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Huang D, He J, Zhang R, Zhong S, Lai S, Jia Y. Sex differences in serum trace elements and minerals levels in unmedicated patients with major depressive episode: The role of suicidal ideation. J Affect Disord 2024; 348:26-34. [PMID: 38086449 DOI: 10.1016/j.jad.2023.12.024] [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: 06/03/2023] [Revised: 09/18/2023] [Accepted: 12/08/2023] [Indexed: 12/22/2023]
Abstract
BACKGROUND We aimed to examine the influence of gender on serum trace elements and minerals levels in depression, as well as the impact of suicidal ideation (SI) on these gender dimorphisms. METHODS A total of 260 unmedicated patients with a current major depressive episode were enrolled. The Beck Scale for Suicide Ideation was utilized to evaluate SI. The serum levels of copper, zinc, iron, calcium, phosphorus, and magnesium were quantified. RESULTS Within the non-SI (NSI) group, females exhibited higher levels of copper (p = 0.001) and phosphorus (p = 0.008), and lower levels of zinc (p = 0.022) and calcium (p = 0.008) compared to males. Conversely, no discernible gender disparities were observed in the SI group (all p > 0.05). Also, no group differences in these trace elements/minerals were observed between the SI and NSI groups (all p > 0.05). Notably, serum iron levels exhibited a significant group-by-sex interaction effect (p = 0.024). Further analysis revealed that iron levels were higher in the SI group than in the NSI group among females (p = 0.048), but lower in females than in males within the NSI group (p < 0.001). Moreover, a positive association between the fourth quantile of serum iron and SI was detected in females (odds ratio [OR] = 2.88, 95 % confidence interval [CI]: 1.08-8.11). CONCLUSIONS Gender effects on serum trace element/mineral levels were different in depressed patients with and without SI. Female patients were susceptible to SI when serum iron was at the upper end of normal.
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Affiliation(s)
- Dong Huang
- Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou 510630, China
| | - Jiali He
- Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou 510630, China
| | - Rongxu Zhang
- Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou 510630, China
| | - Shuming Zhong
- Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou 510630, China
| | - Shunkai Lai
- Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou 510630, China
| | - Yanbin Jia
- Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou 510630, China.
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Olgiati P, Pecorino B, Serretti A. Suicide ideation and male-female differences in major depressive disorder. Int J Psychiatry Clin Pract 2024; 28:53-62. [PMID: 38587055 DOI: 10.1080/13651501.2024.2335950] [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: 05/16/2023] [Accepted: 03/22/2024] [Indexed: 04/09/2024]
Abstract
OBJECTIVE This study aimed to explore male-female differences in suicide ideation (SI) and suicide risk factors in major depressive disorder (MDD). METHODS We analysed 482 adults (sample 1) and 438 elderly outpatients (sample 2) with MDD. Sample 1 was treated with different antidepressant combinations (escitalopram; bupropion plus escitalopram; venlafaxine plus mirtazapine) and assessed by means of the Concise Health Risk Tracking (SI), Quick Inventory of Depressive Symptomatology, Altman Mania Rating Scale and Psychiatric Diagnostic Screening Questionnaire. Sample 2 was treated with venlafaxine and assessed using the Hamilton scale for depression, Anxiety Sensitivity Index and Penn State Worry Questionnaire for anxiety, Beck Scale for Suicide Ideation and Repeatable Battery for the Assessment of Neuropsychological Status. RESULTS In sample 1, females had greater depression severity (O.R 0.961 99%CI: 0.929 - 0.995), males reported more alcohol abuse (O.R 1.299 99%CI: 1.118 - 1.509) and active SI (O.R 1.109 99%CI: 1.005 - 1.255). In sample 2 men showed more severe SI (O.R 1.067; 99%CI: 1.014 - 1.122) and weight loss (OR = 5.89 99%CI: 1.01 - 34.19), women more gastrointestinal symptoms. CONCLUSIONS In these selected samples, although women had more severe depression, men had more suicide risk factors. Such differences might contribute to men's increased suicide risk.
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Affiliation(s)
- Paolo Olgiati
- Department of Sciences of Public Health and Paediatrics, University of Turin, Turin, Italy
- Mental Health Department, Azienda Sanitaria Locale TO4, Turin, Italy
| | - Basilio Pecorino
- Department of Obstetrics and Gynecology, Cannizzaro Hospital, Kore University of Enna, Enna, Italy
| | - Alessandro Serretti
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
- Department of Medicine and Surgery, Kore University of Enna, Enna, Italy
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3
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Mao R, Wang C, Cui L, Mellor D, Wu Z, Fang Y. Gender differences in prevalence and associations between cognitive symptoms and suicidal ideation in patients with recurrent major depressive disorder: findings from the Chinese NSSD study. BMC Psychiatry 2024; 24:83. [PMID: 38297249 PMCID: PMC10829390 DOI: 10.1186/s12888-024-05557-x] [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: 11/30/2023] [Accepted: 01/24/2024] [Indexed: 02/02/2024] Open
Abstract
BACKGROUND This study aimed to explore gender differences in associations between cognitive symptoms and suicidal ideation (SI) among patients with recurrent major depressive disorder (MDD). METHODS We recruited 1222 patients with recurrent MDD from the National Survey on Symptomatology of Depression (NSSD), a survey designed to investigate the symptoms experienced during current major depressive episodes in China. A four-point Likert questionnaire was used to assess the frequency of cognitive symptoms and SI in the past two weeks. RESULTS Gender differences in clinical features and cognitive symptoms of participants with recurrent MDD were found. Specifically, male patients had a higher prevalence of memory loss, decreased verbal output, indecisiveness, and impaired interpersonal relationships, while female patients exhibited a higher prevalence of impaired social and occupational functioning (all P < 0.05). No significant difference in SI prevalence was found between male and female patients. The logistic regression analysis revealed that in male patients, SI was associated with indecisiveness and impaired interpersonal relationships. In female patients, reduced verbal output and impaired social and professional functions were also associated with SI in addition to the above-mentioned variables. CONCLUSION The findings of gender differences in associations between cognitive symptoms and SI highlight the need to carefully assess gender-specific cognitive predictors of SI in patients with recurrent MDD. This has further implications for more targeted prevention and treatment strategies for SI based on gender.
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Affiliation(s)
- Ruizhi Mao
- Clinical Research Center and Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Chenglei Wang
- Shanghai Changning District Mental Health Center, Shanghai, China
| | - Lvchun Cui
- Clinical Research Center and Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - David Mellor
- School of Psychology, Deakin University, Melbourne, Australia
| | - Zhiguo Wu
- Department of Psychological Medicine, Renji Hospital, Shanghai Jiao Tong University School of Medicine, 160 Pujian Road, Shanghai, 200127, China.
- Shanghai Yangpu District Mental Health Center, Shanghai University of Medicine & Health Sciences, Shanghai, China.
| | - Yiru Fang
- Clinical Research Center and Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
- Department of Psychiatry & Affective Disorders Center, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin 2nd Road, Shanghai, 200025, China.
- CAS Center for Excellence in Brain Science and Intelligence Technology, Shanghai, China.
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai, China.
