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Basta M, Skourti E, Simos P, Soumaki E, Li Y, Gerostergios G, Samiotakis G, Dafermos V, Drakaki M, Papadakis N, Vgontzas AN. Associations between sleep complaints, suicidal ideation and depressive symptoms among adolescents and young adults in Greece. J Sleep Res 2023; 32:e13900. [PMID: 37039423 DOI: 10.1111/jsr.13900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2022] [Revised: 03/08/2023] [Accepted: 03/21/2023] [Indexed: 04/12/2023]
Abstract
Depression prevalence increases significantly during adolescence/early adulthood. Depression in youth may present suicidal ideation, while suicide represents the leading cause of death in this age group. Moreover, adolescents/young adults frequently report sleep complaints that may partially be due to depressive symptoms. Studies on the associations between depression, sleep complaints and suicidality in this age group are limited. We aimed to examine associations between depressive symptoms, sleep complaints and suicidal ideation in a large (n = 2771), representative sample of adolescents (age: 15-17 years, n = 512) and young adults (age: 18-24 years, n = 2259) from the general population in Greece. A telephone structured questionnaire was administered. Depressive symptoms were assessed using the modified Patient Health-7 questionnaire score, while presence of suicidal ideation and sleep complaints were assessed using the ninth and third question of Patient Health-9 questionnaire, respectively. Mediation logistic regression analysis revealed significant direct paths from depressive symptoms to sleep complaints (odds ratio [OR] 1.22, 95% confidence interval [CI] 1.19-1.24; OR 1.21, 95% CI 1.18-1.24) and suicidal ideation (OR 1.18, 95% CI 1.14-1.22; OR 1.18, 95% CI 1.14-1.22), as well as sleep complaints and suicidal ideation (OR 1.82, 95% CI 1.32-2.50; OR 1.91, 95% CI 1.33-2.76) in the total group and in young adults, respectively, but not among adolescents. Moreover, we detected a significant indirect effect of depressive symptoms on suicidal ideation mediated by sleep complaints (18.8%) in young adults. These findings support the hypothesis that treatment of sleep disturbances among youth with depression may independently further reduce suicidal risk.
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Affiliation(s)
- M Basta
- Department of Psychiatry, University Hospital of Heraklion, Crete, Greece
- Sleep Research and Treatment Center, Department of Psychiatry, Penn State University, Hershey, Pennsylvania, USA
- Department of Child and Adolescent Psychiatry, University Hospital of Heraklion, Crete, Greece
| | - E Skourti
- Department of Psychiatry, University Hospital of Heraklion, Crete, Greece
| | - P Simos
- Department of Psychiatry, University Hospital of Heraklion, Crete, Greece
- Computational Biomedicine Lab, Institute of Computer Science, Foundation for Research and Technology-Hellas, Heraklion, Greece
| | - E Soumaki
- Department of Child and Adolescent Psychiatry, University Hospital of Heraklion, Crete, Greece
| | - Y Li
- Department of Sleep Medicine, Mental Health Center of Shantou University, Shantou, Guangdong, China
| | - G Gerostergios
- Department of Child and Adolescent Psychiatry, University Hospital of Heraklion, Crete, Greece
| | - G Samiotakis
- Department of Child and Adolescent Psychiatry, University Hospital of Heraklion, Crete, Greece
| | - V Dafermos
- Department of Political Science, University of Crete, Rethymno, Greece
| | - M Drakaki
- Department of Political Science, University of Crete, Rethymno, Greece
| | - N Papadakis
- Department of Political Science, University of Crete, Rethymno, Greece
| | - A N Vgontzas
- Department of Psychiatry, University Hospital of Heraklion, Crete, Greece
- Sleep Research and Treatment Center, Department of Psychiatry, Penn State University, Hershey, Pennsylvania, USA
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Moselli M, Casini MP, Frattini C, Williams R. Suicidality and Personality Pathology in Adolescence: A Systematic Review. Child Psychiatry Hum Dev 2023; 54:290-311. [PMID: 34524583 PMCID: PMC9977705 DOI: 10.1007/s10578-021-01239-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/15/2021] [Indexed: 10/20/2022]
Abstract
This work presents a review of research papers examining the role of emerging personality pathology in suicidal ideation and behaviours in adolescence. Initially, 226 studies were selected in line with PRISMA guidelines, and 33 articles were finally included in this review. The data show percentages of any personality disorder diagnosis ranging from 19.5 to 22.8% in suicide attempters, while in autopsy studies, the rate of personality disorder diagnosis varied between 29.6 and 42.1%. The overwhelming majority of the studies focus on the role of borderline personality disorder (BPD) in suicidal behaviours, also highlighting its predictive role at a longitudinal level. Furthermore, the literature review shows that personality traits supposed to underlie BPD, such as affective instability, impulsivity and identity diffusion, have specific predictive links with suicidal conduct. Other personality pathology dimensions, such as aggressiveness, sadism and perfectionism that are associated with other personality disorders, namely, antisocial and narcissistic personality disorders, have also shown a significant mediating role for suicidal risk. Overall, these results seem to parallel the role of personality pathology in predicting suicide in adulthood and point to the relevance of assessing the presence of emerging patterns of personality disorders for the clinical management of suicidal risk in adolescence.
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Affiliation(s)
- Marta Moselli
- grid.7841.aDepartment of Clinical and Dynamic Psychology, Sapienza University of Rome, Rome, Italy
| | - Maria Pia Casini
- Child Neuropsychiatry Unit, Department of Neuroscience, I.R.C.C.S. Children Hospital Bambino Gesù, Rome, Italy
| | - Camilla Frattini
- grid.7841.aDepartment of Clinical and Dynamic Psychology, Sapienza University of Rome, Rome, Italy
| | - Riccardo Williams
- Department of Clinical and Dynamic Psychology, Sapienza University of Rome, Rome, Italy.
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