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Ma C, Gong B, Wu C. Age-induced changes in affective prosody comprehension and its relationship with general cognitive ability and social support utilization among older adults. NEUROPSYCHOLOGY, DEVELOPMENT, AND COGNITION. SECTION B, AGING, NEUROPSYCHOLOGY AND COGNITION 2024:1-19. [PMID: 39324518 DOI: 10.1080/13825585.2024.2405509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/01/2024] [Accepted: 09/12/2024] [Indexed: 09/27/2024]
Abstract
Aging can impact emotional recognition, affecting older adults' mental health and social function. This study examined how aging affects affective prosody comprehension (APC: understanding emotions through speech) across seven emotions (happiness, surprise, sadness, anger, fear, disgust, and neutrality) and its relationship with cognitive function (via the Montreal Cognitive Assessment) and social support (via the Social Support Rating Scale) in 199 cognitively normal older adults. We found that older adults had lower APC accuracy and more errors, often mistaking negative emotions for neutral or positive ones. APC accuracy was significantly associated with social support, and a partial least squares (PLS) cognitive component fully mediated the relationship between the APC component and social support utilization, explaining 61.7% of the total effect. These results suggest that declines in APC during aging are linked to social support utilization through cognitive function, offering insights for interventions to improve social and cognitive health in older adults.
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Affiliation(s)
- Chifen Ma
- School of Nursing, Peking University, Beijing, China
- College of Health Services and Management, Xuzhou Kindergarten Teachers College, Xuzhou, China
| | - Bingyan Gong
- School of Nursing, Suzhou Medical College of Soochow University, Suzhou, China
| | - Chao Wu
- School of Nursing, Peking University, Beijing, China
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Manelis A, Miceli R, Satz S, Suss SJ, Hu H, Versace A. The Development of Ambiguity Processing Is Explained by an Inverted U-Shaped Curve. Behav Sci (Basel) 2024; 14:826. [PMID: 39336041 PMCID: PMC11429131 DOI: 10.3390/bs14090826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2024] [Revised: 09/07/2024] [Accepted: 09/14/2024] [Indexed: 09/30/2024] Open
Abstract
Understanding the developmental trajectories for recognizing facial expressions is important for a better understanding of development of psychiatric disorders. In this study, we examined the recognition of emotional and neutral facial expressions in 93 typically developing adolescents and adults. The Emotion Intensity Rating task required participants to rate the intensity of emotional expression in happy, neutral, and sad faces on a scale from 1 to 9. A score of '5' had to be assigned to neutral faces, scores between '6' (slightly happy) and '9' (very happy) to happy faces, and scores between '4' (slightly sad) and '1' (very sad) to sad faces. Mixed effects models were used to examine the effects of age and emotion on recognition accuracy, reaction time (RT), and emotional intensity. Participants tended to misjudge neutral faces as sad. Adolescents were less accurate than adults for neutral face recognition. There were significant quadratic effects of age on accuracy (negative quadratic effect) and RT (positive quadratic effect). The most accurate and fastest performance was observed in 25- to 35-year-old subjects. This trajectory may be associated with prefrontal cortex maturation, which provides top-down control over the heightened amygdala response to ambiguity that may be misinterpreted as emotional content.
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Affiliation(s)
- Anna Manelis
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA 15213, USA
| | - Rachel Miceli
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA 15213, USA
| | - Skye Satz
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA 15213, USA
| | - Stephen J Suss
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA 15213, USA
| | - Hang Hu
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA 15213, USA
| | - Amelia Versace
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA 15213, USA
- Department of Radiology, Magnetic Resonance Research Center, University of Pittsburgh Medical Center, University of Pittsburgh, Pittsburgh, PA 15260, USA
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Orsolini L, Corona D, Cervelli AL, Ribuoli E, Longo G, Volpe U. The role of Theory of Mind in the transition towards suicidal attempts in youth NSSI: an exploratory pilot study. Front Psychiatry 2024; 15:1403038. [PMID: 38873534 PMCID: PMC11170150 DOI: 10.3389/fpsyt.2024.1403038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2024] [Accepted: 04/22/2024] [Indexed: 06/15/2024] Open
Abstract
Non-suicidal self-injury (NSSI) can both precede and co-occur with suicidal attempts (SA). Underlying mechanisms/factors leading to the transition to SA in NSSI youths have been proposed (including the role of social cognition), despite they should be yet confirmed. Therefore, the study aims at exploring the role of the Theory of Mind in the differentiation of a sample of NSSI youngsters (aged 15-24) according to the presence of SA. We divided the sample into 4 groups using the Deliberate Self Harm Inventory (DSHI) and Columbia Suicide Severity Rating Scale (C-SSRS): control group (notNSSInotSA), NSSI without SA (NSSInotSA), NSSI with SA (NSSIplusSA), and SA without NSSI (SAonly). NSSIplusSA patients displayed higher Reading the Mind in the Eyes Test (RMET) scores (indicative of ToM abilities) than both the NSSInotSA (p=0.0016) and SAonly groups (p=0.0198), while SAonly patients showed lower RMET scores compared to the control group (p=0.0214). Multiple regression models used to differentiate NSSInotSA and NSSIplusSA found a significant association between RMET and LOSCS-CSC (Level Of Self-Criticism Scale-Comparative Self-Criticism) (pC=0.0802, pD=0.0016, pG=0.0053). Our findings supported the hypothesis that a hypertrophic affective ToM may possibly be associated with the occurrence of SA in youth NSSI. Further larger and longitudinal studies should confirm these preliminary findings, by exploring all social cognition dimensions.
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Deng F, Bueber MA, Cao Y, Tang J, Bai X, Cho Y, Lee J, Lin Z, Yang Q, Keshavan MS, Stone WS, Qian M, Yang LH, Phillips MR. Assessing social cognition in patients with schizophrenia and healthy controls using the reading the mind in the eyes test (RMET): a systematic review and meta-regression. Psychol Med 2024; 54:847-873. [PMID: 38173096 DOI: 10.1017/s0033291723003501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2024]
Abstract
The reading the mind in the eyes test (RMET) - which assesses the theory of mind component of social cognition - is often used to compare social cognition between patients with schizophrenia and healthy controls. There is, however, no systematic review integrating the results of these studies. We identified 198 studies published before July 2020 that administered RMET to patients with schizophrenia or healthy controls from three English-language and two Chinese-language databases. These studies included 41 separate samples of patients with schizophrenia (total n = 1836) and 197 separate samples of healthy controls (total n = 23 675). The pooled RMET score was 19.76 (95% CI 18.91-20.60) in patients and 25.53 (95% CI 25.19-25.87) in controls (z = 12.41, p < 0.001). After excluding small-sample outlier studies, this difference in RMET performance was greater in studies using non-English v. English versions of RMET (Chi [Q] = 8.54, p < 0.001). Meta-regression analyses found a negative association of age with RMET score and a positive association of years of schooling with RMET score in both patients and controls. A secondary meta-analysis using a spline construction of 180 healthy control samples identified a non-monotonic relationship between age and RMET score - RMET scores increased with age before 31 and decreased with age after 31. These results indicate that patients with schizophrenia have substantial deficits in theory of mind compared with healthy controls, supporting the construct validity of RMET as a measure of social cognition. The different results for English versus non-English versions of RMET and the non-monotonic relationship between age and RMET score highlight the importance of the language of administration of RMET and the possibility that the relationship of aging with theory of mind is different from the relationship of aging with other types of cognitive functioning.
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Affiliation(s)
- Fei Deng
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- University of Nottingham School of Economics (Ningbo China), Zhejiang, China
| | - Marlys A Bueber
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yourong Cao
- Guangxi Medical University School of Public Health, Guangxi, China
- The Reproductive Hospital of Guangxi Zhuang Autonomous Region, Guangxi, China
| | - Jeff Tang
- New York University, New York, NY, USA
| | - Xinyu Bai
- Guangxi Medical University School of Public Health, Guangxi, China
- Guangxi Academy of Medical Sciences & The People's Hospital of Guangxi Zhuang Autonomous Region, Guangxi, China
| | - Young Cho
- New York State Psychiatric Institute, New York, NY, USA
| | - Jiwon Lee
- Teachers College, Columbia University, New York, NY, USA
| | - Zhuozhi Lin
- Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Qi Yang
- Ningxia Medical University School of Public Health, Ningxia, China
| | - Matcheri S Keshavan
- Harvard Medical School Department of Psychiatry at Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - William S Stone
- Harvard Medical School Department of Psychiatry at Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Min Qian
- Department of Biostatistics, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Lawrence H Yang
- New York University, New York, NY, USA
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Michael R Phillips
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA
- Department of Psychiatry, Columbia University, New York, NY, USA
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McManimen SL, Hay J, Long C, Bryan CJ, Aase DM. Suicide-related cognitions and emotional bias performance in a community sample. J Affect Disord 2024; 349:197-200. [PMID: 38190852 DOI: 10.1016/j.jad.2024.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 11/21/2023] [Accepted: 01/03/2024] [Indexed: 01/10/2024]
Abstract
BACKGROUND Suicide is theorized to be connected to social interactions and feelings of belongingness. Those with suicide-related cognitions (SRCs) demonstrate attentional bias toward negative or suicide-related words, which can lead to increased feelings of rejection or alienation. As social interactions employ both verbal and nonverbal cues, there exists a gap in understanding how perception of emotional expressions can contribute to the development or exacerbation of suicidal ideation. METHODS The current sample (N = 114, 60.5 % female, 74.6 % white) completed the Suicide Cognitions Scale-Revised (SCS-R) and Patient Health Questionnaire (PHQ-9) to assess SRCs and depression severity. The Emotional Bias Task (EBT) was used to assess emotional response latency. RESULTS Multiple regression analyses on EBT results showed that endorsement of SRCs and depression severity were not associated with any particular emotional response bias. However, presence of SRCs showed an association with longer latencies to identify ambiguous emotional expressions, even when controlling for depressive symptoms and age LIMITATIONS: Measures were self-completed online. Relative homogeneity of the sample and cross-sectional design limits interpretation of the results. CONCLUSIONS Those with more severe SRCs take longer to recognize positive, nonverbal cues. Irregular processing of positive emotional stimuli combined with bias toward negative verbal cues could worsen feelings of rejection or alienation in social interactions, therefore increasing risk of developing SI. This suggests that interventions focusing on allocation of attentional resources to process positive social cues may be beneficial for those with SRCs to reduce severity and risk of suicide.
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Affiliation(s)
- Stephanie L McManimen
- Department of Psychiatry and Behavioral Health, The Ohio State University, Columbus, OH, USA.
| | - Jarrod Hay
- Department of Psychiatry and Behavioral Health, The Ohio State University, Columbus, OH, USA.
| | - Cameron Long
- Department of Psychiatry and Behavioral Health, The Ohio State University, Columbus, OH, USA.
| | - Craig J Bryan
- Department of Psychiatry and Behavioral Health, The Ohio State University, Columbus, OH, USA.
| | - Darrin M Aase
- Department of Psychiatry and Behavioral Health, The Ohio State University, Columbus, OH, USA.
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Miao H, Lu H, Sun Y, Ji J, Lu Y, Meng Y, Wang C, Ding W, Chen X. The protective influence of family support on anxiety, depressive symptoms, and suicidal ideation among elderly Chinese nursing home residents: A study of serial mediation. Medicine (Baltimore) 2024; 103:e36930. [PMID: 38277578 PMCID: PMC10817153 DOI: 10.1097/md.0000000000036930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 12/20/2023] [Indexed: 01/28/2024] Open
Abstract
In light of the aging demographic in China, heightened attention is warranted for the mental well-being of elderly individuals. Nevertheless, the prevalence of suicidal ideation among older residents in Chinese nursing homes and the nuanced impact of family support on this phenomenon, mediated by anxiety and depressive symptoms, remain unclear. A cohort of 506 Chinese elderly adults participated in the study. Psychosocial traits were assessed using the Perceived Social Support from Family scale (PSS-Fa) for family support, the 7-item Generalized Anxiety Disorder scale (GAD-7) for anxiety symptoms, the 9-item Patient Health Questionnaire (PHQ-9) for depressive symptoms, and suicidal ideation. A structural equation model (SEM) was employed to execute a serial mediation model. The analysis of 506 elderly adults revealed that 8.1% reported varying levels of suicidal ideation within Chinese nursing homes. The pathway from family support to anxiety symptoms (standardized beta = -0.025, P = .241), family support to depressive symptoms (standardized beta = -0.072, P < .05), and family support to suicidal ideation (standardized beta = -0.082, P < .05) were explored. Additionally, pathways from anxiety symptoms to suicidal ideation (standardized beta = 0.364, P < .001), anxiety symptoms to depressive symptoms (standardized beta = 0.647, P < .001), and depressive symptoms to suicidal ideation (standardized beta = 0.369, P < .001) were examined. This study elucidated the underlying mechanisms connecting family support to suicidal ideation, with depressive symptoms partially mediating this association. Additionally, our discoveries shed light on the partial mediation of anxiety symptoms by depressive factors when it came to the realm of suicidal ideation.
