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Weiss JR, Serdenes R, Madtha U, Zhao H, Kim V, Lopez-Pastrana J, Eakin MN, O'Toole J, Cooper CB, Woodruff P, Kanner RE, Krishnan JA, Iyer AS, Couper D, Morrison MF. Association Among Chronic Obstructive Pulmonary Disease Severity, Exacerbation Risk, and Anxiety and Depression Symptoms in the SPIROMICS Cohort. J Acad Consult Liaison Psychiatry 2023; 64:45-57. [PMID: 35948252 DOI: 10.1016/j.jaclp.2022.07.008] [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: 02/14/2022] [Revised: 07/22/2022] [Accepted: 07/29/2022] [Indexed: 01/23/2023]
Abstract
BACKGROUND Chronic obstructive pulmonary disease (COPD) is a common, progressive lung disease that often manifests with psychiatric symptoms. Despite this, patients with COPD are not routinely screened for anxiety and depression, which substantially contribute to COPD-related morbidity. OBJECTIVE To determine the relationship among COPD symptom severity, exacerbation risk, and clinically significant anxiety and depression symptoms in ever smokers with COPD. METHODS We used baseline data from the Subpopulations and Intermediate Outcome Measures In COPD Study (SPIROMICS) cohort to examine ever smokers with COPD across Global Initiative for Obstructive Lung Disease (GOLD) disease severity groups. Multivariable logistic regression models were used to calculate odds ratios for clinically significant anxiety and depression for each GOLD group, which was compared to the control group of ever smokers without COPD. Odds ratios were adjusted for subject demographics, medical comorbidities, and substance use covariates, and comparisons were completed using 2-tailed tests. RESULTS Of the 2664 subjects studied, 784 (29.4%) had clinically significant anxiety, and 497 (18.7%) had clinically significant depression. In the multivariable analysis, high pulmonary symptom groups, groups B and D, had increased adjusted odds of clinically significant anxiety (group B: adjusted odds ratios [AOR] 1.28, P = 0.03; group D: AOR 1.95, P < 0.0001) and depression (group B: AOR 2.09, P < 0.0001; group D: AOR 3.04, P < 0.0001). GOLD group D, the group with high pulmonary symptoms and high COPD exacerbation risk, had the greatest risk of both anxiety and depression among the GOLD groups. CONCLUSIONS High COPD symptom severity, even in the absence of elevated COPD exacerbation risk, is associated with clinically significant anxiety and depression. Our separate analyses of anxiety and depression symptoms in a large, multisite, national cohort are unique within the literature and have important treatment implications for COPD patients. Our findings also highlight the utility of screening patients with high COPD symptom severity for anxiety and depression.
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Affiliation(s)
- Jacob R Weiss
- Department of Psychiatry and Behavioral Science, Temple University Hospital, Philadelphia, PA.
| | - Ryan Serdenes
- Department of Psychiatry and Behavioral Science, Temple University Hospital, Philadelphia, PA
| | - Uchechukwu Madtha
- Department of Psychiatry and Behavioral Science, Hospital of the University of Pennsylvania, Philadelphia, PA
| | - Huaqing Zhao
- Department of Biomedical Education and Data Science, Lewis Katz School of Medicine, Philadelphia, PA
| | - Victor Kim
- Department of Thoracic Medicine and Surgery, Temple University Hospital, Philadelphia, PA
| | - Jahaira Lopez-Pastrana
- Department of Psychiatry and Human Behavior, Thomas Jefferson University Hospital, Philadelphia, PA
| | - Michelle N Eakin
- Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Jacqueline O'Toole
- Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Christopher B Cooper
- Departments of Medicine and Physiology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA
| | - Prescott Woodruff
- Division of Pulmonary, Critical Care and Sleep, University of California San Francisco, San Francisco, CA
| | - Richard E Kanner
- Division of Pulmonary and Critical Care, University of Utah School of Medicine, Salt Lake City, UT
| | - Jerry A Krishnan
- Division of Pulmonary, Critical Care, Sleep and Allergy, University of Illinois at Chicago, Chicago, IL
| | - Anand S Iyer
- Lung Health Center, Division of Pulmonary, Allergy and Critical Care Medicine, University of Alabama at Birmingham, Birmingham, AL
| | - David Couper
- Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Mary F Morrison
- Department of Psychiatry and Behavioral Science, Temple University Hospital, Philadelphia, PA
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2
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Seegulam VL, Szentkúti P, Rosellini AJ, Horváth-Puhó E, Jiang T, Lash TL, Sørensen HT, Gradus JL. Risk factors for suicide one year after discharge from hospitalization for physical illness in Denmark. Gen Hosp Psychiatry 2022; 79:76-117. [PMID: 36375345 DOI: 10.1016/j.genhosppsych.2022.09.004] [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: 07/01/2022] [Revised: 09/19/2022] [Accepted: 09/22/2022] [Indexed: 11/17/2022]
Abstract
While suicide risk following psychiatric hospitalization has been studied extensively, risk following hospitalization for physical illness is less well understood. We used random forests to examine risk factors for suicide in the year following physical illness hospitalization in Denmark. In this case-cohort study, suicide cases were all individuals who died by suicide within one year of a hospitalization for a physical illness (n = 4563) and the comparison subcohort was a 5% random sample of individuals living in Denmark on January 1, 1995 who had a hospitalization for a physical illness between January 1, 1995 and December 31, 2015 (n = 177,664). We used random forests to examine identify the most important predictors of suicide stratified by sex. For women, the top 10 most important variables for random forest prediction were all related to psychiatric diagnoses. For men, many physical health conditions also appeared important to suicide prediction. Among the top 10 variables in the variable importance plot for men were influenza, injuries to the head, nervous system surgeries, and cerebrovascular diseases. Suicide prediction after a physical illness hospitalization requires comprehensive consideration of different and multiple factors for each sex.
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Affiliation(s)
- Vijaya L Seegulam
- Department of Epidemiology, Boston University School of Public Health, Boston, USA
| | - Péter Szentkúti
- Department of Clinical Epidemiology, Aarhus University Hospital and Aarhus University, Aarhus, Denmark
| | - Anthony J Rosellini
- Center for Anxiety and Related Disorders, Department of Psychological and Brain Sciences, Boston University, USA
| | - Erzsébet Horváth-Puhó
- Department of Clinical Epidemiology, Aarhus University Hospital and Aarhus University, Aarhus, Denmark
| | - Tammy Jiang
- Department of Epidemiology, Boston University School of Public Health, Boston, USA
| | - Timothy L Lash
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Henrik T Sørensen
- Department of Epidemiology, Boston University School of Public Health, Boston, USA; Department of Clinical Epidemiology, Aarhus University Hospital and Aarhus University, Aarhus, Denmark
| | - Jaimie L Gradus
- Department of Epidemiology, Boston University School of Public Health, Boston, USA; Department of Clinical Epidemiology, Aarhus University Hospital and Aarhus University, Aarhus, Denmark; Department of Psychiatry, Boston University School of Medicine, Boston, USA.
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3
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Burtscher J, Niedermeier M, Hüfner K, van den Burg E, Kopp M, Stoop R, Burtscher M, Gatterer H, Millet GP. The interplay of hypoxic and mental stress: Implications for anxiety and depressive disorders. Neurosci Biobehav Rev 2022; 138:104718. [PMID: 35661753 DOI: 10.1016/j.neubiorev.2022.104718] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 05/26/2022] [Accepted: 05/27/2022] [Indexed: 12/14/2022]
Abstract
Adequate oxygen supply is essential for the human brain to meet its high energy demands. Therefore, elaborate molecular and systemic mechanism are in place to enable adaptation to low oxygen availability. Anxiety and depressive disorders are characterized by alterations in brain oxygen metabolism and of its components, such as mitochondria or hypoxia inducible factor (HIF)-pathways. Conversely, sensitivity and tolerance to hypoxia may depend on parameters of mental stress and the severity of anxiety and depressive disorders. Here we discuss relevant mechanisms of adaptations to hypoxia, as well as their involvement in mental stress and the etiopathogenesis of anxiety and depressive disorders. We suggest that mechanisms of adaptations to hypoxia (including metabolic responses, inflammation, and the activation of chemosensitive brain regions) modulate and are modulated by stress-related pathways and associated psychiatric diseases. While severe chronic hypoxia or dysfunctional hypoxia adaptations can contribute to the pathogenesis of anxiety and depressive disorders, harnessing controlled responses to hypoxia to increase cellular and psychological resilience emerges as a novel treatment strategy for these diseases.
