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Lin YP, Chen WY, Pan CH, Su SS, Tsai SY, Chen CC, Kuo CJ. Age-stratified risk of suicide in patients with schizophrenia. Acta Psychiatr Scand 2024. [PMID: 39142799 DOI: 10.1111/acps.13747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2024] [Revised: 07/31/2024] [Accepted: 08/02/2024] [Indexed: 08/16/2024]
Abstract
OBJECTIVES Schizophrenia is associated with an increased risk of suicide. Few studies have investigated the risk of suicide across different ages, likely due to limitations around sample size. METHODS From the National Health Insurance Research Database in Taiwan, this study identified 195,787 patients with schizophrenia from January 1, 2000, to December 31, 2019. During the study period, 3848 patients died from suicide. We calculated the standardized mortality ratio (SMR) for suicide stratified by age. In this age-stratified, nested case-control study, risk set sampling was used to match each case with 4 living controls by age, sex, and the year of the first diagnosis with schizophrenia. Conditional logistic regression was used for estimating age-stratified risk profiles. RESULTS The SMR was the highest in the <25 years age group (52.8) and inversely correlated with age. Unemployment was associated with an increased risk of suicide in the 25 to 34, 35 to 44, 45 to 54, and 55 to 64 years age groups. Depressive and sleep disorders before suicide were more common among suicide cases with schizophrenia than among controls across all age groups. Drug-induced and alcohol-induced mental disorders were significantly associated with suicide but were observed only in the age group younger than 54. Heart disease, pneumonia, and moderate or severe renal disease were risk factors for suicide in the age groups less than 65. CONCLUSIONS The risk factors for suicide differ by age. This study's findings can be used to optimize health-care interventions for preventing suicide in patients with schizophrenia.
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Affiliation(s)
- Yueh-Pin Lin
- Taipei City Psychiatric Center, Taipei City Hospital, Taipei, Taiwan
| | - Wen-Yin Chen
- Taipei City Psychiatric Center, Taipei City Hospital, Taipei, Taiwan
- School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan
| | - Chun-Hung Pan
- Taipei City Psychiatric Center, Taipei City Hospital, Taipei, Taiwan
- Department of Psychology, National Chengchi University, Taipei, Taiwan
| | - Sheng-Shiang Su
- Taipei City Psychiatric Center, Taipei City Hospital, Taipei, Taiwan
| | - Shang-Ying Tsai
- Psychiatric Research Center, Taipei Medical University Hospital, Taipei, Taiwan
- Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Chiao-Chicy Chen
- Psychiatric Research Center, Taipei Medical University Hospital, Taipei, Taiwan
- Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
- Department of Psychiatry, Mackay Memorial Hospital, Taipei, Taiwan
| | - Chian-Jue Kuo
- Taipei City Psychiatric Center, Taipei City Hospital, Taipei, Taiwan
- Psychiatric Research Center, Taipei Medical University Hospital, Taipei, Taiwan
- Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
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Ramya K, Jagadeswaran D. Alexithymia, Suicidal Ideation, and Self-Esteem As Psychological Factors Affecting Chronic Kidney Disease Patients Under Haemodialysis: A Contextual Review. Cureus 2024; 16:e54383. [PMID: 38371441 PMCID: PMC10874471 DOI: 10.7759/cureus.54383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/15/2024] [Indexed: 02/20/2024] Open
Abstract
Chronic kidney disease is a universal topic gravitating towards various aspects of widespread illness, impacting the overall well-being of human beings. Patients with longstanding renal complaints under dialysis encounter challenges correlated with physical, intuitive, and socio-economic conditions to a greater extent in their daily existence. These portions may include changes in the appearance of a person, restricted physique movements, curbed diet, duration of surgical protocols, travelling time during the period of prevention, financial load, role reversal in the family followed by ruining their livelihood, deprived social rank, difficulty in relational, cordial relationships, and so on. Excluding these details, the sick may be profoundly influenced by sorrow, health anxiety, despair, itching, the impoverished essence of vitality, dysfunction in sexual intimacy, impaired cognition, disturbances in disposition, sleeping fluctuations, frequent panic attacks, delirium, brain-afflicted degeneration disabilities, etcetera. Our analysis focuses on exploring a few unidentified intrinsic factors that distinguish these views over combined elements due to the existing disorder.
