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Wei Z, Ren L, Wang X, Liu C, Cao M, Hu M, Jiang Z, Hui B, Xia F, Yang Q, Liu Y, Deng Y. Network of depression and anxiety symptoms in patients with epilepsy. Epilepsy Res 2021; 175:106696. [PMID: 34186384 DOI: 10.1016/j.eplepsyres.2021.106696] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 05/23/2021] [Accepted: 06/19/2021] [Indexed: 12/13/2022]
Abstract
PURPOSE Depression and anxiety are often comorbid in people with epilepsy. Network models consider this comorbidity as an interacting system of depressive and anxiety symptoms. The present study investigates the network structure of depressive and anxiety symptoms in people with epilepsy and aims to identify the central and bridge symptoms to provide suggestions for the prevention of and intervention for depression-anxiety comorbidity in patients with epilepsy. METHODS A total of 313 patients with epilepsy were enrolled in our study. Anxiety symptoms were evaluated with the Generalized Anxiety Disorder 7-Item questionnaire. Depressive symptoms were evaluated with the Patient Health Questionnaire-9. Network analyses were used for the statistical analysis. RESULTS The findings indicated that ten edges with the strongest regularized partial correlations existed in the network. Six were among depressive symptoms, such as "sleep difficulties" with "fatigue" and " feeling of worthlessness" with "thoughts of death". Four were among anxiety symptoms, such as "nervousness or anxiety" with "uncontrollable worry" and "uncontrollable worry" with "worry too much". Those strongest edges had no connection linking anxiety and depressive symptoms. The symptoms "depressed or sad mood", "trouble relaxing" and "uncontrollable worry" had the highest strength centrality in the network. The results revealed three bridge symptoms: "psychomotor agitation/retardation", "irritable", and "depressed or sad mood". CONCLUSION "Feeling of worthlessness" was identified as a key priority due to associations with suicidal ideation. The current study highlighted the critical central symptoms "depressed or sad mood", "trouble relaxing" and "uncontrollable worry" and the critical bridge symptoms "psychomotor agitation/retardation", "irritable", and "depressed or sad mood". Implications for clinical prevention and intervention based on these symptoms are discussed.
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Affiliation(s)
- Zihan Wei
- Department of Neurology, Xijing Hospital, Fourth Military Medical University, Xi'an, 710032, People's Republic of China
| | - Lei Ren
- Department of Clinical Psychology, Fourth Military Medical University, 169 West Changle Road, Xi'an, 710032, People's Republic of China
| | - Xiaomu Wang
- Department of Neurology, Xijing Hospital, Fourth Military Medical University, Xi'an, 710032, People's Republic of China
| | - Chao Liu
- Department of Neurology, Xijing Hospital, Fourth Military Medical University, Xi'an, 710032, People's Republic of China
| | - Mi Cao
- Department of Neurology, Xijing Hospital, Fourth Military Medical University, Xi'an, 710032, People's Republic of China
| | - Mengmeng Hu
- Department of Neurology, Xijing Hospital, Fourth Military Medical University, Xi'an, 710032, People's Republic of China
| | - Zhao Jiang
- Department of Neurology, Xijing Hospital, Fourth Military Medical University, Xi'an, 710032, People's Republic of China
| | - Bo Hui
- Department of Neurology, Xijing Hospital, Fourth Military Medical University, Xi'an, 710032, People's Republic of China
| | - Feng Xia
- Department of Neurology, Xijing Hospital, Fourth Military Medical University, Xi'an, 710032, People's Republic of China
| | - Qun Yang
- Department of Clinical Psychology, Fourth Military Medical University, 169 West Changle Road, Xi'an, 710032, People's Republic of China
| | - Yonghong Liu
- Department of Neurology, Xijing Hospital, Fourth Military Medical University, Xi'an, 710032, People's Republic of China.
| | - Yanchun Deng
- Department of Neurology, Xijing Hospital, Fourth Military Medical University, Xi'an, 710032, People's Republic of China.
