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Jing Y, Liu Y, Zhou Y, Li M, Gao Y, Zhang B, Li J. Inflammation-related abnormal dynamic brain activity correlates with cognitive impairment in first-episode, drug-naïve major depressive disorder. J Affect Disord 2024; 366:217-225. [PMID: 39197551 DOI: 10.1016/j.jad.2024.08.165] [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: 04/28/2024] [Revised: 07/22/2024] [Accepted: 08/23/2024] [Indexed: 09/01/2024]
Abstract
BACKGROUND Cognitive impairment is common in major depressive disorder (MDD) and potentially linked to inflammation-induced alterations in brain function. However, the relationship between inflammation, dynamic brain activity, and cognitive impairment in MDD remains unclear. METHODS Fifty-seven first-episode, drug-naïve MDD patients and sixty healthy controls underwent fMRI scanning. Dynamic amplitude of low-frequency fluctuations (dALFF) and dynamic functional connectivity (dFC) were measured using the sliding window method. Plasma IL - 6 levels and cognitive function were assessed using enzyme-linked immunosorbent assay (ELISA) and the Repeated Battery for Assessment of Neuropsychological Status (RBANS), respectively. RESULTS MDD patients exhibited decreased dALFF in the bilateral inferior temporal gyrus (ITG), right inferior frontal gyrus, opercular part (IFGoperc), and bilateral middle occipital gyrus (MOG). Regions of dALFF associated with IL-6 included right ITG (r = -0.400/p = 0.003), left ITG (r = -0.381/p = 0.004), right IFGoperc (r = -0.342/p = 0.011), and right MOG (r = -0.327/p = 0.016). Furthermore, IL-6-related abnormal dALFF (including right ITG: r = 0.309/p = 0.023, left ITG: r = 0.276/p = 0.044) was associated with attention impairment. These associations were absent entirely in MDD patients without suicidal ideation. Additionally, IL-6 levels were correlated with dFC of specific brain regions. LIMITATIONS Small sample size and cross-sectional study design. CONCLUSIONS Inflammation-related dALFF was associated with attention impairment in MDD patients, with variations observed among MDD subgroups. These findings contribute to the understanding of the intricate relationship between inflammation, dynamic brain activity and cognitive impairments in MDD.
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Affiliation(s)
- Yifan Jing
- Institute of Mental Health, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, Tianjin 300222, China
| | - Yuan Liu
- Institute of Mental Health, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, Tianjin 300222, China
| | - Yuwen Zhou
- Institute of Mental Health, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, Tianjin 300222, China
| | - Meijuan Li
- Institute of Mental Health, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, Tianjin 300222, China
| | - Ying Gao
- Institute of Mental Health, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, Tianjin 300222, China
| | - Bin Zhang
- Institute of Mental Health, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, Tianjin 300222, China
| | - Jie Li
- Institute of Mental Health, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, Tianjin 300222, China.
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Wang T, Butterworth P, Cooklin A, Strazdins L, Leach L. Investigating the association between Work Family Conflicts (WFC) and suicidal ideation in an Australian community-based cohort study. J Affect Disord 2024; 363:483-491. [PMID: 39019220 DOI: 10.1016/j.jad.2024.07.047] [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: 10/24/2023] [Revised: 06/15/2024] [Accepted: 07/12/2024] [Indexed: 07/19/2024]
Abstract
BACKGROUND Suicidal ideation, a significant public health issue, necessitates further investigation of its correlates and precursors. Extensive research highlights the association between Work Family Conflicts (WFC) and psychological distress, including depression. However, research examining the correlation between high WFC experiences and suicidal ideation is sparse. This study explores the association between WFC and suicidal ideation within an occupation non-specific community sample. METHODS Community-based, representative data from the Australian-based Personality and Total Health (PATH) Through Life project formed the basis of this study. Participants eligible for the study (N = 1312) were employed either full-time or part-time and took part in an online questionnaire. Importantly, the data include robust measures of WFC, active suicidal ideation, and depression. RESULTS After adjusting for psychosocial job characteristics, history of suicidal ideation, and other socio-demographic factors, high WFC was associated with increased odds of active suicidal ideation (Model 4: OR: 1.58, CI: 1.04-2.40). Further, supplementary analyses indicated that depression is an important component of this relationship. Analyses exploring an interaction effect by gender showed that while a significant association between high WFC and suicidality was observed among men after adjustment for all covariates, this association was not evident for women. LIMITATIONS A small number of participants reported suicidal ideation, potentially affecting the statistical power to detect significant effects. WFC was measured at one time-point, prohibiting the exploration of its causal and/or chronic impact on suicidal ideation. CONCLUSION We find evidence that high WFC is linked to increased active suicidal ideation - specifically for men.
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Affiliation(s)
- Tianying Wang
- National Centre for Epidemiology and Population Health (NCEPH), The Australian National University, Canberra, Australia.
| | | | - Amanda Cooklin
- Judith Lumley Centre, La Trobe University, Melbourne, Australia
| | - Lyndall Strazdins
- National Centre for Epidemiology and Population Health (NCEPH), The Australian National University, Canberra, Australia
| | - Liana Leach
- National Centre for Epidemiology and Population Health (NCEPH), The Australian National University, Canberra, Australia
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3
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Riemann G, Chrispijn M, Kupka RW, Penninx BWJH, Giltay EJ. Borderline personality features in relationship to childhood trauma in unipolar depressive and bipolar disorders. J Affect Disord 2024; 363:358-364. [PMID: 39029699 DOI: 10.1016/j.jad.2024.07.101] [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: 03/17/2024] [Revised: 06/09/2024] [Accepted: 07/16/2024] [Indexed: 07/21/2024]
Abstract
BACKGROUND Childhood trauma, including emotional neglect, emotional abuse, physical abuse, and sexual abuse, may contribute to borderline personality features like affective instability, identity problems, negative relationships, and self-harm. This study aims to explore how different types of childhood trauma affect these features in bipolar versus unipolar depressive disorders. METHODS We included 839 participants of the Netherlands Study of Depression and Anxiety (NESDA) with a lifetime diagnosis of major depressive disorder single episode (MDDS; N = 443), recurrent major depressive disorder (MDD-R; N = 331), or bipolar disorder (BD; N = 65). Multivariate regression was used to analyze data from the Childhood Trauma Interview and borderline features (from the self-report Personality Assessment Inventory). RESULTS On average, participants were 48.6 years old (SD: 12.6), with 69.2 % being women, and 50.3 % of participants assessed positive for childhood trauma. Adjusted analyses revealed that participants diagnosed with BD, followed by MDD-R, exhibited the highest number of borderline personality features. Additionally, within the entire group, a strong association was found between childhood trauma, especially emotional neglect, and the presence of borderline personality features. CONCLUSION Given the high prevalence of childhood trauma and borderline personality features, screening for these factors in individuals with mood disorders is crucial. Identifying these elements can inform and enhance the management of the often fluctuating and complex nature of these comorbid conditions, leading to more effective and tailored treatment strategies.
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Affiliation(s)
- Georg Riemann
- Fontys, University of Applied Science, Emmasingel 28, 5611 AZ Eindhoven, the Netherlands.
| | - Melissa Chrispijn
- Dimence Mental Health, Center for Bipolar Disorders, Deventer, the Netherlands
| | - Ralph W Kupka
- Amsterdam UMC, VU University, Department of Psychiatry, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
| | - Brenda W J H Penninx
- Amsterdam UMC, VU University, Department of Psychiatry, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
| | - Erik J Giltay
- Leiden University Medical Center (LUMC), Department of Psychiatry, Leiden, the Netherlands; Health Campus The Hague, Department of Public Health and Primary Care, Leiden University Medical Centre, The Hague, the Netherlands
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4
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Li J, Ma L, Sun H, Li M, Cao Y, Peng Y, Xu J. Efficacy of racemic ketamine or esketamine monotherapy for reducing suicidal ideation in uni- or bipolar depression: a systematic review and meta-analysis. Eur Arch Psychiatry Clin Neurosci 2024:10.1007/s00406-024-01920-x. [PMID: 39382685 DOI: 10.1007/s00406-024-01920-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2023] [Accepted: 09/20/2024] [Indexed: 10/10/2024]
Abstract
The current systematic review and meta-analysis examined the effect of racemic ketamine or esketamine on suicidal ideation in individuals with uni- or bipolar depression. We searched the MEDLINE, Embase, Central, PsycINFO, and Web of Science databases to identify randomized controlled trials that examined the effect of racemic ketamine or esketamine monotherapy on suicidal ideation (SI) in individuals with uni- or bipolar depression. The two monotherapies were compared; the primary outcome was the rate of remission of SI, and the secondary outcome was the SI score. The risk ratio was used as an effect size measure for binary variables, while the standardized mean difference was used as an effect size measure for continuous variables. Our meta-analysis included 13 randomized controlled trials involving 1,1109 individuals with uni- or bipolar depression. Patients receiving racemic ketamine monotherapy had a significantly higher acute SI remission rate than those receiving placebo or midazolam (RR = 2.06, 95% CI 1.47 to 2.91, P < 0.0001). Racemic ketamine also led to significantly lower SI scores than placebo or midazolam (SMD = -0.36, 95% CI -0.71 to -0.01, P = 0.04). The evidence for the treatment of SI with esketamine was inconsistent. The pooled effect sizes for long-term anti-SI effects did not reveal significant differences between therapies. Our study indicated the efficacy of racemic ketamine monotherapy for rapidly and transiently reducing SI in individuals with uni- or bipolar depression, but the efficacy of racemic ketamine monotherapy against long-term suicidal ideation remains unclear. There is not -sufficient evidence to support the anti-suicidal effects of esketamine monotherapy.Protocol registration: Prospero registration number: CRD42023434380.
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Affiliation(s)
- Jiafeng Li
- Mental Health Center, West China Hospital of Sichuan University, Chengdu, China
| | - Ling Ma
- Mental Health Center, West China Hospital of Sichuan University, Chengdu, China
| | - Huan Sun
- Mental Health Center, West China Hospital of Sichuan University, Chengdu, China
| | - Meng Li
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany
- Center for Intervention and Research on adaptive and maladaptive brain Circuits underlying mental health (C-I-R- C), Halle-Jena-Magdeburg, Germany
- Clinical Affective Neuroimaging Laboratory (CANLAB), Leipziger Str. 44, Building 65, 39120, Magdeburg, Germany
| | - Yuan Cao
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany
- Center for Intervention and Research on adaptive and maladaptive brain Circuits underlying mental health (C-I-R- C), Halle-Jena-Magdeburg, Germany
- Clinical Affective Neuroimaging Laboratory (CANLAB), Leipziger Str. 44, Building 65, 39120, Magdeburg, Germany
| | - Yang Peng
- President's Office, West China Hospital of Sichuan University, Chengdu, China
| | - Jiajun Xu
- Mental Health Center, West China Hospital of Sichuan University, Chengdu, China.
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5
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Tubbs AS, Perlis ML, Killgore WDS, Karp JF, Grandner MA, Fernandez FX. Empirical clustering to identify individuals for whom insomnia is more closely related to suicidal ideation. J Affect Disord 2024; 362:36-44. [PMID: 38942202 DOI: 10.1016/j.jad.2024.06.101] [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: 04/01/2024] [Revised: 05/29/2024] [Accepted: 06/25/2024] [Indexed: 06/30/2024]
Abstract
BACKGROUND Although the effect sizes are modest, insomnia is consistently associated with suicidal thoughts and behaviors. Subgroup analyses can efficiently identify for whom insomnia is most relevant to suicidal ideation. To improve clinical case identification, the present study sought to identify subclusters of lifetime suicidal ideators for whom insomnia was most closely related to current suicidal ideation. METHODS Data on N = 4750 lifetime suicidal ideators were extracted from the Military Suicide Research Consortium's Common Data Elements. Data on sociodemographic characteristics, severity and history of suicidal thoughts and behaviors, and related clinical characteristics were clustered by unsupervised machine learning algorithms. Robust Poisson regression estimated cluster by insomnia associations with current suicidal ideation. RESULTS Three clusters were identified: a modest symptom severity cluster (N = 1757, 37.0 %), an elevated severity cluster (N = 1444 30.4 %), and a high severity cluster (N = 1549 32.6 %). In Cluster 1, insomnia was associated with current suicidal ideation (PRR 1.29 [1.13-1.46]) and remained significant after adjusting for sociodemographic and clinical covariates. In Cluster 2, insomnia was associated with current suicidal ideation (PRR 1.14 [1.01-1.30]), but not after adjusting for sociodemographic and clinical covariates. In Cluster 3, insomnia was associated with current suicidal ideation (PRR 1.12 [1.03-1.21]) and remained significant after adjusting for sociodemographic covariates, but not clinical covariates. LIMITATIONS Cross-sectional design, lack of diagnostic data, non-representative sample. CONCLUSION Insomnia appears more closely related to current suicidal ideation among modest severity individuals than other subgroups. Future work should use prospective designs and more comprehensive risk factor measures to confirm these findings.
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Affiliation(s)
- Andrew S Tubbs
- Department of Psychiatry, University of Arizona College of Medicine - Tucson, Tucson, AZ 85724, USA.
| | - Michael L Perlis
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - William D S Killgore
- Department of Psychiatry, University of Arizona College of Medicine - Tucson, Tucson, AZ 85724, USA
| | - Jordan F Karp
- Department of Psychiatry, University of Arizona College of Medicine - Tucson, Tucson, AZ 85724, USA
| | - Michael A Grandner
- Department of Psychiatry, University of Arizona College of Medicine - Tucson, Tucson, AZ 85724, USA
| | - Fabian-Xosé Fernandez
- Evelyn F. McKnight Brain Institute, Department of Psychology, University of Arizona, Tucson, AZ 85719, USA
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Bergamaschi V, Baumann F, Warnke I, Corbisiero S, Ludwig F, Riedel A, Gabriel-Felleiter K, Schmidt SJ. Who Benefits from Acute Psychiatric Home Treatment? A Systematic Review. Community Ment Health J 2024; 60:1408-1421. [PMID: 38940978 PMCID: PMC11408559 DOI: 10.1007/s10597-024-01297-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Accepted: 05/13/2024] [Indexed: 06/29/2024]
Abstract
Home treatment (HT) treats patients in an acute crisis through an interdisciplinary team with daily appointments for a short treatment period. The effectiveness of HT has already been confirmed. However, only few studies addressed specific patient characteristics associated outcome of treatment. This study aimed to identify patient characteristics associated with successful outcomes of HT. A systematic literature search was conducted according to the PRISMA guidelines. A total of 13 studies were included in the systematic review. Being employed, having a regular income, having an anxiety disorder and family involvement were associated with a successful treatment outcome in HT. High symptom severity and former hospital admissions were associated with unsuccessful treatment outcome in HT in the selected studies. HT seems to be especially beneficial for patients with paid employment or regular income, patients with anxiety disorders, and patients with familial or other social support.
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Affiliation(s)
- Vera Bergamaschi
- Institue of Psychology, University of Bern, Bern, Switzerland.
- Luzerner Psychiatrie, Voltastrasse 42, 6005, Lucerne, Switzerland.
| | - Felix Baumann
- Institue of Psychology, University of Bern, Bern, Switzerland
- Luzerner Psychiatrie, Voltastrasse 42, 6005, Lucerne, Switzerland
| | - Ingeborg Warnke
- Luzerner Psychiatrie, Voltastrasse 42, 6005, Lucerne, Switzerland
| | | | - Fabian Ludwig
- Luzerner Psychiatrie, Voltastrasse 42, 6005, Lucerne, Switzerland
| | - Andreas Riedel
- Luzerner Psychiatrie, Voltastrasse 42, 6005, Lucerne, Switzerland
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Moro L, Sicotte R, Joober R, Malla A, Lepage M, Orri M. Trajectories of suicidality during a 2-year early-intervention program for first-episode psychosis: A longitudinal study. Psychiatry Res 2024; 340:116148. [PMID: 39178562 DOI: 10.1016/j.psychres.2024.116148] [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: 01/17/2024] [Revised: 07/19/2024] [Accepted: 08/13/2024] [Indexed: 08/26/2024]
Abstract
Little is known about the individual course of suicidal ideations and attempts (i.e., suicidality) after treatment initiation. We examined the trajectories of suicidality and associated risk factors over a 2-year early intervention program for first-episode psychosis in 450 patients (age range 18-35 years at admission) consecutively admitted from 2003 to 2017. Suicidality was assessed via systematic file review, while sociodemographic and clinical variables were assessed at admission. Latent class growth modelling identified three trajectories: low (69.6 %), initially high (22.9 %), and persistently high (7.6 %) suicidality. Patients who were younger, lived alone and were diagnosed with affective psychosis were significantly more likely to follow the initially high trajectory. Patients who attempted suicide up to 3 months before admission, lived alone and presented lower levels of the PANSS excited factor were significantly more likely to follow the persistently high trajectory. Attempting suicide up to 3 months before admission distinguished persistently high and initially high suicidality trajectories. Suicide risk during early intervention program for first-episode psychosis is heterogenous, with acute and enduring suicidal risk, suggesting the need to adapt suicide prevention strategies to these different risk profiles.