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Affiliation(s)
- Huiying Miao
- Department of Science and Education, Nantong First People’s Hospital, Nantong, Jiangsu Province, China
- Xuetian Outpatient Department, The Nantong First People’s Hospital, China
| | - Hongjian Lu
- Department of Endocrinology, Nantong First People’s Hospital, Nantong, Jiangsu Province, China
| | - Yimei Sun
- Department of President Office, Nantong First People’s Hospital, Nantong, Jiangsu Province, China
| | - Jianfeng Ji
- Department of President Office, Nantong First People’s Hospital, Nantong, Jiangsu Province, China
| | - Yongqi Lu
- Department of Science and Education, Nantong First People’s Hospital, Nantong, Jiangsu Province, China
| | - Yajing Meng
- Department of Pathology, Baylor College of Medicine, Houston, TX
| | - Chunhua Wang
- Department of Endocrinology, Nantong First People’s Hospital, Nantong, Jiangsu Province, China
| | - Wenbin Ding
- Department of President Office, Nantong First People’s Hospital, Nantong, Jiangsu Province, China
- Shanghai Cancer Institute, Shanghai, China
| | - Xiangfan Chen
- Department of Biobank, Nantong First People’s Hospital, Nantong, Jiangsu Province, China
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Parrish EM, Steenkamp L, Chalker SA, Moore RC, Pinkham A, Depp CA. Systematic Review of the Link Between Social Cognition and Suicidal Ideation and Behavior in People With Serious Mental Illness. SCHIZOPHRENIA BULLETIN OPEN 2024; 5:sgae007. [PMID: 38617732 PMCID: PMC11014866 DOI: 10.1093/schizbullopen/sgae007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 04/16/2024]
Abstract
Background and Hypothesis People with serious mental illness (SMI; psychotic and affective disorders with psychosis) are at an increased risk of suicide, yet there is limited research on the correlates of suicide in SMI. Social cognitive impairments are common among people with SMI and several studies have examined social cognition and suicidal ideation (SI) and behavior. This systematic review aims to evaluate the links between various domains of social cognition, SI, and suicidal behavior in SMI. Study Design Electronic databases (PubMed and PsycInfo) were searched through June 2023. Records obtained through this search (N = 618) were screened by 2 independent reviewers according to inclusion criteria. Relevant data were extracted, and study quality was assessed. Study Results Studies (N = 16) from 12 independent samples were included in the systematic review (N = 2631, sample sizes ranged from N = 20 to N = 593). Assessments of social cognition and SI and behavior varied widely between studies. Broadly, effects were mixed. Better emotion recognition of negative affect was linked to SI and a history of suicide attempts, though there is little consistent evidence for the relationship of emotion recognition and SI or behavior. On the other hand, better theory of mind ability was linked to SI and a history of suicide attempts. Furthermore, negative attributional bias was linked to current SI, but not a history of SI or attempt. Conclusions This review suggests mixed associations between social cognition, SI, and behavior in SMI. Future research should evaluate additional mediators and moderators of social cognition and suicide, employing prospective designs.
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Affiliation(s)
- Emma M Parrish
- San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA, USA
| | - Lisa Steenkamp
- Department of Psychiatry, University of California San Diego, San Diego, CA, USA
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC Sophia Children’s Hospital, Rotterdam, the Netherlands
| | - Samantha A Chalker
- Department of Psychiatry, University of California San Diego, San Diego, CA, USA
- Veterans Affairs San Diego Healthcare System, San Diego, CA, USA
| | - Raeanne C Moore
- Department of Psychiatry, University of California San Diego, San Diego, CA, USA
| | - Amy Pinkham
- Department of Psychology, The University of Texas at Dallas, Dallas, TX, USA
| | - Colin A Depp
- Department of Psychiatry, University of California San Diego, San Diego, CA, USA
- Veterans Affairs San Diego Healthcare System, San Diego, CA, USA
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Razeghian Jahromi L, Tlais MA, Kamar H, Jalali A. Comparison of Theory of Mind between Patients with Major Depressive Disorder and Stimulant-Induced Depressive Disorder. IRANIAN JOURNAL OF PSYCHIATRY 2024; 19:21-29. [PMID: 38420284 PMCID: PMC10896759 DOI: 10.18502/ijps.v19i1.14336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/19/2022] [Revised: 09/29/2022] [Accepted: 12/07/2022] [Indexed: 03/02/2024]
Abstract
Objective: Theory of mind (ToM) denotes the ability to understand the mental state of others and perceive their unique beliefs and emotions. In this study, we compared ToM between individuals with major depressive disorder (MDD) and stimulant-induced depressive disorder (SIDD). Method : This cross-sectional, causal-comparative study included patients with MDD or SIDD admitted to Ostad Moharary Neuropsychiatric Hospital between January and June 2022. Each diagnosis was confirmed through a semi-structured interview conducted by a single attending psychiatrist according to the DSM-5 criteria. After consecutive sampling of 110 individuals, 51 patients completed the study in each group. Demographic characteristics were recorded, and the Persian version of the revised Reading the Mind in the Eyes Test (RMET) was used to evaluate ToM. Statistical analysis was performed using SPSS v.25, employing the t-test, chi-squared test, linear regression, and analysis of covariance (ANCOVA). Results: Our analysis included 102 subjects (65.7% male) with a mean age of 35.17 ± 7.54 years. The two groups were similar in age, gender, marital status, working status, occupation, economic class, and ethnicity (P > 0.05). The RMET scores were 12.94 ± 4.03 and 11.86 ± 3.15 in the MDD and SIDD groups, respectively (P = 0.135). Almost all patients had low RMET scores (< 22); only two individuals in the MDD group achieved normal scores (22-30). ANCOVA revealed no significant confounding effects between the independent variables. Furthermore, regression analysis revealed that the level of education had a significant linear relationship (β = 0.249) with the RMET score (P = 0.021). Conclusion: Hospitalized patients with MDD and SIDD have similar ToM deficits, as measured by the RMET.
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Affiliation(s)
- Leila Razeghian Jahromi
- Research Center for Psychiatry and Behavior Science, Department of Psychiatry, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Ali Tlais
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Hassan Kamar
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Alireza Jalali
- Research Center for Psychiatry and Behavior Science, Department of Psychiatry, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
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Lin C, Huang C, Chang W, Chang Y, Liu H, Ng S, Lin H, Lee TM, Lee S, Wu S. Predicting suicidality in late-life depression by 3D convolutional neural network and cross-sample entropy analysis of resting-state fMRI. Brain Behav 2024; 14:e3348. [PMID: 38376042 PMCID: PMC10790060 DOI: 10.1002/brb3.3348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 11/19/2023] [Accepted: 11/20/2023] [Indexed: 02/21/2024] Open
Abstract
BACKGROUND Predicting suicide is a pressing issue among older adults; however, predicting its risk is difficult. Capitalizing on the recent development of machine learning, considerable progress has been made in predicting complex behavior such as suicide. As depression remained the strongest risk for suicide, we aimed to apply deep learning algorithms to identify suicidality in a group with late-life depression (LLD). METHODS We enrolled 83 patients with LLD, 35 of which were non-suicidal and 48 were suicidal, including 26 with only suicidal ideation and 22 with past suicide attempts, for resting-state functional magnetic resonance imaging (MRI). Cross-sample entropy (CSE) analysis was conducted to examine the complexity of MRI signals among brain regions. Three-dimensional (3D) convolutional neural networks (CNNs) were used, and the classification accuracy in each brain region was averaged to predict suicidality after sixfold cross-validation. RESULTS We found brain regions with a mean accuracy above 75% to predict suicidality located mostly in default mode, fronto-parietal, and cingulo-opercular resting-state networks. The models with right amygdala and left caudate provided the most reliable accuracy in all cross-validation folds, indicating their neurobiological importance in late-life suicide. CONCLUSION Combining CSE analysis and the 3D CNN, several brain regions were found to be associated with suicidality.
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Affiliation(s)
- Chemin Lin
- Department of PsychiatryKeelung Chang Gung Memorial HospitalKeelungTaiwan
- College of MedicineChang Gung UniversityTaoyuanTaiwan
- Community Medicine Research CenterChang Gung Memorial HospitalKeelungTaiwan
| | - Chih‐Mao Huang
- Department of Biological Science and TechnologyNational Yang Ming Chiao Tung UniversityHsinchuTaiwan
| | - Wei Chang
- Department of Engineering and System ScienceNational Tsing Hua UniversityHsinchuTaiwan
| | - You‐Xun Chang
- Department of Engineering and System ScienceNational Tsing Hua UniversityHsinchuTaiwan
| | - Ho‐Ling Liu
- Community Medicine Research CenterChang Gung Memorial HospitalKeelungTaiwan
- Department of Imaging PhysicsUniversity of Texas MD Anderson Cancer CenterHoustonTexasUSA
| | - Shu‐Hang Ng
- Department of Head and Neck Oncology GroupLinkou Chang Gung Memorial Hospital and Chang Gung UniversityTaoyuanTaiwan
- Department of Diagnostic RadiologyLinkou Chang Gung Memorial Hospital and Chang Gung UniversityTaoyuanTaiwan
| | - Huang‐Li Lin
- Department of PsychiatryLinkou Chang Gung Memorial HospitalTaoyuanTaiwan
| | - Tatia Mei‐Chun Lee
- Community Medicine Research CenterChang Gung Memorial HospitalKeelungTaiwan
- Laboratory of Neuropsychology and Human NeuroscienceThe University of Hong KongPok Fu LamHong Kong
- State Key Laboratory of Brain and Cognitive ScienceThe University of Hong KongPok Fu LamHong Kong
| | - Shwu‐Hua Lee
- Department of PsychiatryLinkou Chang Gung Memorial HospitalTaoyuanTaiwan
| | - Shun‐Chi Wu
- Department of Engineering and System ScienceNational Tsing Hua UniversityHsinchuTaiwan
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Solomonov N. Improving social reward responsivity and social connectedness in psychotherapies for late-life depression: Engage & Connect as an example. Psychiatry Res 2023; 329:115469. [PMID: 37783093 PMCID: PMC10841452 DOI: 10.1016/j.psychres.2023.115469] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 08/23/2023] [Accepted: 09/06/2023] [Indexed: 10/04/2023]
Abstract
Psychotherapies are effective in reducing late-life depression. Yet, about half of patients remain depressed at treatment end. Advances in neuroscience can inform simplified interventions that target key brain networks impacted by depression. Behavioral activation therapies that increase social connectedness may improve social reward responsivity and alter abnormalities of the Positive Valence System (PVS). Engage & Connect is an example for a scalable and simple neuroscience-informed psychotherapy, aimed to improve PVS functions and social reward responsivity by increasing engagement in rewarding social activities. Interventions that improve social reward responsivity can be promising first-line treatments for late-life depression in the community.
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Affiliation(s)
- Nili Solomonov
- Weill Cornell Institute of Geriatric Psychiatry, Weill Cornell Medicine, New York, NY, USA.
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11
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Yuan J, Wang Y, Liu Z. Temporal relationship between depression and cognitive decline in the elderly: a two-wave cross-lagged study in a Chinese sample. Aging Ment Health 2023; 27:2179-2186. [PMID: 37339082 DOI: 10.1080/13607863.2023.2225432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 06/04/2023] [Indexed: 06/22/2023]
Abstract
Objectives: Less information is available about the temporal relationship between depression in the elderly and cognitive decline. In the current study, we (1) evaluated the temporal association between depression and cognitive decline in older adults over a 4-year period; (2) indicated which cognitive domains have a strong temporal relationship with depression.Methods: Using data from China Family Panel Studies, we examined the relationship between depression and cognition among adults aged 65 and older with a cross-lagged design.Results: The results showed that initial depression affected subsequent cognitive function, especially immediate and delayed recall, but that cognition decline did not predict depression over time.Conclusion: The findings suggest that depression precedes cognitive decline in older adults, which is of great significance for the future research of mild cognitive impairment and dementia in the elderly.
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Affiliation(s)
- Jing Yuan
- School of Nursing, Hebei University, Baoding, China
| | - Yan Wang
- School of Nursing, Hebei University, Baoding, China
| | - Zejun Liu
- Department of Psychology, Educational College, Shanghai Normal University, Shanghai, China
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Zaff O, Wyngaarden JB, Dennison JB, Sazhin D, Chein J, McCloskey M, Alloy LB, Jarcho JM, Smith DV, Fareri DS. Social Context and Reward Sensitivity Enhance Corticostriatal Function during Experiences of Shared Rewards. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.10.19.562908. [PMID: 37905048 PMCID: PMC10614966 DOI: 10.1101/2023.10.19.562908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/02/2023]
Abstract
Although prior research has demonstrated enhanced striatal response when sharing rewards with close social connections, less is known about how individual differences affect ventral striatal (VS) activation and connectivity when experiencing rewards within social contexts. Given that self-reported reward sensitivity and level of substance use have been associated with differences in VS activation, we set out to investigate whether these factors would be independently associated with enhancements to neural reward responses within social contexts. In this pre-registered study, participants (N=45) underwent fMRI while playing a card guessing game in which correct or incorrect guesses resulted in monetary gains and losses that were shared evenly with either a close friend, stranger (confederate), or non-human partner. Consistent with our prior work, we found increased VS activation when sharing rewards with a socially close peer as opposed to an out-of-network stranger. As self-reported reward sensitivity increased, the difference in VS response to rewards shared with friends and strangers decreased. We also found enhanced connectivity between the VS and temporoparietal junction when sharing rewards with close friends as opposed to strangers. Finally, exploratory analyses revealed that as reward sensitivity and sub-clinical substance use increase, the difference in VS connectivity with the right fusiform face area increases as a function of social context. These findings demonstrate that responsivity to the context of close friends may be tied to individual reward sensitivity or sub-clinical substance use habits; together these factors may inform predictions of risk for future mental health disorders.
