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Fatemian H, Moslemi H, Hosseini Y, Moshfeghinia R. C-reactive protein (CRP) level in depressed patients with suicidal behavior: A systematic review and meta-analysis. J Affect Disord 2024; 366:423-433. [PMID: 39187188 DOI: 10.1016/j.jad.2024.08.135] [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: 06/04/2024] [Revised: 07/30/2024] [Accepted: 08/23/2024] [Indexed: 08/28/2024]
Abstract
INTRODUCTION Suicidal behavior necessitates prompt diagnosis due to its severe consequences. C-reactive protein (CRP) levels may offer insights into its pathophysiology and aid in risk assessment, potentially enhancing preventive interventions and treatment strategies. The aim of this study is to assess the CRP levels in depressed patients with and without suicidal behavior. METHODS Our systematic review was registered in Prospero (#CRD42024518477). We searched five databases (PubMed, Scopus, PsycINFO, Web of Science, and CINAHL Complete) for records in English from inception to February 2024. We included observational studies that measured CRP in depressed patients with and without suicidal behavior. We used the Newcastle-Ottawa Scale (NOS) to assess the quality of the included studies. We employed a random-effects model, and the statistical analysis was conducted using Stata software version 17. RESULTS Initial 632 articles narrowed to 15 for systematic review. Fifteen studies with 3652 participants included. Fourteen studies involving 3387 depressed patients, 1269 with suicidal behavior, analyzed CRP levels. Suicidal patients exhibited higher CRP levels (SMD: 0.80 [0.37, 1.23]). Analysis of seven studies with 465 participants, including 200 depressed patients with suicidal behavior and 265 healthy controls, showed higher CRP levels in depressed patients (SMD: 1.58 [0.97, 2.19]). CONCLUSION In summary, our systematic review and meta-analysis of CRP levels in suicidal patients revealed that those with suicidal behavior exhibited higher CRP levels, suggesting possible implications for treatment approaches.
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Affiliation(s)
- Hossein Fatemian
- Medical doctor, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Hossein Moslemi
- Department of Science and Technology Studies, AJA University of Command and Staff, Tehran, Iran
| | - Yasaman Hosseini
- Cognitive Neuroscience Research Center, AJA University of Medical Sciences, Tehran, Iran.
| | - Reza Moshfeghinia
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran; Research Center for Psychiatry and Behavior Sciences, Shiraz University of Medical Sciences, Shiraz, Iran.
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Kılıç N, Taşcı G, Kaya Ş, Özsoy F. Evaluation of peripheral inflammatory parameters of cases with suicide attempts. J Psychiatr Res 2024; 175:368-373. [PMID: 38772127 DOI: 10.1016/j.jpsychires.2024.05.021] [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: 12/23/2023] [Revised: 03/17/2024] [Accepted: 05/08/2024] [Indexed: 05/23/2024]
Abstract
PURPOSE The purpose of the present study was to examine the inflammation markers of patients who have attempted suicide by comparing them with those of healthy controls. The leukocyte cell levels, Neutrophil/Lymphocyte Ratios (NLR), Basophil/Lymphocyte Ratios (BLR), Platelet/Lymphocyte Ratios (PLR), Monocyte/Lymphocyte Ratios (MLR), Systemic Inflammation Index (SII), Neutrophil/Albumin Ratios (NAR) values were compared with those of healthy controls. METHOD A total of 376 people were included in the study (276 patients who attempted suicide, and 100 healthy people (the control group)). The demographic data and laboratory parameters of the participants were analyzed from the hospital automation system. RESULTS The participants' female/male ratio was 158/118 (42.8%/57.1%) in the group of patients who attempted suicide and 41/59 (41/59%) in the control group. When the distribution of laboratory parameters was evaluated, although the NLR, BLR, NAR, SII, and MLR values, which are indicators of peripheral inflammation, were high in patients who attempted suicide (p = 0.049 for MLR, p = 0.000 for other values), the PLR (p = 0.586) value did not differ significantly between the groups. Patients who had attempted more than one suicide had elevated BLR (p = 0.007), SII (p = 0.003), and NAR (p = 0.003) values. DISCUSSION Based on the results obtained, it was considered that paying attention to inflammation parameters in patient follow-ups, and monitoring of SII, NLR, BLR, and NAR values of patients who had attempted suicide once would be beneficial in preventing future suicide attempts. These results strengthen the idea that inflammatory processes play roles in the pathophysiology of suicidal behavior. However, further studies are needed to elucidate the complex pathophysiological mechanisms of immune pathways underlying suicidal behavior.
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Affiliation(s)
| | - Gülay Taşcı
- Elazığ Fethi Sekin City Hospital, Elazığ, Turkey.
| | - Şuheda Kaya
- Elazığ Fethi Sekin City Hospital, Elazığ, Turkey
| | - Filiz Özsoy
- Faculty of Medicine, Department of Psychiatry, Gaziosmanpasa University, Tokat, Turkey
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Wienand D, Wijnen LI, Heilig D, Wippel C, Arango C, Knudsen GM, Goodwin GM, Simon J. Comorbid physical health burden of serious mental health disorders in 32 European countries. BMJ MENTAL HEALTH 2024; 27:e301021. [PMID: 38580438 PMCID: PMC11021748 DOI: 10.1136/bmjment-2024-301021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Accepted: 03/22/2024] [Indexed: 04/07/2024]
Abstract
BACKGROUND Mental health disorders (MHDs) are associated with physical health disparities, but underlying excess risk and health burden have not yet been comprehensively assessed. OBJECTIVE To assess the burden of comorbid physical health conditions (PHCs) across serious MHDs in Europe. METHODS We estimated the relative prevalence risk of PHCs associated with alcohol use disorders (AUD), bipolar disorder (BD), depressive disorders (DD) and schizophrenia (SZ) across working-age populations of 32 European countries in 2019 based on a targeted literature review. Excess physical health burden was modelled using population-attributable fractions and country-level prevalence data. FINDINGS We screened 10 960 studies, of which 41 were deemed eligible, with a total sample size of over 18 million persons. Relative prevalence of PHCs was reported in 54%, 20%, 15%, 5% and 7% of studies, respectively, for SZ, DD, BD, AUD or mixed. Significant relative risk estimates ranged from 1.44 to 3.66 for BD, from 1.43 to 2.21 for DD, from 0.81 to 1.97 for SZ and 3.31 for AUD. Excess physical health burden ranged between 27% and 67% of the total, corresponding to 84 million (AUD), 67 million (BD), 66 million (DD) and 5 million (SZ) PHC diagnoses in Europe. A 1% reduction in excess risk assuming causal inference could result in two million fewer PHCs across investigated MHDs. CONCLUSIONS This is the first comprehensive study of the physical health burden of serious MHDs in Europe. The methods allow for updates, refinement and extension to other MHDs or geographical areas. CLINICAL IMPLICATIONS The results indicate potential population health benefits achievable through more integrated mental and physical healthcare and prevention approaches.
