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Thompson AJ, Henrich CC, Steelesmith DL, Hughes J, Ruch D, Bridge JA, Campo JV, Fontanella CA. Identifying Subgroups of Youth Suicide Decedents Based on Clinical Profiles of Psychiatric and Medical Diagnoses: A Latent Class Analysis. J Adolesc Health 2024; 74:1191-1197. [PMID: 38520430 DOI: 10.1016/j.jadohealth.2024.02.006] [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: 05/22/2023] [Revised: 02/01/2024] [Accepted: 02/02/2024] [Indexed: 03/25/2024]
Abstract
PURPOSE To identify risk subgroups of youth suicide decedents using demographic and clinical psychiatric and medical diagnostic profiles to inform tailored youth suicide prevention efforts. METHODS This study linked Ohio Medicaid and death certificate data for Medicaid enrolled youth aged 8-25 years who died by suicide between January 1, 2010, and December 31, 2020 (N = 511). Latent class analysis was used to identify distinct clinical risk subgroups. RESULTS Three latent classes were identified. Internalizing problems were common across all classes, but especially prevalent in class 1, the High Internalizing + Multiple Comorbidities group (n = 152, 30%). A prior history of suicidal behavior was confined to class 1 decedents, who were otherwise characterized by substance misuse, and multiple psychiatric and medical comorbidities. Class 2 decedents, the Internalizing + Externalizing group (n = 176, 34%), were more often younger, male, Black, and unlikely to have a history of substance misuse. Decedents in class 3, the Internalizing + Substance Misuse group (n = 183, 36%), were more often older and likely to have a history of substance misuse, but unlikely to exhibit other externalizing problems. DISCUSSION Internalizing psychopathology is particularly common among youth who die by suicide, with comorbid externalizing psychopathology, substance misuse, and medical problems contributing to youth suicide risk. Because less than a third of youth who die by suicide have a prior history of recognized suicidal thinking or behavior, universal screening for youth suicide risk should be considered, particularly in younger children, and efforts to integrate suicide prevention in traditional health care settings should be prioritized.
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Affiliation(s)
- Amanda J Thompson
- Center for Suicide Prevention and Research, The Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, Ohio.
| | | | - Danielle L Steelesmith
- Center for Suicide Prevention and Research, The Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, Ohio
| | - Jennifer Hughes
- Big Lots Behavioral Health Services and Division of Child and Family Psychiatry, Nationwide Children's Hospital, Columbus, Ohio; Department of Psychiatry and Behavioral Health, The Ohio State University, Columbus, Ohio
| | - Donna Ruch
- Center for Suicide Prevention and Research, The Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, Ohio; Department of Pediatrics, The Ohio State University, Columbus, Ohio
| | - Jeffrey A Bridge
- Center for Suicide Prevention and Research, The Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, Ohio; Department of Pediatrics, The Ohio State University, Columbus, Ohio
| | - John V Campo
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Cynthia A Fontanella
- Center for Suicide Prevention and Research, The Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, Ohio; Department of Psychiatry and Behavioral Health, The Ohio State University, Columbus, Ohio
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Kim AW. Psychosocial stress, adult suicidal ideation, and the mediating effect of poor sleep quality during the COVID-19 pandemic in South Africa. Am J Hum Biol 2024; 36:e24038. [PMID: 38174783 DOI: 10.1002/ajhb.24038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 11/28/2023] [Accepted: 12/20/2023] [Indexed: 01/05/2024] Open
Abstract
OBJECTIVES South Africa instituted one of the world's strictest lockdowns during the COVID-19 pandemic, which generated heightened conditions of psychosocial stress and posed widespread mental health risks. Despite the elevated burdens of suicidal behaviors and risk of psychiatric disease in the country, few studies have examined the impacts of psychosocial stress from the pandemic on suicidal ideation in South Africa. This study examined the association between psychosocial stress experienced under the COVID-19 pandemic and adult suicidal ideation, as well as degree to which sleep quality and duration mediated this relationship. METHODS An online survey assessed experiences of COVID-19 psychosocial stress, sleep quality and duration, and suicidal ideation in a sample of 189 South African adults during the second and third waves of the COVID-19 pandemic. A causal inference framework for mediation analysis was used to assess the degree to which sleep quality and duration explained the association between COVID-19 psychosocial stress and suicidal ideation. RESULTS Suicidal ideation was reported in 21% of adults. Adults described having moderate sleep quality and an average of 6.9 hours of sleep per night. COVID-19 psychosocial stress significantly predicted adult suicidal ideation in fully adjusted models. Sleep quality, but not sleep duration, significantly mediated the association between COVID-19 psychosocial stress and suicidal ideation, accounting for 25.9% of the total effect. CONCLUSIONS Poor sleep quality may play an important role in exacerbating the alarming stress-induced mental health effects of the COVID-19 pandemic. Further research is necessary to understand the underlying sleep dynamics and associated psychological and neurobiological processes that perpetuate adult suicidal ideation.
