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Martinaitienė D, Sampaio F, Demetrovics Z, Gjoneska B, Portačenko J, Damulevičiūtė A, Garbenytė-Apolinskienė T, Burkauskas J, Kažukauskienė N. A randomised controlled trial assessing the effects of weather sensitivity profile and walking in nature on the psychophysiological response to stress in individuals with coronary artery disease. A study protocol. BMC Psychol 2024; 12:82. [PMID: 38374158 PMCID: PMC10877807 DOI: 10.1186/s40359-024-01574-3] [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: 02/01/2024] [Accepted: 02/05/2024] [Indexed: 02/21/2024] Open
Abstract
BACKGROUND The following protocol pertains to a pioneer study, aiming to investigate how weather sensitivity and walking in different environments affects the psychophysiological responses to the stress of individuals with coronary artery disease (CAD) during rehabilitation (WE_SENSE_THE_NATURE). This randomised control trial will provide fresh insight on the influence of the environmental exposure in CAD patients, as it is seldom investigated in association to the disease. Additionally, findings on the link between personality traits and cognitive functions (especially cognitive flexibility), and weather sensitivity may help reveal a fine-grained perspective on the treatment possibilities for individuals with CAD at risk to stress-vulnerability. METHODS The proposed protocol is for a randomised control trial among individuals attending a cardiac rehabilitation program. We aim to recruit 164 individuals, collecting information related to demographic characteristics, weather sensitivity, functional capacity, personality traits, subjective mental health status, cognitive function, and basal cortisol level of participating individuals. Basal cortisol level refers to cortisol concentration in saliva and will be tested in the morning and the afternoon prior to the day of the experiment. After baseline measurements, the patients will be randomly assigned to either walking outdoors or walking indoors. All measures and their sequential order will remain the same within each group, while the treatment condition (i.e., walking environment) will vary between groups. On the day of the experiment, hemodynamic parameters (assessed via 6-hour blood pressure measurements), stress level (consisting of assessments of cortisol level), and mood (assessed using visual analogues scale) will be registered. Cold stress test will be administered to evaluate the effect of walking in different environments. DISCUSSION The outcomes of this study may have direct clinical applications for the use of different types of exercise environments in cardiac rehabilitation programs. Awareness about the potential influence of weather sensitivity on the psychophysiological reactions to stress in individuals with CAD may contribute to a timely planning and implementation of actions leading to improved medical care services and preventive measures, especially considering the expected weather oscillations and extreme weather events due to unfolding of the climate change. TRIAL REGISTRATION This protocol has been retrospectively registered in ClinicalTrials.gov with identifier code: NCT06139705 on November 20, 2023.
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Affiliation(s)
- Dalia Martinaitienė
- Laboratory of Behavioral Medicine, Neuroscience Institute, Lithuanian University of Health Sciences, Vyduno al. 4, Palanga, LT-00135, Lithuania.
| | - Francisco Sampaio
- Nursing School of Porto, Rua Dr. António Bernardino de Almeida, 830, 844, 856, 4200-072, Porto, Portugal
- CINTESIS@RISE, Nursing School of Porto (ESEP), Rua Dr Plácido da Costa, 4200-450, Porto, Porto, Portugal
| | - Zsolt Demetrovics
- Institute of Psychology, ELTE Eötvös Loránd University, Izabella Utca 46, Budapest, 1064, Hungary
- Centre of Excellence in Responsible Gaming, University of Gibraltar, Gibraltar, Gibraltar
| | - Biljana Gjoneska
- Macedonian Academy of Sciences and Arts, Skopje, North, Macedonia
| | - Justina Portačenko