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Affiliation(s)
- Dennis Wienand
- Department of Health Economics, Center for Public Health, Medical University of Vienna, Vienna, Austria
| | - Lena I Wijnen
- Department of Health Economics, Center for Public Health, Medical University of Vienna, Vienna, Austria
- Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Daniel Heilig
- Department of Health Economics, Center for Public Health, Medical University of Vienna, Vienna, Austria
| | - Christoph Wippel
- Department of Health Economics, Center for Public Health, Medical University of Vienna, Vienna, Austria
| | - Celso Arango
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, IiSGM, CIBERSAM, School of Medicine, Universidad Complutense, Madrid, Spain
| | - Gitte M Knudsen
- Neurobiology Research Unit, Copenhagen University Hospital, Copenhagen, Denmark
- Institute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Guy M Goodwin
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - Judit Simon
- Department of Health Economics, Center for Public Health, Medical University of Vienna, Vienna, Austria
- Department of Psychiatry, University of Oxford, Oxford, UK
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Hernández-Padilla JM, Dobarrio-Sanz I, Correa-Casado M, Del Mar Jiménez-Lasserrotte M, Fernández-Sola C, Ruiz-Fernández MD. Spanish version of the Maastricht Personal Autonomy Questionnaire: A validation study among community-dwelling older adults with chronic multimorbidity. Int J Older People Nurs 2024; 19:e12595. [PMID: 38102809 DOI: 10.1111/opn.12595] [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: 03/23/2023] [Accepted: 11/27/2023] [Indexed: 12/17/2023]
Abstract
BACKGROUND Loss of personal autonomy in older adults with chronic multimorbidity is associated with worsened biopsychosocial health. In order to facilitate the standardised assessment of personal autonomy in older adults with chronic conditions, nurses could use the Maastricht Personal Autonomy Questionnaire (MPAQ). OBJECTIVE To translate, culturally adapt and psychometrically assess the Spanish version of the MPAQ in community-dwelling older adults with chronic multimorbidity (MPAQ-Sp). METHODS Observational cross-sectional study. A convenience sample of 884 community-dwelling older adults was recruited from 10 community centres in five health districts in southeastern Spain. Data were collected between January 2021 and September 2022. The study was completed in four phases. Phase 1: The MPAQ was translated into Spanish. Phase 2: A pilot test of reliability and content validity was conducted. Phase 3: To test the dimensionality of the tool, an exploratory factor analysis (EFA) was conducted. Phase 4: a final validation study was conducted which included a confirmatory factor analysis (CFA) and assessed the validity (content, criterion and construct), reliability and readability of the MPAQ-Sp. RESULTS The average age of the sample was 75.89 years (SD = ±8.04). Their mean number of chronic conditions was 4.84 (SD = ±2.19) and 67% were women. The MPAQ-Sp is comprised of 16 items distributed in four subscales: [1] the 'Degree of autonomy' scale, [2] the 'Working on autonomy' scale, [3] the 'Dilemmas: health over preferences' scale and [4] the 'Dilemmas: preferences over health' scale. CONCLUSIONS The Spanish version of the MPAQ-Sp is a valid and reliable instrument to assess personal autonomy in Spanish-speaking, community-dwelling older adults with chronic multimorbidity. IMPLICATIONS FOR PRACTICE The use of the MPAQ-Sp would allow researchers and healthcare professionals to identify a loss of personal autonomy among Spanish-speaking community-dwelling older adults with chronic multimorbidity.
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Affiliation(s)
| | - Iria Dobarrio-Sanz
- Department of Nursing, Physiotherapy and Medicine, University of Almeria, Almeria, Spain
| | - Matías Correa-Casado
- Department of Nursing, Physiotherapy and Medicine, University of Almeria, Almeria, Spain
| | | | - Cayetano Fernández-Sola
- Department of Nursing, Physiotherapy and Medicine, University of Almeria, Almeria, Spain
- Facultad de Ciencias de la Salud, Universidad Autónoma de Chile, Santiago, Chile
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Cui S, Liu Z, Liu Y, Yao G, Wu Y, Li J, Sun F, Sun L, Sun L. Correlation Between Systemic Immune-Inflammation Index and Suicide Attempts in Children and Adolescents with First-Episode, Drug-Naïve Major Depressive Disorder During the COVID-19 Pandemic. J Inflamm Res 2023; 16:4451-4460. [PMID: 37842191 PMCID: PMC10573448 DOI: 10.2147/jir.s433397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 09/27/2023] [Indexed: 10/17/2023] Open
Abstract
Objective This study aims to investigate the association between the systemic immune-inflammatory index (SII) and suicide attempt (SA) in children and adolescents with first-episode, drug-naïve Major Depressive Disorder (MDD) during the COVID-19 pandemic. Methods A retrospective study was conducted on 263 MDD patients hospitalized at the Third Hospital of Fuyang City between 2020 and 2022. Patients were categorized into two groups based on the presence of previous SA. The study compared the differences in SII and clinical characteristics between the two groups and used the receiver operating characteristic (ROC) curve to determine the optimal critical value of SII and the area under the curve. Binary logistic regression was used to analyze the independent risk factors for SA. Results Compared with the patients without SA history, the patients with a personal history of SA had a higher mean HDRS scores (Z=-2.369, p=0.018), higher mean neutrophil count (Z=-2.870, p=0.004), higher mean platelet count (Z=-2.155, p=0.031), and higher mean SII (Z=-3.170, p=0.002). The optimal critical SII determined by the ROC curve was 548.15 (sensitivity = 63.2%, specificity = 83.1%), and the area under the curve was 0.661. After adjusting for gender, age, BMI, illness duration and HDRS score, the risk of total SA in patients with high SII was 8.296 times higher than in those with low SII (OR = 8.296, 95% CI: 3.803-18.095, P < 0.001), The risk of recent SA was 13.922 times higher in patients with high SII than in those with low SII (OR = 13.922, 95% CI: 5.587-34.693, p < 0.001). However, high SII was not a risk factor for past SA (OR = 0.547, 95% CI: 0.062-4.842, P=0.587). Conclusion SII may be an inexpensive, easily accessible strategy that can assist in determining suicide risk in adolescents with MDD.
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Affiliation(s)
- Shu Cui
- Department of Psychiatry, Third People’s Hospital of Fuyang, Fuyang, Anhui, 236000, People’s Republic of China
| | - Zhiwei Liu
- Department of Psychiatry, Third People’s Hospital of Fuyang, Fuyang, Anhui, 236000, People’s Republic of China
| | - Yun Liu
- Department of Psychiatry, Third People’s Hospital of Fuyang, Fuyang, Anhui, 236000, People’s Republic of China
| | - Gaofeng Yao
- Department of Psychiatry, Third People’s Hospital of Fuyang, Fuyang, Anhui, 236000, People’s Republic of China
| | - Yanhai Wu
- Department of Psychiatry, Third People’s Hospital of Fuyang, Fuyang, Anhui, 236000, People’s Republic of China
| | - Juanjuan Li
- Department of Psychiatry, Third People’s Hospital of Fuyang, Fuyang, Anhui, 236000, People’s Republic of China
| | - Feng Sun
- Department of Psychiatry, Third People’s Hospital of Fuyang, Fuyang, Anhui, 236000, People’s Republic of China
- School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, Anhui, 238000, People’s Republic of China
| | - Liang Sun
- Department of Psychiatry, Third People’s Hospital of Fuyang, Fuyang, Anhui, 236000, People’s Republic of China
- School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, Anhui, 238000, People’s Republic of China
| | - Longlong Sun
- Department of Psychiatry, Third People’s Hospital of Fuyang, Fuyang, Anhui, 236000, People’s Republic of China
- School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, Anhui, 238000, People’s Republic of China
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Neupane SP, Daray FM, Ballard ED, Galfalvy H, Itzhaky L, Segev A, Shelef A, Tene O, Rizk MM, Mann JJ, Zalsman G. Immune-related biomarkers and suicidal behaviors: A meta-analysis. Eur Neuropsychopharmacol 2023; 75:15-30. [PMID: 37356288 DOI: 10.1016/j.euroneuro.2023.05.009] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 05/26/2023] [Accepted: 05/30/2023] [Indexed: 06/27/2023]
Abstract
Biomarkers that can differentiate between psychiatric disorders with and without suicidal behavior history from each other and from healthy volunteers may explain part of the pathogenesis of suicidal behavior. We conducted the hitherto largest meta-analysis comparing immune biomarkers between subjects with and without suicide attempt history or death by suicide. The study protocol was registered with PROSPERO, CRD42020212841. Standardized mean differences (SMD) were pooled with random-effects models. Heterogeneity between studies was assessed with the I2-statistic and publication bias was evaluated by the Egger test and funnel plots. Data were based on 36 studies including 2679 persons with suicidal behaviors and 6839 comparison subjects, and four immune-related biomarkers (CRP, IL-6, TNF-α and IL-1β). Suicidal behavior was associated with higher CRP blood levels compared with: healthy controls (SMD [95%CI] = 1.42[0.85-1.98]); patients with depression alone (SMD [95%CI] = 1.23[0.20-2.26]); and patients with any psychiatric disorders (SMD [95%CI] = 0.39[0.22-0.55]). IL-6 blood level was higher in patients with suicidal behaviors compared with healthy controls (SMD [95%CI] = 1.13[0.45-1.82]) and when compared with psychiatric patients without suicidal behaviors (SMD [95%CI] = 0.22 [0.11-0.33]). Meta-regression and subgroup analyses revealed that increased CRP in suicidal behavior is primarily driven by recent suicidal behavior. These results implicate the immune system and inflammatory response in suicidal behavior independent of a relationship to major psychiatric disorders, and that these biological measures are predominantly state-dependent markers. Future studies are needed to determine the cause-and-effect relationship of these immune system biomarkers with suicidal behavior, and their potential predictive properties.