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Affiliation(s)
- Ori Zaff
- Department of Psychology & Neuroscience, Temple University, Philadelphia, PA, USA
| | - James B. Wyngaarden
- Department of Psychology & Neuroscience, Temple University, Philadelphia, PA, USA
| | - Jeffrey B. Dennison
- Department of Psychology & Neuroscience, Temple University, Philadelphia, PA, USA
| | - Daniel Sazhin
- Department of Psychology & Neuroscience, Temple University, Philadelphia, PA, USA
| | - Jason Chein
- Department of Psychology & Neuroscience, Temple University, Philadelphia, PA, USA
| | - Michael McCloskey
- Department of Psychology & Neuroscience, Temple University, Philadelphia, PA, USA
| | - Lauren B. Alloy
- Department of Psychology & Neuroscience, Temple University, Philadelphia, PA, USA
| | - Johanna M. Jarcho
- Department of Psychology & Neuroscience, Temple University, Philadelphia, PA, USA
| | - David V. Smith
- Department of Psychology & Neuroscience, Temple University, Philadelphia, PA, USA
| | - Dominic S. Fareri
- Derner School of Psychology, Adelphi University, Garden City, NY, USA
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Schafer KM, Wilson E, Joiner T. Traumatic brain injury and suicidality among military veterans: The mediating role of social integration. J Affect Disord 2023; 338:414-421. [PMID: 37364657 DOI: 10.1016/j.jad.2023.06.047] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 06/01/2023] [Accepted: 06/20/2023] [Indexed: 06/28/2023]
Abstract
Suicide is a widespread public health concern, including among military Veterans. Traumatic brain injuries (TBIs) and lack of social integration have both been shown to increase risk for suicidality, an outcome that includes, among other suicide-related variables, suicidal ideation, suicide attempts, and suicide death. Interestingly, TBIs have also been identified as a risk factor for social integration problems. In this cross-sectional study we investigated associations between TBI, social integration, and suicidality. Additionally, mediation analysis was used to test whether social integration mediated the association between TBI and suicidality. A sample of 1469 military Veterans (male, n = 1004, 67.2 %; female, n = 457, 32.3 %; transgender/non-binary/prefer not to say, n = 8, 0.5 %) completed an online survey as part of the Military Health and Well-Being Project. TBI was negatively associated with social integration (r = -0.084, p < .001) and positively with suicidality (r = 0.205, p < .001). Social integration was negatively associated with suicidality (r = -0.161, p < .001). Finally, social integration partially mediated the relationship between TBI and social integration (B = 0.121, 95 % CI [0.031-0.23]). This work shows that in the context of TBI, lack of social integration may promote suicidality. It provides support for many theories of suicide which propose social problems as a risk factor of suicide-related outcomes. It further highlights social integration as potential fodder for novel interventions for suicidality, an approach that would have transtheoretical support.
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Affiliation(s)
| | - Emma Wilson
- Kings College London, United States; Florida State University, United States
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14
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Zhang J, Liang S, Liu X, Li D, Zhou F, Xiao L, Liu J, Sha S. Factors associated with suicidal attempts in female patients with mood disorder. Front Public Health 2023; 11:1157606. [PMID: 37818303 PMCID: PMC10560740 DOI: 10.3389/fpubh.2023.1157606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 09/08/2023] [Indexed: 10/12/2023] Open
Abstract
Aim This study aims to establish a nomogram model to predict the relevance of SA in Chinese female patients with mood disorder (MD). Method The study included 396 female participants who were diagnosed with MD Diagnostic Group (F30-F39) according to the 10th Edition of Disease and Related Health Problems (ICD-10). Assessing the differences of demographic information and clinical characteristics between the two groups. LASSO Logistic Regression Analyses was used to identify the risk factors of SA. A nomogram was further used to construct a prediction model. Bootstrap re-sampling was used to internally validate the final model. The Receiver Operating Characteristic (ROC) curve and C-index was also used to evaluate the accuracy of the prediction model. Result LASSO regression analysis showed that five factors led to the occurrence of suicidality, including BMI (β = -0.02, SE = 0.02), social dysfunction (β = 1.72, SE = 0.24), time interval between first onset and first dose (β = 0.03, SE = 0.01), polarity at onset (β = -1.13, SE = 0.25), and times of hospitalization (β = -0.11, SE = 0.06). We assessed the ability of the nomogram model to recognize suicidality, with good results (AUC = 0.76, 95% CI: 0.71-0.80). Indicating that the nomogram had a good consistency (C-index: 0.756, 95% CI: 0.750-0.758). The C-index of bootstrap resampling with 100 replicates for internal validation was 0.740, which further demonstrated the excellent calibration of predicted and observed risks. Conclusion Five factors, namely BMI, social dysfunction, time interval between first onset and first dose, polarity at onset, and times of hospitalization, were found to be significantly associated with the development of suicidality in patients with MD. By incorporating these factors into a nomogram model, we can accurately predict the risk of suicide in MD patients. It is crucial to closely monitor clinical factors from the beginning and throughout the course of MD in order to prevent suicide attempts.
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Affiliation(s)
- Jinhe Zhang
- Beijing Key Laboratory of Mental Disorders, The National Clinical Research Center for Mental Disorders, The Advanced Innovation Center for Human Brain Protection, Beijing Anding Hospital, Capital Medical University, Beijing, China
- The Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Sixiang Liang
- Beijing Key Laboratory of Mental Disorders, The National Clinical Research Center for Mental Disorders, The Advanced Innovation Center for Human Brain Protection, Beijing Anding Hospital, Capital Medical University, Beijing, China
- The Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Xinyu Liu
- Beijing Key Laboratory of Mental Disorders, The National Clinical Research Center for Mental Disorders, The Advanced Innovation Center for Human Brain Protection, Beijing Anding Hospital, Capital Medical University, Beijing, China
- The Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Dan Li
- Beijing Key Laboratory of Mental Disorders, The National Clinical Research Center for Mental Disorders, The Advanced Innovation Center for Human Brain Protection, Beijing Anding Hospital, Capital Medical University, Beijing, China
- The Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Fuchun Zhou
- Beijing Key Laboratory of Mental Disorders, The National Clinical Research Center for Mental Disorders, The Advanced Innovation Center for Human Brain Protection, Beijing Anding Hospital, Capital Medical University, Beijing, China
- The Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Le Xiao
- Beijing Key Laboratory of Mental Disorders, The National Clinical Research Center for Mental Disorders, The Advanced Innovation Center for Human Brain Protection, Beijing Anding Hospital, Capital Medical University, Beijing, China
- The Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Jun Liu
- Beijing Key Laboratory of Mental Disorders, The National Clinical Research Center for Mental Disorders, The Advanced Innovation Center for Human Brain Protection, Beijing Anding Hospital, Capital Medical University, Beijing, China
- The Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Sha Sha
- Beijing Key Laboratory of Mental Disorders, The National Clinical Research Center for Mental Disorders, The Advanced Innovation Center for Human Brain Protection, Beijing Anding Hospital, Capital Medical University, Beijing, China
- The Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
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15
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Solomonov N, Green J, Quintana A, Lin J, Ognyanova K, Santillana M, Druckman JN, Baum MA, Lazer D, Gunning FM, Perlis RH. A 50-state survey study of thoughts of suicide and social isolation among older adults in the United States. J Affect Disord 2023; 334:43-49. [PMID: 37086804 PMCID: PMC10751855 DOI: 10.1016/j.jad.2023.04.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Revised: 03/26/2023] [Accepted: 04/14/2023] [Indexed: 04/24/2023]
Abstract
BACKGROUND We aimed to characterize the prevalence of social disconnection and thoughts of suicide among older adults in the United States, and examine the association between them in a large naturalistic study. METHODS We analyzed data from 6 waves of a fifty-state non-probability survey among US adults conducted between February and December 2021. The internet-based survey collected the PHQ-9, as well as multiple measures of social connectedness. We applied multiple logistic regression to analyze the association between presence of thoughts of suicide and social disconnection. Exploratory analysis, using generalized random forests, examined heterogeneity of effects across sociodemographic groups. RESULTS Of 16,164 survey respondents age 65 and older, mean age was 70.9 (SD 5.0); the cohort was 61.4 % female and 29.6 % male; 2.0 % Asian, 6.7 % Black, 2.2 % Hispanic, and 86.8 % White. A total of 1144 (7.1 %) reported thoughts of suicide at least several days in the prior 2 week period. In models adjusted for sociodemographic features, households with 3 or more additional members (adjusted OR 1.73, 95 % CI 1.28-2.33) and lack of social supports, particularly emotional supports (adjusted OR 2.60, 95 % CI 2.09-3.23), were independently associated with greater likelihood of reporting such thoughts, as was greater reported loneliness (adjusted OR 1.75, 95 % CI 1.64-1.87). The effects of emotional support varied significantly across sociodemographic groups. CONCLUSIONS Thoughts of suicide are common among older adults in the US, and associated with lack of social support, but not with living alone. TRIAL REGISTRATION NA.
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Affiliation(s)
- Nili Solomonov
- Weill Cornell Institute of Geriatric Psychiatry, Weill Cornell Medicine, New York, NY, United States of America
| | - Jon Green
- Northeastern University, Boston, MA, United States of America
| | - Alexi Quintana
- Northeastern University, Boston, MA, United States of America
| | - Jennifer Lin
- Northwestern University, Evanston, IL, United States of America
| | | | - Mauricio Santillana
- Harvard Medical School, Boston, MA, United States of America; Boston Children's Hospital, Boston, MA, United States of America
| | | | - Matthew A Baum
- Massachusetts General Hospital, Boston, MA, United States of America
| | - David Lazer
- Northwestern University, Evanston, IL, United States of America
| | - Faith M Gunning
- Weill Cornell Institute of Geriatric Psychiatry, Weill Cornell Medicine, New York, NY, United States of America
| | - Roy H Perlis
- Harvard University, Cambridge, MA, United States of America; Harvard Medical School, Boston, MA, United States of America; Massachusetts General Hospital, Boston, MA, United States of America.
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16
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Liang S, Liu X, Li D, Zhang J, Zhao G, Yu H, Zhao X, Sha S. Development and validation of a nomogram to predict suicidal behavior in female patients with mood disorder. Front Psychiatry 2023; 14:1212579. [PMID: 37484676 PMCID: PMC10360170 DOI: 10.3389/fpsyt.2023.1212579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Accepted: 06/21/2023] [Indexed: 07/25/2023] Open
Abstract
Introduction This study aims to explore the risk factors associated with suicidal behavior and establish predictive models in female patients with mood disorders, specifically using a nomogram of the least absolute shrinkage and selection operator (LASSO) regression. Methods A cross-sectional survey was conducted among 396 female individuals diagnosed with mood disorders (F30-F39) according to the International Classification of Diseases and Related Health Problems 10th Revision (ICD-10). The study utilized the Chi-Squared Test, t-test, and the Wilcoxon Rank-Sum Test to assess differences in demographic information and clinical characteristics between the two groups. Logistic LASSO Regression Analyses were utilized to identify the risk factors associated with suicidal behavior. A nomogram was constructed to develop a prediction model. The accuracy of the prediction model was evaluated using a Receiver Operating Characteristic (ROC) curve. Result The LASSO regression analysis showed that psychotic symptoms at first-episode (β = 0.27), social dysfunction (β = 1.82), and somatic disease (β = 1.03) increased the risk of suicidal behavior. Conversely, BMI (β = -0.03), age of onset (β = -0.02), polarity at onset (β = -1.21), and number of hospitalizations (β = -0.18) decreased the risk of suicidal behavior. The area under ROC curve (AUC) of the nomogram predicting SB was 0.778 (95%CI: 0.730-0.827, p < 0.001). Conclusion The nomogram based on demographic and clinical characteristics can predict suicidal behavior risk in Chinese female patients with mood disorders.