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4
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Luo G, Ma H, Wang S, Yao C, Li Y, Sun D, Zhang X. Sex differences in prevalence and clinical correlates of suicide attempts in first-episode and drug-naïve patients with anxious depression in a Chinese Han population: A large-scale cross-sectional study. J Affect Disord 2024; 344:252-260. [PMID: 37838263 DOI: 10.1016/j.jad.2023.10.086] [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: 06/18/2023] [Revised: 09/17/2023] [Accepted: 10/11/2023] [Indexed: 10/16/2023]
Abstract
BACKGROUNDS Anxious depression (AD) has been extensively studied. However, fewer studies have examined sex differences in the prevalence of suicide attempts among AD patients. This study aimed to explore sex differences in suicide attempts and risk factors in patients with AD. METHODS 1380 first episode drug-naïve patients with AD were recruited. Sociodemographic and clinical characteristics were measured using a self-administered demographic questionnaire. The Hamilton Depression Scale (HAMD), Hamilton Anxiety Inventory (HAMA), and positive subscale of the Positive and Negative Syndrome Scale (PANSS) were used to assess patients' clinical symptoms. We also measured the patient's blood glucose, lipids, and thyroid axis hormone levels. RESULTS There were no sex differences in the prevalence of suicide attempts in patients with FEDN anxious depression. In addition, binary logistic regression analysis showed that HAMA score, TSH levels, and TPOAb levels significantly predicted suicide attempts in both male and female patients with AD, while HAMD score significantly predicted suicide attempts in female patients with AD only. CONCLUSIONS The severity of anxiety and higher levels of TSH and TPOAb were associated with an increased risk for suicide attempts in both male and female patients with AD, whereas the severity of depression was only associated with suicide attempts in females.
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Affiliation(s)
- Guoshuai Luo
- Laboratory of Biological Psychiatry, Institute of Mental Health, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, Tianjin 300222, China
| | - Hongyun Ma
- Laboratory of Biological Psychiatry, Institute of Mental Health, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, Tianjin 300222, China
| | - Shuo Wang
- Laboratory of Biological Psychiatry, Institute of Mental Health, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, Tianjin 300222, China
| | - Cong Yao
- Laboratory of Biological Psychiatry, Institute of Mental Health, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, Tianjin 300222, China
| | - Yaxi Li
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 3210 Humin Rd, Shanghai 201108, China
| | - Daliang Sun
- Laboratory of Biological Psychiatry, Institute of Mental Health, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, Tianjin 300222, China.
| | - Xiangyang Zhang
- Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing 100101, China.
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Li J, Zhang Y, Siu Man Chan B, Tan SN, Lu J, Luo X, Shen Y, Zhang XY. Associations between anxiety, depression, and risk of suicidal behaviors in Chinese medical college students. Front Psychiatry 2022; 13:1012298. [PMID: 36532186 PMCID: PMC9757065 DOI: 10.3389/fpsyt.2022.1012298] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 11/09/2022] [Indexed: 12/05/2022] Open
Abstract
Background Previous studies have established a strong association between depression and suicidal behaviors, yet the relationship between anxiety and suicidal behaviors remains unclear. This study examines whether anxiety and depression are independent risk factors for suicidal behaviors in medical college students, and further, whether anxiety may increase the greater risk of suicidal behaviors (SB) in participants with depression. Methods This cross-sectional study was conducted among 4,882 medical students. Demographic information, anxiety, and depression data were collected using online questionnaires or through a widely used social media app named WeChat. Results Anxiety and depression were independent risk factors for suicidal behaviors, and levels of risk correlated positively with the severity of both anxiety and depressive symptoms. A dose-response relationship was identified between the severity of anxiety and the risk of SB, as well as the severity of depression and SB. Furthermore, anxiety increased the risk of suicidal behaviors in participants with depression, with a dose-response relationship between the severity of anxiety symptoms and the risk of SB. Conclusion The findings highlight the importance of screening for anxiety and depressive symptoms in medical college students, as well as reducing anxiety in addition to depressive symptoms in treatment. This study provides valuable data as a reference for clinicians for suicide risk assessments.
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Affiliation(s)
- Jia Li
- Department of Applied Psychology, College of Preschool Education, Changsha Normal University, Changsha, Hunan, China
| | - Yaru Zhang
- Department of Psychiatry, and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Bella Siu Man Chan
- Department of Educational and Counselling Psychology, and Special Education, The University of British Columbia, Vancouver, BC, Canada
| | - Sun Nee Tan
- Djavad Mowafaghian Centre for Brain Health, Faculty of Medicine (Neuroscience), The University of British Columbia, Vancouver, BC, Canada
| | - Jianping Lu
- Department of Child Psychiatry of Shenzhen Kangning Hospital, Mental Health School, Shenzhen Mental Health Center, Shenzhen University, Shenzhen, China
| | - Xuerong Luo
- Department of Psychiatry, and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Yanmei Shen
- Department of Psychiatry, and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Xiang Yang Zhang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
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Kim D, Kim D, Lee K, Choi N, Roh S. Suicidal ideation among the elderly living in the community: Correlation with living arrangement, subjective memory complaints, and depression. J Affect Disord 2022; 298:160-165. [PMID: 34710504 DOI: 10.1016/j.jad.2021.10.066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 10/01/2021] [Accepted: 10/23/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND This study aimed to investigate the correlations of living arrangement, subjective memory complaints, and depression on suicidal ideation in elderly men and women. METHODS There were 1,412 participants (women, 63.5%) from a rural community in South Korea, aged ≥60 years (mean±SD, 73.2 ± 8.0 years). We measured suicidal ideation, subjective memory complaints, and depression using the Columbia-Suicide Severity Rating Scale, Subjective Memory Complaints Questionnaire, and the short form of the Geriatric Depression Scale, respectively. We then estimated correlations of living arrangement, subjective memory complaints, and depression with recent suicidal ideation using multivariate logistic regression analysis. RESULTS With all participants as a group, living alone, subjective memory complaints (SMC+) and high risk of depression (HRD) were found to be significant independent predictors (p = 0.021 for living alone; p = 0.006 for SMC+; p < 0.001 for HRD, respectively) of suicidal ideation (SI+). When men and women were analyzed separately, HRD remained significant both in men and women (OR = 6.01, p < 0.005 for men; OR = 7.23, p < 0.001 for women), while living alone and SMC+ were significant only in men (OR = 3.36, p = 0.013 for living alone; OR = 3.30, p = 0.016 for SMC+). LIMITATIONS The results may not be generalizable to the urban setting as this study included only elderly persons living in the rural community. CONCLUSIONS Living alone and subjective memory complaints were significant predictors of recent suicidal ideation only in men while depression was a significant predictor both in men and women.
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Affiliation(s)
- Dabin Kim
- Department of Psychiatry, Hanyang University College of Medicine, 222, Wangsimni-ro, Seongdong-gu, Seoul 04763, Republic of Korea; Department of Psychiatry, Hanyang University Hospital, Seoul, Republic of Korea.
| | - Daeho Kim
- Department of Psychiatry, Hanyang University College of Medicine, 222, Wangsimni-ro, Seongdong-gu, Seoul 04763, Republic of Korea; Department of Psychiatry, Hanyang University Guri Hospital, Gyeonggi-do, Republic of Korea.
| | - Kounseok Lee
- Department of Psychiatry, Hanyang University College of Medicine, 222, Wangsimni-ro, Seongdong-gu, Seoul 04763, Republic of Korea; Department of Psychiatry, Hanyang University Hospital, Seoul, Republic of Korea.
| | - Nayeon Choi
- Medical Statistics Support Center at the Medical Research Collaboration Center, Hanyang University Industrial-Academic Cooperation Group, Seoul, Republic of Korea.
| | - Sungwon Roh
- Department of Psychiatry, Hanyang University College of Medicine, 222, Wangsimni-ro, Seongdong-gu, Seoul 04763, Republic of Korea; Department of Psychiatry, Hanyang University Hospital, Seoul, Republic of Korea.