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Affiliation(s)
- Johannes Burtscher
- Institute of Sport Sciences, University of Lausanne, Lausanne, Switzerland; Department of Biomedical Sciences, University of Lausanne, Lausanne, Switzerland.
| | - Martin Niedermeier
- Department of Sport Science, University of Innsbruck, Innsbruck, Austria
| | - Katharina Hüfner
- Department of Psychiatry, Psychotherapy, Psychosomatics and Medical Psychology, University Clinic for Psychiatry II, Innsbruck Medical University, Innsbruck, Austria
| | - Erwin van den Burg
- Department of Psychiatry, Center of Psychiatric Neuroscience (CNP), University Hospital of Lausanne (CHUV), Prilly, Lausanne, Switzerland
| | - Martin Kopp
- Department of Sport Science, University of Innsbruck, Innsbruck, Austria
| | - Ron Stoop
- Department of Psychiatry, Center of Psychiatric Neuroscience (CNP), University Hospital of Lausanne (CHUV), Prilly, Lausanne, Switzerland
| | - Martin Burtscher
- Department of Sport Science, University of Innsbruck, Innsbruck, Austria
| | - Hannes Gatterer
- Institute of Mountain Emergency Medicine, Eurac Research, Bolzano, Italy
| | - Grégoire P Millet
- Institute of Sport Sciences, University of Lausanne, Lausanne, Switzerland; Department of Biomedical Sciences, University of Lausanne, Lausanne, Switzerland
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Roncero C, Pérez J, Molina J, Quintano JA, Campuzano AI, Pérez J, Miravitlles M. Frequency and Associated Factors of Suicidal Ideation in Patients with Chronic Obstructive Pulmonary Disease. J Clin Med 2022; 11:2558. [PMID: 35566685 PMCID: PMC9101437 DOI: 10.3390/jcm11092558] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Revised: 04/25/2022] [Accepted: 04/28/2022] [Indexed: 02/04/2023] Open
Abstract
We aimed to examine the prevalence of suicidal ideation in patients with chronic obstructive pulmonary disease (COPD) and the association between demographic and clinical variables and the occurrence of suicidal thoughts. This was a cross-sectional study. Sociodemographic and clinical data were recorded, and questionnaires were used to assess depressive symptoms (Beck Depression Inventory), comorbidities (Charlson Index), cognitive performance (Mini Mental State Examination), and quality of life (EuroQoL-5 dimensions and CAT). Specific questions about suicide-related behavior were included. Multivariate logistic regression analysis identified the significant factors associated with previous suicidal ideation and suicide attempts. The analysis included 1190 subjects. The prevalence of suicidal ideation and suicide attempts were 12.1% and 2.5%, respectively. Severely depressed patients had the highest prevalence of suicide-related behavior. The adjusted logistic model identified factors significantly associated with suicidal ideation: sex (odds ratio (OR) for women vs. men = 2.722 (95% confidence interval (CI) = 1.771-4.183)), depression score (OR = 1.163 (95% IC = 1.127-1.200)), and Charlson Index (OR 1.228 (95% IC 1.082-1.394)). Suicidal ideation is common in COPD patients, especially in women. While addressing suicidal ideation and suicide prevention, clinicians should first consider the management of depressive symptomatology and the improvement of coping strategies.
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Affiliation(s)
- Carlos Roncero
- Psychiatric Service, University of Salamanca Health Care Complex, 37007 Salamanca, Spain;
- Institute of Biomedicine of Salamanca (IBSAL), University of Salamanca, 37007 Salamanca, Spain
| | - Joselín Pérez
- Medical Department, Grupo Ferrer, 08029 Barcelona, Spain; (J.P.); (A.I.C.)
| | - Jesús Molina
- Centro de Salud Francia, Dirección Asistencial Oeste, 28993 Madrid, Spain;
| | | | | | - Javier Pérez
- Psychiatric Service, University of Salamanca Health Care Complex, 37007 Salamanca, Spain;
- Institute of Biomedicine of Salamanca (IBSAL), University of Salamanca, 37007 Salamanca, Spain
| | - Marc Miravitlles
- Department of Pneumology, Vall d’Hebron Institut de Recerca (VHIR), Hospital Universitari Vall d’Hebron, Vall d’Hebron Barcelona Hospital Campus, 08035 Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), 28029 Madrid, Spain
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Alias A, Bertrand L, Bisson-Gervais V, Henry M. Suicide in obstructive lung, cardiovascular and oncological disease. Prev Med 2021; 152:106543. [PMID: 34538370 DOI: 10.1016/j.ypmed.2021.106543] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 03/28/2021] [Accepted: 03/30/2021] [Indexed: 01/04/2023]
Abstract
Healthcare institutions face increasing demands stemming from the burden of noncommunicable diseases. The personal, social, financial and societal impact of these diseases are well-documented. However, the mental health concerns and trajectories of patients afflicted by chronic medical diseases have been under-recognized and are under-resourced. Despite that chronic diseases are associated with substantially increased risk of suicide, the medical world has largely failed to properly address suicide in the medically ill. Considering their high prevalence and mortality rate, this review article will highlight the mental health burden and suicide risk in obstructive lung, cardiovascular (including stroke) and oncological disease, in light of relevant data and conceptual models of suicide. Finally, general evidence-based suicide intervention strategies and potential selective adaptation of these strategies to the chronic medically ill patient populations and medical settings will be reviewed.
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Affiliation(s)
- Ali Alias
- Faculty of Medicine and Health Sciences, McGill University, 3605 de la Montagne, Montreal, QC H3G 2M1, Canada
| | - Lia Bertrand
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, St Joseph's Healthcare Hamilton, West 5(th) Campus, 100 West 5(th) Street, Hamilton, ON L8N 3K7, Canada.
| | - Vanessa Bisson-Gervais
- Faculty of Medicine and Health Sciences, McGill University, 3605 de la Montagne, Montreal, QC H3G 2M1, Canada
| | - Melissa Henry
- Gerald Bronfman Department of Oncology, Faculty of Medicine and Health Sciences, McGill University, 5100 de Maisonneuve Blvd. West, Suite 720, Montreal, QC H4A 3T2, Canada; Segal Cancer Centre, Jewish General Hospital, 3755 Chemin de la Cote-Sainte-Catherine, Montreal, QC H3T 1E2, Canada; Lady-Davis Institute for Medical Research, Jewish General Hospital, 3755 Chemin de la Cote-Sainte-Catherine, Montreal, QC H3T 1E2, Canada
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6
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Sex-based changes in rat brain serotonin and behavior in a model of altitude-related vulnerability to treatment-resistant depression. Psychopharmacology (Berl) 2021; 238:2867-2881. [PMID: 34159421 DOI: 10.1007/s00213-021-05902-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Accepted: 06/08/2021] [Indexed: 01/03/2023]
Abstract
RATIONALE Rates of depression and suicide increase with altitude. In our animal model, rats housed at moderate altitude vs. at sea level exhibit increased depressive symptoms in the forced swim test (FST) and lack of response to selective serotonin reuptake inhibitors (SSRIs). Depression and SSRI resistance are linked to disrupted serotonergic function, and hypobaric hypoxia may reduce the oxygen-dependent synthesis of serotonin. We therefore tested brain serotonin in rats housed at altitude. METHODS Sprague-Dawley rats were housed at altitude (4,500 ft, 10,000 ft) vs. sea level for 7-36 days. Brain serotonin was measured by ELISA, or behavior evaluated in the FST, sucrose preference (SPT), or open-field tests (OFT). RESULTS After 2 weeks at 4,500 ft or 10,000ft vs. sea level, serotonin levels decreased significantly at altitude in the female prefrontal cortex, striatum, hippocampus, and brainstem, but increased with altitude in the male hippocampus and brainstem. Female brain serotonin decreased from 7 to 36 days at 4,500 ft, but males did not vary. At 2 weeks and 24 days, females at altitude exhibit lower brain serotonin and increased depressive symptoms in the FST and SPT, with motor behavior unaltered. In males, serotonin, passive coping in the FST and OFT immobility increased with altitude at 2 weeks, but not at 24 days. Male SPT behavior did not change with altitude. CONCLUSIONS Females may be more vulnerable to depressive symptoms at altitude, while males may be resilient. Chronic hypoxic stress at altitudes as low as 4,500 ft may cause a brain serotonin imbalance to worsen vulnerability to depression and SSRI resistance, and potentially worsen suicide risk.