- Laboratory of Behavioral Medicine, Neuroscience Institute, Lithuanian University of Health Sciences, Vyduno al. 4, Palanga, LT-00135, Lithuania
| | - Austėja Damulevičiūtė
- Laboratory of Behavioral Medicine, Neuroscience Institute, Lithuanian University of Health Sciences, Vyduno al. 4, Palanga, LT-00135, Lithuania
| | - Toma Garbenytė-Apolinskienė
- Laboratory of Behavioral Medicine, Neuroscience Institute, Lithuanian University of Health Sciences, Vyduno al. 4, Palanga, LT-00135, Lithuania
| | - Julius Burkauskas
- Laboratory of Behavioral Medicine, Neuroscience Institute, Lithuanian University of Health Sciences, Vyduno al. 4, Palanga, LT-00135, Lithuania
| | - Nijolė Kažukauskienė
- Laboratory of Behavioral Medicine, Neuroscience Institute, Lithuanian University of Health Sciences, Vyduno al. 4, Palanga, LT-00135, Lithuania
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Yun JY, Choi SH, Park S, Jang JH. Association of executive function with suicidality based on resting-state functional connectivity in young adults with subthreshold depression. Sci Rep 2023; 13:20690. [PMID: 38001278 PMCID: PMC10673918 DOI: 10.1038/s41598-023-48160-y] [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: 09/23/2023] [Accepted: 11/22/2023] [Indexed: 11/26/2023] Open
Abstract
Subthreshold depression (StD) is associated an increased risk of developing major depressive disorder (MDD) and suicidality. Suicidality could be linked to distress intolerance and use of context-dependent strategies. We identified neural correlates of executive functioning among the hubs in the resting-state functional connectome (rs-FCN) and examined associations with recent suicidality in StD and MDD. In total, 79 young adults [27 StD, 30 MDD, and 23 healthy controls (HC)] were scanned using magnetic resonance imaging. Neurocognitive measures of the mean latency to correct five moves in the One Touch Stockings of Cambridge (OTSMLC5), spatial working memory between errors (SWMBE), rapid visual information processing A' (RVPA'), and the stop signal reaction time in the stop signal test (SSTSSRT) were obtained. Global graph metrics were calculated to measure the network integration, segregation, and their balance in the rs-FCN. Regional graph metrics reflecting the number of neighbors (degree centrality; DC), participation in the shortcuts (betweenness centrality; BC), and accessibility to intersections (eigenvector centrality; EC) in the rs-FCN defined group-level hubs for StD, HC, and MDD, separately. Global network metrics were comparable among the groups (all P > 0.05). Among the group-level hubs, regional graph metrics of left dorsal anterior insula (dAI), right dorsomedial prefrontal cortex (dmPFC), right rostral temporal thalamus, right precuneus, and left postcentral/middle temporal/anterior subgenual cingulate cortices were different among the groups. Further, significant associations with neurocognitive measures were found in the right dmPFC with SWMBE, and left dAI with SSTSSRT and RVPA'. Shorter OTSMLC5 was related to the lower centralities of right thalamus and suffer of recent 1-year suicidal ideation (all Ps < 0.05 in ≥ 2 centralities out of DC, BC, and EC). Collectively, salience and thalamic networks underlie spatial strategy and planning, response inhibition, and suicidality in StD and MDD. Anti-suicidal therapies targeting executive function and modulation of salience-thalamic network in StD and MDD are required.
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Affiliation(s)
- Je-Yeon Yun
- Seoul National University Hospital, Seoul, Republic of Korea
- Yeongeon Student Support Center, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Soo-Hee Choi
- Department of Psychiatry, Seoul National University Hospital, Seoul, Republic of Korea
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Susan Park
- Department of Psychiatry, Seoul National University Hospital, Seoul, Republic of Korea
| | - Joon Hwan Jang
- Department of Psychiatry, Seoul National University Health Service Center, 1 Gwanak-Ro, Gwanak-Gu, 08826, Seoul, Republic of Korea.
- Department of Human Systems Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.