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Prevalence of suicidal ideation and planning in patients with major depressive disorder: A meta-analysis of observation studies. J Affect Disord 2021; 293:148-158. [PMID: 34192629 DOI: 10.1016/j.jad.2021.05.115] [Citation(s) in RCA: 50] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Revised: 05/27/2021] [Accepted: 05/31/2021] [Indexed: 11/20/2022]
Abstract
BACKGROUND Suicidal ideation (SI) and suicide planning (SP) are associated with an increased risk of future suicide. We performed a meta-analysis of observational studies to estimate the prevalence of SI and SP in patients with major depressive disorder (MDD) and its associated factors. METHODS A systematic literature search was conducted in PubMed, EMBASE, PsycINFO and Web of Science from their commencement date until 7 October 2020. Original studies containing data on the prevalence of SI and SP in individuals with MDD were analyzed. RESULTS Forty-six articles covering 53,598 patients were included in the meta-analysis. The overall prevalence of SI was 37.7% (95% confidence interval (CI): 32.3-43.4%) and the pooled prevalence of SP was 15.1% (95% CI: 8.0--26.8%). Subgroup analyses revealed that the timeframe over which SI was assessed, source of patients, study design, and diagnostic criteria were significantly associated with the pooled prevalence of SI. Meta-regression analyses revealed that the Hamilton Depression Rating Scale (HAMD) score and percentage of male participants were positively associated with the pooled prevalence of SI. Study quality and mean age were negatively associated with the pooled prevalence of SI. In contrast, survey year and study quality were negatively associated with pooled prevalence of SP LIMITATION: SI and SP were self-reported and subject to recall bias and impression management. CONCLUSIONS SI and SP are common in patients with MDD, especially among inpatients. Preventive measures and treatments focusing on factors associated with SI and SP may reduce the risk of suicide in patients with MDD.
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Derakhshan N, Yaghamei S, Mostafeenezhad N. Suicidal attempt with intracranial sewing needle in a female adult with major depressive disorder, case report. MIDDLE EAST CURRENT PSYCHIATRY 2020. [DOI: 10.1186/s43045-020-00042-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Major depressive disorder is one of the most common psychiatric illnesses. It is counted as an important suicide-attempting factor. Beside common and known suicide methods such as pesticide poisoning and hanging, some unusual methods (adapted by major depressive disorder patients) are reported in the literature. One of these methods is intracranial swing needle insertion.
Case presentation
Hereby, we detail a 44-year-old woman who was admitted to our hospital due to a sewing needle in her brain tissue. The first sign suggesting the existence of a metal foreign body in her brain was the rejection of magnetic resonance imaging ordered (follow-up of a previous admission). Later, a sewing needle was observed in her skull inserted in a suicidal attempt. Her denial of the attempt has aroused the medical team attention to make further study of the patient from a psychiatric point of view. The psychiatric study expressed major depressive disorder in the patient which can justify her suicide intention in the needle insertion.
Conclusions
Treating such patients should be tackled in two fronts. From neurosurgical point of view, it should be decided whether to extract the foreign body or conduct a follow-up in order to determine the necessary time for operation. On the other hand, from a psychiatric point of view, rigorous consult sessions with patient and family members are required to prevent recurrence of such attempts.
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Ge F, Jiang J, Wang Y, Yuan C, Zhang W. Identifying Suicidal Ideation Among Chinese Patients with Major Depressive Disorder: Evidence from a Real-World Hospital-Based Study in China. Neuropsychiatr Dis Treat 2020; 16:665-672. [PMID: 32184605 PMCID: PMC7061409 DOI: 10.2147/ndt.s238286] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Accepted: 01/21/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND A growing body of research suggests that major depressive disorder (MDD) is one of the most common psychiatric conditions associated with suicide ideation (SI). However, how a combination of easily accessible variables built a utility clinically model to estimate the probability of an individual patient with SI via machine learning is limited. METHODS We used the electronic medical record database from a hospital located in western China. A total of 1916 Chinese patients with MDD were included. Easily accessible data (demographic, clinical, and biological variables) were collected at admission (on the first day of admission) and were used to distinguish SI with MDD from non-SI using a machine learning algorithm (neural network). RESULTS The neural network algorithm distinguished 1356 out of 1916 patients translating into 70.08% accuracy (70.68% sensitivity and 67.09% specificity) and an area under the curve (AUC) of 0.76. The most relevant predictor variables in identifying SI from non-SI included free thyroxine (FT4), the total scores of Hamilton Depression Scale (HAMD), vocational status, and free triiodothyronine (FT3). CONCLUSION Risk for SI among patients with MDD can be identified at an individual subject level by integrating demographic, clinical, and biological variables as possible as early during hospitalization (at admission).
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Affiliation(s)
- Fenfen Ge
- Mental Health Center of West China Hospital, Sichuan University, Chengdu, Sichuan 610041, People's Republic of China
| | - Jingwen Jiang
- West China Biomedical Big Data Center, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, People's Republic of China
| | - Yue Wang
- Mental Health Center of West China Hospital, Sichuan University, Chengdu, Sichuan 610041, People's Republic of China
| | - Cui Yuan
- Mental Health Center of West China Hospital, Sichuan University, Chengdu, Sichuan 610041, People's Republic of China
| | - Wei Zhang
- Mental Health Center of West China Hospital, Sichuan University, Chengdu, Sichuan 610041, People's Republic of China
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Ma YJ, Zhou YJ, Wang DF, Li Y, Wang DM, Liu TQ, Zhang XY. Association of Lipid Profile and Suicide Attempts in a Large Sample of First Episode Drug-Naive Patients With Major Depressive Disorder. Front Psychiatry 2020; 11:543632. [PMID: 33132931 PMCID: PMC7561363 DOI: 10.3389/fpsyt.2020.543632] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Accepted: 08/25/2020] [Indexed: 11/24/2022] Open
Abstract
Several studies have reported a link between lipid disorders and suicidality. However, few studies have investigated the relationship between suicidal behavior and blood lipid profiles in patients with first-episode and drug-naive (FEDN) major depressive disorder (MDD). The main purpose of this study was to examine the relationship between plasma lipid profiles and suicide attempts in a large sample of FEDN MDD patients in the Chinese Han population, which has not been reported. A total of 1,718 MDD outpatients were recruited. Their clinical and demographic data as well as plasma lipid parameters were collected. We obtained suicide attempt data through interviews with patients and their family members. We rated the Hamilton Depression Scale (HAMD) and Hamilton Anxiety Scale (HAMA) for all patients. The suicide attempt rate of MDD patients was 20.14%, of which 13.68% in the last month and 6.46% in the past. Further, compared with non-attempters, suicide attempters had significantly higher total levels of cholesterol (TC) and low-density lipoprotein cholesterol (LDL-c), higher HAMA and HAMD scores, but significantly lower high-density lipoprotein cholesterol (HDL-c) levels. Logistic regression analysis showed that suicide attempts were correlated with higher TC, lower HDL-c, and higher HAMA and HAMD scores with the adjusted odds ratio (OR) of 1.35, 0.52,1.28, and 1.08, respectively (all p < 0.05). Our findings suggest that FEDN patients with MDD have a high rate of attempted suicide. In the early stage of MDD patients, certain blood lipid parameters and more severe symptoms of anxiety and depression are correlated with suicide attempts. However, due to the cross-sectional design of this study, it is impossible to draw a causal relationship between lipid profiles and suicide attempts. Moreover, an inverse correlation can also be considered, that is, high cholesterol may be the consequence of suicide attempts and depression.