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7
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Kanekar S, Ettaro R, Hoffman MD, Ombach HJ, Brown J, Lynch C, Sheth CS, Renshaw PF. Sex-Based Impact of Creatine Supplementation on Depressive Symptoms, Brain Serotonin and SSRI Efficacy in an Animal Model of Treatment-Resistant Depression. Int J Mol Sci 2021; 22:ijms22158195. [PMID: 34360959 PMCID: PMC8348220 DOI: 10.3390/ijms22158195] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 07/25/2021] [Accepted: 07/27/2021] [Indexed: 02/05/2023] Open
Abstract
Background: Rates of major depressive disorder (MDD) increase with living at altitude. In our model, rats housed at moderate altitude (in hypobaric hypoxia) exhibit increased depression-like behavior, altered brain serotonin and a lack of antidepressant response to most selective serotonin reuptake inhibitors (SSRIs). A forebrain deficit in the bioenergetic marker creatine is noted in people living at altitude or with MDD. Methods: Rats housed at 4500 ft were given dietary creatine monohydrate (CRMH, 4% w/w, 5 weeks) vs. un-supplemented diet, and impact on depression-like behavior, brain bioenergetics, serotonin and SSRI efficacy assessed. Results: CRMH significantly improved brain creatine in a sex-based manner. At altitude, CRMH increased serotonin levels in the female prefrontal cortex and striatum but reduced male striatal and hippocampal serotonin. Dietary CRMH was antidepressant in the forced swim test and anti-anhedonic in the sucrose preference test in only females at altitude, with motor behavior unchanged. CRMH improved fluoxetine efficacy (20 mg/kg) in only males at altitude: CRMH + SSRI significantly improved male striatal creatine and serotonin vs. CRMH alone. Conclusions: Dietary CRMH exhibits sex-based efficacy in resolving altitude-related deficits in brain biomarkers, depression-like behavior and SSRI efficacy, and may be effective clinically for SSRI-resistant depression at altitude. This is the first study to link CRMH treatment to improving brain serotonin.
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Affiliation(s)
- Shami Kanekar
- Diagnostic Neuroimaging, Department of Psychiatry, University of Utah, Salt Lake City, UT 84108, USA; (R.E.); (M.D.H.); (H.J.O.); (J.B.); (C.L.); (C.S.S.); (P.F.R.)
- VISN19 MIRECC, 500 Foothill Drive, Salt Lake City, UT 84148, USA
- Veterans Affairs Salt Lake City Health Care System, 500 Foothill Drive, Salt Lake City, UT 84148, USA
- Correspondence: ; Tel.: +1-801-587-1477 or +1-801-585-5375
| | - Robert Ettaro
- Diagnostic Neuroimaging, Department of Psychiatry, University of Utah, Salt Lake City, UT 84108, USA; (R.E.); (M.D.H.); (H.J.O.); (J.B.); (C.L.); (C.S.S.); (P.F.R.)
| | - Michael D. Hoffman
- Diagnostic Neuroimaging, Department of Psychiatry, University of Utah, Salt Lake City, UT 84108, USA; (R.E.); (M.D.H.); (H.J.O.); (J.B.); (C.L.); (C.S.S.); (P.F.R.)
| | - Hendrik J. Ombach
- Diagnostic Neuroimaging, Department of Psychiatry, University of Utah, Salt Lake City, UT 84108, USA; (R.E.); (M.D.H.); (H.J.O.); (J.B.); (C.L.); (C.S.S.); (P.F.R.)
| | - Jadeda Brown
- Diagnostic Neuroimaging, Department of Psychiatry, University of Utah, Salt Lake City, UT 84108, USA; (R.E.); (M.D.H.); (H.J.O.); (J.B.); (C.L.); (C.S.S.); (P.F.R.)
| | - Cayla Lynch
- Diagnostic Neuroimaging, Department of Psychiatry, University of Utah, Salt Lake City, UT 84108, USA; (R.E.); (M.D.H.); (H.J.O.); (J.B.); (C.L.); (C.S.S.); (P.F.R.)
| | - Chandni S. Sheth
- Diagnostic Neuroimaging, Department of Psychiatry, University of Utah, Salt Lake City, UT 84108, USA; (R.E.); (M.D.H.); (H.J.O.); (J.B.); (C.L.); (C.S.S.); (P.F.R.)
| | - Perry F. Renshaw
- Diagnostic Neuroimaging, Department of Psychiatry, University of Utah, Salt Lake City, UT 84108, USA; (R.E.); (M.D.H.); (H.J.O.); (J.B.); (C.L.); (C.S.S.); (P.F.R.)
- VISN19 MIRECC, 500 Foothill Drive, Salt Lake City, UT 84148, USA
- Veterans Affairs Salt Lake City Health Care System, 500 Foothill Drive, Salt Lake City, UT 84148, USA
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Zareifopoulos N, Bellou A, Spiropoulou A, Spiropoulos K. Prevalence, Contribution to Disease Burden and Management of Comorbid Depression and Anxiety in Chronic Obstructive Pulmonary Disease: A Narrative Review. COPD 2019; 16:406-417. [DOI: 10.1080/15412555.2019.1679102] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Affiliation(s)
- Nicholas Zareifopoulos
- Department of Pulmonology, University of Patras School of Health Science, Patras, Achaea, Greece
| | - Aggeliki Bellou
- Department of Pulmonology, University of Patras School of Health Science, Patras, Achaea, Greece
| | - Agathi Spiropoulou
- Department of Pulmonology, University of Patras School of Health Science, Patras, Achaea, Greece
| | - Kostas Spiropoulos
- Department of Pulmonology, University of Patras School of Health Science, Patras, Achaea, Greece
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Ju YJ, Kim W, Oh SS, Park EC. Solitary drinking and the risk of depressive symptoms and suicidal ideation in college students: Findings from a nationwide survey in Korea. J Affect Disord 2019; 257:710-715. [PMID: 31382123 DOI: 10.1016/j.jad.2019.07.080] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Revised: 07/17/2019] [Accepted: 07/29/2019] [Indexed: 01/14/2023]
Abstract
BACKGROUND Despite the fact that solitary drinking is becoming more common in Korea, few studies have investigated the association between drinking alone and mental health. This study aimed to investigate the relationship between solitary drinking, depressive symptoms, and suicidal ideation in Korean college students. METHOD Primary data on a nationally representative sample of college students were used. Data were collected by Yonsei University and the Korean Center for Disease Control in 2017 to investigate alcohol-related behaviors and health consequences in students. The association between solitary drinking, depressive symptoms, and suicidal ideation were measured using multivariate logistic regression analysis. RESULTS A total of 3,935 students were analyzed, in which 11.5% had depressive symptoms and 2.8% suicidal ideation. Compared to non-solitary drinkers, solitary drinkers were more likely to have depressive symptoms [Odds Ratio (OR) 2.28, 95% Confidence Interval (95% CI) 1.72-3.02] and suicidal ideation (OR 2.24, 95% CI 1.32-3.81). Moreover, larger differences were found in individuals with higher alcohol use disorders identification test (AUDIT) scores and with more frequent underage drinking experience. LIMITATIONS As this study was cross-sectional in design, causal inferences cannot be made on the association between solitary drinking, depressive symptoms, and suicidal ideation. CONCLUSION Solitary drinking is associated with higher likelihoods of depressive symptoms and suicidal ideation in college students. The results suggest the importance of monitoring solitary drinkers as they may be more vulnerable to the negative mental health effects of alcohol.