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Affiliation(s)
- Laura Moro
- Department of Psychology, University of Montreal, Montreal, Canada; Douglas Research Centre, Montreal, Canada
| | | | - Ridha Joober
- Douglas Research Centre, Montreal, Canada; Prevention and Early Intervention Program for Psychosis (PEPP), Douglas Mental Health University Institute, Montreal, Canada; Department of Psychiatry, McGill University, Montreal, Canada
| | - Ashok Malla
- Douglas Research Centre, Montreal, Canada; Prevention and Early Intervention Program for Psychosis (PEPP), Douglas Mental Health University Institute, Montreal, Canada; Department of Psychiatry, McGill University, Montreal, Canada
| | - Martin Lepage
- Douglas Research Centre, Montreal, Canada; Department of Psychiatry, McGill University, Montreal, Canada
| | - Massimiliano Orri
- Douglas Research Centre, Montreal, Canada; Department of Psychiatry, McGill University, Montreal, Canada; McGill Group for Suicide Studies, Douglas Research Centre, Montreal, Canada; Department of Epidemiology, Biostatistics, and Occupational Health, School of Population and Global Health, McGill University, Montreal, Quebec, Canada; Danish Research Institute for Suicide Prevention, Mental Health Centre Copenhagen, Copenhagen, Denmark.
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8
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Dominguez-Rodriguez A, Sanz-Gomez S, González Ramírez LP, Herdoiza-Arroyo PE, Trevino Garcia LE, de la Rosa-Gómez A, González-Cantero JO, Macias-Aguinaga V, Arenas Landgrave P, Chávez-Valdez SM. Evaluation and Future Challenges in a Self-Guided Web-Based Intervention With and Without Chat Support for Depression and Anxiety Symptoms During the COVID-19 Pandemic: Randomized Controlled Trial. JMIR Form Res 2024; 8:e53767. [PMID: 39348893 PMCID: PMC11474119 DOI: 10.2196/53767] [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: 10/18/2023] [Revised: 03/26/2024] [Accepted: 08/13/2024] [Indexed: 10/02/2024] Open
Abstract
BACKGROUND The COVID-19 pandemic has had an impact on mental health worldwide. Low- and middle-income countries were largely affected by it. Mexico was one of the most affected countries. Extended periods of lockdowns, isolation, and social distancing, among other factors, highlighted the need to introduce web-based psychological interventions to the Mexican population. In this context, Mental Health COVID-19 emerged as a self-guided web-based intervention (SGWI) aimed at adults to improve mental health during the COVID-19 pandemic. OBJECTIVE This study aims to assess the efficacy of 2 modalities of a self-guided intervention (with and without chat support) in reducing depression symptoms, generalized anxiety, community posttraumatic stress, widespread fear, anxiety, sleep quality, physiological and affective coping, and suicide ideation. In addition, it aimed to compare the moderating role of coping strategies, acceptance, and satisfaction in participants' symptom reduction. We hypothesize that the self-guided, chat-supported modality will show higher efficacy than the modality without chat support in achieving clinical change and better performance as a moderator of depression symptoms, generalized anxiety, community posttraumatic stress, widespread fear, anxiety, sleep quality, physiological and affective coping, and suicide ideation, as well as an increase in participants' satisfaction and acceptability. METHODS A randomized controlled trial was conducted. Data were collected from May 2020 to June 2022. We performed intrasubject measures at 4 evaluation periods: pretest, posttest, and follow-up measurements at 3 and 6 months. Differences between intervention groups were assessed through the Mann-Whitney U test for continuous variables and the chi-square test for categorical variables. Changes due to intervention were analyzed using Wilcoxon W test. Moderated regression analysis was performed to test the hypothesized moderating role of coping strategies, usability, and opinion about treatment on clinical change. RESULTS A total of 36 participants completed the intervention; of these, 5 (14%) were part of the SGWI group, and 31 (86%) were on the SGWI plus chat support (SGWI+C) group, which included a chat service with therapists. The perceived high complexity of the system for the SGWI group had a moderating effect associated with a lack of efficacy of the intervention regarding depression, but not when controlled for sociodemographic variables. A perception of lower helpfulness of the intervention was associated with poorer outcomes. Coping strategies did not show moderating effects. CONCLUSIONS Enhancing the utility of web-based interventions for reducing clinical symptoms by incorporating a support chat to boost treatment adherence seemed to improve the perception of the intervention's usefulness. Web-based interventions face several challenges, such as eliminating complexities in platform use and increasing the users' perceived utility of the intervention, among other issues identified in the study. TRIAL REGISTRATION ClinicalTrials.gov NCT04468893; https://clinicaltrials.gov/study/NCT04468893?tab=results. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.2196/23117.
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Affiliation(s)
- Alejandro Dominguez-Rodriguez
- Department of Psychology, Health and Technology, University of Twente, Enschede, Netherlands
- Health Sciences Area, Valencian International University, Valencia, Spain
| | - Sergio Sanz-Gomez
- Health Sciences Area, Valencian International University, Valencia, Spain
- Universidad de Sevilla, Seville, Spain
| | | | | | | | - Anabel de la Rosa-Gómez
- Faculty of Higher Studies Iztacala, National Autonomous University of Mexico, Mexico City, Mexico
| | - Joel Omar González-Cantero
- Department of Behavioral Sciences, Centro Universitario de los Valles, Universidad de Guadalajara, Guadalajara, Mexico
| | | | | | - Sarah Margarita Chávez-Valdez
- Escuela Libre de Psicología AC, ELPAC, University of Behavioral Sciences, Chihuahua, Mexico
- Social Sciences Department, Universidad Autónoma de Ciudad Juárez, Ciudad Juárez, Mexico
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Vázquez FL, Torres ÁJ, Blanco V, Bouza Q, Otero P, Andrade E, Simón MÁ, Bueno AM, Arrojo M, Páramo M, Fernández A. Brief psychological intervention for suicide prevention based on problem-solving applied in different formats to people over 50 years old: protocol for a randomized controlled trial. BMC Psychiatry 2024; 24:628. [PMID: 39334120 PMCID: PMC11430082 DOI: 10.1186/s12888-024-06076-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2024] [Accepted: 09/11/2024] [Indexed: 09/30/2024] Open
Abstract
BACKGROUND Suicide is a major public health problem, especially among individuals over 50 years old. Despite the suitability of this life stage for prevention, research on the efficacy of psychological interventions is scarce and methodologically limited, affecting their clinical utility and efficacy. Brief, flexible interventions that can be applied both in-person and remotely are needed. This study aims to evaluate the efficacy of a brief problem-solving-based suicide prevention program applied through various modalities to individuals over 50 years old. METHODS A randomized controlled trial will be conducted. A sample of 212 adults aged 50 or older with suicidal ideation will be randomly assigned to a problem-solving-based psychological intervention administered face-to-face (PSPI-P; n = 53), by telephone multiconference (PSPI-M; n = 53), via a smartphone app (PSPI-A; n = 53), or to a usual care control group (UCCG; n = 53). The intervention will be delivered in 7 sessions or modules of 90 min each. Blind trained evaluators will conduct assessments at pre-intervention, post-intervention, and follow-ups at 3, 6, and 12 months. The primary outcome will be suicidal ideation evaluated using the Suicidal Ideation Scale (SSI) and the Columbia Suicide Severity Rating Scale (C-SSRS). Secondary outcomes will include hopelessness, anxiety and depression symptoms, reasons for living, impulsivity, problem-solving skills, social support, anger syndrome, gratitude, personality, dropouts, treatment adherence, and satisfaction with the intervention. DISCUSSION This study will provide evidence of the efficacy of a brief problem-solving-based intervention for suicide prevention in individuals over 50 years old, administered face-to-face, by telephone multiconference, and via a smartphone app. If results are favorable, it will indicate that an effective, accessible, clinically and socially useful suicide prevention intervention has been developed for affected individuals, families, and communities. TRIAL REGISTRATION ClinicalTrials.gov NCT06338904. Registered April 1, 2024.
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Grants
- PID2022-141225OB-I00 Ministry of Science, Innovation and Universities / State Investigation Agency
- PID2022-141225OB-I00 Ministry of Science, Innovation and Universities / State Investigation Agency
- PID2022-141225OB-I00 Ministry of Science, Innovation and Universities / State Investigation Agency
- PID2022-141225OB-I00 Ministry of Science, Innovation and Universities / State Investigation Agency
- PID2022-141225OB-I00 Ministry of Science, Innovation and Universities / State Investigation Agency
- PID2022-141225OB-I00 Ministry of Science, Innovation and Universities / State Investigation Agency
- PID2022-141225OB-I00 Ministry of Science, Innovation and Universities / State Investigation Agency
- PID2022-141225OB-I00 Ministry of Science, Innovation and Universities / State Investigation Agency
- PID2022-141225OB-I00 Ministry of Science, Innovation and Universities / State Investigation Agency
- PID2022-141225OB-I00 Ministry of Science, Innovation and Universities / State Investigation Agency
- PID2022-141225OB-I00 Ministry of Science, Innovation and Universities / State Investigation Agency
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Affiliation(s)
- Fernando L Vázquez
- Department of Clinical Psychology and Psychobiology, University of Santiago de Compostela, Santiago de Compostela, Spain.
| | - Ángela J Torres
- Department of Psychiatry, Radiology, Public Health, Nursing and Medicine, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Vanessa Blanco
- Department of Evolutionary and Educational Psychology, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Queila Bouza
- Department of Clinical Psychology and Psychobiology, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Patricia Otero
- Department of Psychology, University of A Coruña, A Coruña, Spain
| | - Elena Andrade
- Department of Social Psychology, Basic Psychology and Methodology, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Miguel Á Simón
- Department of Psychology, University of A Coruña, A Coruña, Spain
| | - Ana M Bueno
- Department of Psychology, University of A Coruña, A Coruña, Spain
| | - Manuel Arrojo
- Galician Health Service (SERGAS), Santiago de Compostela, Spain
| | - Mario Páramo
- Galician Health Service (SERGAS), Santiago de Compostela, Spain
| | - Alba Fernández
- Department of Clinical Psychology and Psychobiology, University of Santiago de Compostela, Santiago de Compostela, Spain
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10
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Goldstein KE, Pietrzak RH, Challman KN, Chu KW, Beck KD, Brenner LA, Interian A, Myers CE, Shafritz KM, Szeszko PR, Goodman M, Haznedar MM, Hazlett EA. Multi-modal risk factors differentiate suicide attempters from ideators in military veterans with major depressive disorder. J Affect Disord 2024; 369:588-598. [PMID: 39341292 DOI: 10.1016/j.jad.2024.09.149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2024] [Revised: 09/16/2024] [Accepted: 09/21/2024] [Indexed: 09/30/2024]
Abstract
BACKGROUND The suicide rate for United States military veterans is 1.5× higher than that of non-veterans. To meaningfully advance suicide prevention efforts, research is needed to delineate factors that differentiate veterans with suicide attempt/s, particularly in high-risk groups, e.g., major depressive disorder (MDD), from those with suicidal ideation (no history of attempt/s). The current study aimed to identify clinical, neurocognitive, and neuroimaging variables that differentiate suicide-severity groups in veterans with MDD. METHODS Sixty-eight veterans with a DSM-5 diagnosis of MDD, including those with no ideation or suicide attempt (N = 21; MDD-SI/SA), ideation-only (N = 17; MDD + SI), and one-or-more suicide attempts (N = 30; MDD + SA; aborted, interrupted, actual attempts), participated in this study. Participants underwent a structured diagnostic interview, neurocognitive assessment, and 3 T-structural/diffusion tensor magnetic-resonance-imaging (MRI). Multinomial logistic regression models were conducted to identify variables that differentiated groups with respect to the severity of suicidal behavior. RESULTS Relative to veterans with MDD-SI/SA, those with MDD + SA had significantly higher left cingulum fractional anisotropy, decreased attentional control on emotional-Stroop, and faster response time with intact accuracy on Go/No-Go. Relative to MDD + SI, MDD + SA had higher left cingulum fractional anisotropy and faster response time with intact accuracy on Go/No-Go. LIMITATIONS Findings are based on retrospective, cross-sectional data and cannot identify causal relationships. Also, a healthy control group was not included given the study's focus on differentiating suicide profiles in MDD. CONCLUSIONS This study suggests that MRI and neurocognition differentiate veterans with MDD along the suicide-risk spectrum and could inform suicide-risk stratification and prevention efforts in veterans and other vulnerable populations.
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Affiliation(s)
- Kim E Goldstein
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
| | - Robert H Pietrzak
- United States Department of Veterans Affairs National Center for PTSD, Clinical Neurosciences Division, VA Connecticut Healthcare System, West Haven, CT, USA; Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | - Katelyn N Challman
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - King-Wai Chu
- Mental Illness Research, Education, and Clinical Center (MIRECC VISN 2), James J. Peters VA Medical Center, Bronx, NY, USA
| | - Kevin D Beck
- Research Service, VA New Jersey Health Care System, East Orange, NJ, USA; Department of Pharmacology, Physiology & Neuroscience, New Jersey Medical School, Rutgers, The State University of New Jersey, Newark, NJ, USA
| | - Lisa A Brenner
- VA Rocky Mountain Mental Illness Research Education and Clinical Center, Eastern Colorado Health Care System, Aurora, CO, USA; Departments of Physical Medicine and Rehabilitation, Psychiatry, and Neurology, University of Colorado, Anschutz Medical Campus, Aurora, CO, USA
| | - Alejandro Interian
- Mental Health and Behavioral Sciences, VA New Jersey Health Care System, Lyons, NJ, USA; Department of Psychiatry, Robert Wood Johnson Medical School, Rutgers, The State University of New Jersey, Piscataway, NJ, USA
| | - Catherine E Myers
- Research Service, VA New Jersey Health Care System, East Orange, NJ, USA; Department of Pharmacology, Physiology & Neuroscience, New Jersey Medical School, Rutgers, The State University of New Jersey, Newark, NJ, USA
| | - Keith M Shafritz
- Department of Psychology, Hofstra University, Hempstead, NY, USA; Institute of Behavioral Science, Feinstein Institutes of Medical Research, Northwell Health, Manhasset, NY, USA
| | - Philip R Szeszko
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Mental Illness Research, Education, and Clinical Center (MIRECC VISN 2), James J. Peters VA Medical Center, Bronx, NY, USA; Mental Health Patient Care Center, James J. Peters VA Medical Center, Bronx, NY, USA
| | - Marianne Goodman
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Mental Illness Research, Education, and Clinical Center (MIRECC VISN 2), James J. Peters VA Medical Center, Bronx, NY, USA; Mental Health Patient Care Center, James J. Peters VA Medical Center, Bronx, NY, USA
| | - M Mehmet Haznedar
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Mental Health Patient Care Center, James J. Peters VA Medical Center, Bronx, NY, USA
| | - Erin A Hazlett
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Mental Illness Research, Education, and Clinical Center (MIRECC VISN 2), James J. Peters VA Medical Center, Bronx, NY, USA; Research & Development, James J. Peters Veterans Affairs Medical Center, Bronx, NY, USA
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11
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Gondivkar SM, Sarode GS, Warhekar A, Yuwanati M, Ingole R, Gadbail AR, Sarode SC, Motghare P. Prevalence and risk factors of suicidal ideation in oral cancer: a systematic review and meta-analysis. Int J Oral Maxillofac Surg 2024:S0901-5027(24)00367-9. [PMID: 39322511 DOI: 10.1016/j.ijom.2024.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 09/01/2024] [Accepted: 09/09/2024] [Indexed: 09/27/2024]
Abstract
The objective was to estimate the pooled prevalence of suicidal ideation (SI) and related risk factors in oral cancer (OC). Studies that specified SI in OC patients were considered eligible. SI prevalence and associated risk factors were extracted from the included studies for qualitative analysis and meta-analysis. Five studies (two retrospective, two cross-sectional, and one prospective longitudinal) were included in this review. Out of a total 15,475 OC patients, SI was reported in 117. The pooled prevalence of SI was 6% (95% confidence interval 1-22%). The prevalence of SI varied widely across the included studies, from 0.26% to 18.7%. Four studies described SI assessment methods, which were DS-MV, PHQ-9, Beck Scale for Suicidal Ideation, and psychiatric interviews. Older age, depression, demoralization, previous cancer history, psychiatric history, alcohol dependence, anxiety, living alone, and poor quality of life were frequently mentioned as risk factors of SI. The prevalence of SI varied across studies and was probably affected by the method of assessment, treatment, and postoperative care. SI was consistently predicted with psychological distress. It is essential to raise awareness of demographic, clinical, and psychological associations with SI in order to assess risks and design interventions for this cohort.