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Affiliation(s)
- Andrew Wooyoung Kim
- Department of Anthropology, University of California, Berkeley, California, USA
- SAMRC/Wits Developmental Pathways for Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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Lengvenyte A, Belzeaux R, Olié E, Hamzeh-Cognasse H, Sénèque M, Strumila R, Cognasse F, Courtet P. Associations of potential plasma biomarkers with suicide attempt history, current suicidal ideation and subsequent suicidal events in patients with depression: A discovery study. Brain Behav Immun 2023; 114:242-254. [PMID: 37648005 DOI: 10.1016/j.bbi.2023.08.025] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 08/22/2023] [Accepted: 08/26/2023] [Indexed: 09/01/2023] Open
Abstract
A growing body of evidences suggests that suicidal ideation (SI) and suicidal behaviors have biological bases. However, no biological marker is currently available to evaluate the suicide risk in individuals with SI or suicide attempt (SA). Moreover, the current risk assessment techniques poorly predict future suicidal events. The aim of this study was to examine the association of 39 new and already described peripheral cells and proteins (implicated in the immune system, oxidative stress and plasticity) with lifetime SA, past month SA, current SI, and future suicidal events (visit to the Emergency Department for SI or SA) in 266 treatment-seeking individuals with mood disorders. Equal parts of patients with and without past history of SA were recruited. All individuals at inclusion gave blood, were evaluated for SA recency, current SI, and were followed for two years afterwards. The 39 peripheral blood cellular and protein markers were entered separately for each outcome in Elastic Net models with 10-fold cross-validation, followed by single-analyte covariate-adjusted regression analyses for pre-selected analytes. Past month SA was associated with increased plasma levels of thrombospondin-2 and C-reactive protein, whereas current SI was associated with lower plasma serotonin levels. These associations were robust to adjustments for key covariates and corrections for multiple testing. The Cox proportional hazards regression showed that higher levels of thrombospondin-1 and of platelet-derived growth factor-AB predicted a future suicidal event. These two associations remained after adjustment for sex, age, and SA history, and outperformed the predictive value of past SA. Thrombospondins and platelet-derived growth factors have never been investigated in the context of suicide. Altogether, our results highlight the involvement in the suicidal process of platelet biological response and plasticity modifiers and also of inflammatory factors. They also suggest that SI and SA may have different biological correlates and that biomarkers associated with past SA or current SI do not automatically also predict future events.
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Affiliation(s)
- Aiste Lengvenyte
- Department of Emergency Psychiatry and Acute Care, Lapeyronie Hospital, CHU Montpellier, Montpellier, France; IGF, University of Montpellier, CNRS, INSERM, Montpellier, France; Faculty of Medicine, Institute of Clinical Medicine, Psychiatric Clinic, Vilnius University, Vilnius, Lithuania.
| | - Raoul Belzeaux
- INT-UMR7289, CNRS Aix-Marseille Université, Marseille, France; University Department of Adult Psychiatry, CHU Montpellier, Montpellier, France; Fondation Fondamental
| | - Emilie Olié
- Department of Emergency Psychiatry and Acute Care, Lapeyronie Hospital, CHU Montpellier, Montpellier, France; IGF, University of Montpellier, CNRS, INSERM, Montpellier, France; Fondation Fondamental
| | - Hind Hamzeh-Cognasse
- Université Jean Monnet, Mines Saint-Étienne, INSERM, U 1059 Sainbiose, Saint-Étienne, France
| | - Maude Sénèque
- Department of Emergency Psychiatry and Acute Care, Lapeyronie Hospital, CHU Montpellier, Montpellier, France; IGF, University of Montpellier, CNRS, INSERM, Montpellier, France
| | - Robertas Strumila
- Department of Emergency Psychiatry and Acute Care, Lapeyronie Hospital, CHU Montpellier, Montpellier, France; IGF, University of Montpellier, CNRS, INSERM, Montpellier, France; Faculty of Medicine, Institute of Clinical Medicine, Psychiatric Clinic, Vilnius University, Vilnius, Lithuania
