Clinical and personality profile of depressed suicide attempters: A preliminary study at the open-door policy Mood Disorder Unit of San Raffaele Hospital

Association between sleep duration, suicidal ideation, suicidal attempt and suicidal behavior among Chinese adolescents

BACKGROUND

A relatively small number of studies have researched the relationship between sleep duration and suicidal ideation, attempts, and behavior. This research aims to investigate the link between sleep duration and suicide in Chinese adolescents, and to examine the role of depression as a mediating factor.

METHOD

Data were collected from 3315 students using a multi-stage random cluster sampling method and self-administered questionnaires. The study applied logistic regression to investigate the relationship between sleep duration and various forms of suicidal behavior, and mediation analysis to understand how depression might influence this relationship.

RESULTS

The average sleep duration among the adolescents was 7.25 h (±0.20), with 59.67 % reporting insufficient sleep. The logistic regression analysis showed that longer sleep duration is linked with lower risks of suicidal ideation (OR: 0.753, 95%CI: 0.696 to 0.814), suicidal attempts (OR: 0.830, 95%CI: 0.748 to 0.922), and suicidal behavior (OR: 0.841, 95%CI: 0.713 to 0.992). Analysis using restricted cubic spline plots indicated the connection between sleep duration and these suicidal factors was not linear. The study found that depression plays a partial mediating role between sleep duration and suicidal ideation, with an effect of 52.29 %.

LIMITATIONS

The cross-sectional study design could not prove causation.

CONCLUSIONS

There is a clear non-linear association between sleep duration and suicidal tendencies in adolescents, with depression acting as a mediator. This suggests that future research could focus on sleep and mood management as ways to address suicide risk in this age group.

Mood disorders and suicide: pilot study on postmortem toxicologic evidence and adherence to psychiatric therapy by determining blood levels of medications

Suicide is one of the leading causes of death today, and among all mental illness, mood disorders account for one of the main risk factors. It is well known and proven that suicides are very common among people undergoing treatment and prescribed psychiatric medication. So far, however, there have only been a few studies dealing with this particular phenomenon. For this reason, autopsy patients who died by suicide, suffered from a mood disorder, and were known to be taking psychiatric medication at the time of death were selected for this study. The blood and urine samples taken during the autopsy underwent toxicological analysis and the results were compared with the prescribed therapy. A total of 22 people were included in the study: 12 presenting with depression and 10 with bipolar disorder. The toxicological analysis revealed that only 6 cases (27%) showed a qualitative match with the prescribed medication. In 5 cases (22.7%) the medication was only partially complied with and in 11 cases (50%) it was not complied with at all. Furthermore, even when medication was present, the value was often below the therapeutic range. Overall, more than 70% of the test subjects adhered to their medication only partially or not at all. Since treatment adherence is considered as a key factor in reducing the risk of suicide, this inevitably raises relevant clinical and forensic questions. Against this background, prospective monitoring of post-mortem medication levels in suicidal individuals and synergistic collaboration between clinicians and forensic pathologists could help to evaluate the effectiveness of specific medical interventions, highlight existing critical problems and develop new approaches to suicide prevention.

Childhood maltreatment and personality disorders in adolescents and adults with psychotic or non-psychotic disorders

Introduction

While the attention to personality disorders (PD) and childhood maltreatment (CM) has grown in recent years, there remains limited understanding of the prevalence and distinctions of PD and CM in clinical populations of Chinese adolescents in comparison to adults.

Methods

A total of 1,417 participants were consecutively sampled from patients diagnosed with either psychotic or non-psychotic disorders in the psychiatric and psycho-counseling clinics at Shanghai Mental Health Center. The participants were categorized into two groups based on their age: adolescents (aged 15-21 years) and adults (aged 22-35 years). PDs were evaluated using a self-reported personality diagnostic questionnaire and a structured clinical interview, while CMs were assessed using the Chinese version of the Child Trauma Questionnaire Short Form.

Results

When comparing self-reported PD traits and CM between adolescents and adults, differences emerge. Adolescents, particularly in the psychotic disorder group, exhibit more pronounced schizotypal PD traits (p=0.029), and this pattern extends to non-psychotic disorders (p<0.001). Adolescents in the non-psychotic disorder group also report higher levels of emotional abuse (p=0.014), with a notable trend in physical abuse experiences compared to adults (p=0.057). Furthermore, the most prevalent PDs in the clinical sample are avoidant, borderline, and obsessive-compulsive PDs. Among patients with psychotic disorders, adolescents exhibit higher rates of schizoid, schizotypal, and obsessive-compulsive PDs compared to adults. Logistic regression analyses highlight distinct predictors for psychotic and non-psychotic disorders in adolescents and adults.