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Affiliation(s)
- Sudan Prasad Neupane
- National Centre for Suicide Research and Prevention, Institute of Clinical Medicine, University of Oslo, Sognsvannsveien 21, Building 12, 2nd floor. N-0372 Oslo, Norway.
| | - Federico M Daray
- Institute of Pharmacology, School of Medicine, University of Buenos Aires, Paraguay 2155, Piso9, Ciudad Autónoma de Buenos Aires, C1121ABG, Argentina
| | - Elizabeth D Ballard
- Section on the Neurobiology and Treatment of Mood Disorders, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Hanga Galfalvy
- Departments of Psychiatry and Biostatistics, Columbia University, New York, NY, United States of America
| | - Liat Itzhaky
- Department of Psychiatry, Columbia University, New York, NY, United States of America; Molecular Imaging and Neuropathology Division, New York State Psychiatric Institute, New York, NY, United States
| | - Aviv Segev
- Shalvata Mental Health Center, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Assaf Shelef
- Lev-Hasharon Mental Health Center and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Oren Tene
- Psychiatric Division, Tel Aviv Sourasky Medical Center, Tel-Aviv University, Tel Aviv, Israel
| | - Mina M Rizk
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America; Molecular Imaging and Neuropathology Division, New York State Psychiatric Institute, New York, NY, United States
| | - J John Mann
- Department of Psychiatry, Columbia University, 1051 Riverside Drive, New York, 10032, NY, United States of America; Division of Molecular Imaging & Neuropathology, New York State Psychiatric Institute, 1051 Riverside Drive, Unit 42, New York, 10032, NY, United States of America; Department of Radiology, Columbia University, 622 West 168th St, New York, 10032, NY, United States of America
| | - Gil Zalsman
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Division of Molecular Imaging and Neuropathology, Department of Psychiatry, Columbia University NY, NY, United States of America
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Jeong KH, Yoon JY, Lee S, Cho S, Woo HJ, Kim S. Changes in the Suicide Rate of Older Adults According to Gender, Age, and Region in South Korea from 2010 to 2017. Healthcare (Basel) 2022; 10:2333. [PMID: 36421657 PMCID: PMC9690192 DOI: 10.3390/healthcare10112333] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 11/15/2022] [Accepted: 11/16/2022] [Indexed: 08/20/2024] Open
Abstract
BACKGROUND South Korea's suicide rates are the highest among Organization for Economic Co-operation and Development (OECD) countries, making it one of the most important societal issues in South Korea. METHODS the statistics on causes of death and resident registration central population (RRCP) provided by the National Statistical Office were used to calculate the suicide rate among older adults in Korea. We examined gender (male, female), age (young-old, old-old), and region (urban, rural) by conducting latent growth modeling to estimate changes in the overall older adult suicide rate and verify its relationship. RESULTS over a period of 8 years, the older adult suicide rate was 104.232 on average in 2010 and it decreased by approximately 10.317 every year, and the rate of decrease gradually slowed down. The initial value of the older adult suicide rate was found to be higher among males, the old-old group, and those living in rural regions. In the quadratic function change rate, only males and the old-old group were statistically significant. CONCLUSION in this study, the direction of and the rate of change in the older adult suicide rates and the relationship between gender, age, and region were examined. It is expected that this study will provide basic data to assist in establishing older adult suicide prevention policies, considering the gender, age, and region of the aging population.
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Affiliation(s)
- Kyu-Hyoung Jeong
- Department of Social Welfare, Semyung University, Jecheon 27136, Republic of Korea
| | - Ji-Yeon Yoon
- Institute for Life and Culture, Sogang University, Seoul 04100, Republic of Korea
| | - Seoyoon Lee
- Interdisciplinary Graduate Program in Social Welfare Policy, Yonsei University, Seoul 03722, Republic of Korea
| | - Sunghwan Cho
- School of Social Work, Virginia Commonwealth University, Richmond, VA 23223, USA
| | - Hyun-Jae Woo
- Health & Welfare Committee, Seoul Metropolitan Council, Seoul 04519, Republic of Korea
| | - Sunghee Kim
- Interdisciplinary Graduate Program in Social Welfare Policy, Yonsei University, Seoul 03722, Republic of Korea
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Effects of stress on endophenotypes of suicide across species: A role for ketamine in risk mitigation. Neurobiol Stress 2022; 18:100450. [PMID: 35685678 PMCID: PMC9170747 DOI: 10.1016/j.ynstr.2022.100450] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 04/05/2022] [Accepted: 04/15/2022] [Indexed: 12/28/2022] Open
Abstract
Suicide is a leading cause of death and morbidity worldwide, yet few interventions are available to mitigate its risk. Barriers to effective treatments involve a limited understanding of factors that predict the onset of suicidal thoughts and behaviors. In the context of suicide risk, stress is a precipitating factor that is largely overlooked in the literature. Indeed, the pathophysiology of stress and suicide are heavily interconnected, underscoring the need to target the stress system in suicide prevention. In this review, we integrate findings from the preclinical and clinical literature that links stress and suicide. We focus specifically on the effects of stress on underlying biological functions and processes associated with suicide, allowing for the review of research using animal models. Owing to the rapid anti-suicidal effects of (R,S)-ketamine, we discuss its ability to modulate various stress-related endophenotypes of suicide, as well as its potential role in preventing suicide in those with a history of chronic life stress (e.g., early life adversity). We highlight future research directions that could advance our understanding of stress-related effects on suicide risk, advocating a dimensional, endophenotype approach to suicide research. Suicide and chronic stress pathophysiology are interconnected. Chronic stress has profound impacts on several endophenotypes of suicide. Animal and human research points to stress as a precipitating factor in suicide. Ketamine modulates specific biological processes associated with stress and suicide. Suicide research into endophenotypes can help inform risk-mitigation strategies.