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Affiliation(s)
- Sixiang Liang
- National Clinical Research Center for Mental Disorders and National Center for Mental Disorders, Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Xinyu Liu
- National Clinical Research Center for Mental Disorders and National Center for Mental Disorders, Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Dan Li
- National Clinical Research Center for Mental Disorders and National Center for Mental Disorders, Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Jinhe Zhang
- National Clinical Research Center for Mental Disorders and National Center for Mental Disorders, Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Guangwei Zhao
- National Clinical Research Center for Mental Disorders and National Center for Mental Disorders, Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Hongye Yu
- National Clinical Research Center for Mental Disorders and National Center for Mental Disorders, Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Xixi Zhao
- National Clinical Research Center for Mental Disorders and National Center for Mental Disorders, Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Sha Sha
- National Clinical Research Center for Mental Disorders and National Center for Mental Disorders, Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
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17
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Liu J, Zhao K, Zhou S, Hong L, Xu Y, Sun S, Tong S, Huang L, Liu J, Wang J, Li N, Lou M, Tang W, Cai Z. Suicidal ideation in Chinese adults with schizophrenia: associations with neurocognitive function and empathy. BMC Psychiatry 2023; 23:311. [PMID: 37138258 PMCID: PMC10155378 DOI: 10.1186/s12888-023-04739-3] [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: 12/26/2022] [Accepted: 03/31/2023] [Indexed: 05/05/2023] Open
Abstract
BACKGROUND Suicidal ideation is common among people diagnosed with schizophrenia spectrum disorders and may be related to neurocognitive, social cognitive, and clinical variables. This study aimed to investigate the relationships between suicidal ideation and both neurocognitive function and empathy. METHODS The sample for this cross-sectional study comprised 301 schizophrenic patients aged 18-44 years. All participants were administered the Beck Scale for Suicide Ideation-Chinese Version (BSI-CV), the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), the Interpersonal Reactivity Index (IRI), and the Positive and Negative Syndrome Scale (PANSS). The demographic and clinical data of the patients were also collected. RESULTS In total, 82 patients reported suicidal ideation. Compared to patients without suicidal ideation, patients with suicidal ideation showed significant differences in the IRI-Personal Distress subscale, PANSS-General Psychopathology symptom scores, and suicide attempts. Moreover, there were moderating effects of neurocognitive function and empathy on the relationship between suicide attempts and suicidal ideation. CONCLUSIONS These results indicate that the personal distress component of empathy, general psychopathology symptoms and suicide attempts are independent risk factors for suicidal ideation in Chinese adults with schizophrenia. Moreover, neurocognitive function may also be related to suicidal ideation through a moderating relationship. In order to reduce suicidal ideation among patients with schizophrenia, early screening of empathy and neurocognitive function is essential.
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Affiliation(s)
- Jie Liu
- School of Mental Health, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Ke Zhao
- Lishui Second People's Hospital Affiliated to Wenzhou Medical University, Lishui, China
| | - Siyao Zhou
- School of Mental Health, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Lan Hong
- School of Mental Health, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Yao Xu
- School of Mental Health, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Shiyu Sun
- School of Mental Health, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Siyu Tong
- School of Mental Health, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Liandan Huang
- The Affiliated Kangning Hospital of Wenzhou Medical University Zhejiang Provincial Clinical Research Center for Mental Disorder, 325000, Wenzhou, China
| | - Jiahong Liu
- The Affiliated Kangning Hospital of Wenzhou Medical University Zhejiang Provincial Clinical Research Center for Mental Disorder, 325000, Wenzhou, China
| | - Jieqiong Wang
- The Affiliated Kangning Hospital of Wenzhou Medical University Zhejiang Provincial Clinical Research Center for Mental Disorder, 325000, Wenzhou, China
| | - Na Li
- School of Mental Health, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Mengbei Lou
- School of Mental Health, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Wei Tang
- School of Mental Health, Wenzhou Medical University, Wenzhou, Zhejiang, China.
- The Affiliated Kangning Hospital of Wenzhou Medical University Zhejiang Provincial Clinical Research Center for Mental Disorder, 325000, Wenzhou, China.
| | - Zhengmao Cai
- The Affiliated Kangning Hospital of Wenzhou Medical University Zhejiang Provincial Clinical Research Center for Mental Disorder, 325000, Wenzhou, China.
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Zhdanava M, Teeple A, Pilon D, Shah A, Caron-Lapointe G, Joshi K. Esketamine nasal spray for major depressive disorder with acute suicidal ideation or behavior: description of treatment access, utilization, and claims-based outcomes in the United States. J Med Econ 2023; 26:691-700. [PMID: 37130075 DOI: 10.1080/13696998.2023.2208993] [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: 05/03/2023]
Abstract
AIMS To describe real-world esketamine nasal spray access and use as well as healthcare resource use (HRU) and costs among adults with evidence of major depressive disorder (MDD) with suicidal ideation or behavior (MDSI). METHODS Adults with ≥1 claim for esketamine nasal spray and evidence of MDSI 12 months before/on the date of esketamine initiation (index date) were selected from Clarivate's Real World Data product (01/2016-03/2021). Patients initiated esketamine on/after 03/05/2019 (esketamine approval for treatment-resistant depression; later approved for MDSI on 08/05/2020) were included in the overall cohort. Esketamine access (measured as approved/abandoned/rejected claims) and use were described post-index; HRU and healthcare costs (2021 USD) were described over 6 months pre- and post-index. RESULTS Among 269 patients in the overall cohort with esketamine pharmacy claims, 46.8% had the first pharmacy claim approved, 38.7% had it rejected, and 14.5% abandoned their claim; 169 patients were initiated on esketamine in the overall cohort (mean age 40.9 years, 62.1% female); 45.0% had ≥8 esketamine treatment sessions (recommended per label) with a mean [median] of 85.0 [58.5] days from index to 8th session (per label 28 days). Among 115 patients with ≥6 months of data post-index, in the 6-month pre- and post-index, respectively, 37.4% and 19.1% had all-cause inpatient admissions, 42.6% and 33.9% had emergency department visits, 92.2% and 81.7% had outpatient visits; mean ± standard deviation all-cause monthly total healthcare costs were $8,371±$15,792 and $6,486±$7,614, respectively. LIMITATIONS This was a descriptive claims-based analysis; no formal statistical comparisons were performed due to limited sample size as data covered up to 24 months of esketamine use in the US clinical setting. CONCLUSIONS Nearly half of patients experience access issues with first esketamine nasal spray treatment session. All-cause HRU and healthcare costs trend lower in the 6 months after relative to 6 months before esketamine initiation.
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Affiliation(s)
| | - Amanda Teeple
- Janssen Scientific Affairs, LLC, Titusville, NJ, USA
| | | | - Aditi Shah
- Analysis Group, Inc., Montréal, QC, Canada
| | | | - Kruti Joshi
- Janssen Scientific Affairs, LLC, Titusville, NJ, USA
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Fujieda M, Uchida K, Ikebe S, Kimura A, Kimura M, Watanabe T, Sakamoto H, Matsumoto T, Uchimura N. Fatigue on Waking, Insomnia, and Workplace Relationship Problems May Help to Detect Suicidal Ideation among New Middle-Aged Primary Care Patients: A 6-Month Prospective Study in Japan. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20085547. [PMID: 37107831 PMCID: PMC10138726 DOI: 10.3390/ijerph20085547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 03/27/2023] [Accepted: 04/13/2023] [Indexed: 05/11/2023]
Abstract
Signs of suicidal depression often go undetected in primary care settings. This study explored predictive factors for depression with suicidal ideation (DSI) among middle-aged primary care patients at 6 months after an initial clinic visit. New patients aged 35-64 years were recruited from internal medicine clinics in Japan. Baseline characteristics were elicited using self-administered and physician questionnaires. DSI was evaluated using the Zung Self-Rating Depression Scale and the Profile of Mood States at enrollment and 6 months later. Multiple logistic regression analysis was conducted to calculate adjusted odds ratios for DSI. Sensitivity, specificity, and likelihood ratios for associated factors were calculated. Among 387 patients, 13 (3.4%) were assessed as having DSI at 6 months. Adjusted for sex, age, and related factors, significant odds ratios for DSI were observed for "fatigue on waking ≥1/month" (7.90, 95% confidence intervals: 1.06-58.7), "fatigue on waking ≥1/week" (6.79, 1.02-45.1), "poor sleep status" (8.19, 1.05-63.8), and "relationship problems in the workplace" (4.24, 1.00-17.9). Fatigue on waking, sleep status, and workplace relationship problems may help predict DSI in primary care. Because the sample size in this investigation was small, further studies with larger samples are needed to confirm our findings.
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Affiliation(s)
- Megumi Fujieda
- Department of Neuropsychiatry, Kurume University School of Medicine, 67 Asahi-machi, Kurume 830-0011, Fukuoka, Japan
- Department of Environmental Medicine, Kurume University School of Medicine, 67 Asahi-machi, Kurume 830-0011, Fukuoka, Japan
- Department of Healthcare Management, College of Healthcare Management, 960-4 Takayanagi, Setaka-machi, Miyama 835-0018, Fukuoka, Japan
- Correspondence: ; Tel.: +81-942-31-7564
| | - Katsuhisa Uchida
- Mental Health and Welfare Center of Shizuoka Prefectural Government, 2-20 Ariake-cho, Suruga-ku, Shizuoka-shi 422-8031, Shizuoka, Japan
| | - Shinichiro Ikebe
- Fuji Medical Association, 2850 Denbo, Fuji 417-0061, Shizuoka, Japan
| | - Akihiro Kimura
- Fuji Medical Association, 2850 Denbo, Fuji 417-0061, Shizuoka, Japan
| | - Masashi Kimura
- Fuji Medical Association, 2850 Denbo, Fuji 417-0061, Shizuoka, Japan
| | - Toshiaki Watanabe
- Fuji Medical Association, 2850 Denbo, Fuji 417-0061, Shizuoka, Japan
| | - Hisako Sakamoto
- Mental Health and Welfare Center of Shizuoka Prefectural Government, 2-20 Ariake-cho, Suruga-ku, Shizuoka-shi 422-8031, Shizuoka, Japan
| | - Teruaki Matsumoto
- Shizuoka General Hospital, 4-27-1 Kitaando, Aoi-ku, Shizuoka-shi 420-8527, Shizuoka, Japan
| | - Naohisa Uchimura
- Department of Neuropsychiatry, Kurume University School of Medicine, 67 Asahi-machi, Kurume 830-0011, Fukuoka, Japan
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A systematic review of predictors of suicidal thoughts and behaviors among autistic adults: Making the case for the role of social connection as a protective factor. Clin Psychol Rev 2023; 99:102235. [PMID: 36459876 DOI: 10.1016/j.cpr.2022.102235] [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: 03/28/2022] [Revised: 09/21/2022] [Accepted: 11/23/2022] [Indexed: 11/29/2022]
Abstract
Autistic adults are a high-risk population for suicidal thoughts and behaviors (STBs). Accordingly, this systematic review aims to review the prevalence of STBs among autistic adults, review the risk and protective factors for STBs in autistic adults, and formulate a disorder-specific conceptualization of risk in this population. We systematically searched PsycINFO and Google Scholar for all studies published prior to March 28th, 2022. We included empirical articles focused on autistic adults, ages 18 years and older, reporting on suicide-related outcomes. In total, 45 peer-reviewed empirical articles were included in the current systematic review. The most frequently studied factors in relation to suicide risk among autistic adults were interpersonal constructs (42.4% of total studies looking at risk/protective factors) and depressive symptoms (36.4% of total studies looking at risk/protective factors). We conclude by summarize two key content areas: exploring social and interpersonal constructs and better understanding the role of depressive symptoms in autism. As researchers continue to explore STBs among autistic adults, it will be necessary to addressing the overreliance on autistic symptoms instead of autism diagnoses, measurement issues of STBs, and a need for treatment adaptations.
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Veid N, Pollari A, Hyvönen K, Pylvänäinen P. Dance movement therapy group improves social functioning and increases positive embodied experiences in social situations. BODY MOVEMENT AND DANCE IN PSYCHOTHERAPY 2022. [DOI: 10.1080/17432979.2022.2122563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Natalia Veid
- Department of Psychology, University of Jyväskylä, Jyväskylä, Finland
- Education and Learning Department, City of Helsinki, Student Welfare Service Unit, Helsinki, Finland
| | - Annukka Pollari
- Education and Learning Department, City of Helsinki, Student Welfare Service Unit, Helsinki, Finland
| | - Katriina Hyvönen
- Institute of Rehabilitation, JAMK University of Applied Sciences, Jyväskylä, Finland
| | - Päivi Pylvänäinen
- Education and Learning Department, City of Helsinki, Student Welfare Service Unit, Helsinki, Finland
- Mood Disorder Unit, Tampere University Hospital, Tampere, Finland
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22
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Abstract
OBJECTIVE Disturbances in interpersonal functioning are prevalent in individuals with suicidality. Foundational for interpersonal functioning is theory of mind (ToM), a social-cognitive ability that allows individuals to understand the thoughts and feelings of others. Recent work has begun to investigate ToM performance in individuals with suicidality, though no review has quantitatively aggregated findings from these varied studies. The current study investigated the relations between ToM and suicidality with meta-analysis. METHOD We identified and meta-analyzed 15 studies that presented data for 2,895 participants (617 of whom had reported at least one suicide attempt). RESULTS Results indicated a significant, negative relation between ToM and suicidality with a medium overall effect size (g = -.475). Moderator analyses revealed that this effect was consistent across age, sex, ToM content, and suicidal outcome. CONCLUSION Deficits in ToM associated with suicidality hold promise for risk-identification, treatment, and prevention work.HighlightsTheory of mind (ToM) abilities are critical for effective interpersonal functioning.Meta-analytics results indicate that ToM deficits are associated with suicidality.Identifying such suicidality-related ToM deficits may inform risk-identification, treatment, and prevention work.