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Li X, Ding S, Hua Y, Gong J, Dong F, Lin J, Du Y, Xia N, Zhu Z, Wang X, Zheng R, Xu H. Comparison of the performance of suicide ideation scales in adult patients with epilepsy in China. Epilepsy Behav 2020; 112:107405. [PMID: 33181897 DOI: 10.1016/j.yebeh.2020.107405] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2020] [Revised: 07/31/2020] [Accepted: 08/06/2020] [Indexed: 11/27/2022]
Abstract
OBJECTIVE The aims of this study were to evaluate and compare the performance of the Chinese version of the Suicide Ideation Scale-Current (SSI-C) and the Suicide Ideation Scale-Worst (SSI-W) as suicide ideation screening tools in patients with epilepsy (PWE). METHODS A consecutive sample of Chinese adult PWE recruited from a tertiary hospital completed the SSI-C and SSI-W and the suicidality module of the Chinese version of the Mini International Neuropsychiatric Interview (MINI) Plus 5.0.0. RESULTS A total of 260 consecutive PWE were recruited. The area under the curve (AUC) for the SSI-C was 0.831, and the optimal cutoff score was >1 (sensitivity 73%, specificity 91%); for the SSI-W, the AUC was 0.958, and the optimal cutoff score was >2 (sensitivity 94.6%, specificity 87.4%). The AUC for the SSI-W was larger than that for the SSI-C, and the two-factor structure was considered significant. CONCLUSION Our results showed that the SSI-C and SSI-W had good validity as suicidal ideation screening tools in PWE in southern China and can be recommended for clinical suicidal ideation screening. The SSI-W is a better suicidal ideation screening tool than the SSI-C according to the results of our study.
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Affiliation(s)
- Xueying Li
- Department of Neurology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, PR China
| | - Siqi Ding
- Department of Neurology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, PR China
| | - Yingjie Hua
- Department of Neurology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, PR China
| | - Jiaoni Gong
- Department of Neurology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, PR China
| | - Feirong Dong
- Department of Psychiatry, the First Affiliated Hospital of Wenzhou, Medical University, Wenzhou, Zhejiang Province, PR China
| | - Jiahe Lin
- Department of Neurology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, PR China
| | - Yanru Du
- Department of Neurology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, PR China
| | - Niange Xia
- Department of Neurology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, PR China
| | - Zhenguo Zhu
- Department of Neurology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, PR China
| | - Xinshi Wang
- Department of Neurology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, PR China
| | - Rongyuan Zheng
- Department of Neurology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, PR China
| | - Huiqin Xu
- Department of Neurology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, PR China.
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Anestis MD, Mohn RS, Dorminey JW, Green BA. Detecting Potential Underreporting of Suicide Ideation Among U.S. Military Personnel. Suicide Life Threat Behav 2019; 49:210-220. [PMID: 29281745 DOI: 10.1111/sltb.12425] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2016] [Accepted: 08/29/2017] [Indexed: 11/29/2022]
Abstract
Using a military sample comprised largely of National Guard personnel, zero-inflation negative binomial regression was applied to estimate the effects of indirect, nonface valid indicators of suicide ideation [Thwarted Belongingness (TB), Perceived Burdensomeness (PB), and Hopelessness], in predicting suicide ideation. Data from a sample of 497 military personnel (82.1% male; mage = 27.24; range = 18-59) were analyzed. TB and the interaction of TB with Hopelessness were significant predictors in the logistic regression, and in the negative binomial regression, the main effects of TB and hopelessness, and the interactions of TB with hopelessness and PB with hopelessness were significant. The findings further indicated that approximately 10% of those not reporting ideation would be predicted to be ideators. Clinically, these results indicate that, in samples reluctant to report ideation, the assessment of suicide risk may improve through the use of relevant measures that do not explicitly reference suicide thoughts.
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Affiliation(s)
| | - Richard S Mohn
- University of Southern Mississippi, Hattiesburg, MS, USA
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Liu Y, Usman M, Zhang J, Gul H. Making Sense of Chinese Employees' Suicidal Ideation: A Psychological Strain-Life Meaning Model. Psychol Rep 2018; 123:201-223. [PMID: 30439305 DOI: 10.1177/0033294118811096] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Using the strain theory of suicide, this study examines how psychological strains influence suicide ideation via the mediating mechanism of the meaning in life. To check the hypothesized model, data were drawn from professional employees ( n=687) across six organizations of various business types to increase the variability of respondent perception and the generalizability of the study findings. The results showed significant correlations among psychological strains, meaning in life, and suicide ideation. Furthermore, this study provides evidence for the mediation effect of meaning in life in the relationship between psychological strain and suicide ideation. Implications and future directions are discussed.