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Affiliation(s)
- Yeong Jun Ju
- Department of Preventive Medicine and Public Health, Ajou University School of Medicine, Suwon, Republic of Korea; Institute of Health Services Research, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Woorim Kim
- Department of Preventive Medicine, Korea University College of Medicine, Seoul, Republic of Korea; Institute of Health Services Research, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Sarah Soyeon Oh
- Institute of Health Services Research, Yonsei University College of Medicine, Seoul, Republic of Korea; Department of Public Health, Graduate School, Yonsei University, Seoul, Republic of Korea
| | - Eun-Cheol Park
- Institute of Health Services Research, Yonsei University College of Medicine, Seoul, Republic of Korea; Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.
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10
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Wong WHS, Kuo WH, Sobolewski C, Bhatia I, Ip P. The Association Between Child Abuse and Attempted Suicide. CRISIS 2019; 41:196-204. [PMID: 31512939 PMCID: PMC8208292 DOI: 10.1027/0227-5910/a000625] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Abstract.Background: Child abuse and suicide among the young population
is a serious and prevalent problem. Many studies have demonstrated that people with adverse
childhood experiences, such as child abuse, are likely to develop suicidal behavior. This
study evaluates the connection between child abuse and suicidal behavior in the Hong Kong
community where incidents of child abuse have been on the rise over the past decade. Aims:
To determine the association between child abuse and attempted suicide in the child
population of Hong Kong using hospital electronic medical records system. Method: From
January 1, 1995 to July 31, 2016, patients with admission age < 18 years with the
diagnosis of child abuse or influenza infection (comparison group) were included in this
study (n = 54,256). In secondary data analysis, an association was found between children
who had experienced child abuse and the outcome measure of hospital admission for attempted
suicide compared with influenza infection. Results: The adjusted hazard ratio of attempting
suicide in children who experienced sexual abuse and physical abuse compared with the
influenza-infected group was 6.48 (95% CI [4.56, 9.19]) and 4.83 (95% CI [3.67, 6.34]). The
age at onset of adverse incidents was negatively associated with the attempted suicide
timing. Female patients had a 1.64 higher risk of repeating attempted suicide. In addition,
nearly 5% of children who had experienced child abuse attempted suicide in the 10 years
after their admission, and more than 36% of patients had a record of repeated suicide
attempt in the 20 years after the initial admission. Limitations: The accuracy of the
diagnosis, selection bias, insufficiency of study period, Berkson's bias, incomplete
socioeconomic status, as well as the absence of psychiatric diagnosis are the limitations.
Conclusion: Our results indicate that there is a significant association between child abuse
and suicide attempts in Hong Kong. If confirmed, the study (a) demonstrates that hospital
admission records are a critical source for identifying children with a high risk for
suicidal behavior; (b) may inform policy makers that additional and long-term intervention
programs should be provided to children so as to reduce subsequent suicide attempts.
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Affiliation(s)
- Wilfred Hing-Sang Wong
- Department of Pediatrics and Adolescent Medicine, The University of Hong Kong, Pokfulam, Hong Kong SAR, PR China.,Department of Public Health Science, Walden University, Minneapolis, MN, USA
| | - Wen-Hung Kuo
- Department of Public Health Science, Walden University, Minneapolis, MN, USA
| | - Curt Sobolewski
- Department of Public Health Science, Walden University, Minneapolis, MN, USA
| | - Inderjeet Bhatia
- Department of Surgery, The University of Hong Kong, Pokfulam, Hong Kong SAR, PR China
| | - Patrick Ip
- Department of Pediatrics and Adolescent Medicine, The University of Hong Kong, Pokfulam, Hong Kong SAR, PR China
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Joo SH, Wang SM, Jeong JE, Hahn CT, Kim TS. Impact of Age at Childbirth on Maternal Mental Health among Premenopausal Women: The 2010-2012 Korean National Health and Nutrition Examination Survey. Psychiatry Investig 2019; 16:679-685. [PMID: 31429221 PMCID: PMC6761791 DOI: 10.30773/pi.2019.07.09] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Accepted: 07/09/2019] [Indexed: 01/25/2023] Open
Abstract
OBJECTIVE No reports have investigated the influence of age at first or last childbirth on maternal mental health. The aim of this study was to determine whether there is an association between age at first or last childbirth and the mental health of premenopausal women. METHODS The data used in this study were collected from the 2010 to 2012 Korea National Health and Nutrition Examination Surveys. A total of 3,370 premenopausal women were considered. The association between childbirth age and maternal mental health factors, including stress, depressed mood, and suicidal ideations were analyzed using multiple logistic regression analyses adjusted for confounding factors. RESULTS After adjusting confounding factors, younger maternal age at first childbirth was found to be associated with an increase in the prevalence of maternal depressed mood and suicidal ideations. Also, older maternal age at last childbirth was related to an increase in maternal stress, depressed mood and suicidal ideations. CONCLUSION Both younger first childbirth and older last childbirth maternal age may be risk factors for poor outcomes of premenopausal women's mental health. These data support the need for comprehensive mental health assessment for premenopausal women who either gave birth at an age too young or too old.
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Affiliation(s)
- Soo Hyun Joo
- Department of Psychiatry, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Sheng-Min Wang
- Department of Psychiatry, Catholic Center for Brain Health, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Jo-Eun Jeong
- Department of Psychiatry, Daejeon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Daejeon, Republic of Korea
| | - Chang Tae Hahn
- Department of Psychiatry, Daejeon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Daejeon, Republic of Korea
| | - Tae-Suk Kim
- Department of Psychiatry, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
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Sampaio MS, Vieira WDA, Bernardino ÍDM, Herval ÁM, Flores-Mir C, Paranhos LR. Chronic obstructive pulmonary disease as a risk factor for suicide: A systematic review and meta-analysis. Respir Med 2019; 151:11-18. [PMID: 31047105 DOI: 10.1016/j.rmed.2019.03.018] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Revised: 03/07/2019] [Accepted: 03/27/2019] [Indexed: 10/27/2022]
Abstract
BACKGROUND Patients living with chronic obstructive pulmonary disease (COPD) commonly present several limitations in their daily activities, high depression rates, and low quality of life, which makes this population a risk group for suicide. This study aims to systematically assess the literature on the association between CPOD and the likelihood of suicide. METHODS The protocol was registered in PROSPERO (CRD42018096618). The Latin-American and Caribbean Health Sciences Literature (LILACS), PubMed, SciELO, Scopus, LIVIVO, Web of Science, and PsychNET databases were used as primary study sources. OpenThesis and OpenGrey were used to partially capture the "grey literature". A manual search was also performed through a systematized analysis of the references of eligible articles. The risk of bias among the studies included was assessed with the Joanna Briggs Institute Critical Appraisal Tools for Systematic Reviews. A random effects meta-analysis was performed to estimate the variation in odds ratio (OR) and 95% confidence intervals (95% CI). RESULTS The search provided 4762 results, from which only seven met the eligibility criteria and were ultimately included in the qualitative assessment of the review. The studies were published from 2002 to 2015. All studies presented low risk of bias. The total sample included 1390 suicide cases of COPD patients. The meta-analysis, which was based on five eligible case control studies, found that people with history of COPD are more likely to commit suicide (OR = 1.90; 95% CI = 1.27-2.48; p = 0.002). CONCLUSION COPD patients are 1.9 times more likely to commit suicide than people without COPD.
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Affiliation(s)
- Marcelo S Sampaio
- Department of Social Dentistry, School of Dentistry, State University of Campinas, Piracicaba, São Paulo, Brazil
| | - Walbert de A Vieira
- Department of Restorative Dentistry, Endodontics Division, School of Dentistry of Piracicaba, State University of Campinas, UNICAMP, Piracicaba, Brazil
| | - Ítalo de M Bernardino
- Department of Dentistry, State University of Paraíba, Campina Grande, Paraíba, Brazil
| | - Álex Moreira Herval
- Department of Preventive and Community Dentistry, School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Carlos Flores-Mir
- Department of Orthodontics, School of Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Luiz R Paranhos
- Department of Preventive and Community Dentistry, School of Dentistry, Federal University of Uberlândia, Uberlândia, Minas Gerais, Brazil.
