, 08041 Barcelona, Spain
- Department of Psychiatry and Forensic Medicine, Autonomous University of Barcelona (UAB), 08193 Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), 28029 Madrid, Spain
- Institut d’Investigació i Innovació Parc Taulí I3PT-CERCA, 08208 Sabadell, Spain
| | - Itziar Montalvo-Aguirrezabala
- Department of Mental Health, Parc Taulí-University Hospital of Sabadell, 08208 Barcelona, Spain
- Department of Psychiatry and Forensic Medicine, Unitat de Neurociència Traslacional I3PT-Inc., Autonomous University of Barcelona (UAB), 08193 Barcelona, Spain
- Department of Psychiatry, Hospital de la Santa Creu i Sant Pau, 08041 Barcelona, Spain
- Department of Psychiatry and Forensic Medicine, Autonomous University of Barcelona (UAB), 08193 Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), 28029 Madrid, Spain
- Institut d’Investigació i Innovació Parc Taulí I3PT-CERCA, 08208 Sabadell, Spain
| | - Diego J. Palao
- Department of Mental Health, Parc Taulí-University Hospital of Sabadell, 08208 Barcelona, Spain
- Department of Psychiatry and Forensic Medicine, Unitat de Neurociència Traslacional I3PT-Inc., Autonomous University of Barcelona (UAB), 08193 Barcelona, Spain
- Department of Psychiatry, Hospital de la Santa Creu i Sant Pau, 08041 Barcelona, Spain
- Department of Psychiatry and Forensic Medicine, Autonomous University of Barcelona (UAB), 08193 Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), 28029 Madrid, Spain
- Institut d’Investigació i Innovació Parc Taulí I3PT-CERCA, 08208 Sabadell, Spain
| |
Collapse
|
43
|
Yarar EZ, Bulut BP, Demirbaş H. Does Gender Really Matter: Childhood Trauma, Trait Anger, and Suicide Risk in Early Adulthood. JOURNAL OF INTERPERSONAL VIOLENCE 2023; 38:NP1222-NP1238. [PMID: 35435769 DOI: 10.1177/08862605221087704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Background: Previous studies have reported mixed findings regarding gender differences in suicidal behavior. This discrepancy may be partly attributable to common predictors of suicide risk, such as childhood trauma and anger, and may also be independent of gender. Objectives: The present study investigated gender differences in the impact of childhood trauma and current trait anger on suicide risk, in a group of young Turkish adults. We hypothesized that trait anger would mediate the association between childhood trauma and suicide risk, independently of gender. Participants and Setting: Participants were 589 university students (84.3% women) aged 18-34 years (M = 21.43, SD = 1.82). Methods: Gender group differences in suicide risk, history of childhood trauma, and trait anger as well as possible covariates (i.e., self-rated socio-economic status and academic performance) were assessed. Possible predictors of suicide risk in gender groups were examined. The role of trait anger as a mediator of the relationship between childhood trauma and suicide risk was also examined. Results: Results showed that men reported a higher suicide risk, history of childhood trauma, and trait anger than women. Early childhood trauma and current trait anger scores were significant predictors of suicide risk in both gender groups. Trait anger significantly mediated the relationship between early trauma history and risk for suicide, independently of gender. Conclusions: Study findings support early reports of the effects of childhood trauma and trait anger on suicide risk. It was suggested that preventive interventions for suicidal behavior and monitoring risk groups with aggressive tendencies and childhood trauma history may be important.