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23
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Senna S, Schwab B, Melo HM, Diaz AP, Schwarzbold ML. Social cognition and suicide-related behaviors in depression: a cross-sectional, exploratory study. REVISTA BRASILEIRA DE PSIQUIATRIA (SAO PAULO, BRAZIL : 1999) 2022; 44:639-643. [PMID: 36709452 PMCID: PMC9851751 DOI: 10.47626/1516-4446-2021-2407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/05/2021] [Accepted: 04/18/2022] [Indexed: 12/24/2022]
Abstract
OBJECTIVE To explore the association between social cognition and previous suicide attempts and non-suicidal self-injurious behavior in adults with unipolar depressive disorders. METHODS Seventy-two patients undergoing outpatient treatment for unipolar depression were enrolled in this cross-sectional study. Theory of mind was assessed using the Hinting Task and the Revised Reading the Mind in the Eyes Test. Empathy was evaluated using the Interpersonal Reactivity Index. Lifetime suicide attempts and non-suicidal self-injurious behavior were assessed using the Columbia Suicide Risk Rating Scale. Participants with and without these suicide-related outcomes were compared in terms of social cognition. RESULTS Patients with previous suicide attempts performed worse on the Reading the Mind in the Eyes Test (p = 0.017). Patients with a history of non-suicidal self-injurious behavior were younger (p = 0.005), had a younger age at first depressive episode (p = 0.017), and scored higher on personal distress in the Interpersonal Reactivity Index (p = 0.027). Only personal distress remained independently associated with non-suicidal self-injurious behavior in multivariable analysis (p = 0.038). CONCLUSION Among patients with depression, those with previous suicide attempts or non-suicidal self-injurious behavior showed worse social cognition. These results encourage future research on social cognition deficits as clinical markers of suicide-related behaviors and as targets for interventions.
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Affiliation(s)
- Sofia Senna
- Programa de Pós-Graduação em Ciências Médicas, Universidade Federal de Santa Catarina (UFSC), Florianópolis, SC, Brazil,Instituto de Psiquiatria de Santa Catarina, São José, SC, Brazil,Correspondence: Sofia Senna Gonçalves, Av. Engelberto Koerich, 333, Colônia Santana, CEP 88123-300, São José, SC, Brazil. E-mail:
| | - Bianca Schwab
- Programa de Pós-Graduação em Ciências Médicas, Universidade Federal de Santa Catarina (UFSC), Florianópolis, SC, Brazil
| | - Hiago M. Melo
- Programa de Pós-Graduação em Neurociências, UFSC, Florianópolis, SC, Brazil
| | - Alexandre P. Diaz
- Louis A. Faillace Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Marcelo L. Schwarzbold
- Programa de Pós-Graduação em Ciências Médicas, Universidade Federal de Santa Catarina (UFSC), Florianópolis, SC, Brazil
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24
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Chard J, Cook R, Press C. Impaired sensitivity to spatial configurations in healthy aging. Cortex 2022; 155:347-356. [DOI: 10.1016/j.cortex.2022.05.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 03/16/2022] [Accepted: 05/16/2022] [Indexed: 11/03/2022]
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25
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Abstract
OBJECTIVE Social cognition is impaired in mild cognitive impairment (MCI) and dementia. However, its relationship to social functioning and perceived social support has yet to be explored. Here, we examine how theory of mind (ToM) relates to social functioning in MCI and dementia. METHODS Older adults (cognitively normal = 1272; MCI = 132; dementia = 23) from the PATH Through Life project, a longitudinal, population-based study, were assessed on the Reading the Mind in the Eyes Test (RMET), measures of social functioning, and social well-being. The associations between RMET performance, social functioning, and cognitive status were analysed using generalised linear models, adjusting for demographic variables. RESULTS Participants with MCI (b=-.52, 95% CI [-.70, -.33]) and dementia (b=-.78, 95% CI [-1.22, -.34]) showed poorer RMET performance than cognitively normal participants. Participants with MCI and dementia reported reduced social network size (b=-.21, 95% CI [-.40, -.02] and b=-.90, 95% CI [-1.38, -.42], respectively) and participants with dementia reported increased loneliness (b = .36, 95% CI [.06, .67]). In dementia, poorer RMET performance was associated with increased loneliness (b=-.07, 95% CI [-.14, -.00]) and a trend for negative interactions with partners (b=-.37, 95% CI [-.74, .00]), but no significant associations were found in MCI. CONCLUSIONS MCI and dementia were associated with poor self-reported social function. ToM deficits were related to poor social function in dementia but not MCI. Findings highlight the importance of interventions to address social cognitive deficits in persons with dementia and education of support networks to facilitate positive interactions and social well-being.
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26
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Chao M, Koay JM, Van Meter A. Does mood affect judgment: Results from an in vivo observational study. CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-022-03437-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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27
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Shiraly R, Mahdaviazad H, Zohrabi R, Griffiths MD. Suicidal ideation and its related factors among older adults: a population-based study in Southwestern Iran. BMC Geriatr 2022; 22:371. [PMID: 35484508 PMCID: PMC9046067 DOI: 10.1186/s12877-022-03049-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Accepted: 04/11/2022] [Indexed: 01/01/2023] Open
Abstract
Objectives Suicidal ideation is a major risk factor for suicide and can negatively affect self-care and health behaviors among the older adults. There are limited data on the prevalence and risk factors of suicidal ideation among the older population during the COVID-19 pandemic. The aim of the present study was to examine the prevalence and risk factors of suicidal ideations among Iranian older adults during the COVID-19 pandemic. Methods A total of 803 older community adults in Shiraz (Southwestern Iran) were surveyed to determine potential factors influencing suicidal ideation, including demographic factors, physical health status, access to healthcare, current depression status, fear of COVID-19, perceived social support, and social engagement. Data were collected utilizing face-to-face interviews between November and December 2020. Multivariate logistic regression analysis was used to identify independent variables associated with suicidal ideations. Results Among the 803 participants, 69 reported suicidal ideations (8.6%). Individuals with suicidal ideations were more likely to have greater fear of COVID-19. However, based on the results of multivariate logistic regression analysis, current depression (OR: 2.07, CI 95%: 1.18–3.65), not being married (OR: 1.82, CI 95%: 1.06–3.13), inability to pay for medical bills (OR: 2.16, CI 95%: 1.23–3.79), low perceived social support (OR: 2.03, CI95%: 1.11–3.71), and having limited social network (OR:1.77, CI 95%: 1.02–3.10) appeared to be more powerful influencing factors. Conclusion Suicidal ideation appears to be relatively common among Iranian older adults during the COVID-19 pandemic. A lack of longitudinal data makes it difficult to establish an association between suicidal ideations and the COVID-19 pandemic. Systematic monitoring of suicidal ideation is recommended among high-risk groups, particularly the older population.
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Affiliation(s)
- Ramin Shiraly
- Department of Community Medicine, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.,Health Behavior Science Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Hamideh Mahdaviazad
- Department of Community Medicine, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Roya Zohrabi
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mark D Griffiths
- International Gaming Research Unit, Psychology Department, Nottingham Trent University, 50 Shakespeare Street, Nottingham, NG1 4FQ, UK
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28
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Nestor BA, Sutherland S, Garber J. Theory of mind performance in depression: A meta-analysis. J Affect Disord 2022; 303:233-244. [PMID: 35176344 PMCID: PMC8961451 DOI: 10.1016/j.jad.2022.02.028] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Revised: 02/04/2022] [Accepted: 02/12/2022] [Indexed: 11/16/2022]
Abstract
BACKGROUND Theory of mind (ToM) is a social-cognitive skill that involves the ability to understand the thoughts and feelings of others. Evidence is mixed regarding the extent of ToM ability in individuals with depression. METHODS We conducted a meta-analysis of 43 studies to investigate the strength of the association between ToM and depression. RESULTS Results indicated significant, small- to moderate impairment in ToM with a medium overall effect size (g = -0.398) in individuals with depression. Moderator analyses compared effect sizes across groups for the following variables: ToM content, process, and sample type. Additionally, meta-regression analyses tested age and gender as continuous moderators. LIMITATIONS The cross-sectional nature of included studies limits this meta-analysis from clarifying temporal or bidirectional relations. CONCLUSIONS We discuss findings in the context of the extant developmental, cognitive, social, and clinical literatures. We also suggest several possible explanations for these findings and offer implications for intervention.
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Affiliation(s)
- Bridget A. Nestor
- Vanderbilt University, Department of Psychology and Human Development, Peabody #552, 230 Appleton Place, Nashville, TN 37203, United States of America
| | - Susanna Sutherland
- Vanderbilt University, Department of Psychology and Human Development, Peabody #552, 230 Appleton Place, Nashville, TN 37203, United States of America
| | - Judy Garber
- Vanderbilt University, Department of Psychology and Human Development, Peabody #552, 230 Appleton Place, Nashville, TN 37203, United States of America
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29
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Cui R, Gujral S, Galfalvy H, Szanto K. The Role of Perceived and Objective Social Connectedness on Risk for Suicidal Thoughts and Behavior in Late-Life and Their Moderating Effect on Cognitive Deficits. Am J Geriatr Psychiatry 2022; 30:527-532. [PMID: 34600819 PMCID: PMC8898978 DOI: 10.1016/j.jagp.2021.08.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 08/06/2021] [Accepted: 08/23/2021] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Impaired cognition increases suicide risk while social connectedness protects against suicide risk in late life. We examined the independent and interactive effects of social connectedness and cognition on suicide risk in late life. METHODS Participants included 570 individuals aged 50+ from a late-life suicide study. The Interpersonal Support Evaluation List and Social Network Index were used to assess perceived and objective social connectedness, respectively, while the Mattis Dementia Rating Scale and Executive Interview were used to assess cognition. RESULTS Suicide attempters and ideators reported lower perceived social connectedness and exhibited worse executive function than non-suicidal depressed and healthy comparison participants, while only attempters had worse objective social connectedness relative to the other groups. Executive dysfunction was linked to low objective social connectedness in attempters but higher objective social connectedness in healthy comparisons. CONCLUSION Interventions targeting suicide risk may consider bolstering social connectedness, particularly in those with low cognitive health.
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Affiliation(s)
| | | | - Hanga Galfalvy
- Columbia University Medical Center, Departments of Psychiatry and Biostatistics, NY, NY
| | - Katalin Szanto
- University of Pittsburgh School of Medicine (RC, SG, KS), Department of Psychiatry, Pittsburgh, PA.
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30
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Suicidal behaviour: What's the brain up to? J Psychiatr Res 2022; 146:210-218. [PMID: 35026694 DOI: 10.1016/j.jpsychires.2021.12.052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2021] [Revised: 12/19/2021] [Accepted: 12/22/2021] [Indexed: 11/23/2022]
Abstract
BACKGROUND Individuals with suicidal behaviours are increasingly recognized as having impairments in brain metabolism. However, these are not well delineated. AIM To evaluate regional cerebral glucose metabolism (rCMglu) in subjects with suicidal behaviours and assess differences in rCMglu between depressed and non-depressed suicidal subjects. METHODS Thirty-three subjects with suicidal behaviours were assessed using Columbia Suicide Severity Rating scale (CSSRS) and Beck's Depression Inventory (BDI). Brain metabolism was assessed using [18F]Fluoro,Deoxy-Glucose Positron Emission Tomography (FDG-PET). RESULTS Of 33 subjects, eighteen had depression. FDG-PET findings revealed that in comparison to mean asymptomatic controls, subjects had decreased rCMglu in right inferior frontal, left Broca's, left inferiolateral andsuperiolateral temporal, right inferior parietal and left posterior cingulate cortex. Increased rCMglu was seen in bilateral superior and medial frontal, right inferiolateral and posteriomedial temporal cortex, and midbrain. CSSRS total intensity inversely correlated with rCMglu in medial frontal cortex, left Broca's and superiolateral temporal cortex and directly correlated with rCMglu in right cerebellum. There was no significant difference in rCMglu between depressed and non depressed group. CONCLUSIONS Significant differences exist in rCMglu of suicidal individuals, chiefly in frontal and temporal regions. Understanding these would help us identify individuals more at risk for suicidal behaviours.