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Fan X, Huang X, Zhao Y, Wang L, Yu H, Zhao G. Predicting Prognostic Effects of Acupuncture for Depression Using the Electroencephalogram. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2022; 2022:1381683. [PMID: 35280515 PMCID: PMC8906952 DOI: 10.1155/2022/1381683] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Accepted: 02/07/2022] [Indexed: 11/17/2022]
Abstract
Depression is considered to be a major public health problem with significant implications for individuals and society. Patients with depression can be with complementary therapies such as acupuncture. Predicting the prognostic effects of acupuncture has a big significance in helping physicians make early interventions for patients with depression and avoid malignant events. In this work, a novel framework of predicting prognostic effects of acupuncture for depression based on electroencephalogram (EEG) recordings is presented. Specifically, EEG, as a widely used measurement to evaluate the therapeutic effects of acupuncture, is utilized for predicting prognostic effects of acupuncture. Max-relevance and min-redundancy (mRMR), with merits of removing redundant information among selected features and remaining high relevance between selected features and response variable, is employed to select important lead-rhythm features extracted from EEG recordings. Then, according to the subject Hamilton Depression Rating Scale (HAMD) scores before and after acupuncture for eight weeks, the reduction rate of HAMD score is calculated as a measure of the prognostic effects of acupuncture. Finally, five widely used machine learning methods are utilized for building the predicting models of prognostic effects of acupuncture for depression. Experimental results show that nonlinear machine learning methods have better performance than linear ones on predicting prognostic effects of acupuncture using EEG recordings. Especially, the support vector machine with Gaussian kernel (SVM-RBF) can achieve the best and most stable performance using the mRMR with both evaluating criteria of FCD and FCQ for feature selection. Both mRMR-FCD and mRMR-FCQ obtain the same best performance, where the accuracy and F 1 score are 84.61% and 86.67%, respectively. Moreover, lead-rhythm features selected by mRMR-FCD and mRMR-FCQ are analyzed. The top seven selected lead-rhythm features have much higher mRMR evaluating scores, which guarantee the good predicting performance for machine learning methods to some degree. The presented framework in this work is effective in predicting the prognostic effects of acupuncture for depression. It can be integrated into an intelligent medical system and provide information on the prognostic effects of acupuncture for physicians. Informed prognostic effects of acupuncture for depression in advance and taking interventions can greatly reduce the risk of malignant events for patients with mental disorders.
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Affiliation(s)
- Xiaomao Fan
- School of Computer Science, South China Normal University, Guangzhou, China
| | - Xingxian Huang
- Department of Acupuncture and Moxibustion, Shenzhen Traditional Chinese Medicine Hospital, Shenzhen, China
| | - Yang Zhao
- School of Data Science, City University of Hong Kong, Hong Kong SAR, China
| | - Lin Wang
- Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Beijing, China
| | - Haibo Yu
- Department of Acupuncture and Moxibustion, Shenzhen Traditional Chinese Medicine Hospital, Shenzhen, China
| | - Gansen Zhao
- School of Computer Science, South China Normal University, Guangzhou, China
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Vasupanrajit A, Jirakran K, Tunvirachaisakul C, Solmi M, Maes M. Inflammation and nitro-oxidative stress in current suicidal attempts and current suicidal ideation: a systematic review and meta-analysis. Mol Psychiatry 2022; 27:1350-1361. [PMID: 34997194 DOI: 10.1038/s41380-021-01407-4] [Citation(s) in RCA: 36] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Accepted: 11/25/2021] [Indexed: 12/12/2022]
Abstract
A meta-analysis showed a significant association between activated immune-inflammatory and nitro-oxidative (IO&NS) pathways and suicide attempts (SA). There is no data on whether recent suicidal ideation (SI) is accompanied by activated IO&NS pathways and whether there are differences between recent SA and SI. The current study searched PubMed, Google Scholar, and Web of Science, for articles published from inception until May 10, 2021, and systematically reviewed and meta-analysed the association between recent SA/SI (<3 months) and IO&NS biomarkers. We included studies which compared psychiatric patients with and without SA and SI and controls (either healthy controls or patients without SA/SI) and used meta-analysis (random-effect model with restricted maximum-likelihood) to delineate effect sizes with 95% confidence intervals (CI). Our search included 59 studies comprising 4.034 SA/SI cases and 12.377 controls. Patients with SA/SI showed activated IO&NS pathways (SMD: 0.299; CI: 0.200; 0.397) when compared to controls. The immune profiles were more strongly associated with SA than with SI, particularly when compared to healthy controls, as evidenced by activated IO&NS (SMD: 0.796; CI: 0.503; 1.089), immune (SMD: 1.409; CI: 0.637; 1.462), inflammatory (SMD: 1.200; CI: 0.584; 1.816), and neurotoxic (SMD: 0.904; CI: 0.431; 1.378) pathways. The effects sizes of the IO&NS, immune and inflammatory profiles were significantly greater in SA than in SI. In conclusion: activated IO&NS pathways are associated with recent SA and SI, and inflammation, T helper-1 activation, nitro-oxidative stress, lowered neuroprotection, and increased neurotoxicity explain at least in part why psychiatric patients show increased suicidal behaviours, especially SA.
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Affiliation(s)
- Asara Vasupanrajit
- Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
| | - Ketsupar Jirakran
- Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.,Maximizing Thai Children's Developmental Potential Research Unit, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Chavit Tunvirachaisakul
- Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.,Cognitive Impairment and Dementia Research Unit, Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Marco Solmi
- University of Ottawa, Psychiatry Department, Ottawa, ON, Canada.,The Ottawa Hospital, University of Ottawa, Ottawa, ON, Canada.,Ottawa Hospital Research Institute (OHRI), Clinical Epidemiology Program, University of Ottawa, Ottawa, ON, Canada
| | - Michael Maes
- Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand. .,Cognitive Impairment and Dementia Research Unit, Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand. .,IMPACT Strategies Research Center, Deakin University, Geelong, VIC, Australia. .,Department of Psychiatry, Medical University of Plovdiv, Plovdiv, Bulgaria.
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11
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Li K, Zhou G, Xiao Y, Gu J, Chen Q, Xie S, Wu J. Risk of Suicidal Behaviors and Antidepressant Exposure Among Children and Adolescents: A Meta-Analysis of Observational Studies. Front Psychiatry 2022; 13:880496. [PMID: 35693956 PMCID: PMC9178080 DOI: 10.3389/fpsyt.2022.880496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 04/26/2022] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES Although several studies have reviewed the suicidal risk of antidepressants, the conclusions remain inconsistent. We, therefore, performed a meta-analysis of observational studies to address the association between exposure to antidepressants, especially selective serotonin reuptake inhibitors (SSRIs) and the risk of suicide and suicide attempt in children and adolescents. METHODS MEDLINE and Embase were searched from January 1990 to April 2021. Seventeen cohort and case-control studies were identified that reported suicide or suicide attempt in children and young adults (aged 5-25 years) who were exposed to any antidepressants. We extracted the estimates and corresponding 95% confidence intervals (CIs) from each publication. RESULTS The results showed that antidepressant exposure significantly increased the risk of suicide and suicide attempt when compared with no antidepressant usage among children and adolescents. The pooled relative risk (RR) was 1.38 (95% CI: 1.16-1.64; I 2 = 83.1%). Among the antidepressants, SSRI use was associated with an increased risk of suicide and suicide attempt, and the pooled RR was 1.28 (95% CI: 1.09-1.51; I 2 = 68.8%). In subgroup analysis, the attempted suicidal risk of antidepressant and SSRI was significantly increased (RR = 1.35, 95% CI: 1.13-1.61; I 2 = 86.2% for all antidepressants; and RR = 1.26, 95% CI: 1.06-1.48; I 2 = 73.8% for SSRIs), while the completed suicidal risk of antidepressant and SSRI was not statistically significant (RR = 2.32, 95% CI: 0.82-6.53; I 2 = 6.28% for all antidepressants; and RR = 1.88, 95% CI: 0.74-4.79; I 2 = 52.0% for SSRIs). In addition, the risk of suicide and suicide attempt between SSRIs and other antidepressants was similar (RR 1.13, 95% CI: 0.87-1.46, I 2 = 32.4%). CONCLUSION The main findings of this meta-analysis provide some evidence that antidepressant exposure seems to have an increased suicidal risk among children and young adults. Since untreated depression remains one of the largest risk factors for suicide and the efficacy of antidepressants is proven, clinicians should evaluate carefully their patients and be cautious with patients at risk to have treatment emergence or worsening of suicidal ideation (TESI/TWOSI) when prescribing antidepressants to children and young patients.