Collapse
Affiliation(s)
- Esra Zıvralı Yarar
- Department of Psychology, 390121Social Sciences University of Ankara, Ankara, Turkey
| | - Burcu Pınar Bulut
- Department of Psychology, 523228Ankara Hacı Bayram Veli University, Ankara, Turkey
| | - Hatice Demirbaş
- Department of Psychology, 523228Ankara Hacı Bayram Veli University, Ankara, Turkey
| |
Collapse
|
44
|
Jin Y, Xu S, Hu Z, Li J, Li H, Wang X, Sun X, Wang Y. Co-occurrence of PTSD and affective symptoms in a large sample with childhood trauma subtypes: A network analysis. Front Public Health 2023; 11:1093687. [PMID: 36960378 PMCID: PMC10028141 DOI: 10.3389/fpubh.2023.1093687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 02/07/2023] [Indexed: 03/09/2023] Open
Abstract
Background Exposure to childhood trauma (CT) is associated with various deleterious mental health outcomes, increasing the risk of suicidal behaviors. The objective of this study is to investigate the different effects of three forms of CT, including emotional abuse (EA), physical abuse (PA), and sexual abuse (SA), on potential psychopathological symptoms among college students. Methods A total of 117,769 students from 63 Chinese colleges participated in this study. There were 1,191 participants in the EA group (1.24%; 95% CI: 1.17-1.31%), 1,272 participants in the PA group (1.32%; 95% CI: 1.25-1.40%), and 3,479 participants in the SA group (3.62%; 95% CI: 3.50-3.73%). CT was measured by the Childhood Trauma Questionnaire-Short Form. Psychopathological symptoms (i.e., depression, anxiety, and PTSD) were measured by the PHQ-9, GAD-7, and Trauma Screening Questionnaire, respectively. Network analysis was applied to analyze psychopathological symptoms between three CT subgroups (EA, PA, and SA). The associations and centralities of the networks were calculated, and the network characteristics of the three subgroups were contrasted. Results The main symptoms across all three groups are uncontrollable worry, sad mood, irritability, and fatigue, which indicates these core symptoms play essential roles in maintaining the whole psychological symptoms network. Furthermore, there are significant differences in symptom associations between the three groups. The comparison of network structures of the three groups shows that the SA group reports more PTSD symptoms, the EA group reports more suicide-related symptoms, and the PA group reports more anxiety symptoms. Conclusion Specific symptoms were disclosed across each group by the distinctive core psychopathological symptoms found in the CT subgroup networks. The present study's findings show different associations between CT and psychopathology and may help classify potential diagnostic processes. Therefore, local governments and academic institutions are recommended for early intervention to promote the psychological well-being of CT survivors.
Collapse
Affiliation(s)
- Yu Jin
- College of Education for the Future, Beijing Normal University, Beijing, China
| | - Shicun Xu
- Northeast Asian Research Center, Jilin University, Changchun, China
- Department of Population, Resources and Environment, Northeast Asian Studies College, Jilin University, Changchun, China
- China Center for Aging Studies and Social-Economic Development, Jilin University, Changchun, China
- *Correspondence: Shicun Xu
| | - Zhishan Hu
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jiaqi Li
- Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, China; School of Psychology, Center for Studies of Psychological Application, and Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, China
| | - Hui Li
- School of Public Health, Jilin University, Changchun, China
| | - Xiaofeng Wang
- Northeast Asian Research Center, Jilin University, Changchun, China
| | - Xi Sun
- Department of Population, Resources and Environment, Northeast Asian Studies College, Jilin University, Changchun, China
| | - Yuanyuan Wang
- Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, China; School of Psychology, Center for Studies of Psychological Application, and Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, China
- Yuanyuan Wang
| |
Collapse
|
45
|
Dwivedi Y, Shelton RC. Genomics in Treatment Development. ADVANCES IN NEUROBIOLOGY 2023; 30:363-385. [PMID: 36928858 DOI: 10.1007/978-3-031-21054-9_15] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/18/2023]
Abstract
The Human Genome Project mapped the 3 billion base pairs in the human genome, which ushered in a new generation of genomically focused treatment development. While this has been very successful in other areas, neuroscience has been largely devoid of such developments. This is in large part because there are very few neurological or mental health conditions that are related to single-gene variants. While developments in pharmacogenomics have been somewhat successful, the use of genetic information in practice has to do with drug metabolism and adverse reactions. Studies of drug metabolism related to genetic variations are an important part of drug development. However, outside of cancer biology, the actual translation of genomic information into novel therapies has been limited. Epigenetics, which relates in part to the effects of the environment on DNA, is a promising newer area of relevance to CNS disorders. The environment can induce chemical modifications of DNA (e.g., cytosine methylation), which can be induced by the environment and may represent either shorter- or longer-term changes. Given the importance of environmental influences on CNS disorders, epigenetics may identify important treatment targets in the future.
Collapse
Affiliation(s)
- Yogesh Dwivedi
- Department of Psychiatry and Behavioral Neurobiology, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Richard C Shelton
- Department of Psychiatry and Behavioral Neurobiology, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA.