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31
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Pagnoni I, Gobbi E, Alaimo C, Campana E, Rossi R, Manenti R, Balconi M, Cotelli M. The relationship between theory of mind and executive functions in major depressive disorders: A review. Front Psychiatry 2022; 13:980392. [PMID: 36051550 PMCID: PMC9424552 DOI: 10.3389/fpsyt.2022.980392] [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: 06/28/2022] [Accepted: 07/25/2022] [Indexed: 11/13/2022] Open
Abstract
Patients suffering from major depressive disorder (MDD) experience difficulties in multiple cognitive and affective abilities. A large body of literature has argued that MDD patients show impaired executive functions (EFs) and deficits in theory of mind (ToM), the ability to infer the mental states of others. However, the relationship between ToM and EFs has been poorly investigated. The aim of this review is to provide an overview of studies that evaluated the association between ToM and EFs in patients with MDD diagnosis. A literature review was conducted to identify all published studies in which ToM and EFs measures were administered to individuals with MDD and in which the relationship between these two domains was investigated. Eleven studies were included, and for each study, we discussed the findings related to ToM, EFs, and the nature of the link between these two aspects. Most of the studies reported that patients with MDD, compared with healthy controls, showed significant impairments in both ToM and EFs abilities. Moreover, this review indicates the presence of a significant association between these two domains in MDD patients, supporting the evidences that executive functioning is important to perform ToM tasks. Although the results that emerged are interesting, the relationship between ToM and EFs in MDD needs further investigation.
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Affiliation(s)
- Ilaria Pagnoni
- Neuropsychology Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Elena Gobbi
- Neuropsychology Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Cristina Alaimo
- Neuropsychology Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Elena Campana
- Neuropsychology Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Roberta Rossi
- Unit of Psychiatry, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Rosa Manenti
- Neuropsychology Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Michela Balconi
- International Research Center for Cognitive Applied Neuroscience (IrcCAN), Catholic University of the Sacred Heart, Milan, Italy.,Research Unit in Affective and Social Neuroscience, Department of Psychology, Catholic University of the Sacred Heart, Milan, Italy
| | - Maria Cotelli
- Neuropsychology Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
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32
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Pacifico D, Sabatini S, Fiordelli M, Albanese E. The role of disability and depressive symptoms in the relation between objective cognitive performance and subjective cognitive decline. Front Psychiatry 2022; 13:963703. [PMID: 36506437 PMCID: PMC9729556 DOI: 10.3389/fpsyt.2022.963703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 11/09/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Subjective cognitive decline (SCD) and subjective memory decline (SMD) are common among older people. Evidence linking SCD and SMD with cognitive and memory impairment is inconsistent. Moreover, little is known about the associations of SCD and SMD with disability. We aimed to explore the associations of SCD and SMD with objective cognitive and memory performance, disability, and depressive symptoms. MATERIALS AND METHODS In a cross-sectional study we conducted face to face interviews in a randomized sample of people aged ≥65 years living in the Canton of Ticino, southern Switzerland, between May 2021 and April 2022. We measured subjective cognitive decline with the MyCog, a subsection of the Subjective Cognitive Decline Questionnaire (SCD-Q); cognitive functioning with the Community Screening Instrument for Dementia; memory with the consortium to establish a registry for alzheimer's disease (CERAD) 10-word list learning task; and disability and depressive symptoms with the world health organization disability assessment schedule 2.0 (WHO-DAS 2.0) and the Euro-Depression (EURO-D) scales, respectively. RESULTS Of the 250 participants 93.6% reported at least one cognitive difficulty, and 40.0% SMD. Both SCD and SMD were associated with poorer objective cognitive/memory performance, and independently with greater disability, and more depressive symptoms. But in participants with high disability and depressive symptoms subjective and objective cognition were no longer associated. Disability fully mediated the associations of poorer objective cognitive and memory performance with subjective cognitive and memory decline. CONCLUSION Routine clinical assessments of cognitive function should include formal enquires about SCD and SMD, and also account for disability and depressive symptoms.
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Affiliation(s)
- Deborah Pacifico
- Faculty of Biomedical Sciences, Institute of Public Health, Università della Svizzera Italiana, Lugano, Switzerland
| | - Serena Sabatini
- Faculty of Biomedical Sciences, Institute of Public Health, Università della Svizzera Italiana, Lugano, Switzerland
| | - Maddalena Fiordelli
- Faculty of Biomedical Sciences, Institute of Public Health, Università della Svizzera Italiana, Lugano, Switzerland
| | - Emiliano Albanese
- Faculty of Biomedical Sciences, Institute of Public Health, Università della Svizzera Italiana, Lugano, Switzerland
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33
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Kern DM, Cepeda MS, Wiegand F. Treatment patterns of patients diagnosed with major depressive disorder and suicidal ideation or attempt: a U.S. population-based study utilizing real-world data. BMC Psychiatry 2021; 21:608. [PMID: 34872530 PMCID: PMC8647448 DOI: 10.1186/s12888-021-03616-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Accepted: 11/18/2021] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND There is a knowledge gap regarding the treatment patterns of patients with major depressive disorder (MDD) who experience suicidal ideation or a suicide attempt (SI/SA). METHODS Patients with SI/SA were identified from a large US-based claims database covering 84 million lives, during 1/1/2014-3/31/2020. Patients with MDD were indexed at their first diagnosis for SI/SA and followed up to 365 days. Treatment patterns were captured at the class level and included procedures of electroconvulsive therapy and transcranial magnetic stimulation, and pharmacotherapy including selective serotonin reuptake inhibitors (SSRIs), serotonin and norepinephrine reuptake inhibitors, tricyclic antidepressants, other antidepressants, anxiolytics, hypnotics/sedatives, antipsychotics, psychostimulants, and lithium. RESULTS There were 42,204 MDD + SI/SA patients identified. In the year prior to the index event > 40% of individuals received an SSRI and more than one-third received an anxiolytic. Within 1 year following, 84.4% received ≥1 of the treatments of interest. Of those, 70.2% went on to a subsequent class-based regimen, 46.3% received a third, and 28.1% received ≥4. More than three-quarters of patients received multiple treatment classes simultaneously. SSRIs were the most common treatments during follow-up (61.9%), followed by other antidepressants (51.3%), anxiolytics (50.8%) and anticonvulsants (43.6%). CONCLUSIONS There was a large amount of variability and polypharmacy in the treatments received by MDD patients with SI/SA, and is much more complex than what has been previously observed in the general MDD population. Within one-year, many patients received four or more unique class-based regimens and most patients received treatments from multiple classes simultaneously, indicating the high unmet medical need and therapy refractoriness of this patient population.
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Affiliation(s)
- David M. Kern
- grid.497530.c0000 0004 0389 4927Janssen Research & Development, LLC, 1125 Trenton Harbourton Rd, Titusville, NJ 08560 USA
| | - M. Soledad Cepeda
- grid.497530.c0000 0004 0389 4927Janssen Research & Development, LLC, 1125 Trenton Harbourton Rd, Titusville, NJ 08560 USA
| | - Frank Wiegand
- grid.497530.c0000 0004 0389 4927Janssen Global Services LLC, Titusville, NJ 08560 USA
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34
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Wang Y, Guobule N, Li M, Li J. The correlation of facial emotion recognition in patients with drug-naïve depression and suicide ideation. J Affect Disord 2021; 295:250-254. [PMID: 34482056 DOI: 10.1016/j.jad.2021.08.051] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Revised: 08/05/2021] [Accepted: 08/21/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND The ability of facial emotion recognition is often impaired in Major depressive disorder (MDD). The impairment of recognizing facial emotions may contribute to the disruption of interpersonal interaction. Perceived social isolation and social rejection are risk factors for suicide. This study aimed to investigate the ability of facial emotion recognition in drug-naïve MDD patients with first-episode with suicidal ideation. METHODS 98 drug-naïve outpatients with the first episode of depression were recruited, including 53 patients with suicidal ideation (SI) and 45 patients without suicidal ideation (NSI). The Beck Scale for Suicide Ideation-Chinese Version was adopted to evaluate the suicidal ideation and suicidal risk in the latest week. Depressive symptoms were assessed with the Hamilton Depression Rating Scale-17 (HDRS-17). Facial Emotion Recognition Test and the repeatable battery for the assessment of neuropsychological status (RBANS) were administered to assess the ability of emotion recognition and cognitive function. RESULTS Our finding indicated that recognizing fear emotions was more accurate in the SI than the NSI group (OR = 1.142; 95% CI = 1.020, 1.280; p = 0.022). Patients with high suicidal risk may have more difficulties recognizing the neutral facial expressions (B=-0.310, 95% CI = -5.031, -0.845, p = 0.007). LIMITATIONS Limitations include a small sample size and use of cross-sectional data. CONCLUSIONS Our finding suggests that the variation of facial emotion recognition in drug-naïve MDD patients with first-episode with suicidal ideation and targeting this signal may help identify suicidal ideation to decrease the risk of suicide behavior in MDD.
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Affiliation(s)
- Yuting Wang
- Laboratory of Biological Psychiatry, Institute of Mental Health, Tianjin Anding Hospital, Tianjin Medical University, Tianjin 300222, China
| | - Nanage Guobule
- Laboratory of Biological Psychiatry, Institute of Mental Health, Tianjin Anding Hospital, Tianjin Medical University, Tianjin 300222, China
| | - Meijuan Li
- Laboratory of Biological Psychiatry, Institute of Mental Health, Tianjin Anding Hospital, Tianjin Medical University, Tianjin 300222, China
| | - Jie Li
- Laboratory of Biological Psychiatry, Institute of Mental Health, Tianjin Anding Hospital, Tianjin Medical University, Tianjin 300222, China.
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Cetin S, Sozeri Varma G, Toker Ugurlu T, Ozdel IO. Theory of Mind in Somatization and Depression: Is It Cause or Phenomenon? J Nerv Ment Dis 2021; 209:911-917. [PMID: 34310521 DOI: 10.1097/nmd.0000000000001399] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
ABSTRACT Although mentalization is important in somatic symptom disorder (SSD) and major depressive disorder (MDD), it is not fully understood. In this study, we aimed to investigate the relation between somatic and depressive symptoms with mentalization. A total of 48 patients diagnosed with SSD, 50 patients diagnosed with MDD, and 50 healthy individuals, participated the study. The Montgomery-Asperg Depression Scale, Symptom Checklist-90 Revised, and Reading the Mind in the Eyes Test (RMET) were applied to the participants. The patients with SSD showed significantly the lowest performance of theory of mind. There was no significant difference between MDD and healthy controls. High somatization score was found to be a predictor for low RMET scores (95% confidence interval, -0.339; p = 0.014). Mentalization deficit seems to be associated with somatization rather than depression.
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Affiliation(s)
| | - Gulfizar Sozeri Varma
- Department of Psychiatry, Faculty of Medicine, Pamukkale University, Denizli, Turkey
| | - Tugce Toker Ugurlu
- Department of Psychiatry, Faculty of Medicine, Pamukkale University, Denizli, Turkey
| | - Ismail Osman Ozdel
- Department of Psychiatry, Faculty of Medicine, Pamukkale University, Denizli, Turkey
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36
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De Leo D, Giannotti AV. Suicide in late life: A viewpoint. Prev Med 2021; 152:106735. [PMID: 34538377 PMCID: PMC8443431 DOI: 10.1016/j.ypmed.2021.106735] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 05/06/2021] [Accepted: 07/16/2021] [Indexed: 01/07/2023]
Abstract
Suicide in old age represents a sad public health concern. Despite the global decline in rates of suicide and the general amelioration of quality of life and access to health care for older adults, their rates of suicide remain the highest virtually in every part of the world. With the aging of the world population and the growing number of mononuclear families, the risk of an increase in isolation, loneliness and dependency does not appear ungrounded. The Covid-19 pandemic is claiming the life of many older persons and creating unprecedented conditions of distress, particularly for this segment of the population. This article briefly examines the main characteristics of suicidal behavior in late life, including observations deriving from the spread of the Sars-2 coronavirus and possible strategies for prevention.
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Liu H, Chen B, Wang Y, Zhao X, Hu J. Social affiliation moderates the link between depressive symptoms and heart rate variability in healthy middle-aged and older individuals: An intensive ecologic momentary assessment study. Psychophysiology 2021; 59:e13958. [PMID: 34687474 DOI: 10.1111/psyp.13958] [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: 12/06/2020] [Revised: 09/30/2021] [Accepted: 10/06/2021] [Indexed: 11/28/2022]
Abstract
Depressive symptoms have been associated with lower cardiac autonomic control, thus contributing to cardiovascular diseases, especially among older adults. Interpersonal factors have been found to attenuate physiologic stress responses, but little is known about whether these factors (e.g., perceived affiliation) would moderate the relation of depressive symptoms and cardiovascular activation. The present research aimed to investigate the interplay of depressive symptoms and momentary-assessed interpersonal perceptions on cardiac vagal tone as indexed by heart rate variability (HRV). The sample consisted of 78 late middle-aged and older community-dwelling participants (48.7% male, mean age = 59.15 years). Participants reported on depressive symptoms and other personal characteristics by questionnaire. Perceptions of interpersonal affiliation, ambulatory HRV, and contextual variables were recorded using ecologic momentary assessment and portable electrocardiogram (ECG) monitoring device throughout 1 week (with a maximum of seven times daily). Multilevel analyses found that depressive symptoms were correlated with lower HRV, whereas momentary interpersonal perceptions of higher affiliation were associated with elevated HRV. A significant association was revealed between depressive symptoms and momentary affiliation perceptions on HRV. When individuals were involved in social interactions with higher affiliation, the effect of depressive symptoms on reducing HRV was attenuated. These findings suggested that the effects of subthreshold depressive symptoms on vagal control of the heart could be altered by the quality of interpersonal experiences.