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Affiliation(s)
- K Ramya
- Clinical Psychology, Saveetha College of Allied Health Sciences, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, IND
| | - D Jagadeswaran
- Renal Science and Dialysis Technology, Saveetha College of Allied Health Sciences, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, IND
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3
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Aune D, Sun X, Nie J, Huang W, Liao B, Wang Y. Self-reported chronic kidney disease and the risk of all-cause and cause-specific mortality: outcome-wide association study of 54 causes of death in the National Health Interview Survey. BMC Nephrol 2022; 23:165. [PMID: 35488232 PMCID: PMC9055730 DOI: 10.1186/s12882-022-02771-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Accepted: 03/31/2022] [Indexed: 11/26/2022] Open
Abstract
Background A diagnosis of chronic kidney disease has been strongly associated with cardiovascular disease and mortality in a number of studies, but the association with specific causes of death has not been assessed in detail. We analysed the association between chronic kidney disease and all-cause mortality and 54 causes of death in the National Health Interview Survey, a prospective study of 210,748 US adults. Methods We used multivariable Cox regression models to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for all-cause and cause-specific mortality associated with self-reported chronic kidney disease. Men and women aged 18–84 years were recruited between 1997 and 2004 and followed up for mortality through December 31, 2006. Results During an average of 6 years follow-up, 9564 deaths occurred. A history of chronic kidney disease vs. no chronic kidney disease was associated with increased risk of all-cause mortality (HR = 2.69, 95% CI: 2.38–3.04), and mortality from septicemia (5.65, 2.84–11.25), viral hepatitis (10.67, 2.43–46.95), other infectious parasitic diseases (10.58, 3.59–31.21), total cancer (1.48, 1.05–2.09), lung cancer (1.94, 1.10–3.44), kidney cancer (4.74, 1.81–12.41), diabetes mellitus (8.57, 5.60–13.11), circulatory disease overall (3.36, 2.70–4.18) and 11 specific circulatory diseases with the strongest associations observed for primary hypertension/renal disease (13.60, 6.42–28.84), hypertensive heart/renal disease (10.72, 2.47–46.49), and other diseases of circulatory system (7.36, 3.22–16.81). Elevated risk was also observed for alcoholic liver disease (5.63, 1.90–16.66), other chronic liver disease (4.41, 1.74–11.17), kidney failure (13.07, 8.23–20.77), and five other causes of death. Conclusions A history of chronic kidney disease was associated with increased risk of all-cause mortality and 27 out of 54 causes of death. Further studies are needed to clarify associations with less common causes of death. Supplementary Information The online version contains supplementary material available at 10.1186/s12882-022-02771-1.