| | - Fabrice Cognasse
- Université Jean Monnet, Mines Saint-Étienne, INSERM, U 1059 Sainbiose, Saint-Étienne, France; Etablissement Français du Sang Auvergne-Rhône-Alpes, Saint-Étienne, France
| | - Philippe Courtet
- Department of Emergency Psychiatry and Acute Care, Lapeyronie Hospital, CHU Montpellier, Montpellier, France; IGF, University of Montpellier, CNRS, INSERM, Montpellier, France; Fondation Fondamental
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Coon H, Shabalin A, Bakian AV, DiBlasi E, Monson ET, Kirby A, Chen D, Fraser A, Yu Z, Staley M, Callor WB, Christensen ED, Crowell SE, Gray D, Crockett DK, Li QS, Keeshin B, Docherty AR. Extended familial risk of suicide death is associated with younger age at death and elevated polygenic risk of suicide. Am J Med Genet B Neuropsychiatr Genet 2022; 189:60-73. [PMID: 35212135 PMCID: PMC9149029 DOI: 10.1002/ajmg.b.32890] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 11/19/2021] [Accepted: 01/31/2022] [Indexed: 12/12/2022]
Abstract
Suicide accounts for >800,000 deaths annually worldwide; prevention is an urgent public health issue. Identification of risk factors remains challenging due to complexity and heterogeneity. The study of suicide deaths with increased extended familial risk provides an avenue to reduce etiological heterogeneity and explore traits associated with increased genetic liability. Using extensive genealogical records, we identified high-risk families where distant relatedness of suicides implicates genetic risk. We compared phenotypic and polygenic risk score (PRS) data between suicides in high-risk extended families (high familial risk (HFR), n = 1,634), suicides linked to genealogical data not in any high-risk families (low familial risk (LFR), n = 147), and suicides not linked to genealogical data with unknown familial risk (UFR, n = 1,865). HFR suicides were associated with lower age at death (mean = 39.34 years), more suicide attempts, and more PTSD and trauma diagnoses. For PRS tests, we included only suicides with >90% European ancestry and adjusted for residual ancestry effects. HFR suicides showed markedly higher PRS of suicide death (calculated using cross-validation), supporting specific elevation of genetic risk of suicide in this subgroup, and also showed increased PRS of PTSD, suicide attempt, and risk taking. LFR suicides were substantially older at death (mean = 49.10 years), had fewer psychiatric diagnoses of depression and pain, and significantly lower PRS of depression. Results suggest extended familiality and trauma/PTSD may provide specificity in identifying individuals at genetic risk for suicide death, especially among younger ages, and that LFR of suicide warrants further study regarding the contribution of demographic and medical risks.
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Affiliation(s)
- Hilary Coon
- Department of Psychiatry & Huntsman Mental Health InstituteUniversity of UtahSalt Lake CityUtahUSA
| | - Andrey Shabalin
- Department of Psychiatry & Huntsman Mental Health InstituteUniversity of UtahSalt Lake CityUtahUSA
| | - Amanda V. Bakian
- Department of Psychiatry & Huntsman Mental Health InstituteUniversity of UtahSalt Lake CityUtahUSA
| | - Emily DiBlasi
- Department of Psychiatry & Huntsman Mental Health InstituteUniversity of UtahSalt Lake CityUtahUSA
| | - Eric T. Monson
- Department of Psychiatry & Huntsman Mental Health InstituteUniversity of UtahSalt Lake CityUtahUSA
| | - Anne Kirby
- Department of Occupational TherapyUniversity of UtahSalt Lake CityUtahUSA
| | - Danli Chen
- Department of Psychiatry & Huntsman Mental Health InstituteUniversity of UtahSalt Lake CityUtahUSA
| | - Alison Fraser
- Pedigree & Population Resource, Huntsman Cancer InstituteUniversity of UtahSalt Lake CityUtahUSA
| | - Zhe Yu
- Pedigree & Population Resource, Huntsman Cancer InstituteUniversity of UtahSalt Lake CityUtahUSA
| | - Michael Staley
- Utah State Office of the Medical ExaminerUtah Department of HealthSalt Lake CityUtahUSA
| | | | - Erik D. Christensen
- Utah State Office of the Medical ExaminerUtah Department of HealthSalt Lake CityUtahUSA
| | | | - Douglas Gray
- Department of Psychiatry & Huntsman Mental Health InstituteUniversity of UtahSalt Lake CityUtahUSA
| | | | - Qingqin S. Li
- Neuroscience Therapeutic AreaJanssen Research & Development LLCTitusvilleUtahUSA
| | - Brooks Keeshin