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Affiliation(s)
- Yue-Jiao Ma
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, The China National Clinical Research Center for Mental Health Disorders, Chinese National Technology Institute of Psychiatry, Key Laboratory of Psychiatry and Mental Health of Hunan Province, Changsha, China.,Department of Addictive Behavior and Addiction Medicine, Medical Faculty Mannheim, Central Institute of Mental Health, Heidelberg University, Mannheim, Germany
| | - Yong-Jie Zhou
- Research Center for Psychological and Health Sciences, China University of Geosciences, Wuhan, China.,Affiliated Wuhan Mental Health Center, Tongji Medical College of Huazhong University of Science & Technology, Wuhan, China
| | - Dong-Fang Wang
- Department of Psychiatry and Psychotherapy, Technical University of Munich, Munich, Germany
| | - Yi Li
- Research Center for Psychological and Health Sciences, China University of Geosciences, Wuhan, China.,Affiliated Wuhan Mental Health Center, Tongji Medical College of Huazhong University of Science & Technology, Wuhan, China
| | - Dong-Mei Wang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
| | - Tie-Qiao Liu
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, The China National Clinical Research Center for Mental Health Disorders, Chinese National Technology Institute of Psychiatry, Key Laboratory of Psychiatry and Mental Health of Hunan Province, Changsha, China
| | - Xiang-Yang Zhang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China.,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
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Ma T, Li B, Le Y, Xu Y, Wang F, Tian Y, Cai Q, Liu Z, Xiao L, Li H. Demyelination contributes to depression comorbidity in a rat model of chronic epilepsy via dysregulation of Olig2/LINGO-1 and disturbance of calcium homeostasis. Exp Neurol 2019; 321:113034. [PMID: 31415741 DOI: 10.1016/j.expneurol.2019.113034] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Revised: 07/30/2019] [Accepted: 08/11/2019] [Indexed: 01/31/2023]
Abstract
Depression is the most common comorbidity among patients with epilepsy. Despite prior assumptions that antiepileptic drugs are to blame, more and more pathological studies have shown that latent neurological alterations associated with white matter injury and demyelination may underlie this link. However, whether disturbances in cerebral myelination contribute to the initiation of depression in epilepsy remains unclear. In the present study, we investigated the connection between demyelination disorders and the development of depression comorbidity in epilepsy. We first induced spontaneous recurrent epilepticus seizure (SRS) in young rats with pilocarpine. We then established depressive behaviors by recurrent forced swimming test and evaluate the depression state by sucrose preference test. The ratio of depression comorbidity in SRS rats was then calculated. Next, myelination in SRS-Depressed (SRS-D) rats was explored via PCR, western blotting, and immunohistochemistry for the key myelin promotion factor, Olig2 and inhibition factor, LINGO-1. Finally, in situ RNA hybridization of NCX3, one of the dominant Ca2+ extrusion proteins in oligodendrocytes (OLs) was performed to explore whether Ca2+ homeostasis of OLs was disturbed in epilepsy-induced hypoxic conditions and involved in the epilepsy-depression comorbidity. Our results revealed that one-quarter of the SRS rats displayed typical depressive behaviors, which were defined as SRS-D rats. In SRS-D rats, severe demyelination was also observed, accompanied with reduced expression of MBP, Olig2, and NCX3 and increased expression of LINGO-1 in the cingulate gyrus. In SRS-Non depressed rats, no significant changes were found from the control animals. This work provides new insights into the demyelination in epilepsy-depression comorbidity, which involves dysregulation of Olig2/LINGO-1 and disturbance of Ca2+ homeostasis.
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Affiliation(s)
- Teng Ma
- Department of Histology and Embryology, Army Medical University, Chongqing 400038, China
| | - Baichuan Li
- Department of Histology and Embryology, Army Medical University, Chongqing 400038, China
| | - Yifan Le
- Department of Histology and Embryology, Army Medical University, Chongqing 400038, China
| | - Yang Xu
- Department of Histology and Embryology, Army Medical University, Chongqing 400038, China
| | - Fei Wang
- Department of Histology and Embryology, Army Medical University, Chongqing 400038, China
| | - Yanping Tian
- Department of Histology and Embryology, Army Medical University, Chongqing 400038, China
| | - Qiyan Cai
- Department of Histology and Embryology, Army Medical University, Chongqing 400038, China
| | - Zhi Liu
- Department of Histology and Embryology, Army Medical University, Chongqing 400038, China
| | - Lan Xiao
- Department of Histology and Embryology, Army Medical University, Chongqing 400038, China
| | - Hongli Li
- Department of Histology and Embryology, Army Medical University, Chongqing 400038, China..
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Li X, Liu H, Hou R, Baldwin DS, Li R, Cui K, Liu C, Sun Q, Wang G, Tan Q, Xu X, Zhao J, Ning Y, Sun X. Prevalence, clinical correlates and IQ of suicidal ideation in drug naïve Chinese Han patients with major depressive disorder. J Affect Disord 2019; 248:59-64. [PMID: 30711870 DOI: 10.1016/j.jad.2018.12.017] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2018] [Revised: 12/03/2018] [Accepted: 12/14/2018] [Indexed: 02/05/2023]
Abstract
BACKGROUND Suicidal ideation (SI) is a common and serious clinical concern in people with major depressive disorder (MDD). Inconsistent evidence suggests that individuals with SI may have a lower measured intelligence quotient (IQ) than those without SI. The aims of this study were to examine SI prevalence and its associations with demographic, clinical variables and IQ in Chinese drug-naïve MDD patients. METHODS 488 drug-naïve Chinese Han patients (male: 203, 41.6%) meeting a DSM-IV diagnosis of MDD were enrolled in a cross-sectional study involving seven hospitals. All participants were asked to complete a series of questionnaires, which include information on socio-demographic and clinical variables. The Hamilton Depression Rating Scale (HAMD), Hamilton Anxiety Rating Scale (HAMA) and Brief Psychiatric Rating Scale (BPRS) were also administered. Verbal IQ (VIQ), performance IQ (PIQ) and full-scale IQ (FIQ) scores were measured using the Chinese version of the Wechsler Adult Intelligence Scale-Ⅲ (WAIS-Ⅲ). We categorized patients with SI based on a cut-off score of ≥3 on HAMD item 3. RESULTS An estimated prevalence 32.8% (160/488) of drug-naïve MDD patients experienced SI during the current episode of illness. Patients with SI were more likely to be divorced (x2 = 6.93, p = 0.031), male (x2 = 6.04, p = 0.014), had higher severity of depression and anxiety symptoms (t = -8.14, p < 0.001, t = -3.28, p < 0.001, respectively), comorbid psychotic features (t = -5.71, p < 0.001), and lower FIQ levels (t = -4.21, p < 0.001), when compared to patients without SI. Using logistic regression analysis and adjusting for confounding variables, the following variables were independently associated with SI: divorced marital status compared to married (OR=4.674, 95% CI: 1.676~13.036), severity of depression symptoms (OR=1.312, 95% CI: 1.196~1.440), psychotic features (OR=1.044; 1.012~1.077), and FIQ /PIQ levels which expressed in OR per SD increase in IQ score (OR=0.740, 95% CI: 0.561~0.977; OR=0.744, 95% CI: 0.557~0.994, respectively). LIMITATIONS A cross-sectional study which did not assess the influence of severity of SI. CONCLUSIONS The prevalence of SI in drug-naive Chinese patients with MDD is high, and associated with marital status, severity of depression, psychotic features and measured IQ. Further research is needed to further explore these and other potentially relevant risk factors which might affect clinical outcomes.