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Affiliation(s)
- Yuxin Liu
- Business School, University of International Business and Economics, Beijing, China
| | - Muhammad Usman
- Business School, University of International Business and Economics, Beijing, China
| | - Jianwei Zhang
- School of Humanities and Social Science, Beijing Institute of Technology, Beijing, China
| | - Habib Gul
- Business School, University of International Business and Economics, Beijing, China
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Kiosses DN, Alexopoulos GS, Hajcak G, Apfeldorf W, Duberstein PR, Putrino D, Gross JJ. Cognitive Reappraisal Intervention for Suicide Prevention (CRISP) for Middle-Aged and Older Adults Hospitalized for Suicidality. Am J Geriatr Psychiatry 2018; 26:494-503. [PMID: 29395858 PMCID: PMC5860974 DOI: 10.1016/j.jagp.2017.11.009] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2017] [Revised: 10/31/2017] [Accepted: 11/12/2017] [Indexed: 11/25/2022]
Abstract
Middle-aged and older adults constitute a high suicide-risk group. Among adults aged 50 years old and older, suicide rates increased and suicide deaths almost doubled during the period from 2000 to 2015. Suicide rates are elevated for patients hospitalized for suicidality (i.e., active suicidal ideation or suicide attempt) and the 3 months post-hospitalization is the time of the highest suicide risk. Psychosocial interventions for middle-aged and older adults hospitalized for suicidality are sparse. In this article, we present the main aspects, stages, techniques and a clinical case study of Cognitive Reappraisal Intervention for Suicide Prevention (CRISP), a psychosocial intervention targeting cognitive reappraisal to reduce suicide risk in middle-aged and older adults who have been recently hospitalized for suicidal ideation or a suicide attempt. CRISP is based on the theory that hospitalization for suicidality is preceded by an emotional crisis ("perfect storm"); this emotional crisis is related to personalized (patient- and situation-specific) triggers; and identifying these personalized triggers and the associated negative emotions and providing strategies for an adaptive response to these triggers and negative emotions will reduce suicidal ideation and improve suicide prevention. CRISP therapists identify these triggers of negative emotions and use cognitive reappraisal techniques to reduce these negative emotions. The cognitive reappraisal techniques have been selected from different psychosocial interventions and the affective neuroscience literature and have been simplified for use with middle-aged and older adults. CRISP may fill a treatment need for the post-discharge high-risk period for middle-aged and older adults hospitalized for suicidality.
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Affiliation(s)
- Dimitris N. Kiosses
- Psychology in Clinical Psychiatry, Weill-Cornell Institute of Geriatric Psychiatry, Weill Cornell Medical College
| | | | - Greg Hajcak
- Biomedical Sciences and Psychology, Florida State University
| | - William Apfeldorf
- Clinical Psychiatry, Weill-Cornell Institute of Geriatric Psychiatry, Weill Cornell Medicine
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Gustavson KA, Alexopoulos GS, Niu GC, McCulloch C, Meade T, Arean PA. Problem-Solving Therapy Reduces Suicidal Ideation In Depressed Older Adults with Executive Dysfunction. Am J Geriatr Psychiatry 2016; 24:11-17. [PMID: 26743100 PMCID: PMC5730069 DOI: 10.1016/j.jagp.2015.07.010] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2013] [Revised: 07/20/2015] [Accepted: 07/21/2015] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To test the hypothesis that Problem Solving Therapy (PST) is more effective than Supportive Therapy (ST) in reducing suicidal ideation in older adults with major depression and executive dysfunction. We further explored whether patient characteristics, such as age, sex, and additional cognitive impairment load (e.g., memory impairments) were related to changes in suicidal ideation over time. DESIGN Secondary data analysis using data from a randomized clinical trial allocating participants to PST or ST at 1:1 ratio. Raters were blind to patients' assignments. SETTING University medical centers. PARTICIPANTS 221 people aged 65 years old and older with major depression determined by Structured Clinical Interview for DSM-III-R diagnosis and executive dysfunction as defined by a score of 33 or less on the Initiation-Perseveration Score of the Mattis Dementia Rating Scale or a Stroop Interference Task score of 25 or less. INTERVENTIONS 12 weekly sessions of PST or ST. MAIN OUTCOME MEASURES The suicide item of the Hamilton Depression Rating Scale. RESULTS Of the 221 participants, 61% reported suicidal ideation (SI). The ST group had a lower rate of improvement in SI after 12 weeks (44.6%) than did the PST group (60.4%, Fisher's exact test p = 0.031). Logistic regression showed significantly greater reductions in SI in elders who received PST at both 12 weeks (OR: .50, Z = -2.16, p = 0.031) and 36 weeks (OR: 0.5, Z = -1.96, p = 0.05) after treatment. CONCLUSIONS PST is a promising intervention for older adults who are at risk for suicide. ClinicalTrials.gov Identifier: NCT00052091.