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Affiliation(s)
- S M Gondivkar
- Department of Oral Medicine and Radiology, Government Dental College and Hospital, Nagpur, Maharashtra, India
| | - G S Sarode
- Department of Oral Pathology and Microbiology, Dr. D.Y. Patil Dental College and Hospital, Dr. D.Y. Patil Vidyapeeth, Pune, Maharashtra, India
| | - A Warhekar
- Department of Dentistry, Government Medical College and Hospital, Akola, Maharashtra, India
| | - M Yuwanati
- Department of Oral Pathology and Microbiology, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamilnadu, India.
| | - R Ingole
- Department of Oral Medicine and Radiology, Government Dental College and Hospital, Nagpur, Maharashtra, India
| | - A R Gadbail
- Department of Dentistry, Shree Bhausaheb Hire Government Medical College and Hospital, Dhule, Maharashtra, India
| | - S C Sarode
- Department of Oral Pathology and Microbiology, Dr. D.Y. Patil Dental College and Hospital, Dr. D.Y. Patil Vidyapeeth, Pune, Maharashtra, India
| | - P Motghare
- Department of Oral Medicine and Radiology, Government Dental College and Hospital, Nagpur, Maharashtra, India
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12
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Gajwani R, Sim F, McAllister K, Smith H, McIntosh E, Moran P, Ougrin D, Smith M, Gumley AI, Chanen AM, Minnis H. The BRIDGE project: a feasibility randomised controlled trial of brief, intensive assessment and integrated formulation for young people (age 14-24) with features of borderline personality disorder (Protocol). Front Psychiatry 2024; 15:1389578. [PMID: 39381608 PMCID: PMC11458484 DOI: 10.3389/fpsyt.2024.1389578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Accepted: 08/23/2024] [Indexed: 10/10/2024] Open
Abstract
Background Borderline personality disorder (BPD) is a severe mental disorder that is characterised by a pervasive pattern of instability of interpersonal relationships, self-image, and mood as well as marked impulsivity. BPD has its peak incidence and prevalence from puberty through to emerging adulthood. BPD is a controversial diagnosis in young people. Commonly, young people with BPD are under-diagnosed, untreated, are not in employment or training and are estranged from their families. Yet, they have complex needs and are at high suicide risk. Aim To assess the feasibility of conducting a randomised controlled trial (f-RCT) of a BRIDGE, a brief intervention programme for young people (age 14-24) with BPD symptoms (sub-threshold or threshold) in a community sample from Scotland, UK. Method Forty young people (age 14-24) meeting criteria for BPD symptoms, will be randomised in a 1:1 ratio to receive either a) the BRIDGE intervention plus service-as-usual or b) service-as-usual alone. Follow up will be 12 weeks and 24 weeks post-intervention. The study is carried out between 2021 to 2024. Outcome The two primary outcomes of the MQ funded, BRIDGE project (f-RCT) are i. recruitment rates and ii. retention rates. The study will present the acceptability and appropriateness of our putative outcome measures for a future definitive randomised controlled trial (d-RCT). Impact Young people with BPD benefit from good clinical care and targeted intervention, however are regularly missed or mislabelled. The community based feasibility trial would provide initial evidence of variable needs of young people with complex needs, who maybe missed or excluded from services as they don't "fit" a model/diagnosis. Workable multi-agency service model proposed in the trial would be a major advance in understanding care pathways regardless of trial outcome. Clinical Trial Registration ClinicalTrial.gov, identifier NCT05023447.
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Affiliation(s)
- Ruchika Gajwani
- School of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
- National Health Service Greater Glasgow and Clyde, Glasgow, United Kingdom
| | - Fiona Sim
- School of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | - Kirsty McAllister
- School of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | - Helen Smith
- National Health Service (NHS) A&A, Ayrshire & Arran, Scotland, United Kingdom
| | - Emma McIntosh
- School of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | - Paul Moran
- Department of Population Health Sciences, University of Bristol, Bristol, United Kingdom
| | - Dennis Ougrin
- Youth Resilience Unit, Wolfson Institute of Population Health, Queen Mary University of London, London, United Kingdom
| | - Michael Smith
- School of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
- National Health Service Greater Glasgow and Clyde, Glasgow, United Kingdom
| | - Andrew Ian Gumley
- School of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
- National Health Service Greater Glasgow and Clyde, Glasgow, United Kingdom
| | - Andrew M. Chanen
- Orygen, Melbourne, VIC, Australia
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Helen Minnis
- School of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
- National Health Service Greater Glasgow and Clyde, Glasgow, United Kingdom
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13
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Mandel AA, Mitchell E, Krush C, Revzina O. Differences in suicide-specific attentional bias based on stimuli across the suicide Stroop and disengagement tasks. J Affect Disord 2024; 369:87-94. [PMID: 39326588 DOI: 10.1016/j.jad.2024.09.136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 09/06/2024] [Accepted: 09/21/2024] [Indexed: 09/28/2024]
Abstract
BACKGROUND Evidence of suicide-specific attentional bias has been mixed, including the effect of specific suicide words (e.g., "suicide" versus "overdose"). The current study examined the psychometric properties and convergent validity of specific suicide words on the Stroop and disengagement tasks. METHODS Adults (79.8 % male, mean age = 42.19 ± 12.66) on a psychiatric inpatient unit completed both tasks, as well as clinical and demographic measures, following a recent suicide attempt (SA) (n = 55) or recent suicidal ideation (SI) with (n = 29) or without (n = 26) a SA history. RESULTS Mean reaction times (RTs) on both tasks demonstrated good internal consistency and were moderately correlated across tasks, while interference scores demonstrated poor reliability and were not correlated. Attentional bias to specific suicide words did not differentiate SA groups, except for a small, unexpected effect on the Stroop task showing greater interference to the word "funeral" among the recent SA group. Correlations with suicide risk factors differed for males and females. LIMITATIONS Participants all endorsed elevated SI, limiting generalizability beyond a recent suicidal crisis. Different suicide words were used on each task limiting direct comparisons. Groups based on SA history and gender were uneven, and correlations need to be replicated. Effects involving interference scores should be interpreted with caution given poor internal consistency. CONCLUSION The suicide Stroop and disengagement tasks partially capture distinct aspects of suicide-relevant attentional bias. Greater attention is needed regarding the particular stimuli and scoring methods as well as the role gender plays in suicide-relevant attentional bias.
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Affiliation(s)
- Abby Adler Mandel
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA; Department of Psychology, The Catholic University of America, Washington, DC, USA.
| | - Emily Mitchell
- Department of Psychology, The Catholic University of America, Washington, DC, USA
| | - Catharine Krush
- Department of Psychology, The Catholic University of America, Washington, DC, USA
| | - Olga Revzina
- Department of Psychology, The Catholic University of America, Washington, DC, USA
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14
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Choi KH, Ha JH, Jue J. Development and validation of suicide crisis scale for international students in South Korea. Front Psychol 2024; 15:1417549. [PMID: 39372959 PMCID: PMC11449707 DOI: 10.3389/fpsyg.2024.1417549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2024] [Accepted: 09/11/2024] [Indexed: 10/08/2024] Open
Abstract
Introduction This study created and validated a scale to measure the level of suicide crisis among international students attending South Korean universities. Methods Study 1 developed questions and constructed the components of the scale using an initial survey of 248 people and exploratory factor analysis. Study 2 validated the scale using a second survey of 340 participants and confirmatory factor analysis. Results The results showed that 21 items were confirmed in six factors, which include lack of social support, burdensomeness, maladaptation to Korean culture, academic maladjustment, suicidal thoughts, and suicide risk. Discussion We verified the convergent validity, criterion validity, and reliability of the scale. The significance and implications of this study are presented, along with suggestions for future research.
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Affiliation(s)
- Ki-Hyun Choi
- Department of Multicultural Education, Hanyang University, Seoul, Republic of Korea
| | - Jung Hee Ha
- Graduate School of Counseling Psychology, Hanyang University, Seoul, Republic of Korea
| | - Juliet Jue
- Department of Art Therapy, Hanyang Cyber University, Seoul, Republic of Korea
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15
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Shin D, Kim H, Lee S, Cho Y, Jung W. Using Large Language Models to Detect Depression From User-Generated Diary Text Data as a Novel Approach in Digital Mental Health Screening: Instrument Validation Study. J Med Internet Res 2024; 26:e54617. [PMID: 39292502 PMCID: PMC11447422 DOI: 10.2196/54617] [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: 11/16/2023] [Revised: 05/17/2024] [Accepted: 08/11/2024] [Indexed: 09/19/2024] Open
Abstract
BACKGROUND Depressive disorders have substantial global implications, leading to various social consequences, including decreased occupational productivity and a high disability burden. Early detection and intervention for clinically significant depression have gained attention; however, the existing depression screening tools, such as the Center for Epidemiologic Studies Depression Scale, have limitations in objectivity and accuracy. Therefore, researchers are identifying objective indicators of depression, including image analysis, blood biomarkers, and ecological momentary assessments (EMAs). Among EMAs, user-generated text data, particularly from diary writing, have emerged as a clinically significant and analyzable source for detecting or diagnosing depression, leveraging advancements in large language models such as ChatGPT. OBJECTIVE We aimed to detect depression based on user-generated diary text through an emotional diary writing app using a large language model (LLM). We aimed to validate the value of the semistructured diary text data as an EMA data source. METHODS Participants were assessed for depression using the Patient Health Questionnaire and suicide risk was evaluated using the Beck Scale for Suicide Ideation before starting and after completing the 2-week diary writing period. The text data from the daily diaries were also used in the analysis. The performance of leading LLMs, such as ChatGPT with GPT-3.5 and GPT-4, was assessed with and without GPT-3.5 fine-tuning on the training data set. The model performance comparison involved the use of chain-of-thought and zero-shot prompting to analyze the text structure and content. RESULTS We used 428 diaries from 91 participants; GPT-3.5 fine-tuning demonstrated superior performance in depression detection, achieving an accuracy of 0.902 and a specificity of 0.955. However, the balanced accuracy was the highest (0.844) for GPT-3.5 without fine-tuning and prompt techniques; it displayed a recall of 0.929. CONCLUSIONS Both GPT-3.5 and GPT-4.0 demonstrated relatively reasonable performance in recognizing the risk of depression based on diaries. Our findings highlight the potential clinical usefulness of user-generated text data for detecting depression. In addition to measurable indicators, such as step count and physical activity, future research should increasingly emphasize qualitative digital expression.
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Affiliation(s)
- Daun Shin
- Department of Psychiatry, Anam Hospital, Korea University, Seoul, Republic of Korea
- Doctorpresso, Seoul, Republic of Korea
| | | | | | - Younhee Cho
- Doctorpresso, Seoul, Republic of Korea
- Department of Design, Seoul National University, Seoul, Republic of Korea
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16
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Ihaddadene RA, Alexopoulos GS, Marino P, Meyers BS, Mulsant BH, Neufeld NH, Rothschild AJ, Voineskos AN, Whyte EM, Flint AJ, Bingham KS. Predictors of attrition during acute pharmacotherapy of psychotic depression in a clinical trial. Psychiatry Res 2024; 342:116192. [PMID: 39299145 DOI: 10.1016/j.psychres.2024.116192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2024] [Revised: 08/07/2024] [Accepted: 09/10/2024] [Indexed: 09/22/2024]
Abstract
Little is known about factors that contribute to attrition in clinical trials of the pharmacotherapy of psychotic depression. The purpose of this study was to identify factors associated with attrition during acute pharmacotherapy in the Study of the Pharmacotherapy of Psychotic Depression II (STOP-PD II) clinical trial. Sociodemographic and clinical variables were assessed at baseline in 269 men and women, aged 18-85 years, who were treated with up to 12 weeks of open-label sertraline plus olanzapine. Univariate analyses examined the association of baseline variables with overall non-completion, as well as reasons for non-completion. Logistic regression was used to model the relationship of the significant univariate predictors with non-completion and its reasons. Seventy-four (27.5 %) participants did not complete the acute treatment phase of STOP-PD II. Male gender, younger age, inpatient status, higher Clinical Global Impression (CGI) severity of illness, and higher severity of psychomotor disturbance were associated with non-completion in univariate analyses. In regression models, higher CGI severity of illness score was the only significant independent predictor of non-completion, explained by withdrawal of consent. Our findings have implications for the retention of persons with psychotic depression in clinical trials.
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Affiliation(s)
- Ryma A Ihaddadene
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - George S Alexopoulos
- Department of Psychiatry, Weill Cornell Institute of Geriatric Psychiatry, Weill Cornell Medicine, New York, USA
| | - Patricia Marino
- Department of Psychiatry, Weill Cornell Institute of Geriatric Psychiatry, Weill Cornell Medicine, New York, USA
| | - Barnett S Meyers
- Department of Psychiatry, Weill Cornell Institute of Geriatric Psychiatry, Weill Cornell Medicine, New York, USA
| | - Benoit H Mulsant
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Nicholas H Neufeld
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Anthony J Rothschild
- University of Massachusetts Chan Medical School and UMass Memorial Health Care, Worcester, USA
| | - Aristotle N Voineskos
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Ellen M Whyte
- Department of Psychiatry, University of Pittsburgh School of Medicine and UPMC Western Psychiatric Hospital, Pittsburgh, USA
| | - Alastair J Flint
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Centre for Mental Health, University Health Network, Toronto, Ontario, Canada.
| | - Kathleen S Bingham
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Centre for Mental Health, University Health Network, Toronto, Ontario, Canada
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17
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Matheson L, Rasmussen S, Moxie J, Cramer RJ. A Qualitative Assessment of Reasons for Living and Dying in the Context of Feeling Trapped Among Adults in the United Kingdom. Arch Suicide Res 2024:1-15. [PMID: 39259004 DOI: 10.1080/13811118.2024.2400915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/12/2024]
Abstract
OBJECTIVE Contemporary approaches to suicide assessment and treatment incorporate reasons for living (RFL) and reasons for dying (RFD). This study qualitatively explored individuals' self-described RFL and RFD in the context of suicidal thinking and behaviors. METHOD Within a community United Kingdom (UK) sample, adults (N = 331, aged 16+) responded to eight open-ended questions probing their experiences of suicide, defeat, and entrapment. Utilizing these data, which were collected from a larger online survey examining risk and protective factors for suicidal behaviors, this study explored RFL and RFD within these narratives. After the research team established an initial code book, RFL and RFD codes were subsequently analyzed through inductive and deductive thematic analyses. RESULTS The present study identified five complimentary RFD-RFL themes: (1) Hopelessness-Hopefulness, (2) Stress of Responsibilities-Duty to Responsibilities, (3) Social Disconnection-Social Connection, (4) Death as Sin-Desire for an Afterlife, and (5) Temporary Escapes as Coping-Entrapment (i.e., a lack of escape). Three subthemes within the RFD theme Entrapment were General/Unspecified, By Feelings, and Within Self. CONCLUSIONS Identified themes reflect the existing quantitative RFL and RFD literature. The identified RFL and RFD themes are discussed with reference to their clinical applications in advancing suicide-specific assessments and interventions. We propose a dimensional framework for RFD and RFL which informs future suicidal behaviors research and practice.
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18
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Ren L, Chen Y, Han X, Chen Z, Wang Z, Li W, Chen H. Reappraisal Mitigates, While COVID-19 Burnout Exacerbates the Impact of Depressive Symptoms on Suicidal Ideation Among Chinese College Students. Psychol Res Behav Manag 2024; 17:3147-3157. [PMID: 39280038 PMCID: PMC11402369 DOI: 10.2147/prbm.s463316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Accepted: 08/20/2024] [Indexed: 09/18/2024] Open
Abstract
Background Suicide is a global public health issue. This study examined the role of COVID-19 burnout and reappraisal in suicidal ideation caused by depressive symptoms among Chinese college students. Methods 587 students (261 boys, M age = 19.53, SD = 1.42) were assessed using the Short Depression-Happiness Scale (SDHS), Positive and Negative Suicide Ideation (PANSI) inventory, and Emotion Regulation Scale (ERS). Results Correlation analysis indicated depressive symptoms were negatively correlated with reappraisal and positively correlated with suicidal ideation and COVID-19 burnout. Reappraisal was negatively correlated with suicidal ideation and COVID-19 burnout. The moderated mediation model showed COVID-19 burnout enhanced the direct effect of depressive symptoms on suicidal ideation and indirectly enhanced this effect by weakening the protective role of reappraisal. Conclusion These finding show that reappraisal acts as a protective factor against suicidal ideation in individuals with depressive symptoms, while COVID-19 burnout exacerbates this effect by weakening reappraisal's protective role.