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Affiliation(s)
- Xirong Li
- Department of Psychiatry, Shandong Mental Health Center, Jinan, China; Department of Psychiatry, Mental Health Center, West China Hospital, Sichuan University, Chengdu, China; Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Haixia Liu
- Department of Psychiatry, Shandong Mental Health Center, Jinan, China
| | - Ruihua Hou
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
| | - David S Baldwin
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Renjun Li
- Department of Psychiatry, Shandong Mental Health Center, Jinan, China
| | - Kaiyan Cui
- Department of Psychiatry, Shandong Mental Health Center, Jinan, China
| | - Chuanxin Liu
- Department of Psychiatry, Jining Medical University, Jining, China
| | - Qian Sun
- Beijing Anding Hospital of Capital University of Medical Sciences, Beijing, China
| | - Gang Wang
- Beijing Anding Hospital of Capital University of Medical Sciences, Beijing, China
| | - Qingrong Tan
- Department of Psychiatry, Xijing Hospital, the Fourth Military Medical University, Xi'an, China
| | - Xiufeng Xu
- Department of Psychiatry, First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Jingping Zhao
- Mental Health Institute, the Second Xiangya Hospital of Central South University, Changsha, China
| | - Yuping Ning
- Guangzhou Brain Hospital, Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Xueli Sun
- Department of Psychiatry, Mental Health Center, West China Hospital, Sichuan University, Chengdu, China.
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Fang X, Zhang C, Wu Z, Peng D, Xia W, Xu J, Wang C, Cui L, Huang J, Fang Y. The association between somatic symptoms and suicidal ideation in Chinese first-episode major depressive disorder. J Affect Disord 2019; 245:17-21. [PMID: 30366233 DOI: 10.1016/j.jad.2018.10.110] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Revised: 09/25/2018] [Accepted: 10/16/2018] [Indexed: 12/17/2022]
Abstract
BACKGROUND Somatic symptoms are prevalent in patients with major depressive disorder (MDD) and often associated with a high risk of suicide. However, which somatic symptoms display as significant risk factors for suicidal ideation (SI) is still poorly understood in MDD. METHODS Two thousand and seventeen Chinese patients with first-episode MDD from the National Survey on Symptomatology of Depression were included in this study. A doctor-rating assessment questionnaire was constructed to evaluate depression related somatic symptoms, and stepwise logistic regression analysis was performed to explore the relationship between somatic symptoms and SI. RESULTS Our results showed a high prevalence of current SI in first-episode MDD (50.87%), while no significant gender differences (53.32% vs. 49.26%, P = 0.076) were observed. In addition, patients who have more somatic symptoms would be at the higher risk to elicit SI, and stepwise logistic regression analysis indicated that age (β = -0.020, P < 0.001), Pre-verbal physical complaints (β = 0.356, P = 0.001), Sensory system complaints (β = 0.707, P = 0.000), Other pain conditions (β = 0.434, P < 0.001), Late insomnia (β = 0.267, P = 0.008), Hypersomnia (β = 0.936, P < 0.001), Weight loss (β = 0.272, P = 0.006), Hyposexuality (β = 0.513, P = P < 0.001) were strongly associated with current SI in first-episode Chinese major depression. CONCLUSIONS Somatic symptoms are strongly associated with SI in first-episode MDD. It is suggestive for clinicians to show concerns for patients' somatic symptoms in practice.
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Affiliation(s)
- Xinyu Fang
- Division of Mood Disorder, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Chen Zhang
- Division of Mood Disorder, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China.
| | - Zhiguo Wu
- Division of Mood Disorder, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Daihui Peng
- Division of Mood Disorder, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Weiping Xia
- Division of Mood Disorder, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Jingjing Xu
- Division of Mood Disorder, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Chenglei Wang
- Division of Mood Disorder, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Lvchun Cui
- Division of Mood Disorder, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Jia Huang
- Division of Mood Disorder, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Yiru Fang
- Division of Mood Disorder, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China.
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Kakuszi B, Bitter I, Czobor P. Suicidal ideation in adult ADHD: Gender difference with a specific psychopathological profile. Compr Psychiatry 2018; 85:23-29. [PMID: 29957374 DOI: 10.1016/j.comppsych.2018.06.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2017] [Revised: 05/28/2018] [Accepted: 06/08/2018] [Indexed: 01/20/2023] Open
Abstract
OBJECTIVE To investigate suicidal ideation (SI) in patients with adult ADHD (aADHD), and its association with gender and psychopathology. METHODS Case-control study with 206 participants (patients = 103/healthy controls = 103; matched on gender, age, and education). SI was assessed by the Beck-I Depression-Inventory. The Conners' Adult ADHD Rating Scale (CAARS) was used to characterize the ADHD symptom-domains. RESULTS Compared to controls, the likelihood of SI was significantly higher in females with ADHD (odds ratio[OR] = 25.0 (95%CI:2.98-200.0); the difference was not significant in males (OR = 2.09 (95%CI:0.75-5.81). In females, "Problems with Self-Concept" scores on the CAARS showed the closest association with SI (OR = 5.60,95%CI:2.34-13.41]), while in males it was "Impulsivity" scores (OR = 3.01,95%CI:1.50-6.06). CONCLUSION Our findings extend previously described transdiagnostic associations of specific psychopathological risk factors to aADHD, including problems with self-concept and impulsivity, which are robustly associated with suicidality across diagnostic boundaries. In addition, they indicate that these associations exhibit pronounced gender-specificity in aADHD.
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Affiliation(s)
- Brigitta Kakuszi
- Semmelweis University, Department of Psychiatry and Psychotherapy, Budapest, Hungary
| | - István Bitter
- Semmelweis University, Department of Psychiatry and Psychotherapy, Budapest, Hungary
| | - Pál Czobor
- Semmelweis University, Department of Psychiatry and Psychotherapy, Budapest, Hungary.