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Yun JY, Myung SJ, Kim KS. Associations among the workplace violence, burnout, depressive symptoms, suicidality, and turnover intention in training physicians: a network analysis of nationwide survey. Sci Rep 2023; 13:16804. [PMID: 37798353 PMCID: PMC10556140 DOI: 10.1038/s41598-023-44119-1] [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: 12/16/2022] [Accepted: 10/04/2023] [Indexed: 10/07/2023] Open
Abstract
Depression and anxiety are the most common mental disorders among physicians, who have a greater risk of suicide than those in other professional occupations. Relationships among a demanding workload, workplace violence, burnout, and intention to turnover have also been reported. The current study examined the principal components and propagating patterns of mental health and working environment interactions in training physicians. A total of 1981 training physicians completed online self-report questionnaires during September-October (midpoint of the training year) 2020. Regularized partial correlations in a mixed graphical model (MGM) and joint probability distributions (directed acyclic graph; DAG) were estimated for four subtypes of workplace violence (verbal abuse/physical violence perpetrated by clients/hospital staff), three burnout subdomains (Maslach Burnout Inventory), thoughts about quitting, and nine depressive symptoms, including suicidality, comprising the DSM-5 diagnostic criteria for major depressive disorder (assessed using the Patient Health Questionnaire-9). Thoughts of death/self-harm showed directional dependencies on the joint probability distributions of psychomotor agitation/retardation, concentration difficulty, self-reproach, and sadness in the DAG. In the MGM, a partial correlation with psychomotor agitation/retardation (r = 0.196) accounted for 56.5% of the variance in thoughts of death/self-harm. Partial correlations with concentration difficulties (r = 0.294), self-reproach (r = 0.257), changes in appetite (r = 0.184), and worker-on-worker physical violence (r = 0.240) in the MGM accounted for 54.4% of the variance in psychomotor agitation/retardation. Thoughts about quitting were partially correlated with and dependent upon the joint probability distributions of emotional exhaustion (r = 0.222), fatigue (r = 0.142), anhedonia (r = 0.178), and sadness (r = 0.237). In contrast, worker-on-worker (r = 0.417) and client-on-physician (r = 0.167) verbal abuse had regularized partial correlations with directional dependencies on thoughts about quitting. Organization-level interventions aiming to reduce the worker-on-worker violence and individual-level approaches of clinical screening program and psychiatric counseling clinic are required. Follow-up studies to verify the effectiveness of these interventions for training physicians are needed.
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Affiliation(s)
- Je-Yeon Yun
- Department of Psychiatry, Seoul National University Hospital, Seoul, Republic of Korea
- Yeongeon Student Support Center, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Sun Jung Myung
- Office of Medical Education, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea.
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.
| | - Kyung Sik Kim
- Department of Surgery, Yonsei University College of Medicine, Seoul, Republic of Korea
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Bajzát B, Soltész P, Soltész-Várhelyi K, Lévay EE, Unoka ZS. Impaired decision-making in borderline personality disorder. Front Psychol 2023; 14:1109238. [PMID: 37599767 PMCID: PMC10436614 DOI: 10.3389/fpsyg.2023.1109238] [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: 11/27/2022] [Accepted: 07/14/2023] [Indexed: 08/22/2023] Open
Abstract
Introduction Borderline personality disorder (BPD) is a complex mental disorder with core symptoms like interpersonal instability, emotion dysregulation, self-harm, and impulsive decision-making. Previous neuropsychological studies have found impairment in the decision-making of patients with BPD related to impulsivity. In our study, we focus on a better, more nuanced understanding of impulsive decision-making in BPD with the help of Rogers' decision-making test that simulates a gambling situation. Methods A novelty of our study is that we excluded from further analysis non-compliant participants based on their performance. Outlier participants on the measures proportion of good choices and average of wager choice number were filtered out to represent the population that understood the basic premise of the task and showed minimal motivation to gain rewards. Thus participants often choosing the less likely color or frequently choosing the first bet amount available (to probably speed up the test) were omitted from further analysis. Another novelty is that we assessed and reported six variables that examine Deliberation Time, Quality of Decision, Risk-taking, Overall proportion bet, Delay aversion, and Risk adjustment. Forty-three women with BPD participated in the study, and 16 non-compliant were excluded. As for the healthy control group, 42 women participated in the study, and four non-compliant were excluded. Thus, we compared the data of 27 patients with BPD with 38 healthy controls. Results Our results show that there are significant differences amongst the groups regarding the Quality of Decision Making (F (1,63) = 5.801, p = 0.019) and Risk Adjustment (F (1,63) = 6.522, p = 0.013). We also found significant interactions between group and winning probability regarding Risk Taking (F (4,252) = 4.765 p = 0.001) and Overall proportion of bets, i.e., the average proportion of bets relative to the total score of the subject (F (4,252) = 4.505, p = 0.002). Discussion Our results show that the two groups use different decision-making strategies that can have various associations with everyday life situations.