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Affiliation(s)
- Dagfinn Aune
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, St. Mary's Campus, Norfolk Place, Paddington, London, W2 1PG, UK. .,Department of Nutrition, Oslo New University College, Oslo, Norway. .,Department of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University Hospital, Oslo, Norway. .,Unit of Cardiovascular and Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
| | - Xibin Sun
- School of Public Health, Guangdong Pharmaceutical University, Guangzhou, China
| | - Jing Nie
- Department of Sociology & Institute for Empirical Social Science Research, School of Humanities and Social Sciences, Xi'an Jiatong University, Xi'an, China
| | - Wentao Huang
- School of Nursing, Guangdong Pharmaceutical University, Guangzhou, China
| | - Bing Liao
- School of Nursing, Guangdong Pharmaceutical University, Guangzhou, China
| | - Yafeng Wang
- Department of Epidemiology and Biostatistics, School of Health Sciences, Wuhan University, 185 Donghu Road, Wuchang District, Wuhan, 430071, China
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4
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Adawi M, Chen W, Bragazzi NL, Watad A, McGonagle D, Yavne Y, Kidron A, Hodadov H, Amital D, Amital H. Suicidal Behavior in Fibromyalgia Patients: Rates and Determinants of Suicide Ideation, Risk, Suicide, and Suicidal Attempts-A Systematic Review of the Literature and Meta-Analysis of Over 390,000 Fibromyalgia Patients. Front Psychiatry 2021; 12:629417. [PMID: 34867495 PMCID: PMC8640182 DOI: 10.3389/fpsyt.2021.629417] [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: 11/14/2020] [Accepted: 10/11/2021] [Indexed: 11/17/2022] Open
Abstract
Background: Suicide is a leading cause of death worldwide, affecting ~800,000 people every year. Fibromyalgia is an extremely prevalent rheumatic disease with a predisposition for comorbid anxiety and depression, which are known risk factors for suicidal behavior. Suicidality and relevant risk factors for suicidal behavior have not been thoroughly studied in patients with fibromyalgia. Objectives: To investigate the risk of suicidal ideation and attempts in patients with fibromyalgia. Methods: A systematic review and meta-analysis was conducted and reported according to the "Preferred Reporting Items for Systematic reviews and Meta-analyses" (PRISMA) standards. Also, the gray literature was extensively searched. Results: Thirteen studies were included in the present systematic review and meta-analysis, including 394,087 fibromyalgia patients. Sample size ranged from 44 to 199,739 subjects, mean age ranged from 45.8 to 54.5 years while the female percentage with fibromyalgia ranged from 17.1 to 100.0%. The overall suicide ideation prevalence was 29.57% (95%CI 1.84-72.07), with an OR 9.12 of (95%CI 1.42-58.77), ranging from 2.34 (95%CI 1.49-3.66) to 26.89 (95%CI 5.72-126.42). Pooled suicide attempt prevalence was 5.69% [95%CI 1.26-31.34], with an OR of 3.12 [95%CI 1.37-7.12]. Suicide risk was higher with respect to the general population with an OR of 36.77 (95%CI 15.55-96.94), as well as suicide events with an HR of 1.38 (95%CI 1.17-1.71). Determinants of suicidality were found to be: employment status, disease severity, obesity and drug dependence, chronic pain and co-morbidities, in particular depression, anxiety, poor sleep, and global mental health. However, in some cases, after adjusting for psychiatric conditions, the threshold of statistical significance was not achieved. Conclusion: Fibromyalgia patients are particularly prone to suicide, in terms of ideation, attempt, risk and events, warranting a pre-emptive screening of their mental health status. Given the few studies available, the high amount of heterogeneity, the evidence of publications bias and the lack of statistical significance when adjusting for underlying psychiatric co-morbidities, further high-quality studies should be conducted. Clinical Trial Registration: ClinicalTrial.gov, identifier 10.17605/OSF.IO/Y4BUE.