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Affiliation(s)
- Kuan Li
- Department of Pharmacy, Shenzhen People's Hospital, The Second Clinical Medical College, Jinan University, The First Affiliated Hospital, Southern University of Science and Technology, Shenzhen, China.,Shenzhen Key Laboratory of Prevention and Treatment of Severe Infections, Shenzhen People's Hospital, The Second Clinical Medical College, Jinan University, The First Affiliated Hospital, Southern University of Science and Technology, Shenzhen, China
| | - Guibao Zhou
- Department of Pharmacy, Shenzhen People's Hospital, The Second Clinical Medical College, Jinan University, The First Affiliated Hospital, Southern University of Science and Technology, Shenzhen, China
| | - Yan Xiao
- Department of Pharmacy, Shenzhen People's Hospital, The Second Clinical Medical College, Jinan University, The First Affiliated Hospital, Southern University of Science and Technology, Shenzhen, China
| | - Jiayu Gu
- Department of Pharmacy, Shenzhen People's Hospital, The Second Clinical Medical College, Jinan University, The First Affiliated Hospital, Southern University of Science and Technology, Shenzhen, China
| | - Qiuling Chen
- Department of Pharmacy, Shenzhen People's Hospital, The Second Clinical Medical College, Jinan University, The First Affiliated Hospital, Southern University of Science and Technology, Shenzhen, China
| | - Shouxia Xie
- Department of Pharmacy, Shenzhen People's Hospital, The Second Clinical Medical College, Jinan University, The First Affiliated Hospital, Southern University of Science and Technology, Shenzhen, China
| | - Junyan Wu
- Department of Pharmacy, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
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Vasupanrajit A, Jirakran K, Tunvirachaisakul C, Maes M. Suicide attempts are associated with activated immune-inflammatory, nitro-oxidative, and neurotoxic pathways: A systematic review and meta-analysis. J Affect Disord 2021; 295:80-92. [PMID: 34416621 DOI: 10.1016/j.jad.2021.08.015] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2021] [Revised: 08/03/2021] [Accepted: 08/06/2021] [Indexed: 02/06/2023]
Abstract
BACKGROUND Suicide attempts (SA) frequently occur in patients with mood disorders and schizophrenia, which are both accompanied by activated immune-inflammatory and nitro-oxidative (IO&NS) pathways. METHODS We searched PubMed, Google Scholar, and Web of Science, for articles published from inception until February 1, 2021. We included studies that compared blood biomarkers in psychiatric patients with (SA+) and without SA (SA-) and heathy controls and we combined different IO&NS biomarkers into immune, inflammatory, and neurotoxic profiles and used meta-analysis (random-effect model with restricted maximum-likelihood) to delineate effect sizes with 95% confidence interval (CI). FINDINGS Our search included 51 studies comprising 4.945 SA+ patients and 24.148 controls. We stratified the control group into healthy controls and SA- patients. SA+ patients showed significantly (p<0.001) increased immune activation (SMD: 1.044; CI: 0.599, 1.489), inflammation (SMD: 1.109; CI: 0.505, 1.714), neurotoxicity (SMD: 0.879; CI: 0.465, 1.293), and lowered neuroprotection (SMD: 0.648; CI: 0.354, 0.941) as compared with healthy controls. When compared with SA- patients, those with SA+ showed significant (p<0.001) immune activation (SMD: 0.290; CI: 0.183, 0.397), inflammation (SMD: 0.311; CI: 0.191, 0.432), and neurotoxicity (SMD: 0.315; CI: 0.198, 0.432), and lowered neuroprotection (SMD: 0.341; CI: 0.167, 0.515). Patients with current, but not lifetime, SA showed significant (p<0.001) levels of inflammation and neurotoxicity as compared with controls. CONCLUSIONS Patients with immune activation are at a higher risk of SA which may be explained by increased neurotoxicity due to inflammation and nitro-oxidative stress. This meta-analysis discovered new biomarkers of SA and therapeutic targets to treat individuals with SA.
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Affiliation(s)
- Asara Vasupanrajit
- Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Ketsupar Jirakran
- Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand; Maximizing Thai Children's Developmental Potential Research Unit, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Chavit Tunvirachaisakul
- Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand; Cognitive Impairment and Dementia Research Unit, Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Michael Maes
- Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand; Cognitive Impairment and Dementia Research Unit, Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand; IMPACT Strategic Research Center, Deakin University, Geelong, Australia; Department of Psychiatry, Medical University of Plovdiv, Plovdiv, Bulgaria.
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13
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Miola A, Dal Porto V, Tadmor T, Croatto G, Scocco P, Manchia M, Carvalho AF, Maes M, Vieta E, Sambataro F, Solmi M. Increased C-reactive protein concentration and suicidal behavior in people with psychiatric disorders: A systematic review and meta-analysis. Acta Psychiatr Scand 2021; 144:537-552. [PMID: 34292580 PMCID: PMC9290832 DOI: 10.1111/acps.13351] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 06/29/2021] [Accepted: 07/17/2021] [Indexed: 01/08/2023]
Abstract
OBJECTIVE Suicide is a leading cause of death worldwide. Identifying factors associated with suicidality (suicidal ideation [SI]/suicidal behavior) could increase our understanding of the pathophysiological underpinnings of suicide and improve its prevention. METHODS We conducted a systematic review (PubMed/PsycInfo/Cochrane databases, up to September 2020) and random-effect meta-analysis including observational studies comparing peripheral C-reactive protein (CRP) levels in suicidal versus non-suicidal patients affected by any psychiatric disorder and healthy controls (HC). Primary outcome was the CRP standardized mean difference (SMD) between patients with high suicidality versus those with absent or low suicidality. Secondary outcomes were SMD of CRP levels between those with suicide attempt versus no suicide attempt, as well as between those with (high) versus low or absent SI. Quality of included studies was measured with Newcastle-Ottawa scale. RESULTS Out of initial 550 references, 21 observational studies involving 7682 subjects (7445 with mood disorders or first-episode psychosis, 237 HC) were included. A significant association of CRP levels with suicidality (SMD 0.688, 95% CI 0.476-0.9, p < 0.001) emerged. CRP levels were higher in individuals with high SI (SMD 1.145, 95% CI 0.273-2.018, p = 0.010) and in those with suicide attempt (SMD 0.549, 95%CI 0.363-0.735, p < 0.001) than non-suicidal individuals (either patients or HC). Main analyses were confirmed in sensitivity analysis (removing HC), and after adjusting for publication bias. The cross-sectional design of included studies, and the high heterogeneity of diagnosis and treatment limit the generalizability of these results. Median quality of included studies was high. CONCLUSION CRP is associated with higher suicidality in patients with mental disorders. Large cohort studies longitudinally monitoring CRP levels are needed to explore its longitudinal association with suicidality.