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15
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Fang X, Zhang C, Wu Z, Peng D, Xia W, Xu J, Wang C, Cui L, Huang J, Fang Y. Prevalence, risk factors and clinical characteristics of suicidal ideation in Chinese patients with depression. J Affect Disord 2018; 235:135-141. [PMID: 29655075 DOI: 10.1016/j.jad.2018.04.027] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2017] [Revised: 03/08/2018] [Accepted: 04/02/2018] [Indexed: 11/29/2022]
Abstract
BACKGROUND Suicide risk is greatly increased in depression. Detection of those at risk is clinically important. Hence, this study aimed to evaluate the prevalence and identify independent risk factors associated with suicidal ideation (SI) in a widespread symptomatology within and outside DSM framework. METHODS This study was part of the National Survey on Symptomatology of Depression (NSSD) which was designed to investigate the magnitude of symptoms of current major depressive episode in China. Stepwise multivariable logistic regression was performed to examine the independent risk factors for SI, including variables that are statistically significant in univariate analysis. Receiver operating characteristic (ROC) was used to evaluate the performance of the regression model. RESULTS A total of 3275 patients (1293 males and 1982 females) were included in our analysis. Of these, 1750 patients (53.4%) had SI. Independent risk predictors included crying (P = 0.000; odds ratio = 1.827), helplessness (P = 0.000; odds ratio = 1.514), worthlessness (P = 0.001; odds ratio = 1.359), hopelessness (P = 0.000; odds ratio = 1.805), unusually restless (P = 0.005; odds ratio = 1.276), self-harm (P = 0.000; odds ratio = 3.385), mood-incongruent psychosis (P = 0.000; odds ratio = 2.782), feeling losing control of oneself (P = 0.009; odds ratio = 1.352), hypersomnia (P = 0.000; odds ratio = 1.805), sensory system complaints (P = 0.000; odds ratio = 1.546), derealization (P = 0.006; odds ratio = 1.580), guilt (P = 0.002; odds ratio = 1.332), suicidal attempts (P = 0.000; odds ratio = 2.841), male gender (P = 0.001; odds ratio = 0.756), the total course of depression (P = 0.010; odds ratio = 1.003) in the regression model. In addition, the areas under the curve of the ROC and the accuracy for the regression model were 0.80 and 0.76, respectively. CONCLUSIONS This study provided an effective risk model for SI in MDD and indicated that all these factors in our model allow better the employment of preventative measures.
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Affiliation(s)
- Xinyu Fang
- Division of Mood Disorder, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Chen Zhang
- Division of Mood Disorder, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China.
| | - Zhiguo Wu
- Division of Mood Disorder, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Daihui Peng
- Division of Mood Disorder, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Weiping Xia
- Division of Mood Disorder, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Jingjing Xu
- Division of Mood Disorder, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Chenglei Wang
- Division of Mood Disorder, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Lvchun Cui
- Division of Mood Disorder, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Jia Huang
- Division of Mood Disorder, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Yiru Fang
- Division of Mood Disorder, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China.
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16
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Dold M, Bartova L, Fugger G, Kautzky A, Souery D, Mendlewicz J, Papadimitriou GN, Dikeos D, Ferentinos P, Porcelli S, Serretti A, Zohar J, Montgomery S, Kasper S. Major Depression and the Degree of Suicidality: Results of the European Group for the Study of Resistant Depression (GSRD). Int J Neuropsychopharmacol 2018; 21:539-549. [PMID: 29860382 PMCID: PMC6007240 DOI: 10.1093/ijnp/pyy009] [Citation(s) in RCA: 55] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2017] [Accepted: 02/22/2018] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND This European multicenter study aimed to elucidate suicidality in major depressive disorder. Previous surveys suggest a prevalence of suicidality in major depressive disorder of ≥50%, but little is known about the association of different degrees of suicidality with socio-demographic, psychosocial, and clinical characteristics. METHODS We stratified 1410 major depressive disorder patients into 3 categories of suicidality based on the Hamilton Rating Scale for Depression item 3 (suicidality) ratings (0=no suicidality; 1-2=mild/moderate suicidality; 3-4=severe suicidality). Chi-squared tests, analyses of covariance, and Spearman correlation analyses were applied for the data analyses. RESULTS The prevalence rate of suicidality in major depressive disorder amounted to 46.67% (Hamilton Rating Scale for Depression item 3 score ≥1). 53.33% were allocated into the no, 38.44% into the mild/moderate, and 8.23% into the severe suicidality patient group. Due to the stratification of our major depressive disorder patient sample according to different levels of suicidality, we identified some socio-demographic, psychosocial, and clinical variables differentiating from the patient group without suicidality already in presence of mild/moderate suicidality (depressive symptom severity, treatment resistance, psychotic features, add-on medications in general), whereas others separated only when severe suicidality was manifest (inpatient treatment, augmentation with antipsychotics and benzodiazepines, melancholic features, somatic comorbidities). CONCLUSIONS As even mild/moderate suicidality is associated with a failure of achieving treatment response, adequate recognition of this condition should be ensured in the clinical practice.
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Affiliation(s)
- Markus Dold
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Lucie Bartova
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Gernot Fugger
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Alexander Kautzky
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Daniel Souery
- Université Libre de Bruxelles, Brussels, Belgium,Psy Pluriel, Centre Européen de Psychologie Médicale, Brussels, Belgium
| | | | - George N Papadimitriou
- First Department of Psychiatry, Medical School, National and Kapodistrian University of Athens, Eginition Hospital, Athens, Greece
| | - Dimitris Dikeos
- First Department of Psychiatry, Medical School, National and Kapodistrian University of Athens, Eginition Hospital, Athens, Greece
| | - Panagiotis Ferentinos
- Second Department of Psychiatry, Medical School, National and Kapodistrian University of Athens, Attikon General Hospital, Athens, Greece
| | - Stefano Porcelli
- Department of Biomedical and NeuroMotor Sciences, University of Bologna, Bologna, Italy
| | - Alessandro Serretti
- Department of Biomedical and NeuroMotor Sciences, University of Bologna, Bologna, Italy
| | - Joseph Zohar
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | | | - Siegfried Kasper
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria,Correspondence: Siegfried Kasper, MD, Professor and Chairman, Medical University of Vienna, Department of Psychiatry and Psychotherapy, Währinger Gürtel 18–20, A-1090 Vienna, Austria ()
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17
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Weiss SJ, Simeonova DI, Kimmel MC, Battle CL, Maki PM, Flynn HA. Anxiety and physical health problems increase the odds of women having more severe symptoms of depression. Arch Womens Ment Health 2016; 19:491-9. [PMID: 26403982 DOI: 10.1007/s00737-015-0575-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2015] [Accepted: 09/13/2015] [Indexed: 01/04/2023]
Abstract
Severely depressed women incur substantial disability and suicide risk, necessitating an understanding of factors that may contribute to severe depression. The purpose of this research was to determine the degree to which age, physical morbidity, anxiety, and hormonal status predict the likelihood of severe depression among women with mood disorders (n = 298). Data arose from a standardized battery of measures in a multi-center clinical registry of patients with mood disorders. The women were being treated at 17 participating sites of the National Network of Depression Centers. Results of logistic regression analyses indicate that a woman's level of anxiety was the strongest predictor of her likelihood of having severe depression (Exp(B) = 1.33, p = .000), including thoughts of death or suicide. The number of physical health problems that a woman reported was also a significant predictor (Exp(B) = 1.09, p = .04). Neither age nor hormonal status was significant in the final model, although a trend was observed for women with surgically induced menopause to have more severe depression. Findings support the need to work closely with medical practitioners to address physical health problems as part of the treatment plan for depression and to give comorbid anxiety and depression equal priority in symptom management.