Discussion

The findings emphasize distinct differences in PDs and CMs between adolescent and adult groups, shedding light on their potential roles in psychotic and non-psychotic disorders.

The role of clinical and Personological features in predicting high lethality suicide attempts: A study among mood disorder patients

Suicidal attempts (SA) represent heterogeneous behaviours ranging in their seriousness from fatal and near-fatal (high-lethality) cases to those that do not require medical attention (low lethality). These considerations stress the need to identify high-risk individuals for high lethality SA in order to target suicide preventive interventions. The present study aims at evaluating the role of sociodemographic and clinical variables and examining personality pathological features in predicting high lethality SA. The sample was composed by 94 patients who were consecutively admitted to the Mood Disorders Unit of the San Raffaele Turro Hospital in Milan. The results of binary logistic regression analyses showed that previous SA and current suicide ideation play a role in predicting serious SA. Considering the DSM-5 personality dysfunctional domains assessed by the Personality Inventory for DSM-5, our logistic regression analyses suggested that high lethality SA was associated with Detachment PID-5 domain. Finally, binary hierarchical regression analysis showed that Detachment domain remained a significant predictor of serious SA over and above the effect of previous SA and suicide ideation. As a whole, our results highlight the importance of a multidimensional approach to develop adequate assessment, effective treatments and prevention of high lethality SA risk.

Validation of the German Five-Factor Narcissism Inventory and Construction of a Brief Form Using Ant Colony Optimization

Narcissism is a multifaceted construct commonly conceptualized as comprising grandiose and vulnerable aspects in a two-factor model. While the manifold correlates of these aspects imposed a challenge for research on the structure of narcissism, recent models converge in a three-factor structure of agentic-extraverted, antagonistic, and neurotic aspects, capturing variance in different conceptualizations and correlates of narcissism. We construct and validate a German adaptation of the Five-Factor Narcissism Inventory (FFNI), a measure assessing these aspects based on the Five-Factor Model. In eight samples (N = 2,921), we found the German FFNI to align with both, two- and three-factor models. The factors display good criterion validity with other narcissism measures, (non-)clinical personality dimensions, interpersonal styles, and (mal-)adaptive adjustment. Neurotic and antagonistic narcissism discriminated between individuals with/without mental disorder diagnoses, and displayed a characteristic profile in incarcerated offenders. Since the FFNI is comprehensive but long, we constructed a 30-item brief form (FFNI-BF) optimizing the internal structure and external validity using ant colony optimization. The FFNI-BF displayed good psychometric characteristics and similar, in certain aspects even advantageous criterion validity. We conclude that the German FFNI validly measures key aspects of narcissism, and the FFNI-BF captures these in a concise manner.

Effects of Personality Characteristics of Different Genders and Quality of Life Analysis on Risk Factors for Suicide in Depressive Patients

Objective

The study was to explore the roles of personality characteristics of different genders and analyze the risk factors of quality of life (QOL) analysis in suicide among depressive patients.

Methods

One hundred and eighty-six depressive patients from January 2018 to March 2019 in the Department of Psychiatry of our hospital were enrolled and divided into Groups A and B considering whether they had a suicidal tendency or not. Among them, 90 in Group A had a suicidal tendency and consisted of 42 males and 48 females, while 96 in Group B had no suicidal tendency and consisted of 44 males and 52 females. Forward and backward selection and then backward selection were performed on all the variables of gender characteristic factors and QOL factors that may cause suicide, on which stepwise regression was finally conducted. Next, univariate logistic regression analysis was first performed to select important variables from the related risk factors that may cause suicide, and then, the multivariate logistic regression model was used to select important independent risk factors. Results and Conclusion. The age of onset, degree of anxiety, moral support, positive mental attitude, and family independence were the independent risk factors that may cause a suicidal tendency for male depressive patients. The age of onset, degree of anxiety, negative life events, moral support, positive mental attitude, family intimacy, psychoticism, and neuroticism were the independent risk factors for female depressive patients. Physiological function, role physical, bodily pain, social function, and emotional role in QOL may be the independent risk factors for a suicidal tendency.