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Suicidal Ideation, Attempt, and Associated Factors among Patients with Tuberculosis in Ethiopia: A Cross-Sectional Study. PSYCHIATRY JOURNAL 2019; 2019:4149806. [PMID: 31001549 PMCID: PMC6436369 DOI: 10.1155/2019/4149806] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Revised: 12/21/2018] [Accepted: 01/13/2019] [Indexed: 02/07/2023]
Abstract
Background Suicidal behaviors among people with tuberculosis are one of the commonest psychiatric emergencies that need a major public health concern. People with tuberculosis show suicidal ideation and attempt, which are problems to end life. In Ethiopia large numbers of people are affected by tuberculosis. Therefore, assessing suicide among patients with tuberculosis is important in implementing further interventions. Methods An institutional based cross-sectional study was conducted among systematic random samples of 415 and face-to-face interview was used. Suicidal ideation and attempt were assessed by using suicidality module World Health Organization (WHO) composite International diagnostic interview (CIDI). Data was analyzed by using SPSS version 20. Bivariate and multivariate binary logistic analyses were done to identify associated factors to both suicidal ideation and attempt. P values less than 0.05 were considered statistically significant and strength of the association was presented by adjusted odds ratio with 95% C.I. Results The prevalence of suicidal ideation and attempt among tuberculosis patients was 17.3% (95%CI, 13.7-20.6) and 7.5 %( 95%CI, 4.8-10.4), respectively. Being female (AOR=2.7, 95% CI 1.39, 5.23), no formal education (AOR=3.35, 95%CI 1.26, 9.91), extra-pulmonary tuberculosis (AOR=2.35, 95%CI 1.1, 4.98), depression (AOR=4.9, 95%CI, 2.56, 9.4), and perceived TB stigma (AOR=3.24, 95%CI, 1.64, 6.45) were statistically associated with suicidal ideation. Factors like being female (AOR=4.57, 95%CI, 1.7, 12.27), MDR-TB (AOR=3.06, 95%CI, 1.23, 7.57), comorbid HIV illness (AOR=6.67, 95%CI, 2.24, 19.94), and depression (AOR=4.75, 95%CI, 1.89, 11.91) were associated with suicidal attempt. Conclusion Developing guidelines and training of health workers in TB clinics is important to screen and treat suicide among patients with tuberculosis.
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Hypoxia-related risk factors for death by suicide in a national clinical sample. Psychiatry Res 2019; 273:247-251. [PMID: 30658209 PMCID: PMC8801295 DOI: 10.1016/j.psychres.2019.01.040] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Revised: 12/11/2018] [Accepted: 01/11/2019] [Indexed: 01/09/2023]
Abstract
The relationship between three markers of chronic hypoxia (altitude, smoking and chronic obstructive pulmonary disease (COPD)) and suicide risk has not been well-studied. We conducted a population-based cohort study evaluating the association between chronic hypoxia and suicide risk. Patients entered the cohort in their first year with a documented healthcare encounter and remained in the cohort until their death or the end of the study period. Generalized estimating equation (GEE) methodology was used to assess the association between suicide and three risk markers of chronic hypoxia. Findings were summarized using odds ratio (OR) and 95% confidence intervals (CI). Among the 9,620,944 patients in the cohort, there were 22,403 suicide deaths. There was a statistically significant progression of suicide risk as altitude rose in increments of 1000 m (OR: 1.22). There was a strong association between the number of hypoxic conditions and the odds of suicide. Patients with three markers of chronic hypoxia was nearly four times more likely to die by suicide than patients with no markers (OR: 3.96). Chronic hypoxia is a risk factor for suicide and having multiple indicators of hypoxia confers a greater risk for suicide, indicating a dose-response relationship.
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15
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Bedolla-Barajas M, Pulido-Guillén NA, Vivar-Aburto B, Morales-Romero J, Ortiz-Peregrina JR, Robles-Figueroa M. Is suicidal ideation associated with allergic asthma and allergic rhinitis? ACTA ACUST UNITED AC 2019. [PMID: 29538540 PMCID: PMC6130331 DOI: 10.1590/s1806-37562017000000129] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Objective: To investigate whether there is an association between suicidal ideation (SI) and allergic diseases in adults. Methods: This was a comparative cross-sectional study involving individuals ranging from 20 to 50 years of age recruited from a university hospital in the city of Guadalajara, Mexico. We included patients with a confirmed diagnosis of allergic asthma, those with a confirmed diagnosis of allergic rhinitis, and healthy controls. All subjects completed the Beck Depression Inventory-II (BDI-II), which includes an item that evaluates the presence of suicidal thoughts or desires within the last two weeks, in order to identify SI. Results: The sample comprised 115 patients with allergic asthma, 111 patients with allergic rhinitis, and 96 healthy controls. The number of individuals identified with SI in the three groups were, respectively, 17 (14.8%), 13 (11.7%), and 8 (8.3%). Regarding the presence of SI, no statistically significant association was found in the allergic asthma group (OR = 1.98; 95% CI: 0.78-4.64; p = 0.154) or in the allergic rhinitis group (OR = 1.46; 95% CI: 0.58-3.68; p = 0.424) when they were compared with the control group. However, the presence of depression was associated with SI in the three groups: allergic asthma (OR = 12.36; 95% CI: 2.67-57.15; p = 0.001); allergic rhinitis (OR = 6.20; 95% CI: 1.66-23.14; p = 0.006); and control (OR = 21.0; 95% CI: 3.75-117.36; p < 0,001). Conclusions: In comparison with the control group, no association was found between SI and the groups with allergic diseases. In contrast, there was association between SI and depression in the three groups.
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Affiliation(s)
- Martín Bedolla-Barajas
- . Servicio de Alergia e Inmunología Clínica, Hospital Civil de Guadalajara "Dr. Juan I. Menchaca", Guadalajara, México
| | | | - Bolívar Vivar-Aburto
- . Servicio de Medicina Interna, Hospital Civil de Guadalajara "Dr. Juan I. Menchaca", Guadalajara, México
| | | | - José Raúl Ortiz-Peregrina
- . Departamento de Inhaloterapia, Neumología y Alergia, Hospital Civil de Guadalajara "Dr. Juan I. Menchaca", Guadalajara, México
| | - Martín Robles-Figueroa
- . Servicio de Medicina Interna, Hospital Civil de Guadalajara "Dr. Juan I. Menchaca", Guadalajara, México
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Abstract
BACKGROUND Suicidal ideation (SI) is understudied in inflammatory bowel diseases (IBD). We aim to determine SI rates among IBD outpatients and to evaluate predictors of SI. MATERIALS AND METHODS This is a prospective observational study of consecutive adult IBD outpatients over 18 months. Patients were screened for depression and SI using patient health questionnaire (PHQ-9). Demographic data were obtained from electronic medical record. Regression modeling was used for predictor analyses. RESULTS In total, 71 of consecutive 1352 IBD outpatients had SI. Significant correlations between SI and depression severity, tricyclic antidepressants (TCA), IBD-related quality of life, and low vitamin D levels were seen. Univariate regression showed that depression severity, TCA use, and quality of life predicted SI. Multivariate regression showed depression severity (β=0.46; P=0.002) and TCA use (β=0.31; P=0.012) made unique contributions. CONCLUSIONS SI is associated with depressive severity and less directly with IBD activity. Low-dose TCA, often used for chronic abdominal pain, is also a risk factor. Identifying the subset of IBD patients most vulnerable to SI can facilitate proper referrals to behavioral services and prevent progression to completed suicides.