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Affiliation(s)
| | | | - Grace C. Niu
- University of California, San Francisco Department of Psychiatry
| | | | - Tanya Meade
- University of Western Sydney, School of Social Sciences and Psychology
| | - Patricia A. Arean
- University of Washington, Department of Psychiatry and Behavioral Sciences
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Abstract
Suicide in older adults is a significant clinical concern. In this review of recent findings, we concentrate on the role of emotions and cognition in suicide risk and behavior in older adults. We discuss the epidemiology of suicide in older adults, integrate recent findings on non-psychotic major depression, schizophrenia and suicidal ideation, explore the relationship of emotion regulation with suicide, present recent advances on suicide in demented patients, and describe the latest developments on cognition and decision processes in suicide.
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Affiliation(s)
- Dimitris N. Kiosses
- Associate Professor of Psychology in Clinical Psychiatry, Weill Cornell Medical College, Weill Cornell Institute of Geriatric Psychiatry, 21 Blomingdale Rd, White Plains, NY 10605, Phone: 914-997-4381,
| | - Katalin Szanto
- Associate Professor of Psychiatry, University of Pittsburgh, 3811 O'Hara St, Pittsburgh, PA 15213, Phone: 412-586-9601,
| | - George S. Alexopoulos
- Professor of Psychiatry, Weill Cornell Medical College, Weill Cornell Institute of Geriatric Psychiatry, 21 Bloomingdale Rd, White Plains, NY 10605, Phone: 914-997-5767,
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Abstract
IMPORTANCE We do not know whether the clinical criteria for major depression (MD) reflect a single or multiple dimensions of genetic risk. OBJECTIVE To determine the structure of genetic and environmental risk factors for the 9 DSM-IV symptomatic MD criteria. DESIGN Population-based twin registry. SETTING Virginia. PARTICIPANTS Seven thousand five hundred members of adult twin pairs from the Virginia Adult Twin Study of Psychiatric and Substance Use Disorders. MAIN OUTCOME MEASURE Symptoms of lifetime MD as assessed at personal interview. RESULTS The best-fit twin model was multidimensional, requiring 3 genetic, 1 common environmental and 3 unique environmental common factors, and criterion-specific unique environmental factors. The first genetic factor was characterized by high loadings on cognitive and psychomotor depressive symptoms. The second and third genetic factors had strong loadings for mood and neurovegetative depressive symptoms, respectively. Genetic factor scores derived from these 3 factors differentially predicted patterns of comorbidity, other historical/clinical features of MD, and demographic variables. These results suggested that the first genetic factor reflected a general liability to internalizing disorders, while the third genetic factor was more specific for melancholic MD. The 3 unique environmental common factors reflected, respectively, global depressive, core mood, and cognitive depressive symptoms. CONCLUSIONS AND RELEVANCE The DSM-IV syndrome of MD does not reflect a single dimension of genetic liability. Rather, these criteria reflect 3 underlying dimensions that index genetic risk for cognitive/psychomotor, mood, and neurovegetative symptoms. While in need of replication, these results, validated by predictions using estimated genetic factor scores, have implications for gene-finding efforts for MD.
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Affiliation(s)
- Kenneth S Kendler
- Virginia Institute for Psychiatric and Behavioral Genetics, Department of Psychiatry, Virginia Commonwealth University, Richmond 23298, USA.