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Affiliation(s)
- Mohammad Adawi
- Padeh and Ziv Medical Centers, Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel
| | - Wen Chen
- Department of Psychiatry, Xiamen Xianyue Hospital, Xiamen, China
| | - Nicola Luigi Bragazzi
- Department of Health Sciences (Dipartimento di Scienze della Salute), Postgraduate School of Public Health, University of Genoa, Genoa, Italy.,Laboratory for Industrial and Applied Mathematics (LIAM), Department of Mathematics and Statistics, York University, Toronto, ON, Canada.,Section of Musculoskeletal Disease, NIHR Leeds Musculoskeletal Biomedical Research Unit, Leeds Institute of Molecular Medicine, Chapel Allerton Hospital, University of Leeds, Leeds, United Kingdom
| | - Abdulla Watad
- Section of Musculoskeletal Disease, NIHR Leeds Musculoskeletal Biomedical Research Unit, Leeds Institute of Molecular Medicine, Chapel Allerton Hospital, University of Leeds, Leeds, United Kingdom.,Department of Medicine 'B', Sheba Medical Center, Tel HaShomer, Israel.,Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel Hashomer, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Dennis McGonagle
- Section of Musculoskeletal Disease, NIHR Leeds Musculoskeletal Biomedical Research Unit, Leeds Institute of Molecular Medicine, Chapel Allerton Hospital, University of Leeds, Leeds, United Kingdom
| | - Yarden Yavne
- Department of Medicine 'B', Sheba Medical Center, Tel HaShomer, Israel.,Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel Hashomer, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Adi Kidron
- Department of Medicine 'B', Sheba Medical Center, Tel HaShomer, Israel.,Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel Hashomer, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Hadas Hodadov
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Daniela Amital
- Ness Ziona Beer-Yaakov Mental Health Center, Beer Yaakov, Israel
| | - Howard Amital
- Department of Medicine 'B', Sheba Medical Center, Tel HaShomer, Israel.,Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel Hashomer, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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5
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Abstract
Chronic kidney disease (CKD) is characterized by increasing prevalence, catalyzing properties in relation to cardiovascular and general mortality, and, in most cases, is asymptomatic, which means late diagnostic verifiability. The global average prevalence of CKD is 13.4%, and CKD C3-5 is 10.6%. The main causes of CKD C5 are diabetes mellitus (DM, 46.9%), hypertension (28.8%) and to a lesser extent, glomerulonephritis (7.1%) and polycystic diseases (2.8%), while other causes account for a total of 14.4%. Despite the simple diagnosis of CKD, one of the key problems of modern therapeutic and pediatric clinics is its low detection rate at the early stages, which, according to some data, reaches 96.6%. This review provides data on the criteria for the diagnosis of CKD, as well as more detailed consideration of the course of CKD in patients with DM, hypertension, and heart failure. Attention is paid to the medicinal origin of CKD, as well as to the development of anxiety and depressive disorders in CKD. General issues of treatment of patients with CKD are considered in detail. Lifestyle changes are an important part of the fight against the development and progression of CKD. Currently, Smoking, alcohol, and physical inactivity have been shown to have a harmful effect on the risk of developing and progressing CKD. Diet plays a certain preventive role. The main drugs with nephroprotective properties are angiotensin-converting enzyme inhibitors and angiotensin II receptor antagonists. Both classes of drugs are effective in proteinuric forms of nephropathies and in combination/association of CKD with diabetes or hypertension. The review also provides data on the nephroprotective properties of mineralocorticoid receptor antagonists, endothelin receptor antagonists, and sodium-glucose co-transporter-2 inhibitors. Given the high importance of identifying and effectively treating patients with CKD, it is necessary to focus on early detection of CKD, especially in high-risk groups. It is necessary to raise public awareness by creating and implementing programs for primary prevention of CKD, as well as awareness of patients, motivating them to follow the doctor's recommendations for a long time, including as part of the implementation of a non-drug strategy to combat CKD. It is important to use the full range of methods of drug therapy for CKD, including measures of universal nephroprotection. It should be remembered that the cost of late diagnosis of CKD is a reduction in life expectancy, primarily due to high rates of cardiovascular mortality, disability, and high-cost medication and kidney replacement therapy.
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6
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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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7
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Gupta S, Patil NM, Karishetti M, Tekkalaki BV. Prevalence and clinical correlates of depression in chronic kidney disease patients in a tertiary care hospital. Indian J Psychiatry 2018; 60:485-488. [PMID: 30581215 PMCID: PMC6278206 DOI: 10.4103/psychiatry.indianjpsychiatry_272_18] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Prognosis and associated complications of chronic kidney disease (CKD) may result in psychological distress and mood disorders especially depression. Prevalence and clinical correlates of depression in CKD patients in the Indian context are not well studied and established. MATERIALS AND METHODS This cross-sectional study included 84 CKD patients. The diagnosis was made based on the diagnostic and statistical manual, 4th edition criteria; psychiatric disorders were ruled out through the mini-neuropsychiatric interview. Montgomery-Asberg Depression Rating Scale was used to assess the severity of depression. Suicidal ideations were evaluated by using a modified scale of suicidal ideations. Data were analyzed using Epi Info 7 software. RESULTS The prevalence of major depression was 44.05%, while the prevalence of depressive symptoms was 82.14%. Age of the patients (P = 0.0065), patients on dialysis (P < 0.0001), and serum creatinine levels >5 (P = 0.0180) showed a statistically significant association with depression. The prevalence of depression was significantly associated with dialysis (P < 0.0001). The severity of depression and the severity of suicidal ideations were well correlated with each other (P < 0.0001). CONCLUSION The increased prevalence of depression and suicidal ideations was observed in CKD patients. We strongly recommend initiating screening of depression in CKD patients for appropriate rehabilitation and improved the quality of life.