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Affiliation(s)
| | | | - Tal Tadmor
- Neurosciences DepartmentUniversity of PaduaPaduaItaly
| | | | | | - Mirko Manchia
- Unit of PsychiatryDepartment of Medical Sciences and Public HealthUniversity of CagliariCagliariItaly,Unit of Clinical PsychiatryUniversity Hospital Agency of CagliariCagliariItaly,Department of PharmacologyDalhousie UniversityHalifaxNova ScotiaCanada
| | - Andre F. Carvalho
- IMPACT ‐ the Institute for Mental and Physical Health and Clinical TranslationSchool of MedicineBarwon HealthDeakin UniversityGeelongAustralia
| | - Michael Maes
- Department of PsychiatryFaculty of MedicineKing Chulalongkorn Memorial HospitalChulalongkorn UniversityBangkokThailand,School of MedicineIMPACT Strategic Research CentreDeakin UniversityGeelongVictoriaAustralia
| | - Eduard Vieta
- Bipolar and Depressive Disorders UnitHospital ClinicInstitute of NeuroscienceUniversity of BarcelonaIDIBAPSCIBERSAMBarcelonaSpain
| | | | - Marco Solmi
- Department of PsychiatryUniversity of OttawaOttawaOntarioCanada,Department of Mental HealthThe Ottawa HospitalOttawaOntarioCanada
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Kumar K, Srivastava S, Sharma B, Avasthi RK, Kotru M. Comparison Between Inflammatory Biomarkers (High-Sensitivity C-Reactive Protein and Neutrophil-Lymphocyte Ratio) and Psychological Morbidity in Suicide Attempt Survivors Brought to Medicine Emergency. Cureus 2021; 13:e17459. [PMID: 34603861 PMCID: PMC8475737 DOI: 10.7759/cureus.17459] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/25/2021] [Indexed: 11/15/2022] Open
Abstract
Objectives: This study aimed to compare inflammatory biomarkers (high-sensitivity {hs} C-reactive protein, neutrophil-lymphocyte ratio) and psychological morbidity in suicide attempt survivors. Methods: One hundred ninety-eight poisoning cases screened, 40 age-matched suicide attempt survivors (SAS), 40 healthy controls (HC) between the age of 18 years and 60 years were included. Complete hemogram, neutrophil-lymphocyte ratio (NLR), hsCRP values obtained, compared with Hospital Anxiety and Depression Scale (HADS), suicide intent scale, presumptive stressful life events scale (PSLES), general health questionnaire 12-item (GHQ-12) (Hindi version), and Hindi Mental State Examination (HMSE). Results: A statistically significant difference was observed in hsCRP (p=0.016) and NLR (p=0.029) of depressed-suicidal participants vs healthy controls. hsCRP values of anxious-suicidal subjects vs healthy controls showed a statistically significant difference (p=0.001). There was a statistically significant difference between patients, healthy controls in HADS anxiety and HADS depression mean scores (p<0.001). The PSLES items were ranked according to the mean stress scores of all the items (mean±SD), highest four were excessive alcohol use by the family member 47.50 (±27.03), conflicts with in-laws 50 (±27.73), family conflict 50 (±29.42), marital conflict 50.63 (±32.76). There was a statistically significant difference in hemoglobin (p<0.001), red blood cells count (p<0.001), hematocrit (p<0.001) between suicide attempt survivors and healthy controls. Conclusion: Both hsCRP and NLR have emerged as potential inflammatory biomarkers for depressive patients with suicidal attempts. Additionally, there may be a link between anemia and suicide risk in patients with depression.
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Affiliation(s)
- Kuldeep Kumar
- Medicine, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, IND
| | - Shruti Srivastava
- Psychiatry, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, IND
| | - Bhanu Sharma
- Medicine, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, IND
| | - Rajnish K Avasthi
- Medicine, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, IND
| | - Mrinalini Kotru
- Pathology, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, IND
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15
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Simon GE, Matarazzo BB, Walsh CG, Smoller JW, Boudreaux ED, Yarborough BJH, Shortreed SM, Coley RY, Ahmedani BK, Doshi RP, Harris LI, Schoenbaum M. Reconciling Statistical and Clinicians' Predictions of Suicide Risk. Psychiatr Serv 2021; 72:555-562. [PMID: 33691491 DOI: 10.1176/appi.ps.202000214] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Statistical models, including those based on electronic health records, can accurately identify patients at high risk for a suicide attempt or death, leading to implementation of risk prediction models for population-based suicide prevention in health systems. However, some have questioned whether statistical predictions can really inform clinical decisions. Appropriately reconciling statistical algorithms with traditional clinician assessment depends on whether predictions from these two methods are competing, complementary, or merely duplicative. In June 2019, the National Institute of Mental Health convened a meeting, "Identifying Research Priorities for Risk Algorithms Applications in Healthcare Settings to Improve Suicide Prevention." Here, participants of this meeting summarize key issues regarding the potential clinical application of suicide prediction models. The authors attempt to clarify the key conceptual and technical differences between traditional risk prediction by clinicians and predictions from statistical models, review the limited evidence regarding both the accuracy of and the concordance between these alternative methods of prediction, present a conceptual framework for understanding agreement and disagreement between statistical and clinician predictions, identify priorities for improving data regarding suicide risk, and propose priority questions for future research. Future suicide risk assessment will likely combine statistical prediction with traditional clinician assessment, but research is needed to determine the optimal combination of these two methods.
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Affiliation(s)
- Gregory E Simon
- Kaiser Permanente Washington Health Research Institute, Seattle (Simon, Shortreed, Coley); Department of Veterans Affairs Rocky Mountain Mental Illness Research, Education and Clinical Center, and Department of Psychiatry, University of Colorado School of Medicine, Aurora (Matarazzo); Department of Medicine and Department of Biomedical Informatics, Vanderbilt University, Nashville, Tennessee (Walsh); Department of Psychiatry, Massachusetts General Hospital, Boston (Smoller); Department of Emergency Medicine and Department of Psychiatry, University of Massachusetts Medical School, Worcester (Boudreaux); Kaiser Permanente Northwest Center for Health Research, Portland, Oregon (Yarborough); Department of Biostatistics, University of Washington, Seattle (Shortreed, Coley); Center for Health Policy and Health Services Research, Henry Ford Health System, Detroit (Ahmedani); Department of Community Medicine and Healthcare, University of Connecticut, Farmington (Doshi); Shifa Consulting, Arlington, Virginia (Harris); Division of Services and Intervention Research, National Institute of Mental Health, Bethesda, Maryland (Schoenbaum)
| | - Bridget B Matarazzo
- Kaiser Permanente Washington Health Research Institute, Seattle (Simon, Shortreed, Coley); Department of Veterans Affairs Rocky Mountain Mental Illness Research, Education and Clinical Center, and Department of Psychiatry, University of Colorado School of Medicine, Aurora (Matarazzo); Department of Medicine and Department of Biomedical Informatics, Vanderbilt University, Nashville, Tennessee (Walsh); Department of Psychiatry, Massachusetts General Hospital, Boston (Smoller); Department of Emergency Medicine and Department of Psychiatry, University of Massachusetts Medical School, Worcester (Boudreaux); Kaiser Permanente Northwest Center for Health Research, Portland, Oregon (Yarborough); Department of Biostatistics, University of Washington, Seattle (Shortreed, Coley); Center for Health Policy and Health Services Research, Henry Ford Health System, Detroit (Ahmedani); Department of Community Medicine and Healthcare, University of Connecticut, Farmington (Doshi); Shifa Consulting, Arlington, Virginia (Harris); Division of Services and Intervention Research, National Institute of Mental Health, Bethesda, Maryland (Schoenbaum)