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Affiliation(s)
- Lijie Ren
- Mental Health Center, Shanghai Customs University, Shanghai, People's Republic of China
| | - Ye Chen
- School of Customs and Public Administration, Shanghai Customs University, Shanghai, People's Republic of China
| | - Xianguo Han
- School of Psychology, Shanghai Normal University, Shanghai, People's Republic of China
| | - Ziyi Chen
- School of Customs and Public Administration, Shanghai Customs University, Shanghai, People's Republic of China
| | - Zhi Wang
- School of Customs and Public Economics, Shanghai Customs University, Shanghai, People's Republic of China
| | - Wenxiao Li
- School of Customs and Public Administration, Shanghai Customs University, Shanghai, People's Republic of China
| | - Hongyuan Chen
- School of Customs and Public Administration, Shanghai Customs University, Shanghai, People's Republic of China
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19
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Zeng QB, Zou DC, Huang XB, Shang DW, Huang X, Yang XH, Ning YP, Balbuena L, Xiang YT, Zheng W. Efficacy and safety of esketamine versus propofol in electroconvulsive therapy for treatment-resistant depression: A randomized, double-blind, controlled, non-inferiority trial. J Affect Disord 2024; 368:320-328. [PMID: 39265871 DOI: 10.1016/j.jad.2024.09.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2024] [Revised: 09/05/2024] [Accepted: 09/08/2024] [Indexed: 09/14/2024]
Abstract
BACKGROUND Electroconvulsive therapy (ECT) is a commonly used alternative for treatment-resistant depression (TRD). Although esketamine has a rapid pharmacological antidepressant action, it has not been studied as an ECT anesthetic. The objective of this study was to compare the efficacy and safety of esketamine with propofol when both are used as ECT anesthetic agents. METHODS Forty patients with TRD were assigned to one of two arms in a double-blind, randomized controlled trial: esketamine or propofol anesthesia for a series of eight ECT sessions. Using a non-inferiority design, the primary outcome was the reduction in HAMD-17 depressive symptoms. The other outcomes were: rates of response and remission, anxiety, suicidal ideation, cognitive function, and adverse events. These were compared in an intention-to-treat analysis. RESULTS Esketamine-ECT was non-inferior to propofol-ECT for reducing TRD symptoms after 8 sessions (adjusted Δ = 2.0, 95 % CI: -1.2-5.1). Compared to propofol-ECT, esketamine-ECT also had higher depression response (80 % vs. 70 %; p = .06) and remission (65 % vs. 55 %; p = .11) rates but non-inferiority was not established. In four components of cognitive function (speed of processing, working memory, visual learning, and verbal learning) esketamine-ECT was non-inferior to propofol-ECT. The results for anxiety, suicidal ideation, and adverse events (all p's > .05) were inconclusive. CONCLUSION Esketamine was non-inferior to propofol when both are used as anesthetics for TRD patients undergoing ECT. Replication studies with larger samples are needed to examine the inconclusive results. REGISTRATION NUMBER ChiCTR2000033715.
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Affiliation(s)
- Qing-Bin Zeng
- The Affiliated Brain Hospital, Guangzhou Medical University, Guangzhou, China; Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou, China
| | - De-Cheng Zou
- The Third People's Hospital of Foshan, Foshan, Guangdong, China
| | - Xing-Bing Huang
- The Affiliated Brain Hospital, Guangzhou Medical University, Guangzhou, China; Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou, China
| | - De-Wei Shang
- The Affiliated Brain Hospital, Guangzhou Medical University, Guangzhou, China; Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou, China
| | - Xiong Huang
- The Affiliated Brain Hospital, Guangzhou Medical University, Guangzhou, China; Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou, China
| | - Xin-Hu Yang
- The Affiliated Brain Hospital, Guangzhou Medical University, Guangzhou, China; Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou, China
| | - Yu-Ping Ning
- The Affiliated Brain Hospital, Guangzhou Medical University, Guangzhou, China; Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou, China
| | - Lloyd Balbuena
- Department of Psychiatry, University of Saskatchewan, Saskatoon, SK, Canada
| | - Yu-Tao Xiang
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, China; Centre for Cognitive and Brain Sciences, University of Macau, Macao SAR, China.
| | - Wei Zheng
- The Affiliated Brain Hospital, Guangzhou Medical University, Guangzhou, China; Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou, China.
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Choo TH, Wall M, Brodsky BS, Herzog S, Mann JJ, Stanley B, Galfalvy H. Temporal prediction of suicidal ideation in an ecological momentary assessment study with recurrent neural networks. J Affect Disord 2024; 360:268-275. [PMID: 38795778 PMCID: PMC11296397 DOI: 10.1016/j.jad.2024.05.093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Revised: 05/04/2024] [Accepted: 05/18/2024] [Indexed: 05/28/2024]
Abstract
INTRODUCTION Ecological Momentary Assessment (EMA) holds promise for providing insights into daily life experiences when studying mental health phenomena. However, commonly used mixed-effects linear statistical models do not fully utilize the richness of the ultidimensional time-varying data that EMA yields. Recurrent Neural Networks (RNNs) provide an alternative data analytic method to leverage more information and potentially improve prediction, particularly for non-normally distributed outcomes. METHODS As part of a broader research study of suicidal thoughts and behavior in people with borderline personality disorder (BPD), eighty-four participants engaged in EMA data collection over one week, answering questions multiple times each day about suicidal ideation (SI), stressful events, coping strategy use, and affect. RNNs and mixed-effects linear regression models (MEMs) were trained and used to predict SI. Root mean squared error (RMSE), mean absolute percent error (MAPE), and a pseudo-R2 accuracy metric were used to compare SI prediction accuracy between the two modeling methods. RESULTS RNNs had superior accuracy metrics (full model: RMSE = 3.41, MAPE = 42 %, pseudo-R2 = 26 %) compared with MEMs (full model: RMSE = 3.84, MAPE = 56 %, pseudo-R2 = 16 %). Importantly, RNNs showed significantly more accurate prediction at higher values of SI. Additionally, RNNs predicted, with significantly higher accuracy, the SI scores of participants with depression diagnoses and of participants with higher depression scores at baseline. CONCLUSION In this EMA study with a moderately sized sample, RNNs were better able to learn and predict daily SI compared with mixed-effects models. RNNs should be considered as an option for EMA analysis.
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Affiliation(s)
- Tse-Hwei Choo
- Mental Health Data Science Division, New York State Psychiatric Institute, New York, NY, United States of America; Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, NY, United States of America.
| | - Melanie Wall
- Mental Health Data Science Division, New York State Psychiatric Institute, New York, NY, United States of America; Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, NY, United States of America; Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, United States of America
| | - Beth S Brodsky
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, United States of America; Molecular Imaging and Neuropathology Division, New York State Psychiatric Institute, New York, NY, United States of America
| | - Sarah Herzog
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, United States of America; Molecular Imaging and Neuropathology Division, New York State Psychiatric Institute, New York, NY, United States of America
| | - J John Mann
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, United States of America; Molecular Imaging and Neuropathology Division, New York State Psychiatric Institute, New York, NY, United States of America
| | - Barbara Stanley
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, United States of America; Molecular Imaging and Neuropathology Division, New York State Psychiatric Institute, New York, NY, United States of America
| | - Hanga Galfalvy
- Mental Health Data Science Division, New York State Psychiatric Institute, New York, NY, United States of America; Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, NY, United States of America; Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, United States of America
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21
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Kivelä LMM, van der Does W, Antypa N. Sleep, hopelessness, and suicidal ideation: An ecological momentary assessment and actigraphy study. J Psychiatr Res 2024; 177:46-52. [PMID: 38972264 DOI: 10.1016/j.jpsychires.2024.06.039] [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: 02/01/2024] [Revised: 05/17/2024] [Accepted: 06/24/2024] [Indexed: 07/09/2024]
Abstract
Recent research shows that sleep disturbances are linked to increased suicidal ideation. In the present longitudinal cohort study, we used subjective (ecological momentary assessment, EMA) and objective (actigraphy) measures to examine the effects of sleep parameters on next-day suicidal ideation. Further, we examined hopelessness as a mediator between insufficient sleep and increased suicidal ideation. Individuals with current suicidal ideation (N = 82) completed 21 days of EMA and actigraphy to estimate suicidal ideation, hopelessness and sleep parameters. Multilevel linear-mixed models were used to examine the effects of sleep parameters on next-day suicidal ideation, as well as for the mediating effect of hopelessness (in the morning) on the association between previous night's sleep and suicidal ideation levels the next day. Significant concordance existed between subjective and objective sleep measures, with moderate-to-large correlations (r = 0.44-0.58). Lower subjective sleep quality and efficiency, shorter total sleep time and increased time awake after sleep onset were significantly associated with increased next-day suicidal ideation (controlling for previous-day suicidal ideation). Actigraphy-measured sleep fragmentation was also a significant predictor of next-day ideation. Hopelessness mediated the effects of the subjective sleep parameters on suicidal ideation, but did not account for the association with sleep fragmentation. Therefore, individuals' psychological complaints (hopelessness, suicidal ideation) were better predicted by subjective sleep complaints than by objective sleep indices. Increased hopelessness following from perceived insufficient sleep appears an important explanatory factor when considering the link between sleep disturbances and suicidal ideation.
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Affiliation(s)
- Liia M M Kivelä
- Department of Clinical Psychology, Institute of Psychology, Leiden University, the Netherlands
| | - Willem van der Does
- Department of Clinical Psychology, Institute of Psychology, Leiden University, the Netherlands; Leiden University Treatment and Expertise Center (LUBEC), Leiden, the Netherlands
| | - Niki Antypa
- Department of Clinical Psychology, Institute of Psychology, Leiden University, the Netherlands.
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22
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Kivelä LMM, Fiß F, van der Does W, Antypa N. Examination of Acceptability, Feasibility, and Iatrogenic Effects of Ecological Momentary Assessment (EMA) of Suicidal Ideation. Assessment 2024; 31:1292-1308. [PMID: 38098238 PMCID: PMC11292966 DOI: 10.1177/10731911231216053] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/02/2024]
Abstract
Ecological momentary assessment (EMA) can be used to examine the dynamics of suicidal ideation in daily life. While the general acceptability and feasibility of EMA in suicide research has been established, further examination of potential iatrogenic effects (i.e., negative reactivity) and identifying those more likely to react negatively is needed. Participants (N = 82) with current suicidal ideation completed 21 days of EMA (4×/day) and filled in M = 78% (Med = 84%) of the EMA. No positive or negative affect reactivity was observed in EMA ratings over the study period. Retrospectively, most participants rated their experience as positive (69%); 22% indicated mood worsening, and 18% suicidal ideation reactivity. Those with more borderline personality traits, posttraumatic stress disorder (PTSD), and higher depressive, anxiety, and suicidal ideation symptoms, were more likely to report iatrogenic effects. In conclusion, while high compliance rates and lack of affect reactivity during EMA indicate that EMA is well tolerated in suicide research, a minority of participants may report subjective mood effects in retrospect.
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Affiliation(s)
| | - F. Fiß
- Leiden University, The Netherlands
| | - W. van der Does
- Leiden University, The Netherlands
- Leiden University Treatment and Expertise Centre (LUBEC), The Netherlands
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23
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Lohani M, Bryan CJ, Elsey JS, Dutton S, Findley SP, Langenecker SA, West K, Baker JC. Collaboration matters: A randomized controlled trial of patient-clinician collaboration in suicide risk assessment and intervention. J Affect Disord 2024; 360:387-393. [PMID: 38838788 DOI: 10.1016/j.jad.2024.06.004] [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: 09/19/2023] [Revised: 04/17/2024] [Accepted: 06/02/2024] [Indexed: 06/07/2024]
Abstract
BACKGROUND Clinician collaboration can help high-risk individuals to manage their suicidal crises. However, limited research has directly examined how higher patient-clinician collaboration during assessment and intervention can effectively reduce suicidal ideation. This novel randomized clinical trial compared a high vs. low level of patient-clinician collaboration by pairing commonly used assessment (Structured Interview vs. Narrative Assessment) and intervention approaches (Safety Planning Intervention vs. Crisis Response Planning). We hypothesized that the interventions involving higher (than lower) patient-clinician collaboration during assessment (Narrative Assessment) or intervention (Crisis Response Planning) would lead to larger reductions in suicidal ideation. METHODS Eighty-two participants with a history of suicide ideation and/or attempts were randomly assigned to one of the four interventions varying in patient-clinician collaboration. After attrition, sixty-six participants completed the study. Suicidal ideation via ecological momentary assessment was measured 14 days before and 14 days after treatment. RESULTS Although the severity of suicidal ideation decreased in all groups, the two groups that included highly collaborative assessment had larger pre-post reductions in suicidal ideation (Narrative Assessment+Safety Plan; dwithin = 0.26, and Narrative Assessment+Crisis Response Plan; dwithin = 0.19) than the groups that included a checklist-based assessment (Structured Interview). LIMITATIONS Longer follow-up periods with a larger sample would have provided an understanding of the durability of intervention effects. CONCLUSION Results suggest that the inclusion of higher patient-clinician collaboration techniques during suicide risk assessment can effectively reduce suicidal thoughts. Thus, clinician-led collaborative risk assessment approaches can enhance the effects of safety planning-type interventions among patients with elevated risk for suicide versus checklist-based assessment approaches.
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Affiliation(s)
- Monika Lohani
- Department of Psychology, University of Utah, United States of America.
| | - Craig J Bryan
- Department of Psychiatry and Behavioral Health, The Ohio State University, United States of America
| | - Jamie S Elsey
- Department of Educational Psychology, University of Utah, United States of America
| | - Sam Dutton
- Department of Educational Psychology, University of Utah, United States of America
| | - Samuel P Findley
- Department of Educational Psychology, University of Utah, United States of America
| | - Scott A Langenecker
- Department of Psychiatry and Behavioral Health, The Ohio State University, United States of America
| | - Kristen West
- Department of Educational Psychology, University of Utah, United States of America
| | - Justin C Baker
- Department of Psychiatry and Behavioral Health, The Ohio State University, United States of America
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Wu Y, Zhang H, Shen Q, Jiang X, Yuan X, Li M, Chen M, Zhou J, Cui J. Exploring the neurocognitive correlates of suicidal ideation in major depressive disorder: The role of frontoparietal and default mode networks. J Psychiatr Res 2024; 177:211-218. [PMID: 39032275 DOI: 10.1016/j.jpsychires.2024.07.009] [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: 03/22/2024] [Revised: 06/20/2024] [Accepted: 07/09/2024] [Indexed: 07/23/2024]
Abstract
Suicidal ideation (SI) is a common symptom of major depressive disorder (MDD), often accompanied by cognitive alterations and emotional dysregulation. However, it is unclear whether cognitive dysfunction in patients with MDD is related to the presence or absence of SI and impaired connectivity within or between large-scale neurocognitive networks. Previous studies have shown that the frontoparietal network (FPN) and default mode network (DMN) are critical for cognitive control and emotional regulation. Participants were 51 MDD patients with suicidal ideation (MDDSI), 52 MDD patients without suicidal ideation (MDDNSI), and 55 healthy controls (HC). Using areas located within FPN and DMN networks as regions of interest (ROIs), we compared the cognitive performance of the three groups and the strength of the resting state functional connections (RSFC) within and between the FPN and DMN networks. Additionally, we examined the correlation between the strength of FC within the FPN and cognitive function in the SI group. Furthermore, network-based statistics (NBS) were used to correct for the strength of FPN and DMN functional connections. The study identified significant cognitive deficits in MDD patients. Reduced strength of FC was observed within the FPN and DMN networks in the SI group compared to the NSI group. In the SI group, the strength of FC within the FPN network was positively correlated with attention/vigilance. These insights underscore the critical roles of the FPN and DMN in the suicidal ideation, shedding light on the cognitively relevant neurobiological characteristics of MDDSI, providing new insights into the neural mechanisms of MDDSI. URL: https://www.chictr.org.cn/bin/project/edit?pid=131537. Registration number: ChiCTR2100049646.
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Affiliation(s)
- Yang Wu
- Department of Psychiatry, Jining Medical University, Jining, 272000, China
| | - Hongyong Zhang
- Medical Imaging Department, Shandong Daizhuang Hospital, Jining, 272000, China
| | - Qinge Shen
- Department of Psychiatry, Jining Medical University, Jining, 272000, China
| | - Xianfei Jiang
- Department of Psychiatry, Shandong Daizhuang Hospital, Jining, 272000, China
| | - Xiaochi Yuan
- Department of Equipment, Shandong Daizhuang Hospital, Jining, 272000, China
| | - Meng Li
- Precision Medicine Laboratory, Shandong Daizhuang Hospital, Jining, 272000, China
| | - Min Chen
- Department of Psychiatry, Shandong Daizhuang Hospital, Jining, 272000, China
| | - Jingjing Zhou
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital & the Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, 100088, China
| | - Jian Cui
- Department of Psychiatry, Shandong Daizhuang Hospital, Jining, 272000, China; Precision Medicine Laboratory, Shandong Daizhuang Hospital, Jining, 272000, China.