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Affiliation(s)
- Shivam Gupta
- Department of Psychiatry, Jawaharlal Nehru Medical College, KLE University, Belagavi, Karnataka, India
| | - Nanasaheb Madhavrao Patil
- Department of Psychiatry, Jawaharlal Nehru Medical College, KLE University, Belagavi, Karnataka, India
| | - Mallikarjun Karishetti
- Department of Medicine, Jawaharlal Nehru Medical College, KLE University, Belagavi, Karnataka, India
| | - Bheemsain V Tekkalaki
- Department of Psychiatry, Jawaharlal Nehru Medical College, KLE University, Belagavi, Karnataka, India
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8
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Kang HJ, Bae KY, Kim SW, Shin IS, Hong YJ, Ahn Y, Jeong MH, Yoon JS, Kim JM. Genetic predisposition toward suicidal ideation in patients with acute coronary syndrome. Oncotarget 2017; 8:94951-94958. [PMID: 29212281 PMCID: PMC5706927 DOI: 10.18632/oncotarget.21661] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2017] [Accepted: 09/21/2017] [Indexed: 11/25/2022] Open
Abstract
The genetic predisposition toward suicidal ideation has been explored to identify subgroups at high risk and to prevent suicide. Acute coronary syndrome (ACS) is associated with an increased risk of suicide, but few studies have explored the genetic predisposition toward suicide in ACS populations. Therefore, this longitudinal study explored the genetic predisposition toward suicidal ideation in ACS patients. In total, of 969 patients within 2 weeks after ACS, 711 were followed at 1 year after ACS. Suicidal ideation was evaluated with the relevant items on the Montgomery-Åsberg Depression Rating Scale. Ten genetic polymorphisms associated with serotonergic systems, neurotrophic factors, carbon metabolism, and inflammatory cytokines were examined. Associations between genetic polymorphisms and suicidal ideation within 2 weeks and 1 year of ACS were investigated using logistic regression models. The 5-HTTLPR s allele was significantly associated with suicidal ideation within 2 weeks of ACS after adjusting for covariates and after the Bonferroni correction. TNF-α -308G/A, IL-1β -511C/T, and IL-1β + 3953C/T were significantly associated with suicidal ideation within 2 weeks after ACS, but these associations did not reach significance after the Bonferroni correction in unadjusted analyses and after adjusting for covariance. However, no significant association between genetic polymorphisms and suicidal ideation was found at 1 year. Genetic predisposition, 5-HTTLPR s allele in particular, may confer susceptibility to suicidal ideation in ACS patients during the acute phase of ACS.
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Affiliation(s)
- Hee-Ju Kang
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Korea
| | - Kyung-Yeol Bae
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Korea
| | - Sung-Wan Kim
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Korea
| | - Il-Seon Shin
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Korea
| | - Young Joon Hong
- Department of Cardiology, Chonnam National University Medical School, Gwangju, Korea
| | - Youngkeun Ahn
- Department of Cardiology, Chonnam National University Medical School, Gwangju, Korea
| | - Myung Ho Jeong
- Department of Cardiology, Chonnam National University Medical School, Gwangju, Korea
| | - Jin-Sang Yoon
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Korea
| | - Jae-Min Kim
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Korea
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9
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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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