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Affiliation(s)
- Bettina Bajzát
- Department of Psychiatry and Psychotherapy, Faculty of General Medicine, Semmelweis University, Budapest, Hungary
| | - Péter Soltész
- Department of Psychiatry and Psychotherapy, Faculty of General Medicine, Semmelweis University, Budapest, Hungary
| | - Klára Soltész-Várhelyi
- Department of General Psychology, Faculty of Humanities and Social Sciences, Pázmány Péter Catholic University, Budapest, Hungary
| | - Evelyn Erika Lévay
- Department of Psychiatry and Psychotherapy, Faculty of General Medicine, Semmelweis University, Budapest, Hungary
| | - Zsolt Szabolcs Unoka
- Department of Psychiatry and Psychotherapy, Faculty of General Medicine, Semmelweis University, Budapest, Hungary
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Riera-Serra P, Gili M, Navarra-Ventura G, Riera-López Del Amo A, Montaño JJ, Coronado-Simsic V, Castro A, Roca M. Longitudinal associations between executive function impairments and suicide risk in patients with major depressive disorder: A 1-year follow-up study. Psychiatry Res 2023; 325:115235. [PMID: 37178501 DOI: 10.1016/j.psychres.2023.115235] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 04/16/2023] [Accepted: 04/30/2023] [Indexed: 05/15/2023]
Abstract
Impaired executive function (EF) is a key feature of patients with major depressive disorder (MDD) that several studies have linked to suicidal ideation and suicide attempts. This is the first longitudinal study to examine the association between impaired EF and suicide risk in adult patients with MDD. Longitudinal prospective study with 3 assessment points: baseline, 6 and 12 months. The Columbia-Suicide Severity Rating Scale (C-SSRS) was used to assess suicidality. The Cambridge Neuropsychological Test Automated Battery (CANTAB) was used to assess EF. The association between EF impairments and suicidality was analyzed using mixed-effects models. Out of 167 eligible outpatients, 104 were included in the study. Of these, 72 were re-evaluated at 6 months and 60 at 12 months, obtaining 225 complete observations of the EF. Impaired decision-making and risk-taking behavior were associated with suicidal ideation. Difficulty in impulse control was related to suicidal ideation and to greater severity of suicidal ideation. Impaired spatial planning and working memory was linked to suicide attempts. Our results add to previous literature that the association between EF impairments and suicidality is maintained over the long term, supporting it as a longitudinal risk factor and a possible neurocognitive marker of suicide in patients with MDD.
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Affiliation(s)
- Pau Riera-Serra
- Research Institute of Health Sciences (IUNICS), University of the Balearic Islands (UIB), Palma (Mallorca), Spain; Health Research Institute of the Balearic Islands (IdISBa), Hospital Universitario Son Espases, Edificio S, Palma (Mallorca), Spain
| | - Margalida Gili
- Research Institute of Health Sciences (IUNICS), University of the Balearic Islands (UIB), Palma (Mallorca), Spain; Health Research Institute of the Balearic Islands (IdISBa), Hospital Universitario Son Espases, Edificio S, Palma (Mallorca), Spain; Department of Psychology, University of the Balearic Islands (UIB), Palma (Mallorca), Spain
| | - Guillem Navarra-Ventura
- Research Institute of Health Sciences (IUNICS), University of the Balearic Islands (UIB), Palma (Mallorca), Spain; Health Research Institute of the Balearic Islands (IdISBa), Hospital Universitario Son Espases, Edificio S, Palma (Mallorca), Spain.