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25
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McCall WV, Mercado K, Dzurny TN, McCloud LL, Krystal AD, Benca RM, Rosenquist PB, Looney SW. Insomnia and the effect of zolpidem-extended-release on the sleep items of the Hamilton Rating Scale for Depression in outpatients with depression, insomnia, and suicidal ideation: Relationship to patient age. J Psychopharmacol 2024; 38:827-831. [PMID: 39119911 DOI: 10.1177/02698811241268900] [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] [Indexed: 08/10/2024]
Abstract
BACKGROUND There are limited data regarding gamma-aminobutyric acid (GABA) allosteric modulator sleep-aid medications in persons with depression, insomnia, and suicidal ideation (SI). AIMS This secondary analysis examined the relationship of age to insomnia and the impact of age on the treatment of insomnia with zolpidem extended-release (zolpidem-ER) in depressed suicidal patients. A prior report found that the addition of zolpidem-ER promoted significantly superior reductions in global severity of insomnia in depressed outpatients with insomnia and SI over 8 weeks, but here we report the differences among early, middle, and late insomnia. METHODS This secondary analysis examined the three early, middle, and late insomnia items of the Hamilton Rating Scale for Depression (HRSD) and their relationship to age and responsiveness to treatment with zolpidem-ER. One hundred and three patients with major depression, SI, and insomnia received open-label serotonin reuptake inhibitors and were randomly allocated 1:1 to receive zolpidem-ER or placebo at bedtime. Results: Older age at baseline was associated with worse middle and late insomnia, but not with early insomnia. Subsequent treatment with zolpidem-ER produced superior improvement in early and middle insomnia, but not late insomnia. CONCLUSIONS These findings are consistent with the known age-related advancement of sleep timing in the general population and depressed outpatients and with the expected effects of a short half-life GABA allosteric modulator sleep aid. By implication, prescribers of pharmacologic treatment of insomnia in depressed patients should consider an alternative to zolpidem-ER when late insomnia is a concern.Trial registration number: ClinicalTrials.gov Identifier: NCT01689909.
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Affiliation(s)
- William V McCall
- Department of Psychiatry and Health Behavior, Medical College of Georgia, Augusta University, Augusta, GA, USA
| | - Kayla Mercado
- Department of Population Health Sciences, Medical College of Georgia, Augusta University, Augusta, GA, USA
| | - Tess N Dzurny
- Department of Psychiatry and Health Behavior, Medical College of Georgia, Augusta University, Augusta, GA, USA
| | - Laryssa L McCloud
- Department of Psychiatry and Health Behavior, Medical College of Georgia, Augusta University, Augusta, GA, USA
| | - Andrew D Krystal
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, USA
| | - Ruth M Benca
- Department of Psychiatry and Behavioral Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Peter B Rosenquist
- Department of Psychiatry and Health Behavior, Medical College of Georgia, Augusta University, Augusta, GA, USA
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26
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Wu F, Yi Y, Lian Y, Chen Q, Luo L, Yang H, Li H, Feng Y, Feng S, Zhou S, Huang Y, Li Z, Zhang X. Sex differences in the association between suicidal ideation and neurocognitive function in Chinese patients with schizophrenia. Eur Arch Psychiatry Clin Neurosci 2024; 274:1355-1363. [PMID: 37184751 DOI: 10.1007/s00406-023-01616-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 04/26/2023] [Indexed: 05/16/2023]
Abstract
There is increasing evidence that sex differences exist in many clinical manifestations of patients with schizophrenia, including suicidal ideation (SI) and neurocognitive function. The present study was performed to explore the sex differences in the association between SI and neurocognitive function in Chinese patients with schizophrenia. A total of 1188 inpatients with schizophrenia were recruited from multicenter psychiatric hospitals. The Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) was utilized to evaluate the neurocognitive function of all patients. The Positive and Negative Syndrome Scale (PANSS) was utilized to assess the psychopathology of patients. The Beck Scale for Suicide Ideation (BSSI) was used to assess the severity of SI. In male patients, the suicide risk score was significantly associated with PANSS negative symptoms (r = 0.167, p = 0.043), visuospatial subscale (r = - 0.261, p = 0.001), and RBANS total scores (r = - 0.172, p = 0.037). Furthermore, multivariate linear regression analysis showed that the visuospatial subscale (β = - 0.490, t = - 3.273, p = 0.001) was independently associated with the suicide risk score in male patients. In female patients, the suicide risk score was significantly correlated with PANSS positive symptoms (r = 0.249, p = 0.021), negative symptoms (r = 0.394, p < 0.001), general psychopathology (r = 0.276, p = 0.01) and PANSS total score (r = 0.365, p = 0.001). Multivariate linear regression analysis showed that PANSS negative symptoms (β = 1.849, t = 3.933, p = 0.001) were significantly associated with suicide risk scores in female patients. Our findings indicate that there are sex differences in the association between SI and neurocognitive function in patients with schizophrenia. Based on the findings of our study, gender-specific prevention and intervention strategies may make a difference in reducing SI in Chinese schizophrenia patients.
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Affiliation(s)
- Fengchun Wu
- Department of Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University, 36 Mingxin Rd, Liwan District, Guangzhou, 510370, China
- Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Guangzhou, China
- Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou, China
| | - Yun Yi
- Department of Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University, 36 Mingxin Rd, Liwan District, Guangzhou, 510370, China
- Department of Psychiatry, The Brain Hospital of Guangxi Zhuang Autonomous Region, Guangxi, China
| | - Yunling Lian
- Department of Psychiatry, Qingdao Mental Health Center, Qingdao, China
| | - Qiang Chen
- Department of Psychiatry, The Brain Hospital of Guangxi Zhuang Autonomous Region, Guangxi, China
| | - Lanfang Luo
- Department of Psychiatry, The Brain Hospital of Guangxi Zhuang Autonomous Region, Guangxi, China
| | - Hanlun Yang
- School of Pharmaceutical Sciences (Shenzhen), Sun Yat-Sen University, Guangzhou, China
| | - Hehua Li
- Department of Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University, 36 Mingxin Rd, Liwan District, Guangzhou, 510370, China
| | - Yangdong Feng
- Department of Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University, 36 Mingxin Rd, Liwan District, Guangzhou, 510370, China
| | - Shixuan Feng
- Department of Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University, 36 Mingxin Rd, Liwan District, Guangzhou, 510370, China
| | - Sumiao Zhou
- Department of Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University, 36 Mingxin Rd, Liwan District, Guangzhou, 510370, China
| | - Yuanyuan Huang
- Department of Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University, 36 Mingxin Rd, Liwan District, Guangzhou, 510370, China.
| | - Zezhi Li
- Department of Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University, 36 Mingxin Rd, Liwan District, Guangzhou, 510370, China.
- Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou, China.
| | - Xiangyang Zhang
- Department of Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University, 36 Mingxin Rd, Liwan District, Guangzhou, 510370, China.
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, 100101, China.
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Situmorang DDB. Discussion, implications, and recommendations of several alternative interventions to intervene suicidal ideation in youth with autism spectrum disorder. Asian J Psychiatr 2024; 101:104196. [PMID: 39226757 DOI: 10.1016/j.ajp.2024.104196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2024] [Revised: 06/29/2024] [Accepted: 08/19/2024] [Indexed: 09/05/2024]
Abstract
The purpose of this article is to provide an additional point of view containing discussion, implications, and recommendations for intervention to autistic persons who have suicidal ideation and behavior. Therefore, the author hopes that this article can complement reports on several previous studies that have had an extraordinary impact.
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Affiliation(s)
- Dominikus David Biondi Situmorang
- Department of Guidance and Counseling, Atma Jaya Catholic University of Indonesia, Jl. Jenderal Sudirman 51, DKI Jakarta, 12930, Indonesia.
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Kivelä LMM, van der Does AJW, Gilissen R, Antypa N. Digital phenotypes of real-time suicidal ideation: Correlates and consequences. Acta Psychiatr Scand 2024. [PMID: 39187415 DOI: 10.1111/acps.13750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Revised: 07/18/2024] [Accepted: 08/17/2024] [Indexed: 08/28/2024]
Abstract
INTRODUCTION Suicidal ideation variability refers to within-day fluctuations in suicidal ideation, and has recently been proposed as an indicator of suicide risk. However, not much is known yet about its correlates and clinical relevance. METHODS We examined characteristics of real-time suicidal ideation using Ecological Momentary Assessment in 82 individuals with current active suicidal ideation. Data were collected four times daily over 21 days. Latent profile analysis was used to identify subtypes of suicidal ideation. We further examined sociodemographic and clinical correlates of the profiles, and their association with the occurrence of suicide attempts during a 1-year follow-up. RESULTS We identified three "digital" phenotypes of suicidal ideation that differed on the frequency, intensity and variability of ideation. The profiles were: high frequency, high intensity, moderate variability (Phenotype 1), moderate/high frequency, moderate intensity, high variability (Phenotype 2), and moderate frequency, low intensity, low variability (Phenotype 3). Phenotypes 1 and 2 were associated with a worse clinical profile at baseline (higher suicidal ideation and depressive symptom severity), and increased odds of suicide attempt during follow-up, compared to Phenotype 3. Phenotype 1 was further characterized by repeated suicidal behavior. CONCLUSIONS Two phenotypes of real-time suicidal ideation were identified that appear to confer a higher risk of suicidal behavior in the near future (12 months). These phenotypes were characterized by higher variability of suicidal ideation-and also higher intensity and frequency of ideation. Considering the small sample size, the clinical usefulness of the profiles remains to be demonstrated.
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Affiliation(s)
- L M M Kivelä
- Department of Clinical Psychology, Institute of Psychology, Leiden University, Leiden, The Netherlands
| | - A J W van der Does
- Department of Clinical Psychology, Institute of Psychology, Leiden University, Leiden, The Netherlands
- Leiden University Treatment and Expertise Center (LUBEC), Leiden, The Netherlands
| | - R Gilissen
- 113 Suicide Prevention, Amsterdam, The Netherlands
| | - Niki Antypa
- Department of Clinical Psychology, Institute of Psychology, Leiden University, Leiden, The Netherlands
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29
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Shin Y, Nam JK, Park M, Lee A, Kim Y. Latent transition analysis on post-traumatic stress and post-traumatic growth among firefighters. Eur J Psychotraumatol 2024; 15:2387477. [PMID: 39140605 PMCID: PMC11328797 DOI: 10.1080/20008066.2024.2387477] [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: 12/11/2023] [Revised: 07/12/2024] [Accepted: 07/21/2024] [Indexed: 08/15/2024] Open
Abstract
Background: Firefighters, in the course of their professional responsibilities, confront an array of stressors contingent upon the distinctive characteristics of their duties.Objective: This study investigated the longitudinal impact of trauma incidents during duty on firefighters using latent transition analysis.Method: Data from 346 firefighters in South Korea who had experienced trauma events while on duty were utilized. Initially, latent groups were identified based on the relationship between post-traumatic stress disorder (PTSD) and post-traumatic growth (PTG). Groups were labelled based on the analysis of differences in PTSD, mental health, and growth-related factors among classified groups. Subsequently, transition probabilities and patterns from Time 1 to Time 2 were examined, followed by an investigation into variances based on demographic factors (gender, age) and occupational factors (work experience, shift pattern) using variance analysis and multinomial logistic regression analysis.Results: First, at Time 2, a five-group model was classified into 'Growth,' 'Resilience or Numbness,' 'Struggle,' 'Partial Struggle,' and 'PTSD' groups. Second, upon examining the transition patterns between latent groups, four patterns emerged: 'continued distress,' 'growth,' 'adaptation,' and 'escalated distress.' Third, the 'Struggle' group showed a 0% probability of transitioning to the 'Growth' group, whereas it displayed the highest probability among the groups transitioning to the 'PTSD' group. Fourth, latent transition analysis results showed a strong tendency for the 'Growth' group and 'Resilience or Numbness' group to remain in the same category. Fifth, age was found to be a significant factor affecting the transition of latent groups.Conclusion: This research represents the inaugural attempt to longitudinally investigate the interplay between PTSD and PTG among firefighters.
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Affiliation(s)
- Yongchan Shin
- Counseling & Welfare Center for Youth, Dangjin City Youth Foundation, Dangjin-si, South Korea
| | - JeeEun Karin Nam
- Graduate School of Education, Kyung Hee University, Seoul, South Korea
| | - Minho Park
- Korea Institute for Curriculum and Evaluation, Jincheon-gun, South Korea
| | - Aeyoung Lee
- Department of Counseling and Psychotherapy, Inje University, Gimhae-si, South Korea
| | - Youngkeun Kim
- Department of Counseling and Psychotherapy, Inje University, Gimhae-si, South Korea
- Department of Psychology, University of Windsor, Windsor, Canada
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30
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Hidalgo-Fuentes S, Caro-Cañizares I, Izquierdo-Sotorrío E. Frequency of suicidal ideation inventory: A reliability generalization meta-analysis. DEATH STUDIES 2024:1-12. [PMID: 39141592 DOI: 10.1080/07481187.2024.2390904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/16/2024]
Abstract
The objectives of this reliability generalization meta-analysis were to estimate the overall reliability of the Frequency of Suicidal Ideation Inventory (FSII), a short, easily administered test developed to assess suicidal ideation and to examine possible moderating variables. A systematic search was conducted in five databases from the year of publication (2016) of the FSII until March 2024. All studies that applied the FSII and reported a Cronbach's alpha coefficient were included. Analyses were performed using a random effects model applying Bonett's transformation. Our analysis of 32 studies (k = 39) yielded an overall alpha of .91 (95% CI = .90, .92). We found that the type of administration, population, and language of the FSII moderated its reliability, which is high overall and appropriate for use in both research and clinical settings.
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Affiliation(s)
- Sergio Hidalgo-Fuentes
- Departamento de Psicología y Salud, Facultad de Ciencias de la Salud y la Educación, Universidad a Distancia de Madrid, Collado Villalba, Madrid, Spain
- Departamento de Psicología Básica, Facultad de Psicología y Logopedia, Universitat de València, Valencia, Spain
| | - Irene Caro-Cañizares
- Departamento de Psicología y Salud, Facultad de Ciencias de la Salud y la Educación, Universidad a Distancia de Madrid, Collado Villalba, Madrid, Spain
| | - Eva Izquierdo-Sotorrío
- Departamento de Psicología y Salud, Facultad de Ciencias de la Salud y la Educación, Universidad a Distancia de Madrid, Collado Villalba, Madrid, Spain
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31
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Mason GE, Auerbach RP, Stewart JG. Predicting the trajectory of non-suicidal self-injury among adolescents. J Child Psychol Psychiatry 2024. [PMID: 39136673 DOI: 10.1111/jcpp.14046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/10/2024] [Indexed: 09/12/2024]
Abstract
BACKGROUND Non-suicidal self-injury (NSSI) is common among adolescents receiving inpatient psychiatric treatment and the months post-discharge is a high-risk period for self-injurious behavior. Thus, identifying predictors that shape the course of post-discharge NSSI may provide insights into ways to improve clinical outcomes. Accordingly, we used machine learning to identify the strongest predictors of NSSI trajectories drawn from a comprehensive clinical assessment. METHODS The study included adolescents (N = 612; females n = 435; 71.1%) aged 13-19-years-old (M = 15.6, SD = 1.4) undergoing inpatient treatment. Youth were administered clinical interviews and symptom questionnaires at intake (baseline) and before termination. NSSI frequency was assessed at 1-, 3-, and 6-month follow-ups. Latent class growth analyses were used to group adolescents based on their pattern of NSSI across follow-ups. RESULTS Three classes were identified: Low Stable (n = 83), Moderate Fluctuating (n = 260), and High Persistent (n = 269). Important predictors of the High Persistent class in our regularized regression models (LASSO) included baseline psychiatric symptoms and comorbidity, past-week suicidal ideation (SI) severity, lifetime average and worst-point SI intensity, and NSSI in the past 30 days (bs = 0.75-2.33). Only worst-point lifetime suicide ideation intensity was identified as a predictor of the Low Stable class (b = -8.82); no predictors of the Moderate Fluctuating class emerged. CONCLUSIONS This study found a set of intake clinical variables that indicate which adolescents may experience persistent NSSI post-discharge. Accordingly, this may help identify youth that may benefit from additional monitoring and support post-hospitalization.