- Department of PediatricsUniversity of UtahSalt Lake CityUtahUSA
- Primary Children's Hospital Center for Safe and Healthy FamiliesSalt Lake CityUtahUSA
| | - Anna R. Docherty
- Department of Psychiatry & Huntsman Mental Health InstituteUniversity of UtahSalt Lake CityUtahUSA
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Fanelli G, Sokolowski M, Wasserman D, Kasper S, Zohar J, Souery D, Montgomery S, Albani D, Forloni G, Ferentinos P, Rujescu D, Mendlewicz J, De Ronchi D, Serretti A, Fabbri C. Polygenic risk scores for neuropsychiatric, inflammatory, and cardio-metabolic traits highlight possible genetic overlap with suicide attempt and treatment-emergent suicidal ideation. Am J Med Genet B Neuropsychiatr Genet 2022; 189:74-85. [PMID: 35191176 PMCID: PMC9305542 DOI: 10.1002/ajmg.b.32891] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 10/01/2021] [Accepted: 01/31/2022] [Indexed: 12/11/2022]
Abstract
Suicide is the second cause of death among youths. Genetics may contribute to suicidal phenotypes and their co-occurrence in other neuropsychiatric and medical conditions. Our study aimed to investigate the association of polygenic risk scores (PRSs) for 24 neuropsychiatric, inflammatory, and cardio-metabolic traits/diseases with suicide attempt (SA) or treatment-worsening/emergent suicidal ideation (TWESI). PRSs were computed based on summary statistics of genome-wide association studies. Regression analyses were performed between PRSs and SA or TWESI in four clinical cohorts. Results were then meta-analyzed across samples, including a total of 688 patients with SA (Neff = 2,258) and 214 with TWESI (Neff = 785). Stratified genetic covariance analyses were performed to investigate functionally cross-phenotype PRS associations. After Bonferroni correction, PRS for major depressive disorder (MDD) was associated with SA (OR = 1.24; 95% CI = 1.11-1.38; p = 1.73 × 10-4 ). Nominal associations were shown between PRSs for coronary artery disease (CAD) (p = 4.6 × 10-3 ), loneliness (p = .009), or chronic pain (p = .016) and SA, PRSs for MDD or CAD and TWESI (p = .043 and p = .032, respectively). Genetic covariance between MDD and SA was shown in 86 gene sets related to drugs having antisuicidal effects. A higher genetic liability for MDD may underlie a higher SA risk. Further, but milder, possible modulatory factors are genetic risk for loneliness and CAD.
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Affiliation(s)
- Giuseppe Fanelli
- Department of Biomedical and Neuromotor SciencesUniversity of BolognaBolognaItaly,Department of Human GeneticsRadboud University Medical Center, Donders Institute for Brain, Cognition and BehaviourNijmegenThe Netherlands
| | - Marcus Sokolowski
- National Centre for Suicide Research and Prevention of Mental Ill‐Health (NASP)Karolinska InstituteStockholmSweden
| | - Danuta Wasserman
- National Centre for Suicide Research and Prevention of Mental Ill‐Health (NASP)Karolinska InstituteStockholmSweden
| | | | - Siegfried Kasper
- Department of Psychiatry and PsychotherapyMedical University ViennaViennaAustria
| | - Joseph Zohar
- Department of PsychiatrySheba Medical Center, Tel Hashomer, and Sackler School of Medicine, Tel Aviv UniversityTel HashomerIsrael
| | - Daniel Souery
- Laboratoire de Psychologie MédicaleUniversité Libre de Bruxelles and Psy Pluriel, Centre Européen de Psychologie MédicaleBrusselsBelgium
| | | | - Diego Albani
- Laboratory of Biology of Neurodegenerative DisordersDepartment of Neuroscience, Istituto di Ricerche Farmacologiche Mario Negri IRCCSMilanItaly
| | - Gianluigi Forloni
- Laboratory of Biology of Neurodegenerative DisordersDepartment of Neuroscience, Istituto di Ricerche Farmacologiche Mario Negri IRCCSMilanItaly
| | | | - Dan Rujescu
- University Clinic for PsychiatryPsychotherapy and Psychosomatic, Martin‐Luther‐University, Halle‐WittenbergGermany
| | | | - Diana De Ronchi
- Department of Biomedical and Neuromotor SciencesUniversity of BolognaBolognaItaly
| | - Alessandro Serretti
- Department of Biomedical and Neuromotor SciencesUniversity of BolognaBolognaItaly
| | - Chiara Fabbri
- Department of Biomedical and Neuromotor SciencesUniversity of BolognaBolognaItaly,Social, Genetic & Developmental Psychiatry CentreInstitute of Psychiatry, Psychology & Neuroscience, King's College LondonLondonUK
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