| | - Colin G Walsh
- Kaiser Permanente Washington Health Research Institute, Seattle (Simon, Shortreed, Coley); Department of Veterans Affairs Rocky Mountain Mental Illness Research, Education and Clinical Center, and Department of Psychiatry, University of Colorado School of Medicine, Aurora (Matarazzo); Department of Medicine and Department of Biomedical Informatics, Vanderbilt University, Nashville, Tennessee (Walsh); Department of Psychiatry, Massachusetts General Hospital, Boston (Smoller); Department of Emergency Medicine and Department of Psychiatry, University of Massachusetts Medical School, Worcester (Boudreaux); Kaiser Permanente Northwest Center for Health Research, Portland, Oregon (Yarborough); Department of Biostatistics, University of Washington, Seattle (Shortreed, Coley); Center for Health Policy and Health Services Research, Henry Ford Health System, Detroit (Ahmedani); Department of Community Medicine and Healthcare, University of Connecticut, Farmington (Doshi); Shifa Consulting, Arlington, Virginia (Harris); Division of Services and Intervention Research, National Institute of Mental Health, Bethesda, Maryland (Schoenbaum)
| | - Jordan W Smoller
- Kaiser Permanente Washington Health Research Institute, Seattle (Simon, Shortreed, Coley); Department of Veterans Affairs Rocky Mountain Mental Illness Research, Education and Clinical Center, and Department of Psychiatry, University of Colorado School of Medicine, Aurora (Matarazzo); Department of Medicine and Department of Biomedical Informatics, Vanderbilt University, Nashville, Tennessee (Walsh); Department of Psychiatry, Massachusetts General Hospital, Boston (Smoller); Department of Emergency Medicine and Department of Psychiatry, University of Massachusetts Medical School, Worcester (Boudreaux); Kaiser Permanente Northwest Center for Health Research, Portland, Oregon (Yarborough); Department of Biostatistics, University of Washington, Seattle (Shortreed, Coley); Center for Health Policy and Health Services Research, Henry Ford Health System, Detroit (Ahmedani); Department of Community Medicine and Healthcare, University of Connecticut, Farmington (Doshi); Shifa Consulting, Arlington, Virginia (Harris); Division of Services and Intervention Research, National Institute of Mental Health, Bethesda, Maryland (Schoenbaum)
| | - Edwin D Boudreaux
- Kaiser Permanente Washington Health Research Institute, Seattle (Simon, Shortreed, Coley); Department of Veterans Affairs Rocky Mountain Mental Illness Research, Education and Clinical Center, and Department of Psychiatry, University of Colorado School of Medicine, Aurora (Matarazzo); Department of Medicine and Department of Biomedical Informatics, Vanderbilt University, Nashville, Tennessee (Walsh); Department of Psychiatry, Massachusetts General Hospital, Boston (Smoller); Department of Emergency Medicine and Department of Psychiatry, University of Massachusetts Medical School, Worcester (Boudreaux); Kaiser Permanente Northwest Center for Health Research, Portland, Oregon (Yarborough); Department of Biostatistics, University of Washington, Seattle (Shortreed, Coley); Center for Health Policy and Health Services Research, Henry Ford Health System, Detroit (Ahmedani); Department of Community Medicine and Healthcare, University of Connecticut, Farmington (Doshi); Shifa Consulting, Arlington, Virginia (Harris); Division of Services and Intervention Research, National Institute of Mental Health, Bethesda, Maryland (Schoenbaum)
| | - Bobbi Jo H Yarborough
- Kaiser Permanente Washington Health Research Institute, Seattle (Simon, Shortreed, Coley); Department of Veterans Affairs Rocky Mountain Mental Illness Research, Education and Clinical Center, and Department of Psychiatry, University of Colorado School of Medicine, Aurora (Matarazzo); Department of Medicine and Department of Biomedical Informatics, Vanderbilt University, Nashville, Tennessee (Walsh); Department of Psychiatry, Massachusetts General Hospital, Boston (Smoller); Department of Emergency Medicine and Department of Psychiatry, University of Massachusetts Medical School, Worcester (Boudreaux); Kaiser Permanente Northwest Center for Health Research, Portland, Oregon (Yarborough); Department of Biostatistics, University of Washington, Seattle (Shortreed, Coley); Center for Health Policy and Health Services Research, Henry Ford Health System, Detroit (Ahmedani); Department of Community Medicine and Healthcare, University of Connecticut, Farmington (Doshi); Shifa Consulting, Arlington, Virginia (Harris); Division of Services and Intervention Research, National Institute of Mental Health, Bethesda, Maryland (Schoenbaum)
| | - Susan M Shortreed
- Kaiser Permanente Washington Health Research Institute, Seattle (Simon, Shortreed, Coley); Department of Veterans Affairs Rocky Mountain Mental Illness Research, Education and Clinical Center, and Department of Psychiatry, University of Colorado School of Medicine, Aurora (Matarazzo); Department of Medicine and Department of Biomedical Informatics, Vanderbilt University, Nashville, Tennessee (Walsh); Department of Psychiatry, Massachusetts General Hospital, Boston (Smoller); Department of Emergency Medicine and Department of Psychiatry, University of Massachusetts Medical School, Worcester (Boudreaux); Kaiser Permanente Northwest Center for Health Research, Portland, Oregon (Yarborough); Department of Biostatistics, University of Washington, Seattle (Shortreed, Coley); Center for Health Policy and Health Services Research, Henry Ford Health System, Detroit (Ahmedani); Department of Community Medicine and Healthcare, University of Connecticut, Farmington (Doshi); Shifa Consulting, Arlington, Virginia (Harris); Division of Services and Intervention Research, National Institute of Mental Health, Bethesda, Maryland (Schoenbaum)
| | - R Yates Coley
- Kaiser Permanente Washington Health Research Institute, Seattle (Simon, Shortreed, Coley); Department of Veterans Affairs Rocky Mountain Mental Illness Research, Education and Clinical Center, and Department of Psychiatry, University of Colorado School of Medicine, Aurora (Matarazzo); Department of Medicine and Department of Biomedical Informatics, Vanderbilt University, Nashville, Tennessee (Walsh); Department of Psychiatry, Massachusetts General Hospital, Boston (Smoller); Department of Emergency Medicine and Department of Psychiatry, University of Massachusetts Medical School, Worcester (Boudreaux); Kaiser Permanente Northwest Center for Health Research, Portland, Oregon (Yarborough); Department of Biostatistics, University of Washington, Seattle (Shortreed, Coley); Center for Health Policy and Health Services Research, Henry Ford Health System, Detroit (Ahmedani); Department of Community Medicine and Healthcare, University of Connecticut, Farmington (Doshi); Shifa Consulting, Arlington, Virginia (Harris); Division of Services and Intervention Research, National Institute of Mental Health, Bethesda, Maryland (Schoenbaum)
| | - Brian K Ahmedani
- Kaiser Permanente Washington Health Research Institute, Seattle (Simon, Shortreed, Coley); Department of Veterans Affairs Rocky Mountain Mental Illness Research, Education and Clinical Center, and Department of Psychiatry, University of Colorado School of Medicine, Aurora (Matarazzo); Department of Medicine and Department of Biomedical Informatics, Vanderbilt University, Nashville, Tennessee (Walsh); Department of Psychiatry, Massachusetts General Hospital, Boston (Smoller); Department of Emergency Medicine and Department of Psychiatry, University of Massachusetts Medical School, Worcester (Boudreaux); Kaiser Permanente Northwest Center for Health Research, Portland, Oregon (Yarborough); Department of Biostatistics, University of Washington, Seattle (Shortreed, Coley); Center for Health Policy and Health Services Research, Henry Ford Health System, Detroit (Ahmedani); Department of Community Medicine and Healthcare, University of Connecticut, Farmington (Doshi); Shifa Consulting, Arlington, Virginia (Harris); Division of Services and Intervention Research, National Institute of Mental Health, Bethesda, Maryland (Schoenbaum)
| | - Riddhi P Doshi