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Affiliation(s)
- Geneva E Mason
- Department of Psychology, University of Victoria, Victoria, BC, Canada
| | - Randy P Auerbach
- Department of Psychiatry, Columbia University, New York, NY, USA
- Division of Child and Adolescent Psychiatry, New York State Psychiatric Institute, New York, NY, USA
| | - Jeremy G Stewart
- Department of Psychology, Queen's University, Kingston, ON, Canada
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32
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Szücs A, Galfalvy H, Alessi MG, Kenneally LB, Valderas JM, Maier AB, Szanto K. Diligent for better or worse: Conscientiousness is associated with higher likelihood of suicidal behavior and more severe suicidal intent in later life. Compr Psychiatry 2024; 135:152523. [PMID: 39126760 DOI: 10.1016/j.comppsych.2024.152523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2024] [Revised: 07/18/2024] [Accepted: 08/04/2024] [Indexed: 08/12/2024] Open
Abstract
BACKGROUND Contradictory findings link trait conscientiousness in mid- and late life to increased healthspan and lifespan, as well as to death by suicide. It remains unclear whether conscientiousness is associated with higher odds of attempting suicide or with more severe suicidal behavior among attempters, and whether its relationship to suicide risk varies with aging-related stressors, such as declining health. METHODS In this cross-sectional study comprising 313 depressed adults aged ≥40 years and participating in the Longitudinal Research Program in Late-Life Suicide (Pittsburgh, USA), we employed logistic and linear regression to test whether conscientiousness was associated with the presence of recent suicidal behavior (≤2 years) and with intent severity in recent attempters (n = 84). We further tested whether the above relationships varied based on mental, cognitive, and physical health status, measured as depression severity, cognitive functioning, and the presence/absence of severe physical illness. RESULTS Participants were 62.1 years old on average (SD = 7.6), 85% White, and 53% female. Recent attempters had a mean age of 61.8 years at their most recent attempt (SD = 8.5), had lower cognitive functioning and were more likely severely physically ill than comparisons. Conscientiousness was positively associated with a higher likelihood of recent suicidal behavior overall (adjusted OR = 1.44, 95% CI = 1.09, 1.90, p = .010), but not in case of co-occurring severe physical illness (interaction OR = 0.54, 95% CI = 0.30, 0.97, p = .039). Conscientiousness was also positively associated with suicidal intent at the most recent attempt (adjusted β = 1.60, SE = 0.62, p = .012), explaining 7% of its variance, although this association lost significance after adjusting for other personality dimensions. CONCLUSIONS Highly conscientious middle-aged and older adults may be at increased risk of resolute suicidal behavior, although conscientiousness may not confer additional suicide risk among those severely physically ill.
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Affiliation(s)
- Anna Szücs
- Vrije Universiteit Amsterdam, Faculty of Behavioural and Movement Sciences, The Netherlands; National University of Singapore, Yong Loo Lin School of Medicine, Department of Medicine, Singapore.
| | | | - Maria G Alessi
- University of North Carolina at Charlotte, Program in Health Psychology, USA
| | | | - Jose M Valderas
- National University of Singapore, Yong Loo Lin School of Medicine, Department of Medicine, Singapore
| | - Andrea B Maier
- Vrije Universiteit Amsterdam, Faculty of Behavioural and Movement Sciences, The Netherlands; National University of Singapore, Yong Loo Lin School of Medicine, Department of Medicine, Singapore
| | - Katalin Szanto
- University of Pittsburgh, School of Medicine, Department of Psychiatry, USA
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33
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Ebulum GC, Eze JE, Ezeihuoma OP, Njoku C, Chukwuorji JC. Roles of Loneliness, Stress, and Religiosity in Suicide Ideation Among Nigerian Older Adults. Int J Aging Hum Dev 2024:914150241268006. [PMID: 39105289 DOI: 10.1177/00914150241268006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/07/2024]
Abstract
Suicidal behavior in older adults is a fundamental public health problem globally and the highest suicide rates occur in low- and middle-income countries (LMICs). However, there is limited research on suicidality among older adults, especially in sub-Saharan Africa. We sought to find out whether loneliness, stress and religiosity would be associated with suicide ideation in a sample of sub-Saharan African older adults (N = 500; aged 51-70 years, Mage = 58.97, SD = 6.16; 45.6% women). They completed the Beck Suicidal Ideation Scale, the UCLA Loneliness Scale-version 3, Perceived Stress Scale, and Religiosity Scale. Regression results showed that whereas suicidal ideation could be increased by loneliness and stress, religious older adults were less likely to report suicidal ideation. Interventions aimed at managing and protecting the mental health of older adults during their transition to late adulthood should guard them against loneliness and buffer their resilience and coping strategies with the connectedness that religiosity offers.
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Affiliation(s)
- Genevieve Chimaoge Ebulum
- Department of Community Medicine, David Umahi Federal University of Health Sciences, Uburu, Ebonyi, Nigeria
| | - John E Eze
- Department of Psychology, University of Nigeria, Nsukka, Nigeria
| | | | - Crystal Njoku
- Department of Medicine, American University of Antigua College of Medicine, Osbourn, Antigua & Barbuda
| | - JohnBosco Chika Chukwuorji
- Department of Psychology, University of Nigeria, Nsukka, Nigeria
- Charles Stewart Mott Department of Public Health, College of Human Medicine, Michigan State University, Flint, MI, USA
- Promotion of Health and Innovation Lab, International Network for Well-being, Enugu, Nigeria
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34
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Wang C, Lan X, Liu W, Zhan Y, Zheng W, Chen X, Liu G, Mai S, Lu H, McIntyre RS, Zhou Y, Ning Y. Non-improvement predicts subsequent non-response to repeated-dose intravenous ketamine for depression: a re-analysis of a 2-week open-label study in patients with unipolar and bipolar depression. Transl Psychiatry 2024; 14:324. [PMID: 39107286 PMCID: PMC11303529 DOI: 10.1038/s41398-024-03027-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 05/09/2024] [Accepted: 07/17/2024] [Indexed: 08/10/2024] Open
Abstract
There is insufficient evidence to guide dose and frequency optimization with repeated-dose ketamine for depression. This study assessed the value of symptomatic non-improvement after the first few ketamine infusions as a predictor of overall non-response in depression for early decision-making to discontinue treatment. A total of 135 individuals with major depressive disorder or bipolar disorder experiencing a current major depressive episode were administered six repeated doses of intravenous ketamine. Depressive symptoms were assessed using the Montgomery-Åsberg Depression Rating Scale (MADRS) at baseline, 4 h after the first infusion, and 24 h after each infusion. Improvement, partial response, and response were defined as a reduction rate of ≥ 20%, 30%, and 50% in MADRS scores, respectively. This study examined the relationship between improvement (as opposed to non-improvement after each infusion or consecutive non-improvements after the first few infusions) and partial response and response after the sixth infusion. This analysis was summarized using sensitivity, specificity, and other diagnostic test parameters. The sensitivities of improvement at 24 h post-infusion 4 and improvement at 24 h post-infusion 3, vs. three consecutive non-improvements, as predictors for overall partial response and response exceeded 90%. No significant reduction in depressive symptoms was seen in non-improvers following the remaining infusions after the above-identified point. Our study suggests that non-improvement after four infusions, or more conservatively three consecutive non-improvements after three infusions, could serve as a signal of overall non-response to repeated-dose intravenous ketamine for depression and that subsequent treatments would not be warranted.
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Affiliation(s)
- Chengyu Wang
- The Affiliated Brain Hospital, Guangzhou Medical University, Guangzhou, China
- Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou, China
| | - Xiaofeng Lan
- The Affiliated Brain Hospital, Guangzhou Medical University, Guangzhou, China
- Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou, China
| | - Weijian Liu
- The Affiliated Brain Hospital, Guangzhou Medical University, Guangzhou, China
- Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou, China
- Peking University Sixth Hospital, Peking University Institute of Mental Health, Peking University, Beijing, China
| | - Yanni Zhan
- The Affiliated Brain Hospital, Guangzhou Medical University, Guangzhou, China
- Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou, China
| | - Wei Zheng
- The Affiliated Brain Hospital, Guangzhou Medical University, Guangzhou, China
- Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou, China
| | - Xiaoyu Chen
- The Affiliated Brain Hospital, Guangzhou Medical University, Guangzhou, China
- Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou, China
| | - Guanxi Liu
- The Affiliated Brain Hospital, Guangzhou Medical University, Guangzhou, China
- Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou, China
- The First School of Clinical Medicine, Southern Medical University, Guangzhou, China
| | - Siming Mai
- The Affiliated Brain Hospital, Guangzhou Medical University, Guangzhou, China
- Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou, China
| | - Hanna Lu
- Department of Psychiatry, Chinese University of Hong Kong, Hong Kong SAR, China
| | - Roger S McIntyre
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Yanling Zhou
- The Affiliated Brain Hospital, Guangzhou Medical University, Guangzhou, China.
- Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou, China.
| | - Yuping Ning
- The Affiliated Brain Hospital, Guangzhou Medical University, Guangzhou, China.
- Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou, China.
- The First School of Clinical Medicine, Southern Medical University, Guangzhou, China.
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35
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Shin YL, Bae SM. An Analysis of the Longitudinal Effects of Academic Stress, Insecure Attachment, and Sense of Community on Adolescent Suicidal Ideation. Child Psychiatry Hum Dev 2024:10.1007/s10578-024-01742-x. [PMID: 39103733 DOI: 10.1007/s10578-024-01742-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/19/2024] [Indexed: 08/07/2024]
Abstract
This study aimed to examine the independent influences of academic stress, insecure attachment, and sense of community on suicidal ideation among adolescents. In particular, the independent influence of the sense of community on adolescent suicide was verified by controlling for other variables. For this purpose, youth data (7324 persons) from the panel data of the 4th to 6th Korean Education Longitudinal Studies of the Korea Educational Development Institute were used. Statistical analyses were performed using a generalized estimation equation (GEE). The analysis revealed that gender, academic stress, insecure attachment, and sense of community significantly influenced suicidal ideation. Female students had higher suicidal ideation than male students, and the higher the academic stress and degree of insecure attachment, the higher the suicidal ideation. In particular, the independent influence of a sense of community on suicidal ideation was significant; the higher the sense of community, the lower the suicide ideation score. The implication of this study is to comprehensively consider the factors related to adolescent suicidal ideation in various systems based on Bronfenbrenner's ecological theory. This research suggests that helping schools and communities to increase their sense of community, which is a macrosystem factor, is important in preventing adolescent suicide.
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Affiliation(s)
- Ye-Lim Shin
- Department of Psychology, Graduate School, Dankook University, Cheonan, Republic of Korea
| | - Sung-Man Bae
- Department of Psychology, Graduate School, Dankook University, Cheonan, Republic of Korea.
- Department of Psychology and Psychotherapy, College of Health Science, Dankook University, 119 Dandae-Ro, Dongnam-Gu, Cheonan, Chungnam, Republic of Korea.
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36
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Mournet AM, Kleiman EM. A systematic review and meta-analysis on the efficacy of sleep interventions to treat suicidal ideation. J Sleep Res 2024; 33:e14133. [PMID: 38164094 DOI: 10.1111/jsr.14133] [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: 08/21/2023] [Revised: 11/28/2023] [Accepted: 12/07/2023] [Indexed: 01/03/2024]
Abstract
Researchers at the intersection of sleep and suicide research have advocated for investigation of sleep disturbances as a therapeutic target for the purposes of treating and preventing suicide. This study aims to provide the first systematic review and meta-analysis on the efficacy of sleep interventions to treat suicidal ideation. This systematic review and meta-analysis, registered with the International Prospective Register of Systematic Reviews, was conducted in PsycINFO, through Ovid. A sample of eight articles were deemed eligible and a total of 21 effect sizes were included. Egger's test suggested that no publication bias was present (b = 0.3695; p = 0.0852). The pooled effect size for sleep treatments on suicidal ideation was small (g = -0.0931, p = 0.3047). Significant heterogeneity was present (I2 = 44.13%), indicating the need for moderator analyses. Treatment type (medication versus psychotherapy; g = -0.2487, p = 0.3368), sex (g = -0.0007; p = 0.9263), and race (g = -0.0081; p = 0.1624) were all considered as moderators and were all found to be insignificant. This meta-analysis revealed that initial studies exploring the efficacy of sleep interventions on suicidal ideation demonstrate small effect sizes. Despite this, the handful of studies included in this review nonetheless highlight this as an important area for continued exploration. The use of larger and more diverse samples, as well as intentionally designing sleep-related interventions to improve ideation and behaviour, have the potential to enhance the efficacy of sleep interventions for this novel purpose.
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Affiliation(s)
| | - Evan M Kleiman
- Rutgers, The State University of New Jersey, New Brunswick, New Jersey, USA
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37
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de Santiago-Díaz AI, Barrio-Martínez S, Gómez-Ruiz E, Carceller-Meseguer T, Sastre-Yañez J, Ortíz-García de la Foz V, Ayesa-Arriola R. Effectiveness of early and intensive intervention on suicide prevention: CARS programme. Psychiatry Res 2024; 338:115964. [PMID: 38824711 DOI: 10.1016/j.psychres.2024.115964] [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: 01/30/2024] [Revised: 05/09/2024] [Accepted: 05/11/2024] [Indexed: 06/04/2024]
Abstract
The aim of this study was to evaluate the outcomes of the Programme for Management of Suicidal Behaviour and Suicide Prevention (CARS). Individuals treated in the emergency department of University Hospital Marqués de Valdecilla for suicidal thoughts or attempts (N = 401) between 1-March-2016 and 31-December-2018 were considered. No randomization by patients or groups was performed. Student's t-test, chi-square and repeated measure analysis of variance were used. Kaplan-Meier survival function and Cox proportional hazard regression models were employed to estimate the risks of relapse. Outcome of those who voluntary enrol CARS were compared with treatment as usual (TAU) at 6- and 12-months follow-up. The results indicate a significant reduction and delayed occurrence of suicidal behaviour over a 12-month follow-up period with the CARS programme compared to TAU, along with a decreased frequency of hospital admissions. CARS programme demonstrates a substantial impact, significantly reducing the risk of recurrent suicidal behaviour by 35.5 % and the risk of repeated suicidal attempts by 47.2 % at the 12-month follow-up. The programme exhibits a dual protective effect, diminishing suicidal behaviour and fostering improved long-term outcomes. In conclusion, CARS effectively reduced suicidal behaviour recurrence, achieving significant decreases in suicidal thoughts, plans and attempts.
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Affiliation(s)
- Ana Isabel de Santiago-Díaz
- Department of Psychiatry, University Hospital Marqués de Valdecilla (HUMV), Santander, Spain; Instituto de Investigación Valdecilla (IDIVAL), Santander, Spain.
| | | | - Elsa Gómez-Ruiz
- Department of Psychiatry, University Hospital Marqués de Valdecilla (HUMV), Santander, Spain; Instituto de Investigación Valdecilla (IDIVAL), Santander, Spain
| | - Telva Carceller-Meseguer
- Department of Psychiatry, University Hospital Marqués de Valdecilla (HUMV), Santander, Spain; Instituto de Investigación Valdecilla (IDIVAL), Santander, Spain
| | - Javier Sastre-Yañez
- Department of Psychiatry, University Hospital Marqués de Valdecilla (HUMV), Santander, Spain; Instituto de Investigación Valdecilla (IDIVAL), Santander, Spain
| | - Víctor Ortíz-García de la Foz
- Instituto de Investigación Valdecilla (IDIVAL), Santander, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Santander, Spain
| | - Rosa Ayesa-Arriola
- Instituto de Investigación Valdecilla (IDIVAL), Santander, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Santander, Spain.
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38
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Yeom JW, Yoon Y, Seo JY, Cho CH, Lee T, Lee JB, Jeon S, Kim L, Lee HJ. Daily Self-Monitoring and Feedback of Circadian Rhythm Measures in Major Depression and Bipolar Disorder Using Wearable Devices and Smartphones-The Circadian Rhythm for Mood (CRM®) Trial Protocol: A Randomized Sham Controlled Double-Blind Trial. Psychiatry Investig 2024; 21:918-924. [PMID: 39086163 PMCID: PMC11321874 DOI: 10.30773/pi.2024.0133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2024] [Revised: 06/03/2024] [Accepted: 06/23/2024] [Indexed: 08/02/2024] Open
Abstract
The circadian rhythm for mood (CRM) is a digital therapeutic, which aims to prevent mood episode and improve clinical course in patients with major mood disorders. Developed on the circadian rhythm hypothesis of mood disorder, CRM predicts the impending risk of mood episode with its built-in algorithm, utilizing wearable devices data and daily self-reports, and provides personalized feedback. In a pilot study of the CRM, the users experienced less frequent and shorter duration of mood episodes than the non-users. To investigate the efficacy of the upgraded CRM, a double-blind, randomized, sham-controlled, parallel-group trial is designed. Patients aged between 19 and 70, diagnosed with bipolar I disorder, bipolar II disorder, or major depressive disorder, in a euthymic state for more than two months, can participate. During this 12-month trial, participants are assessed for episode recurrence every three months, and the efficacy of the CRM as a potential digital therapeutic is evaluated. Trial registration: ClinicalTrials.gov Identifier: NCT05400785.