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Kanekar S, Sheth CS, Ombach HJ, Olson PR, Bogdanova OV, Petersen M, Renshaw CE, Sung YH, D'Anci KE, Renshaw PF. Hypobaric hypoxia exposure in rats differentially alters antidepressant efficacy of the selective serotonin reuptake inhibitors fluoxetine, paroxetine, escitalopram and sertraline. Pharmacol Biochem Behav 2018; 170:25-35. [PMID: 29738811 DOI: 10.1016/j.pbb.2018.05.002] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2017] [Revised: 05/01/2018] [Accepted: 05/03/2018] [Indexed: 01/19/2023]
Abstract
Treatment-resistant depression, a chronic condition that affects 30% of depressed patients on antidepressants, is highly linked to suicidal behavior. Chronic hypoxia exposure via living at altitude (hypobaric hypoxia) or with chronic hypoxic diseases is demographically linked to increased risk for depression and suicide. We previously demonstrated that housing rats at altitude for a week incrementally increases depression-like behavior in the forced swim test (FST) in females, but not males. In animal models, high altitude exposure reduces brain serotonin, and selective serotonin reuptake inhibitors (SSRIs) can lose efficacy when brain serotonin levels are low. To address whether residence at moderate altitude is detrimental to SSRI function, we examined SSRI efficacy in the FST after a week of housing rats at altitudes of 4500 ft. or 10,000 ft. as compared to at sea level. In females, the tricyclic antidepressant desipramine (positive control) functioned well in all groups, increasing latency to immobility and decreasing immobility, by increasing climbing. However, the SSRIs fluoxetine, paroxetine and escitalopram were ineffective in females in all groups: only paroxetine improved swimming in the FST as expected of a SSRI, while all three unexpectedly reduced climbing. Fluoxetine was also ineffective in male rats. Sertraline was the only SSRI with antidepressant efficacy at altitude in both females and males, increasing swimming, climbing and latency to immobility, and reducing immobility. Hypobaric hypoxia thus appears to be detrimental to efficacy of the SSRIs fluoxetine, paroxetine and escitalopram, but not of sertraline. Unlike the other SSRIs, sertraline can improve both serotonergic and dopaminergic transmission, and may be less impacted by a hypoxia-induced serotonin deficit. A targeted approach may thus be necessary for successful antidepressant treatment in patients with depression who live at altitude or with chronic hypoxic diseases, and that sertraline may be the SSRI of choice for prescription for this population.
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Affiliation(s)
- Shami Kanekar
- Diagnostic Neuroimaging, Department of Psychiatry, University of Utah, Salt Lake City, UT, United States; VISN19 MIRECC, 500 Foothill Drive, Salt Lake City, UT 84148, United States; The Brain Institute, University of Utah, 383 Colorow Drive, Salt Lake City, UT 84108, United States.
| | - Chandni S Sheth
- Diagnostic Neuroimaging, Department of Psychiatry, University of Utah, Salt Lake City, UT, United States
| | - Hendrik J Ombach
- Diagnostic Neuroimaging, Department of Psychiatry, University of Utah, Salt Lake City, UT, United States
| | - Paul R Olson
- The Brain Institute, University of Utah, 383 Colorow Drive, Salt Lake City, UT 84108, United States
| | - Olena V Bogdanova
- The Brain Institute, University of Utah, 383 Colorow Drive, Salt Lake City, UT 84108, United States
| | - Matthew Petersen
- Diagnostic Neuroimaging, Department of Psychiatry, University of Utah, Salt Lake City, UT, United States
| | - Chloe E Renshaw
- Diagnostic Neuroimaging, Department of Psychiatry, University of Utah, Salt Lake City, UT, United States
| | - Young-Hoon Sung
- Diagnostic Neuroimaging, Department of Psychiatry, University of Utah, Salt Lake City, UT, United States
| | | | - Perry F Renshaw
- Diagnostic Neuroimaging, Department of Psychiatry, University of Utah, Salt Lake City, UT, United States; VISN19 MIRECC, 500 Foothill Drive, Salt Lake City, UT 84148, United States; The Brain Institute, University of Utah, 383 Colorow Drive, Salt Lake City, UT 84108, United States; Veterans Affairs Salt Lake City Health Care System, 500 Foothill Drive, Salt Lake City, UT 84148, United States
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Seo MS, Hwang IC, Shim JY, Ahn HY, Kim S. The relationship between pulmonary function and suicidal ideation in Korean adults: a nationwide survey. PSYCHOL HEALTH MED 2018; 23:1037-1045. [PMID: 29678118 DOI: 10.1080/13548506.2018.1467020] [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: 10/17/2022]
Abstract
Controversy surrounds the association between lung function and mental health in the general population, and previous reported results were confounded by the effect of other chronic illnesses. This study aimed to investigate whether reduced lung function was related to mental health issues, taking into consideration the relevant potential confounders. We used data from the 2008-2013 Korean National Health and Nutrition Examination Survey to examine the relationship between lung function and three mental issues (recognized stress, depressive mood, and suicidal ideation) among 22,068 Korean adults. A multiple logistic regression with adjustment for potential covariates including chronic illnesses revealed that a .5-L decrement of forced vital capacity increased the risk for suicidal ideation in both genders, but there was no significant association with recognized stress or depressive mood. We found an inverse relationship between lung function and suicidal ideation in the Korean general population.
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Affiliation(s)
- Min-Seok Seo
- a Department of Family Medicine , Incheon St. Mary's Hospital , Incheon , Republic of Korea.,b Yonsei University Graduate School of Medicine , Seoul , Republic of Korea
| | - In Cheol Hwang
- c Department of Family Medicine , Gachon University Gil Medical Center , Incheon , Republic of Korea
| | - Jae-Yong Shim
- b Yonsei University Graduate School of Medicine , Seoul , Republic of Korea
| | - Hong Yup Ahn
- d Department of Statistics , Dongguk University , Seoul , Republic of Korea
| | - Sewan Kim
- e Shingil Yonsei Clinic , Seoul , Republic of Korea
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19
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Jhee JH, Lee E, Cha MU, Lee M, Kim H, Park S, Yun HR, Jung SY, Kee YK, Yoon CY, Han SH, Yoo TH, Kang SW, Park JT. Prevalence of depression and suicidal ideation increases proportionally with renal function decline, beginning from early stages of chronic kidney disease. Medicine (Baltimore) 2017; 96:e8476. [PMID: 29095304 PMCID: PMC5682823 DOI: 10.1097/md.0000000000008476] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
Depression and suicidal ideation are prevalent mental health problems in patients with chronic kidney disease (CKD. However, the association between mental health problems and kidney disease has been investigated in severe cases only. Thus, this study evaluated the relationship between mental health problems and renal function in a community-based prospective cohort study comprising patients with mild to moderate kidney disease. A total of 44,938 participants who were participated in Korean National Health and Nutrition Examination Survey IV, V, and VI from 2007 to 2014 were enrolled. Estimated glomerular filtration rate (eGFR) was calculated using the CKD Epidemiology Collaboration equation. The study outcome was the prevalence of depression and suicidal ideations assessed by self-reporting surveys. Logistic regression analysis was performed to evaluate the relationship between renal function and outcomes. The mean age of the study subjects was 49.2 ± 16.6 years, and the mean eGFR was 94.0 mL/min/1.73 m. The prevalence of depression and suicidal ideation increased with decreasing eGFR. Multivariate logistic regression analysis showed that the risk of depression increased in subjects with eGFR <45 mL/min/1.73 m [odds ratio (OR) 1.47; 95% confidence interval (CI) 1.09-1.98]. The risk of suicidal ideation gradually increased in groups with eGFR <90 mL/min/1.73 m (OR, 1.11; 95% CI, 1.03-1.20), even after adjustments for confounding variables. In conclusion, depression and suicidal ideation are related closely with renal dysfunction. The risk of having depression and suicidal ideation increased even in patient with mild renal dysfunction. Therefore, evaluation and management strategies regarding mental health problems should be taken into account throughout all stages of CKD.