| | - Antonio Riera-López Del Amo
- Research Institute of Health Sciences (IUNICS), University of the Balearic Islands (UIB), Palma (Mallorca), Spain; Health Research Institute of the Balearic Islands (IdISBa), Hospital Universitario Son Espases, Edificio S, Palma (Mallorca), Spain
| | - Juan José Montaño
- Health Research Institute of the Balearic Islands (IdISBa), Hospital Universitario Son Espases, Edificio S, Palma (Mallorca), Spain; Department of Psychology, University of the Balearic Islands (UIB), Palma (Mallorca), Spain
| | - Victoria Coronado-Simsic
- Research Institute of Health Sciences (IUNICS), University of the Balearic Islands (UIB), Palma (Mallorca), Spain; Health Research Institute of the Balearic Islands (IdISBa), Hospital Universitario Son Espases, Edificio S, Palma (Mallorca), Spain
| | - Adoración Castro
- Research Institute of Health Sciences (IUNICS), University of the Balearic Islands (UIB), Palma (Mallorca), Spain; Health Research Institute of the Balearic Islands (IdISBa), Hospital Universitario Son Espases, Edificio S, Palma (Mallorca), Spain
| | - Miquel Roca
- Research Institute of Health Sciences (IUNICS), University of the Balearic Islands (UIB), Palma (Mallorca), Spain; Health Research Institute of the Balearic Islands (IdISBa), Hospital Universitario Son Espases, Edificio S, Palma (Mallorca), Spain; Department of Medicine, University of the Balearic Islands (UIB), Palma (Mallorca), Spain
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Rzeszutek MJ, DeFulio A, Sylvester GE. A Systematic Review of Behavior-Outcome Psychological Assessments as Correlates of Suicidality. Arch Suicide Res 2022; 26:1757-1793. [PMID: 35023805 DOI: 10.1080/13811118.2021.2022049] [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: 11/02/2022]
Abstract
AIM Identifying correlates of suicidality is an important goal for suicide researchers because these correlates may predict suicidal behaviors. Psychological tasks that assess sensitivity to the outcomes of actions (i.e., consequence-based learning) have been commonly used by researchers seeking to identify correlates of suicidality. This is likely due to the straightforward integration of the tasks within most theoretical frameworks for understanding suicidality. Contextual factors have been shown to have a substantial effect on responding in behavior-outcome tasks. However, the direct relevance of these factors as determinants of behavior in suicide research is not clear. Thus, the purpose of this review was to assess the role of context in tasks involving behavior-outcome relations in suicide research. METHODS Four databases were searched using terms from general learning theory. Articles that featured evaluation of tasks with hypothetical or real outcomes to differentiate suicidality were included. RESULTS Eighty-two studies met inclusion criteria. Across studies there were 27 different tasks. Most instances of tasks across studies involved rewards (76.9%), while others emphasized punishment (15.7%), social (5.6%), or virtual suicide (1.8%) outcomes. Differentiation of suicidality was detected by 43.4%, 64.7%, 83.3%, and 50% of tasks featuring reward, punishment, social contexts, and virtual suicide respectively. All but five studies were retrospective. CONCLUSION Tasks that more closely mimic contexts and outcomes related to suicide appear to produce more pronounced differentiation of people with suicidality from people without suicidality. The lack of prospective designs is an important limitation of the literature.HIGHLIGHTSTasks that involve punishment or social outcomes better discriminate suicidality.Reward-based tasks are overused in suicide research.The conditioning hypothesis of suicidality is closely aligned with the literature.Only 5 of 82 studies incorporated prospective measures.
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Sun G, Liu Z, Ma Z, Lew B, Jia C. The Relationship Between Negative Focused Disposition and Suicidal Ideation Among College Students: The Mediating Effects of Somatic Anxiety, General Distress, and Depression. Front Psychiatry 2022; 13:928666. [PMID: 35836665 PMCID: PMC9275592 DOI: 10.3389/fpsyt.2022.928666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 06/06/2022] [Indexed: 12/03/2022] Open
Abstract
OBJECTIVE Suicide among college students is a major public health problem. Research has confirmed that negative focused disposition had a significant effect on suicidal ideation. This study aims to evaluate somatic anxiety, general distress and depression as mediators of the relationship between negative focused disposition and suicidal ideation. METHODS A total of 1798 college students (942 males) were recruited to complete measures of negative focused disposition, somatic anxiety, general distress, positive affect and suicidal ideation. The mediation models were conducted to assess the mediating effects of somatic anxiety, general distress and depression. RESULTS There was a significant and positive correlation between negative focused disposition and suicidal ideation in Chinese college students. On mediation analysis, somatic anxiety, general distress and depression mediated the relationship between negative focused disposition and suicidal ideation. CONCLUSIONS Negative focused disposition appears to directedly associate with suicidal ideation and can indirectly relate to suicidal ideation through the relation with somatic anxiety, general distress and depression. College students with few positive expectations of the future may benefit from interventions focusing on somatic anxiety, general distress and depression.