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Rushing NC, Corsentino E, Hames JL, Sachs-Ericsson N, Steffens DC. The relationship of religious involvement indicators and social support to current and past suicidality among depressed older adults. Aging Ment Health 2013; 17:366-74. [PMID: 23121118 PMCID: PMC3596433 DOI: 10.1080/13607863.2012.738414] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Elderly people, particularly those with major depression, are at the highest risk for suicide than any other age group. Religious involvement is associated with a range of health outcomes including lower odds of death by suicide. However, not much is known about the effects of religious involvement on suicidal ideation in the elderly or which aspects of religiosity are beneficial. This study examined the relative influence of various conceptualizations of religious involvement, above and beyond the protective effects of social support, on current and past suicidality among depressed older adults. Participants were 248 depressed patients, 59 years and older, enrolled in the Neurocognitive Outcomes of Depression in the Elderly study. A psychiatrist assessed current suicidal ideation using the suicidal thoughts item from the Montgomery-Asberg Depression Rating Scale. Past history of suicide attempts, four religious involvement indicators, social support indicators, and control variables were assessed via self-report. Church attendance, above and beyond importance of religion, private religious practices, and social support, was associated with less suicidal ideation; perceived social support partially mediated this relationship. Current religious practices were not predictive of retrospective reports of past suicide attempts. Church attendance, rather than other religious involvement indicators, has the strongest relationship to current suicidal ideation. Clinicians should consider public religious activity patterns and perceived social support when assessing for other known risk and protective factors for suicide and in developing treatment plans.
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Affiliation(s)
| | | | | | | | - David C. Steffens
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center
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Wu GH, Tsao LI, Huang HC. Struggle Between Survival and Death: The Life Experiences of Taiwanese Older Adults with Suicidal Ideation. J Gerontol Nurs 2012; 38:37-44. [DOI: 10.3928/00989134-20120307-10] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Abstract
OBJECTIVES To examine whether there is an association between area socioeconomic status and the experience of suicidal ideation among older adults. DESIGN Secondary analyses of data from a prospective study of naturalistic outcomes of depressive symptoms. SETTING Monroe County, NY. PARTICIPANTS A cohort of older adults (≥65 years, N = 515) attending primary care settings. MEASUREMENTS Area socioeconomic status was based on the median household incomes of the census tracts (CTs) in which participants lived. At 6- and 12-month follow-up, the longitudinal interval follow-up evaluation was used to assess weekly depressive symptom status over the previous 6 months, which was used to construct a measure of any suicidal ideation during the study. RESULTS Residents of CTs with median household incomes of less than $30,000/yr were more likely to experience suicidal ideation than residents of higher income CTs (unadjusted odds ratio [OR], 4.60; 95% confidence interval [CI], 1.64-12.86). Adjustment for demographic and baseline clinical factors did not eliminate the association (OR, 5.44; 95% CI, 1.71-17.24). Subsequent models that adjusted for medical, functional, and psychosocial variables did not explain this association either. CONCLUSIONS There is a robust association between lower CT income and the occurrence of suicidal ideation in a primary care cohort of older adults over 1 year. These findings indicate the need for more research into how social worlds come to influence the emotional well being of older adults and whether social factors such as CT income can be used to identify individuals at increased risk for suicidal behavior.
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Violanti JM, Charles LE, Hartley TA, Mnatsakanova A, Andrew ME, Fekedulegn D, Vila B, Burchfiel CM. Shift-work and suicide ideation among police officers. Am J Ind Med 2008; 51:758-68. [PMID: 18704914 DOI: 10.1002/ajim.20629] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND This cross-sectional study assessed the association of shift work with suicide ideation among police officers. METHODS Shift work was based on daily payroll records over 5 years (41 women, 70 men). Standardized psychological measures were employed. ANOVA and Poisson regression were used to evaluate associations. RESULTS Among policewomen with increased depressive symptoms, prevalence of suicide ideation increased by 116% for every 10-unit increase in percentage of hours worked on day shift (prevalence ratio (PR) = 2.16; 95% confidence interval (CI) = 1.22-3.71). Among policemen with higher (but not lower) posttraumatic stress disorder (PTSD) symptoms, prevalence of suicide ideation increased by 13% with every 10-unit increase in the percentage of hours worked on afternoon shift (PR = 1.13; 95% CI = 1.00-1.22). CONCLUSION Prevalence of suicide ideation significantly increased among policewomen with higher depressive symptoms and increasing day shift hours, and among policemen with higher PTSD symptoms with increasing afternoon shift hours.