| |
Collapse
|
46
|
Dissecting early life stress-induced adolescent depression through epigenomic approach. Mol Psychiatry 2023; 28:141-153. [PMID: 36517640 PMCID: PMC9812796 DOI: 10.1038/s41380-022-01907-x] [Citation(s) in RCA: 20] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 11/29/2022] [Accepted: 12/02/2022] [Indexed: 12/15/2022]
Abstract
Early life stress (ELS), such as abuse and neglect during childhood, can lead to psychiatric disorders in later life. Previous studies have suggested that ELS can cause profound changes in gene expression through epigenetic mechanisms, which can lead to psychiatric disorders in adulthood; however, studies on epigenetic modifications associated with ELS and psychiatric disorders in adolescents are limited. Moreover, how these epigenetic modifications can lead to psychiatric disorders in adolescents is not fully understood. Commonly, DNA methylation, histone modification, and the regulation of noncoding RNAs have been attributed to the reprogramming of epigenetic profiling associated with ELS. Although only a few studies have attempted to examine epigenetic modifications in adolescents with ELS, existing evidence suggests that there are commonalities and differences in epigenetic profiling between adolescents and adults. In addition, epigenetic modifications are sex-dependent and are influenced by the type of ELS. In this review, we have critically evaluated the current evidence on epigenetic modifications in adolescents with ELS, particularly DNA methylation and the expression of microRNAs in both preclinical models and humans. We have also clarified the impact of ELS on psychiatric disorders in adolescents to predict the development of neuropsychiatric disorders and to prevent and recover these disorders through personalized medicine.
Collapse
|
47
|
Chang H, Yao Z, Zhang Y, Chen J, Shi P. The relationship between abuse and neglect and adolescent suicidality: A moderated mediation model. Front Psychol 2022; 13:1019878. [PMID: 36467224 PMCID: PMC9714442 DOI: 10.3389/fpsyg.2022.1019878] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Accepted: 10/25/2022] [Indexed: 08/26/2023] Open
Abstract
Abuse and neglect can lead to suicide in adolescents; however, the internal mechanisms between abuse and neglect and suicidality remain unclear. We hypothesized that abuse and neglect could affect adolescent suicidality, and that mediating and moderating mechanisms exist between these two variables. We tested the mediating effects of stressful life events (misunderstanding and discrimination by others, poor academic performance, failed exams, interpersonal problems, and school punishment) on suicidal tendencies and moderating effects of resilience among 5,852 adolescents from 37 middle schools in five provinces of North, south, East, west, and central China. We used a questionnaire to collect data and adopted structural equation modeling to verify the correlation, mediating, and moderating effects among the variables. The results showed that stressful life events mediated the relationship between abuse, neglect, and suicide. Furthermore, resilience moderated the direct effect and second half of the mediating effect.
Collapse
Affiliation(s)
- Hongjuan Chang
- School of Nursing, Xinxiang Medical College, Xinxiang, China
| | - Zhenzhu Yao
- Graduate School of China Medical University, Shenyang, China
| | - Yu Zhang
- School of Nursing and Health, Henan University, Kaifeng, China
| | - Jiaqi Chen
- School of Nursing, Xinxiang Medical College, Xinxiang, China
| | - Peipei Shi
- College of Life Science and Technology, Xinxiang Medical College, Xinxiang, China
| |
Collapse
|
48
|
Alabi AA. Suicide attempts among students of higher education, Nelson Mandela Bay Municipality, South Africa. S Afr Fam Pract (2004) 2022; 64:e1-e7. [PMID: 36453798 PMCID: PMC9724133 DOI: 10.4102/safp.v64i1.5609] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 08/26/2022] [Accepted: 08/26/2022] [Indexed: 12/06/2023] Open
Abstract
BACKGROUND Worldwide, death by suicide is a leading cause of death among young people, and students of higher educational institutions constitute a vulnerable group. This study aimed to determine the lifetime prevalence and associated factors of suicide attempt among students of a higher education institution in Nelson Mandela Municipality. METHODS A cross sectional study was conducted among students of East Cape Midland College in Nelson Mandela Municipality. The participants were selected by stratified random sampling and a standardised self-administered questionnaire was used to collect data. RESULTS The prevalence of lifetime suicide attempts was 16.0% among the participants. Multivariate logistic regression analysis revealed higher odds of suicide attempts among participants who: experienced bullying (OR: 1.66, CI: 1.05-2.61; p 0.001), had underlying medical conditions (OR: 3.27, CI: 2.08-5.14; p 0.001), had abnormal body weight perceptions (OR: 1.64, CI: 1.03-2.62; p 0.05), had experienced sexual abuse (OR: 5.72, CI: 2.86-11.45; p 0.001), or had someone very close who had experienced sexual abuse (OR: 1.77, CI: 1.02-3.05; p 0.05). CONCLUSION This study identified history of sexual abuse, bullying, perceptions of abnormal body weight and underlying medical conditions as associated risk factors of suicide attempts among the participants. The high prevalence of suicide attempts among the participants (16%) demonstrates the urgent need for campus-based interventions and prevention strategies aimed at addressing the identified associated factors.