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Affiliation(s)
- Huiying Liu
- Department of Sociology, Central South University, Changsha, China.,Sau Po Centre on Ageing, The University of Hong Kong, Hong Kong, Hong Kong
| | - Beizhuo Chen
- Department of Sociology, Central South University, Changsha, China
| | - Yao Wang
- Fuwai Hospital National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences & Peking Union Medical College Fuwai Hospital, Beijing, China
| | - Xinyi Zhao
- School of Health Humanities, Peking University, Beijing, China
| | - Jian Hu
- Department of Hematology, Xiangya Hospital, Central South University, Changsha, China
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Lutz J, Van Orden KA, Bruce ML, Conwell Y. Social Disconnection in Late Life Suicide: An NIMH Workshop on State of the Research in Identifying Mechanisms, Treatment Targets, and Interventions. Am J Geriatr Psychiatry 2021; 29:731-744. [PMID: 33622593 PMCID: PMC8286287 DOI: 10.1016/j.jagp.2021.01.137] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 01/27/2021] [Indexed: 12/13/2022]
Abstract
Both social disconnection and suicide are significant public health concerns among older adults, and social disconnection is associated with greater risk for suicide-related thoughts and behaviors in late life. We present a synthesis of research discussed during a workshop hosted by the National Institute of Mental Health on social disconnection and late-life suicide. Social disconnection is related to suicide risk in late life via a variety of mechanisms, including biological, behavioral, and psychological correlates. Researchers in several scientific fields have begun to establish these connections and identify targets for interventions to reduce risk in late life. While research has demonstrated that social connection is amenable to change, there is little research to date on the most evidence-based interventions to mitigate social disconnection or the related risks. However, there are several promising biological, behavioral, and psychological interventions that may target various mechanisms, as well as social disconnection itself. With a relative paucity of research in this area, these lines of study are ripe for innovative investigation. In order to most effectively advance the field, we must establish more consistent definitions of social connection and disconnection; more accurately measure and assess older adults' social needs; examine the most effective approaches and modalities for assessment and intervention; take into account important contextual factors; and apply a translational, convergent scientific approach.
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Affiliation(s)
- Julie Lutz
- Center for the Study and Prevention of Suicide, Department of Psychiatry (JL), University of Rochester Medical Center, Rochester, NY.
| | - Kimberly A Van Orden
- Center for the Study and Prevention of Suicide, Department of Psychiatry (KAVO), University of Rochester Medical Center, Rochester, NY
| | - Martha L Bruce
- Department of Psychiatry (MLB), Geisel School of Medicine, Dartmouth, NH
| | - Yeates Conwell
- Center for the Study and Prevention of Suicide, Department of Psychiatry (YC), University of Rochester Medical Center, Rochester, NY
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Ali R, Hoque E, Duberstein P, Schubert L, Razavi SZ, Kane B, Silva C, Daks JS, Huang M, Van Orden K. Aging and Engaging: A Pilot Randomized Controlled Trial of an Online Conversational Skills Coach for Older Adults. Am J Geriatr Psychiatry 2021; 29:804-815. [PMID: 33308893 PMCID: PMC8140061 DOI: 10.1016/j.jagp.2020.11.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2020] [Revised: 10/29/2020] [Accepted: 11/12/2020] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Communication difficulties negatively impact relationship quality and are associated with social isolation and loneliness in later life. There is a need for accessible communication interventions offered outside specialty mental health settings. DESIGN Pilot randomized controlled trial. SETTING Assessments in the laboratory and intervention completed in-home. PARTICIPANTS Twenty adults age 60 and older from the community and a geriatric psychiatry clinic. INTERVENTION A web-based communication coach that provides automated feedback on eye contact, facial expressivity, speaking volume, and negative content (Aging and Engaging Program, AEP), delivered with minimal assistance in the home (eight brief sessions over 4-6 weeks) or control (education and videos on communication). MEASUREMENTS System Usability Scale and Social Skills Performance Assessment, an observer-rated assessment of social communication elicited through standardized role-plays. RESULTS Ninety percent of participants completed all AEP sessions and the System Usability Scale score of 68 was above the cut-off for acceptable usability. Participants randomized to AEP demonstrated statistically and clinically significant improvement in eye contact and facial expressivity. CONCLUSION The AEP is acceptable and feasible for older adults with communication difficulties to complete at home and may improve eye contact and facial expressivity, warranting a larger RCT to confirm efficacy and explore potential applications to other populations, including individuals with autism and social anxiety.
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Affiliation(s)
- Rafayet Ali
- Department of Computer Science, University of Rochester
| | - Ehsan Hoque
- Department of Computer Science, University of Rochester
| | - Paul Duberstein
- Department of Health Behavior, Society & Policy, Rutgers University School of Public Health
| | | | | | - Benjamin Kane
- Department of Computer Science, University of Rochester
| | - Caroline Silva
- Department of Psychiatry, University of Rochester School of Medicine & Dentistry
| | | | - Meghan Huang
- Department of Psychology, University of Rochester
| | - Kim Van Orden
- Department of Psychiatry (CS, KVO), University of Rochester School of Medicine & Dentistry, Rochester, NY.
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40
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Van Orden KA, Areán PA, Conwell Y. A Pilot Randomized Trial of Engage Psychotherapy to Increase Social Connection and Reduce Suicide Risk in Later Life. Am J Geriatr Psychiatry 2021; 29:789-800. [PMID: 33952416 PMCID: PMC8286301 DOI: 10.1016/j.jagp.2021.03.009] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 03/09/2021] [Accepted: 03/29/2021] [Indexed: 12/20/2022]
Abstract
BACKGROUND Targeting social connection to prevent suicide in later life shows promise but requires additional study to identify the most effective and acceptable interventions. This study examines acceptability, feasibility, and efficacy of Engage Psychotherapy to improve subjective disconnection (target mechanisms: low belonging and perceived burden), and improve clinical and functional outcomes (depression, suicide ideation, quality of life). METHODS Pilot randomized trial with adults age 60 and older who reported feeling lonely and/or like a burden. Participants were randomly assigned to 10 sessions of 'Social Engage' (S-ENG; n = 32) or care-as-usual (CAU; n = 30), with follow-up assessments at 3 weeks, 6 weeks, and 10 weeks. RESULTS S-ENG is feasible to deliver over 10 sessions and acceptable to older adults who report social disconnection-a population at risk for suicide. Participants were willing and able to focus each session on social engagement and demonstrated high levels of compliance. Social Engage did not show preliminary evidence of impact on belonging or perceived burden but was effective in reducing depressive symptoms and improving social-emotional quality of life. DISCUSSION S-ENG holds promise for improving social-emotional quality of life and depressive symptoms. Future research is needed to identify and measure target mechanisms that account for clinical and functional improvement.
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Affiliation(s)
- Kimberly A Van Orden
- Department of Psychiatry (KAO, YC), University of Rochester Medical Center, Rochester, NY.
| | - Patricia A Areán
- Department of Psychiatry & Behavioral Sciences (PAA), University of Washington, WA
| | - Yeates Conwell
- Department of Psychiatry (KAO, YC), University of Rochester Medical Center, Rochester, NY
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Szanto K, Whitman K. Improving Social Connections to Reduce Suicide Risk: A Promising Intervention Target? Am J Geriatr Psychiatry 2021; 29:801-803. [PMID: 34078585 PMCID: PMC8434874 DOI: 10.1016/j.jagp.2021.04.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Accepted: 04/26/2021] [Indexed: 11/30/2022]
Affiliation(s)
- Katalin Szanto
- Department of Psychiatry (KS, KW), University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Kathrine Whitman
- Department of Psychiatry (KS, KW), University of Pittsburgh School of Medicine, Pittsburgh, PA
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42
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Saberi A, Mohammadi E, Zarei M, Eickhoff SB, Tahmasian M. Structural and functional neuroimaging of late-life depression: a coordinate-based meta-analysis. Brain Imaging Behav 2021; 16:518-531. [PMID: 34331655 DOI: 10.1007/s11682-021-00494-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Accepted: 06/28/2021] [Indexed: 10/20/2022]
Abstract
Several neuroimaging studies have investigated localized aberrations in brain structure, function or connectivity in late-life depression, but the ensuing results are equivocal and often conflicting. Here, we provide a quantitative consolidation of neuroimaging in late-life depression using coordinate-based meta-analysis by searching multiple databases up to March 2020. Our search revealed 3252 unique records, among which we identified 32 eligible whole-brain neuroimaging publications comparing 674 patients with 568 controls. The peak coordinates of group comparisons between the patients and the controls were extracted and then analyzed using activation likelihood estimation method. Our sufficiently powered analysis on all the experiments, and more homogenous subsections of the data (patients > controls, controls > patients, and functional imaging experiments) revealed no significant convergent regional abnormality in late-life depression. This inconsistency might be due to clinical and biological heterogeneity of LLD, as well as experimental (e.g., choice of tasks, image modalities) and analytic flexibility (e.g., preprocessing and analytic parameters), and distributed patterns of neural abnormalities. Our findings highlight the importance of clinical/biological heterogeneity of late-life depression, in addition to the need for more reproducible research by using pre-registered and standardized protocols on more homogenous populations to identify potential consistent brain abnormalities in late-life depression.
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Affiliation(s)
- Amin Saberi
- Institute of Medical Science and Technology, Shahid Beheshti University, Tehran, Iran
| | - Esmaeil Mohammadi
- Institute of Medical Science and Technology, Shahid Beheshti University, Tehran, Iran.,Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mojtaba Zarei
- Institute of Medical Science and Technology, Shahid Beheshti University, Tehran, Iran
| | - Simon B Eickhoff
- Institute of Neuroscience and Medicine (INM-7: Brain and Behaviour), Research Centre Jülich, Jülich, Germany.,Institute of Systems Neuroscience, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Masoud Tahmasian
- Institute of Medical Science and Technology, Shahid Beheshti University, Tehran, Iran.
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Mukku SSR, Dahale AB, Muniswamy NR, Muliyala KP, Sivakumar PT, Varghese M. Geriatric Depression and Cognitive Impairment-An Update. Indian J Psychol Med 2021; 43:286-293. [PMID: 34385720 PMCID: PMC8327864 DOI: 10.1177/0253717620981556] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Depression and cognitive impairment often coexist in older adults. The relation between depression and cognitive impairment is complex. The objective of this article is to review recent literature on cognitive impairment in older adults with depression and provide clinicians an update. METHODS We searched PubMed, Google Scholar, Science Direct, and Psych Info for the articles published in the English language related to late-life depression (LLD)/geriatric depression and cognitive impairment. We considered original research articles, relevant systematic reviews, chapters, and important conceptual articles published in the last 9 years (2011-2019). We selected relevant articles for this narrative review. CONCLUSION The concept pseudodementia, indicating depression with cognitive impairment mimicking dementia, is now seen only as a historical concept. The current literature strongly agrees with fact that cognitive deficits often exist in LLD. The cognitive deficits in depression were initially seen as trait marker; however, some recent studies suggest that cognitive deficits persist even in the remission phase. There is heterogeneity among the studies in terms of the nature of the cognitive deficits, but higher number of studies reported impairment in attention and executive function. LLD with cognitive deficits is at a higher risk of progression to dementia. In older adults, depression with cognitive impairments requires a comprehensive evaluation. Electroencephalography, event-related potentials, fluorodeoxyglucose-positron emission tomography, amyloid positron emission tomography, and CSF amyloid will supplement clinical evaluation in differentiating functional depressive disorder with cognitive impairment from depression with an underlying degenerative condition.
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Affiliation(s)
- Shiva Shanker Reddy Mukku
- Geriatric Clinic and Services, Dept. of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Ajit Bhalchandra Dahale
- Dept. of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | | | - Krishna Prasad Muliyala
- Dept. of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Palanimuthu Thangaraju Sivakumar
- Geriatric Clinic and Services, Dept. of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Mathew Varghese
- Geriatric Clinic and Services, Dept. of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
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44
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Kuroda Y, Orui M, Hori A. Trends in Suicide Mortality in 10 Years around the Great East Japan Earthquake: Analysis of Evacuation and Non-Evacuation Areas in Fukushima Prefecture. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18116005. [PMID: 34205006 PMCID: PMC8199884 DOI: 10.3390/ijerph18116005] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 05/29/2021] [Accepted: 05/30/2021] [Indexed: 12/11/2022]
Abstract
This study analyzed the suicide mortality rate in 12 municipalities in Fukushima Prefecture designated as evacuation areas following the 2011 nuclear disaster. Changes in suicide rates were examined using an exponential smoothing time series model. In the evacuation areas, the suicide rate of men increased immediately after the disaster and then decreased from 47.8 to 23.1 per 100,000 during about 1½ years after the disaster. However, with the lifting of the evacuation order, it again exceeded that of non-evacuation areas and continued to do so for the next 3 years. On the other hand, the suicide rate in women in the evacuation areas increased later than that in men. These results indicate the need for continuous support following the lifting of the evacuation order. In addition, it is necessary to enhance social networks, which continue to confer protection, because of the isolation of the elderly as highlighted in our previous study.