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Affiliation(s)
- John M Violanti
- Department of Social & Preventive Medicine, School of Public Health & Health Professions, State University of NY at Buffalo, Buffalo, New York
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Chapman AL, Lynch TR, Rosenthal MZ, Cheavens JS, Smoski MJ, Krishnan KRR. Risk Aversion Among Depressed Older Adults with Obsessive Compulsive Personality Disorder. COGNITIVE THERAPY AND RESEARCH 2007. [DOI: 10.1007/s10608-006-9114-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Abstract
Further inquiry into processes that lead to suicide in the police occupation is necessary. Suicide ideation in police officers and possible correlates associated with such ideation is explored in this paper. The focus was on psychologically traumatic police work experiences, the development of posttraumatic stress (PTSD) in officers, and the inordinate use of alcohol associated with this condition. The impact of these occupationally based factors and their association with suicide ideation has not yet been fully explored. Results suggest that certain traumatic police work exposures increase the risk of high level PTSD symptoms, which subsequently increase the risk of high alcohol use and suicide ideation. The combined impact of PTSD and increased alcohol use led to a ten-fold increase risk for suicide ideation.
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Affiliation(s)
- John M Violanti
- School of Public Health and Health Professions, State University of New York at Buffalo, 270 Farber Hall, Buffalo, NY, USA.
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Useda JD, Duberstein PR, Conner KR, Conwell Y. Personality and attempted suicide in depressed adults 50 years of age and older: a facet level analysis. Compr Psychiatry 2004; 45:353-61. [PMID: 15332198 DOI: 10.1016/j.comppsych.2004.06.002] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
We examined the contribution of personality traits to attempted suicide, the number of suicidal attempts, and suicidal ideation in a sample of depressed inpatients. Personality was assessed via the Revised NEO Personality Inventory (NEO-PI-R). Bivariate analyses showed that suicide attempters were more self-conscious, self-effacing, impulsive, and vulnerable to stress, and less warm, gregarious, and inclined to experience positive emotions. Multivariate regression analyses controlling for age, gender, severity of depression, and psychiatric comorbidity showed that patients with a lifetime history of attempted suicide were less inclined to experience positive emotions and be more self-effacing. Patients with more severe suicidal ideation were less warm and more self-effacing. Results indicated that specific personality traits confer risk for suicidal behaviors in middle age and older adults. Interventions tailored to specific personality profiles in this high-risk group should be developed, and their efficacy examined.
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Affiliation(s)
- J David Useda
- Laboratory of Personality and Development, Center for the Study and Prevention of Suicide, Department of Psychiatry, University of Rochester Medical Center, NY 14642, USA
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Salloway S, Correia S, Boyle P, Malloy P, Schneider L, Lavretsky H, Sackheim H, Roose S, Krishnan KRR. MRI subcortical hyperintensities in old and very old depressed outpatients: the important role of age in late-life depression. J Neurol Sci 2002; 203-204:227-33. [PMID: 12417389 DOI: 10.1016/s0022-510x(02)00296-4] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
OBJECTIVE There is increasing evidence that cerebrovascular factors play a key role in the etiology of late-life depression. This study examined the severity of subcortical hyperintensities (SH) and the relationship between SH and depression characteristics in two samples of elderly depressed outpatients differing in age. METHODS The samples consisted of 59 subjects age 60 and over, (69+/-5.6 years), who participated in a trial of sertraline, and 111 subjects age 75 and over, (79+/-4.1 years), who participated in a trial of citalopram. RESULTS The citalopram group was significantly older than the sertraline group and had more severe SH (72% vs. 42% high ratings). The High SH group was significantly older than the Low SH group in the sertraline study but there was no difference in age in the SH groups in the citalopram sample. There was no relationship between SH severity and baseline depression or age of onset. However, age strongly correlated with later age of onset. There was no relationship between SH severity and cardiovascular risk factors or treatment response in the sertraline sample. CONCLUSION Age is a major factor for the development of SH and late-life depression. There may not be an association between SH and depression severity, cardiovascular risk factors, or treatment response in geriatric depressed outpatients. The etiologic factors and clinical course of late-life depression requires further study.
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Treatment of elderly depression with personality disorder comorbidity using dialectical behavior therapy. COGNITIVE AND BEHAVIORAL PRACTICE 2000. [DOI: 10.1016/s1077-7229(00)80058-9] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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