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Affiliation(s)
- Sandra J Weiss
- Department of Community Health Systems, University of California, San Francisco, 9 Koret Way, Box 0608, San Francisco, CA, 94143, USA.
| | - Diana I Simeonova
- Department of Psychiatry and Behavioral Sciences, Emory University, 12 Executive Park Drive, NE, Atlanta, GA, 30329, USA
| | - Mary C Kimmel
- Department of Psychiatry, University of North Carolina at Chapel Hill, 101 Manning Drive, Chapel Hill, NC, 27514, USA
| | - Cynthia L Battle
- Department of Psychiatry and Human Behavior, Brown University and Butler Hospital Psychosocial Research Program, 345 Blackstone Blvd, Providence, RI, 02906, USA
| | - Pauline M Maki
- Departments of Psychiatry and Psychology, University of Illinois at Chicago, 912 South Wood Street, Chicago, IL, 60612, USA
| | - Heather A Flynn
- Department of Behavioral Science and Social Medicine, Florida State University, 115 West Call Street, Tallahasse, FL, 32306, USA
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Nam YY, Kim CH, Roh D. Comorbid panic disorder as an independent risk factor for suicide attempts in depressed outpatients. Compr Psychiatry 2016; 67:13-8. [PMID: 27095329 DOI: 10.1016/j.comppsych.2016.02.011] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2015] [Revised: 01/15/2016] [Accepted: 02/13/2016] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVE Although comorbid panic disorder is associated with more severe symptoms and poorer therapeutic response in depressive patients, the relationship between panic disorder and risk of suicide attempt has not been confirmed. This study aimed to examine the relationship between comorbid panic disorder and clinical characteristics associated with suicidal risk as well as the likelihood of suicide attempt. METHOD A total of 223 outpatients with current major depressive disorder participated in the study. Both subjects with panic disorder (33%) and those without panic disorder (67%) were compared based on history of suicide attempts, current psychopathologies, and traits of impulsivity and anger. RESULTS Subjects with panic disorder had higher levels of impulsivity, depression, and hopelessness and were more likely to report a history of suicide attempts. Subjects with panic disorder were younger at the time of first suicide attempt than those without panic disorder. Logistic regression analyses indicated that comorbid panic disorder was significantly associated with a history of suicide attempts after adjusting for other clinical correlates (odds ratio = 2.8; p < 0.01). CONCLUSIONS These findings suggest that comorbid panic disorder in patients with major depressive disorder may be associated with a more severe burden of illness and may independently increase the likelihood of suicide attempt.
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Affiliation(s)
- Yoon-Young Nam
- Division of Planning and Public Relations, National Center for Mental Health, Seoul, Republic of Korea
| | - Chan-Hyung Kim
- Department of Psychiatry, Yonsei University College of Medicine, Seoul, Republic of Korea; Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Daeyoung Roh
- Department of Psychiatry, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon-si, Gangwon-do, Republic of Korea.
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Mattisson C, Bogren M, Brådvik L, Horstmann V. Mortality of subjects with mood disorders in the Lundby community cohort: a follow-up over 50 years. J Affect Disord 2015; 178:98-106. [PMID: 25801522 DOI: 10.1016/j.jad.2015.02.028] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2014] [Revised: 02/23/2015] [Accepted: 02/24/2015] [Indexed: 11/28/2022]
Abstract
AIMS To compare causes of death and mortality among subjects with and without mood disorder in the Lundby Cohort and to analyse additional mental disorders as risk factors for mortality in subjects with mood disorders. BACKGROUND The Lundby study is a longitudinal study that investigated mental health in an unselected population. The study commenced in 1947; the population was further investigated in 1957, 1972, and 1997. METHODS Experienced psychiatrists performed semi-structured diagnostic interviews, and best estimate consensus diagnoses of mental disorders were assessed at each field investigation. Subjects with mood disorder (n=508, 195 males, 313 females) were identified until 1997. Causes and dates of death between 1947 and 2011 were obtained from the Swedish cause of death register and were compared between subjects diagnosed with mood disorder and other participants. Mortality was compared between those with mood disorders and the remaining cohort with Cox regression analyses. Other mental disorders were considered as risk factors for death for subjects with mood disorders. RESULTS The hazard ratio for mortality in mood disorders was HR=1.18. However, the mortality was elevated only for males, HR=1.5. Comorbid anxiety disorders, organic disorders, dementia and psychotic disorders were significant risk factors for death. A total of 6.3% of the participants with mood disorder and 1.2% of the remaining participants committed suicide. CONCLUSIONS As expected, the suicide rate was higher among participants with mood disorders. Only males with mood disorders had elevated mortality. The impact on mortality from other mental disorders seems to vary between the genders.
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Affiliation(s)
- C Mattisson
- Department of Clinical Sciences, Lund Division of Psychiatry, The Lundby Study, Baravägen 1G, Lund University Hospital, SE-221 85 Lund, Sweden.
| | - M Bogren
- Department of Clinical Sciences, Lund Division of Psychiatry, The Lundby Study, Baravägen 1G, Lund University Hospital, SE-221 85 Lund, Sweden
| | - L Brådvik
- Department of Clinical Sciences, Lund Division of Psychiatry, The Lundby Study, Baravägen 1G, Lund University Hospital, SE-221 85 Lund, Sweden
| | - V Horstmann
- Department of Health Sciences, Faculty of Medicine, Lund University, SE-221 00 Lund, Sweden
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20
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Lin CH, Wang FC, Lin SC, Chen CC, Huang CJ. A comparison of inpatients with anxious depression to those with nonanxious depression. Psychiatry Res 2014; 220:855-60. [PMID: 25262642 DOI: 10.1016/j.psychres.2014.08.048] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2013] [Revised: 07/17/2014] [Accepted: 08/24/2014] [Indexed: 10/24/2022]
Abstract
Anxiety symptoms are common for patients with major depressive disorder (MDD). Anxious depression has been considered MDD with high levels of anxiety symptoms. The objective of this study was to investigate the factors associated with anxious depression for Chinese inpatients with MDD. A total of 174 acutely ill patients were enrolled. Baseline demographic variables, suicide risk, depression severity, quality of life (QOL), and daily functional impairment were assessed. Those MDD patients with a 17-item Hamilton Depression Rating Scale (HAMD-17) anxiety/somatization factor score≥7 were defined as anxious depression. Logistic regression was employed to examine the factors associated with anxious depression. One hundred and forty-one (81.0%) of the subjects reported anxious depression. Patients with anxious depression were more likely to have melancholic features, to be older, to experience more severe depression, to be at greater risk of suicide, to have more pain, poorer quality of life, and more severe functional impairment. Anxious depression is common in inpatients with MDD. These findings suggest that anxious depression significantly differs from nonanxious depression on several clinically relevant variables. These data add to a growing body of evidence that anxious depression is a more complex presentation of depression.
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Affiliation(s)
- Ching-Hua Lin
- Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung, Taiwan; Department of Psychiatry, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Fu-Chiang Wang
- Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung, Taiwan
| | - Shih-Chi Lin
- Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung, Taiwan
| | - Cheng-Chung Chen
- Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung, Taiwan; Department of Psychiatry, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chun-Jen Huang
- Department of Psychiatry, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Psychiatry, Kaohsiung Municipal Ta-Tung Hospital, Taiwan.