Collapse
Affiliation(s)
- Adeyinka A Alabi
- Department of Family Medicine, Faculty of Health Science, Walter Sisulu University, Port Elizabeth, South Africa; and, Department of Family Medicine, Dora Nginza Provincial Hospital, Port Elizabeth.
| |
Collapse
|
49
|
Ozakar Akca S, Oztas G, Karadere ME, Yazla Asafov E. Childhood trauma and its relationship with suicide probability and Self-Esteem: A case study in a university in Turkey. Perspect Psychiatr Care 2022; 58:1839-1846. [PMID: 34904227 DOI: 10.1111/ppc.12997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 11/14/2021] [Accepted: 11/16/2021] [Indexed: 12/01/2022] Open
Abstract
PURPOSE The aim of this study is to investigate to what extent childhood trauma affects suicide probability and self-esteem of university students. DESIGN AND METHODS In this descriptive study, 3602 university students continuing their education in the 2019-2020 academic year were selected into the sample. The data in the study were collected using a personal information form, "Childhood Trauma Questionnaire (CTQ)", "Suicide Probability Scale (SPS)" and Rosenberg Self-Esteem Scale (RSES). The data were evaluated using appropriate statistical methods, and p < 0.05 value was considered statistically significant. FINDINGS In the study, students' mean scale scores of CTQ and SPS were found high (38.1 ± 13.7; 87.7 ± 10.7, respectively), and the RSES total mean scale score was found average (1.7 ± 1.4). CTQ total mean score was found to show a positive correlation between SPS and RSES total mean scores. It has been established that the past traumatic experiences of university students decrease self-esteem and are associated with suicide probability. PRACTICE IMPLICATIONS Risk management programs for university students should be organized by determining the risk groups exposed to Childhood Trauma by psychiatric and child nurses.
Collapse
Affiliation(s)
- Selen Ozakar Akca
- Department of Child Health and Diseases Nursing, Faculty of Health Sciences, Hitit University, Corum, Turkey
| | - Gulay Oztas
- Department of Child Health and Diseases Nursing, Faculty of Health Sciences, Yozgat Bozok University, Yozgat, Turkey
| | - Mehmet Emrah Karadere
- Department of Psychiatry, Faculty of Medical, Medeniyet University, Istanbul, Turkey
| | - Ece Yazla Asafov
- Department of Mental Health and Disease, Faculty of Medical, Hitit University, Corum, Turkey
| |
Collapse
|
50
|
Özsoy F, Taşcı G, Kulu M, Okan F, Yılmaz S, Korkmaz S, Atmaca M. Stigmas and childhood traumas associated with psychological help-seeking in suicide attempted individuals. Perspect Psychiatr Care 2022; 58:2970-2977. [PMID: 35975396 DOI: 10.1111/ppc.13148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 06/27/2022] [Accepted: 08/06/2022] [Indexed: 11/30/2022] Open
Abstract
PURPOSE The aim was to investigate the possible associations of suicide attempt with childhood trauma, social support, psychological support seeking, stigmatizations. The study was case-control study and included 100 participants (50 suicide, 50 controls). CONCLUSION BDI, BAI scores were higher in the patient (p < 0.001). While scores of all-subscales of Childhood-Trauma-Questionnaire were higher (p < 0.05) in the patients, scores of Perceived-Social-Support were lower (p < 0.001). Repeating suicide attempts has higher Stigma-Scale-for-Receiving-Psychological-Help scores than the patients who attempted to the first time (p = 0.045). PRACTICE IMPLICATION Suicide is relationship with more childhood traumas, less social support. Repeating suicide attempts, individuals felt public stigma for receiving psychological help.
Collapse
Affiliation(s)
- Filiz Özsoy
- Department of Psychiatry, Gaziosmanpaşa University School of Medicine, Tokat, Turkey
| | - Gülay Taşcı
- Department of Psychiatry, Elazig Fethi Sekin City Hospital, Elazig, Turkey
| | - Müberra Kulu
- Department of Psychiatry, Tokat State Hospital, Tokat, Turkey
| | - Fatih Okan
- Public Health Nursing, Gaziosmanpaşa University School of Medicine, Tokat, Turkey
| | - Seda Yılmaz
- Department of Psychiatry, Elazıg Medical Park Hospital, Istınye University, Elazıg, Turkey
| | - Sevda Korkmaz
- Department of Psychiatry, Fırat University School of Medicine, Elazıg, Turkey
| | - Murad Atmaca
- Department of Psychiatry, Fırat University School of Medicine, Elazıg, Turkey
| |
Collapse
|