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Affiliation(s)
- Guoxiao Sun
- School of Physical Education, Shandong University, Jinan, China
| | - Zongyu Liu
- School of Physical Education, Shandong University, Jinan, China
| | - Zhiyao Ma
- School of Physical Education, Shandong University, Jinan, China
| | - Bob Lew
- Griffith University, School of Applied Psychology, Australian Inst Suicide Res & Prevent, Brisbane, QLD, Australia
| | - Cunxian Jia
- School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
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Pellegrini L, Maietti E, Rucci P, Burato S, Menchetti M, Berardi D, Maina G, Fineberg NA, Albert U. Suicidality in patients with obsessive-compulsive and related disorders (OCRDs): A meta-analysis. Compr Psychiatry 2021; 108:152246. [PMID: 34062378 DOI: 10.1016/j.comppsych.2021.152246] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 05/03/2021] [Indexed: 11/28/2022] Open
Abstract
INTRODUCTION Previous meta-analyses showed that OCD is associated with a substantial risk of suicidal behaviours. Conclusive rates of suicidal ideation (current and lifetime) and suicide attempts based on pooled prevalence rates have not so far been calculated using meta-analysis for the other DSM-5 Obsessive-Compulsive and Related Disorders (OCRDs). OBJECTIVES This meta-analysis aims to separately calculate the pooled prevalence rates of lifetime suicide attempts and current or lifetime suicidal ideation in BDD, Hoarding Disorder (HD), Skin Picking Disorder (SPD) and Trichotillomania (TTM) and to identify factors associated with increased suicide rates. METHODS Our protocol was pre-registered with PROSPERO (CRD42020164395). A systematic review and meta-analysis following PRISMA reporting guidelines was performed by searching in PubMed/Medline, PsycINFO, Web of Science and CINAHL databases from the date of the first available article to April 20th, 2020. Stata version 15 was used for the statistical analysis. Given the small number of studies in TTM and SPD, the two grooming disorders were grouped together. Meta-analyses of proportions based on random effects (Der-Simonian and Laird method) were used to derive the pooled estimates. RESULTS Thirty-eigth studies (N = 4559 participants) were included: 23 for BDD, 8 for HD, 7 for Grooming Disorders. For BDD, the pooled prevalence of lifetime suicide attempts, current and lifetime suicidal ideation was, respectively 35.2% (CI:23.4-47.8), 37.2% (CI:23.8-51.6) and 66.1% (CI:53.5-77.7). For HD, the pooled prevalence of lifetime suicide attempts, current and lifetime suicidal ideation was 24.1% (CI:12.8-37.6), 18.4% (CI:10.2-28.3) and 38.3% (CI:35.0-41.6), respectively. For Grooming Disorders, the pooled prevalence of lifetime suicide attempts and current suicidal ideation were 13.3% (CI:5.9-22.8) and 40.4% (CI:35.7-45.3), respectively (no data available for lifetime suicidal ideation). CONCLUSIONS The OCRDs as a group are associated with relatively high rates of suicidal behaviour. Through indirect comparisons, we infer that BDD has the greatest risk. Comorbid substance abuse, possibly reflecting poor underlying impulse control, is associated with higher rates of suicidal behaviour in BDD. Our data emphasize the need for clinicians to consider the risk of suicidal behaviour in the management of patients presenting with all forms of OCRDs.
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Affiliation(s)
- Luca Pellegrini
- School of Life and Medical Sciences, University of Hertfordshire, Hatfield, UK; Hertfordshire Partnership University NHS Foundation Trust, Welwyn Garden City, UK; Department of Biomedical and Neuromotor Sciences, University of Bologna, Italy.
| | - Elisa Maietti
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Italy
| | - Paola Rucci
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Italy
| | - Sofia Burato
- Department of Medicine, Surgery and Health Sciences, UCO Clinica Psichiatrica, University of Trieste, Trieste, Italy
| | - Marco Menchetti
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Italy
| | - Domenico Berardi
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Italy
| | - Giuseppe Maina
- Rita Levi Montalcini Department of Neuroscience, University of Torino, Italy
| | - Naomi A Fineberg
- School of Life and Medical Sciences, University of Hertfordshire, Hatfield, UK; Hertfordshire Partnership University NHS Foundation Trust, Welwyn Garden City, UK; University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Umberto Albert
- Department of Medicine, Surgery and Health Sciences, UCO Clinica Psichiatrica, University of Trieste, Trieste, Italy
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