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Affiliation(s)
- Ji Won Yeom
- Department of Psychiatry, Korea University College of Medicine, Seoul, Republic of Korea
- Chronobiology Institute, Korea University, Seoul, Republic of Korea
| | - Yeaseul Yoon
- Department of Psychiatry, Korea University College of Medicine, Seoul, Republic of Korea
- Chronobiology Institute, Korea University, Seoul, Republic of Korea
| | - Ju Yeon Seo
- Department of Psychiatry, Korea University College of Medicine, Seoul, Republic of Korea
- Chronobiology Institute, Korea University, Seoul, Republic of Korea
| | - Chul-Hyun Cho
- Department of Psychiatry, Korea University College of Medicine, Seoul, Republic of Korea
- Chronobiology Institute, Korea University, Seoul, Republic of Korea
| | - Taek Lee
- Division of Computer Science and Engineering, College of Software and Convergence, Sun Moon University, Asan, Republic of Korea
| | - Jung-Been Lee
- Division of Computer Science and Engineering, College of Software and Convergence, Sun Moon University, Asan, Republic of Korea
| | - Sehyun Jeon
- Samsung Sleep & Mind Clinic, Seoul, Republic of Korea
| | - Leen Kim
- Department of Psychiatry, Korea University College of Medicine, Seoul, Republic of Korea
- Chronobiology Institute, Korea University, Seoul, Republic of Korea
| | - Heon-Jeong Lee
- Department of Psychiatry, Korea University College of Medicine, Seoul, Republic of Korea
- Chronobiology Institute, Korea University, Seoul, Republic of Korea
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39
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Haddadi A, Matinnia N, Yazdi‐Ravandi S. The relationship between corona disease anxiety and sleep disturbances and suicidal ideation in medical staff: The mediating role of resiliency and cognitive flexibility: A cross-sectional study. Health Sci Rep 2024; 7:e2282. [PMID: 39144407 PMCID: PMC11322221 DOI: 10.1002/hsr2.2282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Revised: 07/02/2024] [Accepted: 07/22/2024] [Indexed: 08/16/2024] Open
Abstract
Background and Aims Medical staff have experienced anxiety, sleep disturbances, and suicide due to the COVID-19 epidemic. Thus, this study examined the relationship between corona disease anxiety, sleep problems, and suicidal ideation in medical staff and how resiliency and cognitive flexibility mediate it. Methods This descriptive-analytical cross-sectional study examined medical staff. In 2022, participants were affiliated with Hamadan University of Medical Sciences, Iran educational and treatment centers. Sampling was done at primary COVID-19 treatment centers. Data was collected using validated instruments. Ethics were observed during data collecting. Results Path analysis was employed to test hypotheses. Analysis showed significant positive relationships between Corona disease anxiety and sleep disturbances (p = 0.001, β = 0.438) and suicidal ideation (p = 0.001, β = 0.310). Conversely, negative and significant associations were identified between resiliency and cognitive flexibility with sleep disturbances and suicidal ideation. Conclusions The study illustrates how medical staff's psychological health is linked to COVID-19. High Corona disease anxiety causes sleep disturbances and suicidal thoughts. Resilience and cognitive flexibility modulated Corona disease anxiety, sleep problems, and suicidal thoughts. The comprehensive study focuses on medical staff mental health issues, suggesting targeted solutions.
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Affiliation(s)
- Arya Haddadi
- Department of Clinical Psychology, Faculty of Medical Sciences, Hamedan BranchIslamic Azad UniversityHamedanIran
- Behavioral Disorders and Substance Abuse Research CenterHamadan University of Medical SciencesHamadanIran
| | - Nasrin Matinnia
- Department of Nursing, Faculty of Medical Sciences, Hamedan BranchIslamic Azad UniversityHamedanIran
| | - Saeid Yazdi‐Ravandi
- Behavioral Disorders and Substance Abuse Research CenterHamadan University of Medical SciencesHamadanIran
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40
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Huang F, Lu W, Zhao X, Li N, Zhao T, Guo S, Liu B, Ren R, Yang L, Wang L, Gao Y, Wang R, Song M, Lin Q, Xu Y, Jin N, Liu K, Bai M, Wang X. Suicidal ideation in medical students of Hebei province: prevalence and associated factors. Front Psychiatry 2024; 15:1398668. [PMID: 39140111 PMCID: PMC11319246 DOI: 10.3389/fpsyt.2024.1398668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2024] [Accepted: 07/08/2024] [Indexed: 08/15/2024] Open
Abstract
Objectives This study investigated the prevalence of suicidal ideation (SI) among Chinese medical students and its associated risk factors. Methods A total of 6643 medical students (2383 males/4260 females) were recruited from a medical college in Hebei Province, China. Demographic data were collected via a self-administered questionnaire. The Childhood Trauma Questionnaire Short Form (CTQ-SF) was used to evaluate childhood maltreatment (CM), and the Adolescent Self-Rating Life Events Checklist (ASLEC) was used to evaluate the stressful life events. Suicidal ideation was assessed using the Beck Scale for Suicide Ideation (BSSI). Univariate and multivariate logistic regression models were used to analyze the factors affecting SI. Results The prevalence of SI in medical students was 11.5% (763/6643). Multivariate logistic regression analysis revealed that SI was significantly associated with younger age, a female sex, being lovelorn, being introverted, experiencing CM during childhood, and experiencing stressful life events within the past 12 months. Of the five subtypes of CM, emotional abuse may have the strongest effect on SI (OR=2.76, 95% CI: 1.72-4.42). The joint effects of CM and stressful life events were significantly associated with an increased risk of SI (OR=5.39, 95% CI: 4.15-6.98). Conclusion The prevalence of SI among medical students is high, and medical students who have experienced CM and stressful life events have a higher tendency towards SI. Screening for both CM and stressful life events may be an effective way of identifying individuals at high risk of SI.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Xueyi Wang
- Mental Health Center, The First Hospital of Hebei Medical University, Hebei Clinical Medical Research Center for Mental Disorders, Shijiazhuang, China
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Yurtseven A, Kavalci C, Aydin YY, Aydin K, Demir ÖF, Özdemir Ş, Kavalci G. The investigation of relationship between serum melatonin levels with Beck Depression Inventory and Beck Scale for Suicidal Ideation in suicide patients. REVISTA DA ASSOCIACAO MEDICA BRASILEIRA (1992) 2024; 70:e20231614. [PMID: 39045956 PMCID: PMC11288271 DOI: 10.1590/1806-9282.20231614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Accepted: 03/03/2024] [Indexed: 07/25/2024]
Abstract
OBJECTIVE Melatonin plays a role in many biological and physiological events. There are studies in the literature relating melatonin levels to many psychiatric disorders such as schizophrenia, bipolar disorder, and major depressive disorder. We aimed to investigate the relationship between serum melatonin levels with the Beck Depression Inventory and the Beck Scale for Suicidal Ideation in suicide patients. METHODS The study was conducted prospectively with volunteer patients aged 20-50 years who were admitted to the emergency department after a suicide attempt. The social and occupational status, educational levels, marital status, and stressor factors of patients were questioned. Beck Depression Inventory and Beck Scale for Suicidal Ideation were applied to each patient included in the study. Blood melatonin levels were evaluated using the enzyme-linked immunosorbent assay method. The data were analyzed with the SPSS 23.00 statistical program. Descriptive values were expressed by the number of cases (n), percentage (%), median (interquartile range), and mean±standard deviation. The Kolmogorov-Smirnov test was used to assess the distribution of continuous variables, and the Pearson or Spearman correlation test was used to assess the relationship between disease severity and melatonin level. A value of p<0.05 was considered statistically significant. RESULTS No statistically significant correlation was found between melatonin level and the Beck Depression Inventory score (r=-0.098, p=0.44). However, a statistically weak, inverse, and significant correlation was discovered between melatonin levels and the Beck Scale for Suicidal Ideation score (r=-0.465, p=0.00). CONCLUSION According to our results, it was determined that there was a significant negative relationship between melatonin level and the Beck Scale for Suicidal Ideation scoring.
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Affiliation(s)
- Aynur Yurtseven
- Dışkapı Yıldırım Beyazıt Training and Research Hospital, Department of Emergency – Ankara, Turkey
| | - Cemil Kavalci
- Health Science of Turkey, Antalya Training and Research Hospital, Department of Emergency – Antalya, Turkey
| | - Yasemin Yilmaz Aydin
- Dışkapı Yıldırım Beyazıt Training and Research Hospital, Department of Emergency – Ankara, Turkey
| | - Kemal Aydin
- Dışkapı Yıldırım Beyazıt Training and Research Hospital, Department of Emergency – Ankara, Turkey
| | - Ömer Faruk Demir
- Dışkapı Yıldırım Beyazıt Training and Research Hospital, Department of Emergency – Ankara, Turkey
| | - Şeyda Özdemir
- ışkapı Yıldırım Beyazıt Training and Research Hospital, Department of Biochemistry – Ankara, Turkey
| | - Gülsüm Kavalci
- Antalya Training and Research Hospital, Department of Anesthesiology – Antalya, Turkey
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Abdel Samie M, Nasreldin M, Shahin M, Amer DA, Mohamed RM, Taher DB, Sayed T, Ahmed N, Mabrouk A, Mamdouh J, Gohar SM. Association between suicidal ideation, negative symptoms and theory of mind in first episode psychosis. Soc Psychiatry Psychiatr Epidemiol 2024:10.1007/s00127-024-02709-y. [PMID: 39014044 DOI: 10.1007/s00127-024-02709-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Accepted: 06/24/2024] [Indexed: 07/18/2024]
Abstract
PURPOSE Suicidal thoughts are common among patients with first episode psychosis (FEP). The impact of symptoms' severity and social cognition on suicidal risk should be a focus of attention. This study aimed at assessment of the severity of suicidal ideation in patients with FEP and its potential association with the theory of mind (ToM) impairment and symptoms' severity. METHODS Ninety-six participants were recruited consecutively and subdivided into three equal groups: FEP, schizophrenia, and healthy controls (HC). The symptoms' severity was assessed using Positive and Negative Syndrome Scale (PANSS) and Beck Depression Inventory (BDI). Suicidal ideation was evaluated using Beck Scale for Suicidal Ideation (BSSI). Reading the Mind in the Eyes revised version (RMET) was used to assess ToM. RESULTS Suicidal ideation was significantly higher only in FEP compared to HC (p = 0.001). Both FEP and schizophrenia had substantially lower performance than HC on RMET (p < 0.001). Higher depression (β = 0.452, p = 0.007) and negative symptoms (β = 0.433, p = 0.027) appeared to be significantly associated with increased suicidal ideation severity in FEP while RMET did not. CONCLUSION Patients with FEP and chronic schizophrenia have comparable deficits in theory of mind dimension of social cognition. The severity of negative and depressive symptoms potentially contributes to the increased risk of suicide in FEP.
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Affiliation(s)
- Mai Abdel Samie
- Department of Psychiatry, Faculty of Medicine, Cairo University, El Saraya Street, El Manyal, Cairo, 11956, Egypt
| | - Mohamed Nasreldin
- Department of Psychiatry, Faculty of Medicine, Cairo University, El Saraya Street, El Manyal, Cairo, 11956, Egypt
| | - Mostafa Shahin
- Department of Psychiatry, Faculty of Medicine, Cairo University, El Saraya Street, El Manyal, Cairo, 11956, Egypt
| | - Dalal A Amer
- Department of Psychiatry, Faculty of Medicine, Cairo University, El Saraya Street, El Manyal, Cairo, 11956, Egypt
| | - Rania Mamdouh Mohamed
- Department of Psychiatry, Faculty of Medicine, Cairo University, El Saraya Street, El Manyal, Cairo, 11956, Egypt
| | - Dina Badie Taher
- Department of Psychiatry, Faculty of Medicine, Cairo University, El Saraya Street, El Manyal, Cairo, 11956, Egypt
| | - Talha Sayed
- Department of Psychiatry, Faculty of Medicine, Cairo University, El Saraya Street, El Manyal, Cairo, 11956, Egypt
| | - Nadine Ahmed
- Department of Psychiatry, Faculty of Medicine, Cairo University, El Saraya Street, El Manyal, Cairo, 11956, Egypt
| | - Ali Mabrouk
- Department of Psychiatry, Faculty of Medicine, Cairo University, El Saraya Street, El Manyal, Cairo, 11956, Egypt
| | - Joseph Mamdouh
- Department of Psychiatry, Faculty of Medicine, Cairo University, El Saraya Street, El Manyal, Cairo, 11956, Egypt
| | - Sherif M Gohar
- Department of Psychiatry, Faculty of Medicine, Cairo University, El Saraya Street, El Manyal, Cairo, 11956, Egypt.
- TIPS Centre for Clinical Research in Psychosis, Stavanger University Hospital, Stavanger, Norway.
- Faculty of Health Sciences, Network for Medical Sciences, University of Stavanger, Stavanger, Norway.
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Bornheimer LA, Verdugo JL, Brdar NM, Im V, Jeffers N, Bushnell CB, Hoener K, Tasker M, DeWeese K, Florence T, Jester JM, King CA, Taylor SF, Himle JA. A cognitive-behavioral treatment for suicide prevention among adults with schizophrenia spectrum disorders in community mental health: Study protocol for a pilot feasibility and acceptability randomized clinical trial. Pilot Feasibility Stud 2024; 10:99. [PMID: 38997747 PMCID: PMC11241875 DOI: 10.1186/s40814-024-01523-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 07/01/2024] [Indexed: 07/14/2024] Open
Abstract
BACKGROUND Suicide is among the leading causes of death for adults with schizophrenia spectrum disorders (SSDs), and there is a paucity of evidence-based suicide prevention-focused interventions tailored for this vulnerable population. Cognitive-Behavioral Suicide Prevention for psychosis (CBSPp) is a promising intervention developed in the UK that required modifications for delivery in community mental health (CMH) settings in the United States of American. This pilot trial evaluates the feasibility, acceptability, and preliminary effectiveness of our modified CBSPp intervention in comparison to services as usual (SAU) within a CMH setting in a Midwestern state of the USA. METHODS This is a single-site randomized pilot trial with a planned enrollment of 60 adults meeting criteria for both SSD and SI/A. Eligible participants will be randomized 1:1 to either 10 sessions of CBSPp or SAU. Clinical and cognitive assessments will be conducted within a 4-waive design at baseline (prior to randomization and treatment) and approximately 1 month (mid-treatment), 3 months (post-treatment), and 5 months (follow-up) after baseline assessment. Qualitative interviews will also be conducted at post-treatment. The primary objective is to determine whether CBSPp is feasible and acceptable, involving examinations of recruitment rate, treatment engagement and adherence, retention and completion rates, and experiences in the CBSPp treatment and overall study. The secondary objective is to preliminarily evaluate whether modified CBSPp is associated with reductions in clinical (suicide ideation, suicide attempt, symptoms of psychosis, depression, and emergency/hospital service, hopelessness, defeat, and entrapment) and cognitive (information processing biases, appraisals, and schemas) outcomes in comparison to SAU from baseline to post-treatment assessment. DISCUSSION This randomized pilot trial will provide clinically relevant information about whether CBSPp can improve SI/A, depression, and psychosis among adults with SSDs. Testing this modified cognitive-behavioral suicide prevention-focused intervention has the potential for a large public health impact by increasing the intervention's utility and usability in CMH where many individuals with SSDs receive care, and ultimately working towards reductions in premature suicide death. TRIAL REGISTRATION ClinicalTrials.gov NCT#05345184. Registered on April 12, 2022.
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Affiliation(s)
- Lindsay A Bornheimer
- School of Social Work, University of Michigan, Ann Arbor, MI, USA.