- Kaiser Permanente Washington Health Research Institute, Seattle (Simon, Shortreed, Coley); Department of Veterans Affairs Rocky Mountain Mental Illness Research, Education and Clinical Center, and Department of Psychiatry, University of Colorado School of Medicine, Aurora (Matarazzo); Department of Medicine and Department of Biomedical Informatics, Vanderbilt University, Nashville, Tennessee (Walsh); Department of Psychiatry, Massachusetts General Hospital, Boston (Smoller); Department of Emergency Medicine and Department of Psychiatry, University of Massachusetts Medical School, Worcester (Boudreaux); Kaiser Permanente Northwest Center for Health Research, Portland, Oregon (Yarborough); Department of Biostatistics, University of Washington, Seattle (Shortreed, Coley); Center for Health Policy and Health Services Research, Henry Ford Health System, Detroit (Ahmedani); Department of Community Medicine and Healthcare, University of Connecticut, Farmington (Doshi); Shifa Consulting, Arlington, Virginia (Harris); Division of Services and Intervention Research, National Institute of Mental Health, Bethesda, Maryland (Schoenbaum)
| | - Leah I Harris
- Kaiser Permanente Washington Health Research Institute, Seattle (Simon, Shortreed, Coley); Department of Veterans Affairs Rocky Mountain Mental Illness Research, Education and Clinical Center, and Department of Psychiatry, University of Colorado School of Medicine, Aurora (Matarazzo); Department of Medicine and Department of Biomedical Informatics, Vanderbilt University, Nashville, Tennessee (Walsh); Department of Psychiatry, Massachusetts General Hospital, Boston (Smoller); Department of Emergency Medicine and Department of Psychiatry, University of Massachusetts Medical School, Worcester (Boudreaux); Kaiser Permanente Northwest Center for Health Research, Portland, Oregon (Yarborough); Department of Biostatistics, University of Washington, Seattle (Shortreed, Coley); Center for Health Policy and Health Services Research, Henry Ford Health System, Detroit (Ahmedani); Department of Community Medicine and Healthcare, University of Connecticut, Farmington (Doshi); Shifa Consulting, Arlington, Virginia (Harris); Division of Services and Intervention Research, National Institute of Mental Health, Bethesda, Maryland (Schoenbaum)
| | - Michael Schoenbaum
- Kaiser Permanente Washington Health Research Institute, Seattle (Simon, Shortreed, Coley); Department of Veterans Affairs Rocky Mountain Mental Illness Research, Education and Clinical Center, and Department of Psychiatry, University of Colorado School of Medicine, Aurora (Matarazzo); Department of Medicine and Department of Biomedical Informatics, Vanderbilt University, Nashville, Tennessee (Walsh); Department of Psychiatry, Massachusetts General Hospital, Boston (Smoller); Department of Emergency Medicine and Department of Psychiatry, University of Massachusetts Medical School, Worcester (Boudreaux); Kaiser Permanente Northwest Center for Health Research, Portland, Oregon (Yarborough); Department of Biostatistics, University of Washington, Seattle (Shortreed, Coley); Center for Health Policy and Health Services Research, Henry Ford Health System, Detroit (Ahmedani); Department of Community Medicine and Healthcare, University of Connecticut, Farmington (Doshi); Shifa Consulting, Arlington, Virginia (Harris); Division of Services and Intervention Research, National Institute of Mental Health, Bethesda, Maryland (Schoenbaum)
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The effect of character traits and coping style on suicide attempts in Japanese adults with mental disorders. JOURNAL OF AFFECTIVE DISORDERS REPORTS 2021. [DOI: 10.1016/j.jadr.2021.100110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Xiong F, Wang L, Shen L, Guo W, Li S, Guan Q. The relationship between multimorbidity and suicidal ideation: A meta-analysis. J Psychosom Res 2020; 138:110257. [PMID: 32992210 DOI: 10.1016/j.jpsychores.2020.110257] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 08/06/2020] [Accepted: 09/19/2020] [Indexed: 12/11/2022]
Abstract
OBJECTIVE Multimorbidity refers to the individual has two or more medical conditions, which include physical multimorbidity (two or more physical conditions), mental multimorbidity (two or more mental conditions) and physical and mental multimorbidity (one or more mental and one or more physical conditions). This study is to assess the relationship between multimorbidity and suicidal ideation (SI) by conducting a meta-analysis. METHODS Through using subject word and random word, Web of Science, Cochrane Library and PubMed were searched for related records up to March 2020. The Newcastle-Ottawa scale and the Agency for Healthcare Research and Quality were used to evaluate the quality of included studies. Subgroup and sensitivity analysis were performed. The publication bias was evaluated by the funnel plots, Begg's test and Egger's test. RESULTS A total of 19 studies were included for analysis. The pooled odd ratio (OR) for the association between multimorbidity and SI was 2.90 (95%CI 2.29-3.67, P < .001). Subgroup analysis based on nature of study, category of multimorbidity, country, whether adjusted the covariates, and quality ratings was performed. The result of sensitivity analysis indicated that no individual studies had a substantial impact on the pooled OR. There was no publication bias in the studies. CONCLUSIONS Multimorbidity is one important factor in increased risk of SI. It is critical to assessing SI among patients with multimorbidity in primary care and specialty medical practices, particularly among physical and mental multimorbidity patients who may have higher risk of SI.
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Affiliation(s)
- Feiyang Xiong
- School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250012, China; NHC Key Laboratory of Health Economics and Policy Research, Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250012, China.
| | - Li Wang
- School of Public Health, Nanjing Medical University, Nanjing 211166, China.
| | - Lianlian Shen
- School of Public Health, Nanjing Medical University, Nanjing 211166, China.
| | - Wenhui Guo
- School of Public Health, Nanjing Medical University, Nanjing 211166, China.
| | - Shixue Li
- School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250012, China; NHC Key Laboratory of Health Economics and Policy Research, Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250012, China.
| | - Qiangdong Guan
- School of Public Health, Nanjing Medical University, Nanjing 211166, China.
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Are quantity and content of psychiatric interventions associated with suicide? A case-control study of a Swedish sample. BMC Psychiatry 2020; 20:13. [PMID: 31918712 PMCID: PMC6953246 DOI: 10.1186/s12888-019-2421-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Accepted: 12/24/2019] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Research is required to identify those psychiatric interventions with a protective effect against suicide. The overarching aim of the current study was to examine whether completed suicide in psychiatric patients in a Swedish population was associated with the quantity and nature of previous medical and psychosocial treatment interventions. METHODS This retrospective case-control study (n = 308) compared a group of deceased psychiatric patients with matched controls. For every case of suicide, a control was found within psychiatry that matched according to sex, age, and primary psychiatric diagnosis. A stepwise forward logistic regression model with suicide as the dependent outcome variable was used. RESULTS Receiving pharmacotherapy combined with psychotherapy [OR: 0.44 (95% CI: 0.226-0.876), p = 0.019] and a higher number of outpatient visits in psychiatry [OR: 0.99 (95% CI: 0.982-0.999), p = 0.028] were negatively associated with suicide. These associations were still significant after controlling for previous serious suicide attempts and somatic comorbidity. CONCLUSIONS Frequent visits and pharmacotherapy combined with psychotherapy seem to be important for preventing suicide in psychiatric patients. The reasons for not receiving such therapy are important issues for further study.
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