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Affiliation(s)
- Jong H. Jhee
- Department of Internal Medicine, College of Medicine, Institute of Kidney Disease Research
| | - Eun Lee
- Department of Psychiatry, Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Min-Uk Cha
- Department of Internal Medicine, College of Medicine, Institute of Kidney Disease Research
| | - Misol Lee
- Department of Internal Medicine, College of Medicine, Institute of Kidney Disease Research
| | - Hyoungnae Kim
- Department of Internal Medicine, College of Medicine, Institute of Kidney Disease Research
| | - Seohyun Park
- Department of Internal Medicine, College of Medicine, Institute of Kidney Disease Research
| | - Hae-Ryong Yun
- Department of Internal Medicine, College of Medicine, Institute of Kidney Disease Research
| | - Su-Young Jung
- Department of Internal Medicine, College of Medicine, Institute of Kidney Disease Research
| | - Youn K. Kee
- Department of Internal Medicine, College of Medicine, Institute of Kidney Disease Research
| | - Chang-Yun Yoon
- Department of Internal Medicine, College of Medicine, Institute of Kidney Disease Research
| | - Seung H. Han
- Department of Internal Medicine, College of Medicine, Institute of Kidney Disease Research
| | - Tae-Hyun Yoo
- Department of Internal Medicine, College of Medicine, Institute of Kidney Disease Research
| | - Shin-Wook Kang
- Department of Internal Medicine, College of Medicine, Institute of Kidney Disease Research
| | - Jung T. Park
- Department of Internal Medicine, College of Medicine, Institute of Kidney Disease Research
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Relationship between the number of family members and stress by gender: Cross-sectional analysis of the fifth Korea National Health and Nutrition Examination Survey. PLoS One 2017; 12:e0184235. [PMID: 28886136 PMCID: PMC5590891 DOI: 10.1371/journal.pone.0184235] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2016] [Accepted: 08/21/2017] [Indexed: 01/19/2023] Open
Abstract
Background Due to gendered inequalities in the division of domestic work, women with paid employment and family caregiving responsibilities can feel extremely tired with general distress and depression. Therefore, the purpose of this study was to examine the association between the number of family members and stress level by gender among Korean adults using a nationally representative dataset. Methods We used a sample of 6,293 subjects aged 19 or older (3,629 female and 2,264 male) from the fifth Korea National Health and Nutrition Examination Survey. A multivariable logistic regression analysis with sociodemographic and health-related characteristics was conducted. Because there were gender differences, a stratified analysis was performed for each gender. Results Age, number of family members, education level, occupational status, depression, self-rated health status, and chronic diseases were found to have a significant association with stress level in the study subjects (p<0.05). The probability of perceiving stress increased among females from family with two members (OR 1.521), three family members (OR 1.893), or four or more family members without spouse (OR 2.035) compared to those who live alone. Conclusion We found that unmarried women are more likely to be stressed as the number of family members increases. Gender expectations giving women the main responsibility for domestic and care work may become a source of stress. Reconciliation of family and work remains women’s responsibility in Korea. As family problems are recently becoming a big issue, our study shows the importance of considering gender difference in studies on stress according to family roles and functions.
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21
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Gould TD, Georgiou P, Brenner LA, Brundin L, Can A, Courtet P, Donaldson ZR, Dwivedi Y, Guillaume S, Gottesman II, Kanekar S, Lowry CA, Renshaw PF, Rujescu D, Smith EG, Turecki G, Zanos P, Zarate CA, Zunszain PA, Postolache TT. Animal models to improve our understanding and treatment of suicidal behavior. Transl Psychiatry 2017; 7:e1092. [PMID: 28398339 PMCID: PMC5416692 DOI: 10.1038/tp.2017.50] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2016] [Revised: 01/16/2017] [Accepted: 02/01/2017] [Indexed: 02/08/2023] Open
Abstract
Worldwide, suicide is a leading cause of death. Although a sizable proportion of deaths by suicide may be preventable, it is well documented that despite major governmental and international investments in research, education and clinical practice suicide rates have not diminished and are even increasing among several at-risk populations. Although nonhuman animals do not engage in suicidal behavior amenable to translational studies, we argue that animal model systems are necessary to investigate candidate endophenotypes of suicidal behavior and the neurobiology underlying these endophenotypes. Animal models are similarly a critical resource to help delineate treatment targets and pharmacological means to improve our ability to manage the risk of suicide. In particular, certain pathophysiological pathways to suicidal behavior, including stress and hypothalamic-pituitary-adrenal axis dysfunction, neurotransmitter system abnormalities, endocrine and neuroimmune changes, aggression, impulsivity and decision-making deficits, as well as the role of critical interactions between genetic and epigenetic factors, development and environmental risk factors can be modeled in laboratory animals. We broadly describe human biological findings, as well as protective effects of medications such as lithium, clozapine, and ketamine associated with modifying risk of engaging in suicidal behavior that are readily translatable to animal models. Endophenotypes of suicidal behavior, studied in animal models, are further useful for moving observed associations with harmful environmental factors (for example, childhood adversity, mechanical trauma aeroallergens, pathogens, inflammation triggers) from association to causation, and developing preventative strategies. Further study in animals will contribute to a more informed, comprehensive, accelerated and ultimately impactful suicide research portfolio.
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Affiliation(s)
- T D Gould
- Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA
- Department of Pharmacology, University of Maryland School of Medicine, Baltimore, MD, USA
- Department of Anatomy and Neurobiology, University of Maryland School of Medicine, Baltimore, MD, USA
| | - P Georgiou
- Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA
| | - L A Brenner
- Department of Psychiatry, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
- Rocky Mountain Mental Illness Research Education and Clinical Center, Denver, CO, USA
- Military and Veteran Microbiome Consortium for Research and Education, U.S. Department of Veterans Affairs, Washington, DC, USA
- Department of Physical Medicine and Rehabilitation, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - L Brundin
- Center for Neurodegenerative Science, Van Andel Research Institute, Grand Rapids, MI, USA
| | - A Can
- Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA
- Department of Psychology, Notre Dame of Maryland University, Baltimore, MD, USA
| | - P Courtet
- Department of Emergency Psychiatry and Post Acute Care, CHU Montpellier, Montpellier, France
- Université Montpellier, Inserm U1061, Montpellier, France
| | - Z R Donaldson
- Department of Molecular, Cellular, and Developmental Biology, University of Colorado Boulder, Boulder, CO, USA
- Department of Psychology, University of Colorado, Boulder, Boulder, CO, USA
- Department of Neuroscience, University of Colorado Boulder, Boulder, CO, USA
| | - Y Dwivedi
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - S Guillaume
- Department of Emergency Psychiatry and Post Acute Care, CHU Montpellier, Montpellier, France
- Université Montpellier, Inserm U1061, Montpellier, France
| | - I I Gottesman
- Department of Psychology, University of Minnesota, Minneapolis, MN, USA
- Department of Psychiatry, University of Minnesota Medical School, Minneapolis, MN, USA
| | - S Kanekar
- Department of Psychiatry, University of Utah, Salt Lake City, UT, USA
| | - C A Lowry
- Rocky Mountain Mental Illness Research Education and Clinical Center, Denver, CO, USA
- Military and Veteran Microbiome Consortium for Research and Education, U.S. Department of Veterans Affairs, Washington, DC, USA
- Department of Integrative Physiology and Center for Neuroscience, University of Colorado Boulder, Boulder, CO, USA
- Department of Physical Medicine and Rehabilitation and Center for Neuroscience, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - P F Renshaw
- Rocky Mountain Mental Illness Research Education and Clinical Center, Denver, CO, USA
- Department of Psychiatry, University of Utah, Salt Lake City, UT, USA
| | - D Rujescu
- Department of Psychiatry, University of Halle-Wittenberg, Halle, Germany
| | - E G Smith
- Edith Nourse Rogers Memorial Veterans Hospital, Bedford, MA, USA
| | - G Turecki
- Department of Psychiatry, McGill University, Montreal, QC, Canada
| | - P Zanos
- Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA
| | - C A Zarate
- Experimental Therapeutics and Pathophysiology Branch, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
| | - P A Zunszain
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - T T Postolache
- Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA
- Rocky Mountain Mental Illness Research Education and Clinical Center, Denver, CO, USA
- Military and Veteran Microbiome Consortium for Research and Education, U.S. Department of Veterans Affairs, Washington, DC, USA
- VISN 5 Mental Illness Research Education and Clinical Center, Baltimore MD, USA
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22
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Park JH, Hong JY, Han K, Suh SW, Park SY, Yang JH, Han SW. Prevalence of symptomatic hip, knee, and spine osteoarthritis nationwide health survey analysis of an elderly Korean population. Medicine (Baltimore) 2017; 96:e6372. [PMID: 28328825 PMCID: PMC5371462 DOI: 10.1097/md.0000000000006372] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Osteoarthritis is prominent among the elderly, with symptoms originating from multiple parts of the body. A cross-sectional study of a nationwide survey was performed to describe the prevalence of and identify factors related to symptomatic hip, knee, and spine osteoarthritis.This cross-sectional study collected data from the Fifth Korean National Health and Nutrition Examination Survey (KNHANES V-5; 2010-2012). After excluding ineligible subjects, there were 8976 subjects in this study (3830 males and 5146 females). All subjects reported symptoms and disabilities related to osteoarthritis. Plain radiographs of the spine, hip, and knee were taken in all subjects.Overall, 9.3% of male participants and 28.5% of female participants were diagnosed with symptomatic osteoarthritis according to survey criteria. Women showed a significantly higher prevalence in all age groups (P < 0.05). Multiple-joint osteoarthritis was diagnosed in 10.8% of male patients and 22.8% of female patients with osteoarthritis. Several demographic and lifestyle variables were related to osteoarthritis morbidity. Anthropometric and laboratory measurements were also related to osteoarthritis morbidity. In addition, mental distress and quality of life were significantly compromised in osteoarthritis. There were more significant relationships for these factors among women with a higher prevalence of multijoint osteoarthritis.A significant proportion of the elderly with single- or multiple-joint osteoarthritis had a variety of pain origins that were closely related. Osteoarthritis was also significantly related to several factors, including mental distress and quality of life.