- Department of Psychiatry, Michigan Medicine, Ann Arbor, MI, USA.
| | | | - Nicholas M Brdar
- School of Social Work, University of Michigan, Ann Arbor, MI, USA
| | - Vitalis Im
- School of Social Work, University of Michigan, Ann Arbor, MI, USA
| | - Nakea Jeffers
- School of Social Work, University of Michigan, Ann Arbor, MI, USA
| | | | - Katie Hoener
- Washtenaw County Community Mental Health, Ann Arbor, MI, USA
| | - Melisa Tasker
- Washtenaw County Community Mental Health, Ann Arbor, MI, USA
| | - Krista DeWeese
- Washtenaw County Community Mental Health, Ann Arbor, MI, USA
| | | | - Jennifer M Jester
- School of Social Work, University of Michigan, Ann Arbor, MI, USA
- Department of Psychiatry, Michigan Medicine, Ann Arbor, MI, USA
| | - Cheryl A King
- Department of Psychiatry, Michigan Medicine, Ann Arbor, MI, USA
| | | | - Joseph A Himle
- School of Social Work, University of Michigan, Ann Arbor, MI, USA
- Department of Psychiatry, Michigan Medicine, Ann Arbor, MI, USA
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Schlegelmilch M, Plint AC, Barrowman N, Gray C, Bhatt M. Intravenous ketamine for emergency department treatment of suicidal ideation in a paediatric population: protocol for a double-blind, randomised, placebo-controlled, parallel-arm pilot trial (KSI study). BMJ Open 2024; 14:e085681. [PMID: 38969374 PMCID: PMC11227786 DOI: 10.1136/bmjopen-2024-085681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Accepted: 05/20/2024] [Indexed: 07/07/2024] Open
Abstract
INTRODUCTION Suicidal ideation (SI) is a common and severe cause of morbidity in adolescents. Patients frequently present to the emergency department (ED) for care, yet there is no acute therapeutic intervention for SI. A single dose of intravenous ketamine has demonstrated efficacy in rapidly reducing SI in adults; however, ketamine has not been studied in paediatrics. We aim to determine the feasibility of a trial of a single intravenous ketamine dose to reduce SI for patients in the paediatric ED. METHODS AND ANALYSIS This will be a single-centre, double-blind, randomised, placebo-controlled, parallel-arm pilot trial of intravenous ketamine for ED treatment of SI in a paediatric population. INTERVENTION one intravenous dose of 0.5 mg/kg of ketamine (max 50 mg), over 40 min. Placebo: one intravenous dose of 0.5 mL/kg (max 50 mL) of normal saline, over 40 min. Participants will be randomised in a 1:1 ratio. SI severity will be measured at baseline, 40 min, 80 min, 120 min, 24 hours and 7 days. We aim to recruit 20 participants. The primary feasibility outcome is the proportion of eligible patients who complete the study protocol. We will pilot three SI severity tools and explore the efficacy, safety and tolerability of the intervention. ETHICS AND DISSEMINATION This study will be conducted according to Canadian Biomedical Research Tutorial, international standards of Good Clinical Practice and the Health Canada, Food and Drug Act, Part C, Division 5. The study documents have been approved by the CHEO Research Institute Research Ethics Board (CHEO REB (23/02E)). Participants must provide free and informed consent to participate. If incapable due to age, assenting participants with parental/legal guardian consent may participate. On completion, we will endeavour to present results at international conferences, and publish the results in a peer-reviewed journal. Participants will receive a results letter. TRIAL REGISTRATION NUMBER NCT05468840.
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Affiliation(s)
| | - Amy C Plint
- Department of Pediatrics, CHEO, Ottawa, Ontario, Canada
| | | | - Clare Gray
- Department of Psychiatry, CHEO, Ottawa, Ontario, Canada
| | - Maala Bhatt
- Department of Pediatrics, CHEO, Ottawa, Ontario, Canada
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Lee Y, Gilbert JR, Waldman LR, Zarate CA, Ballard ED. Potential association between suicide risk, aggression, impulsivity, and the somatosensory system. Soc Cogn Affect Neurosci 2024; 19:nsae041. [PMID: 38874947 PMCID: PMC11219302 DOI: 10.1093/scan/nsae041] [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: 10/02/2023] [Revised: 04/05/2024] [Accepted: 06/13/2024] [Indexed: 06/15/2024] Open
Abstract
Aggression and impulsivity are linked to suicidal behaviors, but their relationship to the suicidal crisis remains unclear. This magnetoencephalography (MEG) study investigated the link between aggression, impulsivity, and resting-state MEG power and connectivity. Four risk groups were enrolled: high-risk (HR; n = 14), who had a recent suicidal crisis; lower-risk (LR; n = 41), who had a history of suicide attempts but no suicide attempt or ideation in the past year; clinical control (CC; n = 38), who had anxiety/mood disorders but no suicidal history; and minimal risk (MR; n = 28), who had no psychiatric/suicidal history. No difference in resting-state MEG power was observed between the groups. Individuals in the HR group with high self-reported aggression and impulsivity scores had reduced MEG power in regions responsible for sensory/emotion regulation vs. those in the HR group with low scores. The HR group also showed downregulated bidirectional glutamatergic feedback between the precuneus (PRE) and insula (INS) compared to the LR, CC, and MR groups. High self-reported impulsivity was linked to reduced PRE to INS feedback, whereas high risk-taking impulsivity was linked to upregulated INS to postcentral gyrus (PCG) and PCG to INS feedback. These preliminary findings suggest that glutamatergic-mediated sensory and emotion-regulation processes may function as potential suicide risk markers.
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Affiliation(s)
- Yoojin Lee
- Experimental Therapeutics and Pathophysiology Branch, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, MD 20892, United States
| | - Jessica R Gilbert
- Experimental Therapeutics and Pathophysiology Branch, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, MD 20892, United States
| | - Laura R Waldman
- Experimental Therapeutics and Pathophysiology Branch, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, MD 20892, United States
| | - Carlos A Zarate
- Experimental Therapeutics and Pathophysiology Branch, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, MD 20892, United States
| | - Elizabeth D Ballard
- Experimental Therapeutics and Pathophysiology Branch, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, MD 20892, United States
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Stewart JG, Pizzagalli DA, Auerbach RP. Stress exposure in at-risk, depressed, and suicidal adolescents. J Child Psychol Psychiatry 2024; 65:942-958. [PMID: 38100210 PMCID: PMC11161328 DOI: 10.1111/jcpp.13935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/20/2023] [Indexed: 12/29/2023]
Abstract
BACKGROUND Stress exposure contributes to the onset, maintenance, and recurrence of major depressive disorder (MDD) in adolescents. However, the precise stress facets (e.g. chronicity, domain) most strongly linked to outcomes at different stages along the depression severity continuum remain unclear. Across two studies, chronic and episodic stressors were comprehensively assessed among: (a) healthy youth with (High-Risk [HR]) and without (Low-Risk [LR]) a maternal history of MDD and (b) adolescents with current MDD and suicide ideation and healthy controls (HC). METHOD Study 1 included LR (n = 65) and HR (n = 22) 12- to 14-year-olds (49 females; 56.32%) with no lifetime history of mental disorders. Study 2 enrolled 87 mid-to-late adolescents (64 females; 73.56%), including 57 MDD youth from a short-term intensive treatment service and 30 HCs from the community. All depressed youth reported recent suicide ideation; some had no lifetime history suicide attempts (SI; n = 31) and others reported at least one past year attempt (SA; n = 26). The Life Events and Difficulties Schedule was used to capture stressor severity in both studies. RESULTS We used multiple linear regression models that adjusted for demographic and clinical covariates. Being in the HR versus LR group was associated with more severe chronic (β = .22, CI95 = 0.01-0.42, p = .041), independent (β = .34, CI95 = 0.12-0.56, p = .003), and interpersonal (β = .23, CI95 = 0.004-0.45, p = .047) stress severity. By contrast, the MDD group reported significantly more severe chronic (β = .62, CI95 = 0.45-0.79, p < .001) and dependent (β = .41, CI95 = 0.21-0.61, p < .001) stress than the HC group, but not independent (p = .083) stress. Stress severity did not differ between recent attempters versus youth who reported suicide ideation alone (SA vs. SI contrast). However, the SA group reported a higher rate of targeted rejection events (RR = 3.53, CI95 = 1.17-10.70, p = .026). CONCLUSIONS Our findings clarify the stressor features that may most strongly contribute to adolescent depression and its clinical correlates at two important points along depression's clinical course.
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Affiliation(s)
- Jeremy G. Stewart
- Department of Psychology, Queen’s University, Kingston, Ontario, Canada
| | - Diego A. Pizzagalli
- Center for Depression, Anxiety and Stress Research, McLean Hospital, Belmont, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Randy P. Auerbach
- Department of Psychiatry, Columbia University, New York, NY, USA
- Division of Child and Adolescent Psychiatry, New York State Psychiatric Institute, New York, NY, USA
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Barzilai E, Miron N, D'Andrea W. Understanding Capacities for Interpersonal Distress Tolerance in Individuals with Suicide Ideation. Arch Suicide Res 2024; 28:994-1008. [PMID: 37812201 DOI: 10.1080/13811118.2023.2265433] [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] [Indexed: 10/10/2023]
Abstract
INTRO The relationship between suicide ideation (SI) and distress tolerance (DT) is characterized by inconclusive results. The current study aimed to test the association between tolerance for interpersonal distress and SI in light of the Interpersonal-Psychological Theory of Suicide. METHODS 194 participants ranging in SI severity were recruited via Amazon Mechanical Turk and completed a cognitive distress task (Distress Tolerance Task) and an interpersonal distress task (CyberBall) to assess (1) the association between SI severity and persistence with the tasks, and (2) self-reported psychological distress associated with the tasks. RESULTS A series of multilevel model analyses showed that increased SI predicted greater persistence with the interpersonal-distress task versus the cognitive distress task. In addition, higher SI predicted more distress during the interpersonal task. CONCLUSIONS Individuals with higher SI levels demonstrated a greater capability to persist with the interpersonal distress, despite feeling psychologically worse. These findings further support the central role of interpersonal needs in SI by emphasizing the importance of operationalizing DT in a manner that is relevant to suicide desire.
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Nobile B, Jaussent I, Kahn JP, Leboyer M, Risch N, Olié E, Courtet P. Risk factors of suicide re-attempt: A two-year prospective study. J Affect Disord 2024; 356:535-544. [PMID: 38657762 DOI: 10.1016/j.jad.2024.04.058] [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: 02/08/2024] [Revised: 04/09/2024] [Accepted: 04/14/2024] [Indexed: 04/26/2024]
Abstract
BACKGROUND History of suicide attempt (SA) is the strongest predictor of a new SA and suicide. It is primordial to identify additional risk factors of suicide re-attempt. The aim of this study was to identify risk factors of suicide re-attempt in patients with recent SA followed for 2 years. METHODS In this multicentric cohort of adult inpatients, the median of the index SA before inclusion was 10 days. Clinicians assessed a large panel of psychological dimensions using validated tools. Occurrence of a new SA or death by suicide during the follow-up was recorded. A cluster analysis was used to identify the dimensions that best characterized the population and a variable "number of personality traits" was created that included the three most representative traits: anxiety, anger, and anxious lability. Risk factors of re-attempt were assessed with adjusted Cox regression models. RESULTS Among the 379 patients included, 100 (26.4 %) re-attempted suicide and 6 (1.6 %) died by suicide. The two major risk factors of suicide re-attempt were no history of violent SA and presenting two or three personality traits among trait anxiety, anger and anxious lability. LIMITATIONS It was impossible to know if treatment change during follow-up occur before or after the re-attempt. DISCUSSION One of the most important predictors of re-attempt in suicide attempters with mood disorders, was the presence of three personality traits (anger, anxiety, and anxious lability). Clinicians should provide close monitoring to patients presenting these traits and proposed treatments specifically targeting these dimensions, especially anxiety.
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Affiliation(s)
- B Nobile
- Department of Emergency Psychiatry and Acute Care, CHU, Montpellier, France; IGF, Univ. Montpellier, CNRS, INSERM, Montpellier, France; FondaMental Foundation, France.
| | - I Jaussent
- Institute for Neurosciences of Montpellier INM, INSERM Montpellier, University of Montpellier, Montpellier, France
| | - J P Kahn
- Université de Lorraine, Nancy, France; Clinique Soins-Etudes de Vitry le François, Fondation Sant'e des Etudiants de France (FSEF), Paris, France
| | - M Leboyer
- FondaMental Foundation, France; Univ Paris Est Créteil, INSERM U955, IMRB, Translational NeuroPsychiatry Laboratory, Créteil, France; AP-HP, Hôpitaux Universitaires Henri Mondor, Département Médico-Universitaire de Psychiatrie et d'Addictologie (DMU IMPACT), Fédération Hospitalo-Universitaire de Médecine de Précision en Psychiatrie (FHU ADAPT), Créteil, France
| | - N Risch
- IGF, Univ. Montpellier, CNRS, INSERM, Montpellier, France
| | - E Olié
- Department of Emergency Psychiatry and Acute Care, CHU, Montpellier, France; IGF, Univ. Montpellier, CNRS, INSERM, Montpellier, France; FondaMental Foundation, France
| | - Ph Courtet
- Department of Emergency Psychiatry and Acute Care, CHU, Montpellier, France; IGF, Univ. Montpellier, CNRS, INSERM, Montpellier, France; FondaMental Foundation, France
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Villa J, Campbell DG, Parrish EM, Jeon ME, Robison M, Joiner T, Pinkham AE, Harvey PD, Depp CA. Associations between fearlessness about death and suicidal ideation in individuals with psychosis. Schizophr Res 2024; 269:96-102. [PMID: 38761436 DOI: 10.1016/j.schres.2024.05.006] [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: 09/22/2023] [Revised: 04/13/2024] [Accepted: 05/04/2024] [Indexed: 05/20/2024]
Abstract
BACKGROUND Despite high rates of suicide among people with psychosis, relatively little is known about the mechanisms underlying the transition from suicidal ideation to behavior in this population. The Interpersonal Psychological Theory of Suicide (IPTS) proposes that fearlessness about death (FAD) may play a role in this relationship. The present study tested whether constructs of the IPTS [thwarted belongingness (TB), perceived burdensomeness (PB), and FAD] were associated with the severity of suicidal ideation in a sample of adults with histories of psychosis. METHOD 261 adults with histories of psychosis completed measures of IPTS constructs, current severity of suicidal ideation, and history of suicidal attempts. We examined differences between those with past suicide attempts and those without and conducted regression analyses to evaluate the associations among TB, PB, FAD and severity of current suicidal ideation. RESULTS Contrary to expectations, a history of suicidal behavior was not uniquely associated with FAD. Regression analyses revealed TB × PB and FAD × PB interactions emerged as significant correlates of the severity of suicidal ideation, with the relationship between PB and suicidal ideation more pronounced at higher levels of FAD and TB. Interestingly, positive symptoms of psychosis were positively associated with PB. IMPLICATIONS This study provides support for broadening the investigation of FAD as a contributor to suicidal ideation in individuals with psychotic symptoms. Future research investigating the role of other contributors that may influence capability for suicide (e.g., impulsivity) may add additional understanding of suicide in this population.
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Affiliation(s)
- Jennifer Villa
- Department of Psychology, University of Montana, Missoula, MT, United States of America.
| | - Duncan G Campbell
- Department of Psychology, University of Montana, Missoula, MT, United States of America
| | - Emma M Parrish
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, United States of America
| | - Min Eun Jeon
- Department of Psychology, Florida State University, Tallahassee, FL, United States of America
| | - Morgan Robison
- Department of Psychology, Florida State University, Tallahassee, FL, United States of America
| | - Thomas Joiner
- Department of Psychology, Florida State University, Tallahassee, FL, United States of America
| | - Amy E Pinkham
- School of Behavioral and Brain Sciences, The University of Texas at Dallas, Richardson, TX, United States of America
| | - Philip D Harvey
- Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, FL, United States of America; Research Service, Bruce W. Carter VA Medical Center, Miami, FL, United States of America
| | - Colin A Depp
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, United States of America
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Smith AR, Forrest LN, Kinkel-Ram SS, Grunewald W, Tubman SD, Esche A, Levinson C. A longitudinal network analysis of suicide risk factors among service members and veterans sampled for suicidal ideation or attempt. Psychol Med 2024; 54:2623-2633. [PMID: 38651175 DOI: 10.1017/s0033291724000734] [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] [Indexed: 04/25/2024]
Abstract
BACKGROUND Suicidal thoughts and behaviors are elevated among active-duty service members (ADSM) and veterans compared to the general population. Hence, it is a priority to examine maintenance factors underlying suicidal ideation among ADSM and veterans to develop effective, targeted interventions. In particular, interpersonal risk factors, hopelessness, and overarousal have been robustly connected to suicidal ideation and intent. METHODS To identify the suicidal ideation risk factors that are most relevant, we employed network analysis to examine between-subjects (cross-sectional), contemporaneous (within seconds), and temporal (across four hours) group-level networks of suicidal ideation and related risk factors in a sample of ADSM and veterans (participant n = 92, observations n = 10 650). Participants completed ecological momentary assessment (EMA) surveys four times a day for 30 days, where they answered questions related to suicidal ideation, interpersonal risk factors, hopelessness, and overarousal. RESULTS The between-subjects and contemporaneous networks identified agitation, not feeling close to others, and ineffectiveness as the most central symptoms. The temporal network revealed that feeling ineffective was most likely to influence other symptoms in the network over time. CONCLUSION Our findings suggest that ineffectiveness, low belongingness, and agitation are important drivers of moment-to-moment and longitudinal relations between risk factors for suicidal ideation in ADSM and veterans. Targeting these symptoms may disrupt suicidal ideation.
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Affiliation(s)
- April R Smith
- Department of Psychological Sciences, Auburn University, Auburn, AL, USA
| | - Lauren N Forrest
- Department of Psychiatry and Behavioral Health, The Pennsylvania State University, College of Medicine, Hershey, PA, USA
| | | | - William Grunewald
- Department of Psychological Sciences, Auburn University, Auburn, AL, USA
| | - S David Tubman
- USAF School of Aerospace Medicine, Wright-Patterson AFB, OH, USA
| | - Aaron Esche
- Wright-Patterson Medical Center, Wright-Patterson Airforce Base, OH, USA
| | - Cheri Levinson
- Department of Psychological and Brain Sciences, University of Louisville, Louisville, KY, USA
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