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Affiliation(s)
- Yujiro Kuroda
- Research Department, Fukushima Prefectural Centre for Environmental Creation, Fukushima 963-7700, Japan
- Correspondence: ; Tel.: +81-247-61-6140
| | - Masatsugu Orui
- Sendai City Mental Health and Welfare Center, Sendai 980-0845, Japan;
| | - Arinobu Hori
- Department of Psychiatry, Hori Mental Clinic, Fukushima 979-2335, Japan;
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45
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Sabatini S, Woods RT, Ukoumunne OC, Ballard C, Collins R, Clare L. Associations of subjective cognitive and memory decline with depression, anxiety, and two-year change in objectively-assessed global cognition and memory. AGING NEUROPSYCHOLOGY AND COGNITION 2021; 29:840-866. [PMID: 33971790 DOI: 10.1080/13825585.2021.1923634] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Research studies exploring the association of cognitive complaints with objectively assessed cognitive decline report inconsistent results. However, many of these have methodological limitations. We investigated whether 1) more severe subjective cognitive decline (SCD) and subjective memory decline (SMD) predict change in objectively assessed global cognition, remote memory, recent memory, learning; 2) the predictive value of more severe SMD over change in objectively assessed remote memory, recent memory, and learning is stronger for individuals that report an SMD that started within the past five years than for those that report an SMD that started five or more years previously and/or stronger for those that experienced SMD within the past two years than for those who had not; and 3) greater depression and anxiety are associated with more severe SCD and SMD. We used two-year longitudinal data from the CFAS-Wales study (N = 1,531; mean (SD) age = 73.0 (6.0) years). We fitted linear regression models. More severe SCD and SMD did not predict change in objectively assessed global cognition, remote memory, and recent memory but predicted lower scores in learning. The prediction of SMD over change in learning was not stronger when individuals reported an SMD that started within the past five years compared to when they reported an SMD that started five or more years previously nor when individuals reported an SMD that started within the past two years than those who did not. Greater depression and anxiety were associated with more severe SCD and SMD. More severe SMD may be useful for predicting lower learning ability and for identifying individuals experiencing depression and anxiety.
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Affiliation(s)
- Serena Sabatini
- College of Medicine and Health, University of Exeter, Exeter, UK
| | - Robert T Woods
- Dementia Services Development Centre, School of Health Sciences, Bangor University, Bangor, UK
| | - Obioha C Ukoumunne
- NIHR Applied Research Collaboration South West Peninsula, University of Exeter, UK
| | - Clive Ballard
- College of Medicine and Health, University of Exeter, Exeter, UK
| | - Rachel Collins
- College of Medicine and Health, University of Exeter, Exeter, UK
| | - Linda Clare
- College of Medicine and Health, University of Exeter, Exeter, UK
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46
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Lin C, Huang CM, Karim HT, Liu HL, Lee TMC, Wu CW, Toh CH, Tsai YF, Yen TH, Lee SH. Greater white matter hyperintensities and the association with executive function in suicide attempters with late-life depression. Neurobiol Aging 2021; 103:60-67. [PMID: 33845397 DOI: 10.1016/j.neurobiolaging.2020.12.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2020] [Revised: 11/27/2020] [Accepted: 12/15/2020] [Indexed: 10/21/2022]
Abstract
Late-life depression (LLD) is associated with greater risk of suicide and white matter hyperintensities (WMH), which are also found in suicide attempters regardless of age. Greater periventricular WMH are related to worse cognitive function. We investigated the spatial distribution of WMH in suicide attempters with LLD and its association with cognitive function. We recruited 114 participants with LLD (34 with history of suicide attempt and 80 without) and 47 older adult controls (individuals without LLD or history of suicide attempt). WMH were quantified by an automated segmentation algorithm and were classified into different regions. Suicide attempters with LLD had significantly higher global WMH (F3, 150 = 2.856, p = 0.039) and periventricular WMH (F3, 150 = 3.635, p = 0.014) compared to other groups. Suicide attempters with high WMH had significantly lower executive function, which could be an underlying mechanism for cognitive decline in older adults with suicidality.
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Affiliation(s)
- Chemin Lin
- Department of Psychiatry, Chang Gung Memorial Hospital, Keelung, Taiwan; College of Medicine, Chang Gung University, Taoyuan County, Taiwan; Community Medicine Research Center, Chang Gung Memorial Hospital, Keelung, Taiwan
| | - Chih-Mao Huang
- Department of Biological Science and Technology, National Chiao Tung University, Hsinchu, Taiwan
| | - Helmet T Karim
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Ho-Ling Liu
- Department of Imaging Physics, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Tatia Mei-Chun Lee
- Laboratory of Neuropsychology, The University of Hong Kong, Hong Kong; State Key Laboratory of Brain and Cognitive Science, The University of Hong Kong, Hong Kong
| | - Changwei W Wu
- Brain and Consciousness Research Center, Shuang-Ho Hospital, New Taipei, Taiwan; Graduate Institute of Mind, Brain and Consciousness, Taipei Medical University, Taipei, Taiwan
| | - Cheng Hong Toh
- Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Linkou, Taoyuan County, Taiwan
| | - Yun-Fang Tsai
- School of Nursing, College of Medicine, Chang Gung University, Tao-Yuan City, Taiwan; Department of Nursing, Chang Gung University of Science and Technology, Tao-Yuan City, Taiwan
| | - Tzung-Hai Yen
- College of Medicine, Chang Gung University, Taoyuan County, Taiwan; Department of Nephrology and Clinical Poison Center, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Shwu-Hua Lee
- College of Medicine, Chang Gung University, Taoyuan County, Taiwan; Department of Psychiatry, Linkou Chang Gung Memorial Hospital, Taoyuan County, Taiwan.
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Romirowsky A, Zweig R, Glick Baker L, Sirey JA. The Relationship Between Maladaptive Personality and Social Role Impairment in Depressed Older Adults in Primary Care. Clin Gerontol 2021; 44:192-205. [PMID: 30362909 PMCID: PMC6486454 DOI: 10.1080/07317115.2018.1536687] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Objective: Personality pathology is associated with impaired social functioning in adults, though further evidence is needed to examine the individual contributions of personality traits and processes to social functioning in depressed older adults. This study is a secondary analysis examining the relationship between maladaptive personality traits and processes and social role impairment in depressed older adults in primary care. Methods: Participants (N = 56) were 77% female and ranged in age between 55-89 (M = 66.82, SD = 8.75). Personality pathology was measured by maladaptive traits (NEO-FFI) and processes (Inventory of Interpersonal Problems; IIP-PD-15). Individual variable as well as combined predictive models of social role impairment were examined. Results: Higher neuroticism (β = 0.30, p < .05), lower agreeableness (β = -0.35 p < .001) and higher IIP-PD-15 (β = 0.28, p < .01) scores predicted greater impairment in social role functioning. A combined predictive model of neuroticism and IIP-PD-15 scores predicted unique variance in social role impairment (R2 = .71). Conclusion: These results link select personality traits and interpersonal processes to social role impairment, suggesting that these are indicators of personality pathology in older adults. Clinical Implications: These findings lend preliminary support for clinical screening of personality pathology in depressed older adults utilizing both personality trait and process measures.
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Affiliation(s)
| | - Richard Zweig
- Ferkauf Graduate School of Psychology, Yeshiva University
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Tekin U, Erermiş HS, Satar A, Aydın AN, Köse S, Bildik T. Social cognition in first episode adolescent depression and its correlation with clinical features and quality of life. Clin Child Psychol Psychiatry 2021; 26:140-153. [PMID: 33246372 DOI: 10.1177/1359104520973254] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Research has suggested that patients with depression have deficits in social cognition, however they provide limited data regarding adolescent depression. Moreover, the relationship of social cognition with clinical features and quality of life is less studied. This study investigated social cognition in depressive adolescents and the correlations of social cognition with clinical features and quality of life. Thirty-five depressed adolescents and 37 healthy controls were assessed. Emotion perception and decoding ToM, quality of life and clinical variables were evaluated. No significant differences were found between depression and control groups regarding social cognitive tests. The results indicated that examined clinical features were not correlated significantly with social cognitive tests. Results suggest that social cognitive abilities are not disturbed in adolescents with first depressive episode.
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Affiliation(s)
- Uğur Tekin
- Department of Child and Adolescent Psychiatry, University of Health Sciences, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey
| | - Hatice Serpil Erermiş
- Department of Child and Adolescent Psychiatry, School of Medicine, Ege University, Izmir, Turkey
| | - Ayşegül Satar
- Department of Child and Adolescent Psychiatry, School of Medicine, Ege University, Izmir, Turkey
| | - Ayşe Nur Aydın
- Department of Child and Adolescent Psychiatry, School of Medicine, Ege University, Izmir, Turkey
| | - Sezen Köse
- Department of Child and Adolescent Psychiatry, School of Medicine, Ege University, Izmir, Turkey
| | - Tezan Bildik
- Department of Child and Adolescent Psychiatry, School of Medicine, Ege University, Izmir, Turkey
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Gray V, Douglas KM, Porter RJ. Emotion processing in depression and anxiety disorders in older adults: systematic review. BJPsych Open 2020; 7:e7. [PMID: 33267933 PMCID: PMC7791559 DOI: 10.1192/bjo.2020.143] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Emotional cognition and effective interpretation of affective information is an important factor in social interactions and everyday functioning, and difficulties in these areas may contribute to aetiology and maintenance of mental health conditions. In younger people with depression and anxiety, research suggests significant alterations in behavioural and brain activation aspects of emotion processing, with a tendency to appraise neutral stimuli as negative and attend preferentially to negative stimuli. However, in ageing, research suggests that emotion processing becomes subject to a 'positivity effect', whereby older people attend more to positive than negative stimuli. AIMS This review examines data from studies of emotion processing in Late-Life Depression and Late-Life Anxiety to attempt to understand the significance of emotion processing variations in these conditions, and their interaction with changes in emotion processing that occur with ageing. METHOD We conducted a systematic review following PRISMA guidelines. Articles that used an emotion-based processing task, examined older persons with depression or an anxiety disorder and included a healthy control group were included. RESULTS In Late-Life Depression, there is little consistent behavioural evidence of impaired emotion processing, but there is evidence of altered brain circuitry during these processes. In Late-Life Anxiety and Post-Traumatic Stress disorder, there is evidence of interference with processing of negative or threat-related words. CONCLUSIONS How these findings fit with the positivity bias of ageing is not clear. Future research is required in larger groups, further examining the interaction between illness and age and the significance of age at disease onset.
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Affiliation(s)
- Vanessa Gray
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
| | - Katie M Douglas
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
| | - Richard J Porter
- Department of Psychological Medicine, University of Otago; and Canterbury District Health Board, Christchurch, New Zealand
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Clark CB, Armstrong J, Ballout MH, Ewy R. Examining the link between facial affect recognition and violent offending: A comparison between web-recruited volunteers with histories of violent and non-violent offending. CRIMINAL BEHAVIOUR AND MENTAL HEALTH : CBMH 2020; 30:228-239. [PMID: 32744391 DOI: 10.1002/cbm.2164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Revised: 03/02/2020] [Accepted: 07/09/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND The link between facial affect recognition and criminal justice involvement has been extensively researched, yet there are virtually no data on the capacity for facial affect recognition in post-incar+cerated individuals, and the results of many studies are limited due to a narrow focus on psychopathy rather than offence category. AIMS To test the first hypothesis that individuals reporting a history of a violent offence would show a deficit in facial affect recognition and the second hypothesis that the violent offender's deficit would be exclusive to recognition of negative expressions, not affecting positive or neutral expressions. METHOD Post-incarcerated individuals (N = 298) were recruited online through Qualtrics and completed questionnaires assessing their criminal justice background and demographics. They completed measures of facial affect recognition, anxiety and depression, and components of aggression. RESULTS A logistic regression, including sex, ethnicity, age and years of education and depression/anxiety scores, indicated that committing a violent offence was independently associated with lower facial affect recognition scores as well as male gender and a trait-based propensity towards physical aggression, but no other co-variable. These data provided no evidence that this deficit was specific to negative emotions. CONCLUSIONS AND IMPLICATIONS FOR FUTURE RESEARCH/PRACTICE Our study is one of the first to examine facial affect recognition in a post-incarcerated sample. It suggests that deficits in facial affect recognition, already well documented among violent prisoners, persist. While acknowledging that these may be relatively fixed characteristics, this study also suggests that, for these people, nothing happening during their imprisonment was touching this. Improving capacity in facial affect recognition should be considered as a target of intervention for violent offenders, developing or revising in-prison programmes as required.
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Affiliation(s)
- C Brendan Clark
- Department of Psychology, Wichita State University, Wichita, Kansas, USA
| | - Jacob Armstrong
- Department of Psychology, Wichita State University, Wichita, Kansas, USA
| | | | - Ryley Ewy
- Department of Psychology, Wichita State University, Wichita, Kansas, USA
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