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MESH Headings
- Age Factors
- Aged
- Aged, 80 and over
- Anthropometry
- Cross-Sectional Studies
- Female
- Health Surveys
- Humans
- Korea/epidemiology
- Life Style
- Male
- Middle Aged
- Osteoarthritis, Hip/diagnostic imaging
- Osteoarthritis, Hip/epidemiology
- Osteoarthritis, Hip/psychology
- Osteoarthritis, Knee/diagnostic imaging
- Osteoarthritis, Knee/epidemiology
- Osteoarthritis, Knee/psychology
- Osteoarthritis, Spine/diagnostic imaging
- Osteoarthritis, Spine/epidemiology
- Osteoarthritis, Spine/psychology
- Prevalence
- Quality of Life
- Socioeconomic Factors
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Affiliation(s)
- Jung-Ho Park
- Department of Orthopedics, Korea University Ansan Hospital, Ansan
| | - Jae-Young Hong
- Department of Orthopedics, Korea University Ansan Hospital, Ansan
| | - Kyungdo Han
- Department of Biostatistics, College of Medicine, Catholic University
| | - Seung-Woo Suh
- Department of Orthopedics, Korea University Guro Hospital
| | - Si-Young Park
- Department of Orthopedics, Korea University Anam Hospital, Seoul, South Korea
| | - Jae-Hyuk Yang
- Department of Orthopedics, Korea University Guro Hospital
| | - Seung-Woo Han
- Department of Orthopedics, Korea University Ansan Hospital, Ansan
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23
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Hong JY, Han K, Shin DH, Chun EM. Quality of Life Analysis and Smoking Correlation in Symptomatic Spine Osteoarthritis: A Nationwide Health Survey Analysis of an Elderly Population with EQ-5D. PLoS One 2016; 11:e0151315. [PMID: 26991429 PMCID: PMC4798754 DOI: 10.1371/journal.pone.0151315] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2015] [Accepted: 02/26/2016] [Indexed: 11/19/2022] Open
Abstract
Objectives To analyze quality of life in people with symptomatic spine osteoarthritis (OA) using the results of a cross-sectional, nationwide survey. Materials and Methods This study used data from the Fifth Korean National Health and Nutrition Examination Survey (KNHANES V-5; 2010–2012). After excluding ineligible subjects, the total number of subjects in the study was 8,963, including 4,091 males and 4,872 females. All participants reported disabilities related to spine OA. Plain radiographs of the spine were taken for all participants. Results Age, sex, smoking, drinking, education, and income level were significantly related to spine OA morbidity (P<0.05). OA morbidity was significantly higher in female ex-smokers (OR; 2.94, P<0.05). Quality of life (EQ-5D: L1~5) was significantly compromised in the group with spine OA compared to the group without spine OA (P<0.05). Overall, LQ 1, 2, 3, 4, and 5 domain scores were significantly higher in the group with spine OA (P<0.05). In the group with spine OA, quality of life was reduced on more than three questions for 34.3% of the group (EQ-5D: grade≥2); on two questions, for 18.5% of the group; and on one question, for 11.1% of the group. Mental stress, melancholy, and suicidal thinking were also more common in the group with spine OA (P<0.05). The group with radiographic spine OA but without symptoms did not have compromised EQ-5D scores, whereas the group with radiographic OA and symptoms showed a significantly reduced quality of life. Conclusions Quality of life was significantly reduced in the group with symptomatic spine OA in a large cross-sectional analysis. Physicians should consider quality of life in the treatment of patients with spine OA
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Affiliation(s)
- Jae-Young Hong
- Department of Orthopedics, Korea University Ansan Hospital, Ansan, South Korea
| | - Kyungdo Han
- Department of Biostatistics, College of Medicine, Catholic University, Seoul, South Korea
| | - Dong-Hyup Shin
- Department of Orthopedics, Korea University Ansan Hospital, Ansan, South Korea
| | - Eun Mi Chun
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Ewha Womans University Mokdong Hospital, Seoul, South Korea
- * E-mail:
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24
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Berlin I, Hakes JK, Hu MC, Covey LS. Tobacco use and suicide attempt: longitudinal analysis with retrospective reports. PLoS One 2015; 10:e0122607. [PMID: 25849514 PMCID: PMC4388646 DOI: 10.1371/journal.pone.0122607] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2014] [Accepted: 02/11/2015] [Indexed: 11/18/2022] Open
Abstract
Background Suicide has been associated with smoking/tobacco use but its association of and change in smoking/tobacco use status with suicide attempt (SA) is not well established. Methods We investigated whether persistent, former tobacco use, initiation, quitting tobacco use, relapse to tobacco use, and DSM-IV nicotine dependence predict independently SA using Wave 1 and 2 data of the National Epidemiologic Survey of Alcohol and Related Conditions. Data from 34,653 US adults interviewed at Wave 1 (2001-02) and Wave 2 (2004-05) were analyzed. The main outcome measure was SA between Wave 1 and Wave 2 as reported at Wave 2. Results Among the 1,673 respondents reporting lifetime SA at Wave 2, 328 individuals reported SA between Wave 1 and Wave 2. Current and former tobacco use at Wave 1 predicted Wave 2 SA independently of socio-demographic characteristics, psychiatric history, and prior SA (Adjusted Odds Ratio (AOR): 1.49; 95% CI: 1.13-1.95, AOR: 1.31; 95% CI:1.01-1.69, respectively versus never tobacco users). The strongest association with SA was observed among former tobacco users who relapsed after Wave 1 (AOR: 4.66; 95% CI: 3.49-6.24) and among tobacco use initiators after Wave 1 (AOR: 3.16; 95% CI: 2.23-4.49). Persistent tobacco use (current tobacco use at both Wave 1 and Wave 2) also had an increased risk of SA (AOR: 1.89; 95% CI: 1.47-2.42). However, former tobacco users in both Waves 1 and 2 did not show a significantly elevated risk for SA in Wave 2 (AOR:1.09, 95% CI: 0.78-1.52) suggesting that the risk resided mainly in Wave 1 former tobacco users who relapsed to tobacco use by Wave 2. DSM-IV nicotine dependence did not predict SA at Wave 2. Conclusion In a representative sample of US adults, relapse, tobacco use initiation, and persistent tobacco use, which are amenable to intervention, were associated with risk of SA.
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Affiliation(s)
- Ivan Berlin
- Département de Pharmacologie, Hôpital Pitié-Salpêtrière-Assistance publique-Hôpitaux de Paris-Faculté de médicine, Université P.& M. Curie—INSERM U1178, Paris, France
- * E-mail:
| | - Jahn K. Hakes
- Center for Administrative Records Research and Applications, U.S. Census Bureau, Suitland, MD, United States of America
| | - Mei-Chen Hu
- New York State Psychiatric Institute, Department of Psychiatry, Columbia University Medical Center, New York, NY, United States of America
| | - Lirio S. Covey
- New York State Psychiatric Institute, Department of Psychiatry, Columbia University Medical Center, New York, NY, United States of America
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