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21
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Subramaniam M, Abdin E, Seow ELS, Picco L, Vaingankar JA, Chong SA. Suicidal Ideation, Suicidal Plan and Suicidal Attempts Among Those with Major Depressive Disorder. ANNALS OF THE ACADEMY OF MEDICINE, SINGAPORE 2014. [DOI: 10.47102/annals-acadmedsg.v43n8p412] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Introduction: The aims of the study were to identify the prevalence and sociodemographic and clinical correlates of suicidal behaviours using data from a cross-sectional survey among those with major depressive disorder (MDD) in Singapore. Materials and Methods: The Singapore Mental Health Study (SMHS) was a cross-sectional epidemiological study that surveyed Singapore residents (Singapore citizens and permanent residents) aged 18 years and above. The assessment of mental disorders was established using version 3.0 of the Composite International Diagnostic Interview (CIDI 3.0). For the purposes of this study, suicidal behaviour was assessed by questions which were asked to respondents who answered positively to the screening questions in the CIDI 3.0 “Depression” module. Results: The prevalence of suicidal ideation, plan and attempt among those with lifetime MDD was 43.6%, 13.7% and 12.3%, respectively. We found that suicidal ideation, plan and attempt were significantly associated with ethnicity, education and income. The rate of those who had sought some professional help was higher among those with suicidal plan (71.7%) and attempt (72.3%) as compared to those with suicidal ideation (48.7%) and those with MDD but no suicidal behaviour (29%). Conclusion: Individuals with MDD and suicidal behaviour do differ from their non-suicidal counterparts as they have a different sociodemographic and clinical profile. There is a need for more research and a better understanding of this population which in turn could lead to the development and implementation of relevant interventions.
Key words: Composite International Diagnostic Interview, Depression, Prevalence, Singapore Mental Health Study, Suicidal behaviour
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Affiliation(s)
| | | | - Esmond LS Seow
- Research Division, Institute of Mental Health, Singapore
| | - Louisa Picco
- Research Division, Institute of Mental Health, Singapore
| | | | - Siow Ann Chong
- Research Division, Institute of Mental Health, Singapore
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Castro-Díaz S, Gómez-Restrepo C, Gil F, Uribe Restrepo M, Miranda C, de la Espriella M, Arenas Á, Pinto D. [Risk Factors for Suicidal Ideation in Patients with Depressive Disorders in Colombia]. ACTA ACUST UNITED AC 2014; 43 Suppl 1:27-35. [PMID: 26574111 DOI: 10.1016/j.rcp.2013.11.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2013] [Accepted: 11/28/2013] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Suicidal ideation is a poor prognostic factor in patients with depression, due to the risk of suicide attempt or completed suicide. However, it is a relatively unexplored aspect in the Colombian population. It is important to identify the associated factors in order to develop appropriate treatment strategies. OBJECTIVE To identify risk factors for suicidal ideation in patients with major depressive disorder between 18 and 65 years in 5 Colombian cities. METHODS Data from 295 patients diagnosed with major depressive disorder were used from the Study of the Economic Burden of Depression in Colombia. The association between the clinical and psychosocial variables with the presence of suicidal ideation was assessed using two-level hierarchical models. RESULTS Female sex was a factor associated with a lower risk of suicidal ideation. Factors associated with the presence of suicidal ideation include unemployment, smoking and alcohol use in the past 30 days, mental health perceived as fair or poor, diagnosis of double depression, inpatient treatment, low income, unemployment, and a major financial crisis in the last 2 years. CONCLUSIONS Suicidal ideation is highly prevalent in patients with major depressive disorder. Risk factors associated with both the clinical and psychosocial domain must be carefully evaluated during risk assessment of patients with this diagnosis.
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Affiliation(s)
- Sergio Castro-Díaz
- Médico, residente de Psiquiatría de tercer año, Departamento de Psiquiatría y Salud Mental, Pontificia Universidad Javeriana, Bogotá, Colombia.
| | - Carlos Gómez-Restrepo
- Médico psiquiatra, psicoanalista, epidemiólogo clínico, profesor del Departamento de Psiquiatría y Salud Mental, director del Departamento de Epidemiología Clínica y Bioestadística, Pontificia Universidad Javeriana, Hospital Universitario San Ignacio, Bogotá, Colombia
| | - Fabián Gil
- Estadístico y bioestadístico, profesor asistente del Departamento de Epidemiología Clínica y Bioestadística, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Miguel Uribe Restrepo
- Médico psiquiatra, psicoanalista, Departamento de Psiquiatría y Salud Mental, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Carlos Miranda
- Médico psiquiatra, director médico del Hospital Psiquiátrico Universitario del Valle, profesor de la Universidad del Valle, Cali, Colombia
| | - Mauricio de la Espriella
- Médico psiquiatra, director médico de la Clínica Nuestra Señora del Perpetuo Socorro, Pasto. Profesor del Departamento de Psiquiatría y Salud Mental, Pontificia Universidad Javeriana, Pasto, Colombia
| | - Álvaro Arenas
- Médico psiquiatra, director científico de la Clínica la Inmaculada. Instructor del Departamento de Psiquiatría y Salud Mental, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Diana Pinto
- Médica, magistra en Administración de Salud, DSc en Economía y Política de Salud Internacional. Profesora asociada del Departamento de Epidemiología Clínica y Bioestadística, Pontificia Universidad Javeriana, Bogotá, Colombia
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Abstract
The suicide rate of females is very close to that of males in China, in contrast to Western societies, in which the rates of male suicide outnumber those of females by three to four times. This study investigated the prevalence of suicidal ideation and prosuicide attitude (acceptability) among females of childbearing age. With the Chinese version of the Scale for Suicide Ideation and the General Social Survey questionnaire, we examined the demographic and psychological risk factors of suicide among Chinese rural young females aged 15 to 34 years. Logistic regression analysis was performed to explore the factors related to suicidal ideation and suicide acceptability. The prevalence rates of suicidal ideation and suicide acceptability among the sampled females are 22.5% and 3.8%, respectively. Education, depression, social support, hopelessness, and negative life events were significantly associated with suicidal ideation. Ethnicity, education, abortion, and depression were significantly associated with suicide acceptability. There is statistical difference between suicide ideation and acceptability. The results indicate that mental disorder remains a major risk factor of suicidal ideation. Sociodemographic and psychological characteristics are associated with suicide acceptability.
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Shtayermman O, Fayda MG, Knight KL. Risk Factors for Suicidal Ideation among College Students: 6-Month Follow-up. INTERNATIONAL QUARTERLY OF COMMUNITY HEALTH EDUCATION 2013; 33:69-82. [DOI: 10.2190/iq.33.1.f] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
This study was a 6-month follow-up study examining risk factors for suicide among college students. The sample included 95 participants who also participated in the first data collection period. Online questionnaires were completed by participants from the first wave. Thirteen percent of the sample had clinically significant levels of suicidal ideation, 3.2% met the criteria for dysthymia, and 15.8% and 17.9% met the DSM-IV criteria for a diagnosis of Major Depressive Disorder and Generalized Anxiety Disorder, respectfully. About 9.5% met criteria for alcohol dependence and 16.8% met criteria for drug abuse. Overall, 23% of the variance was explained in suicidal ideation with depressive symptoms, presence of anxiety, and high relational victimization scores attributing to 15% of the variance. Results of the 6-month follow-up support prior research suggesting high correlation between Major Depressive Disorder and suicidal ideation. However, there was no correlation found between levels of suicidal ideation and Generalized Anxiety Disorders.
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Trivedi MH, Morris DW, Wisniewski SR, Nierenberg AA, Gaynes BN, Kurian BT, Warden D, Stegman D, Shores-Wilson K, Rush AJ. Clinical and sociodemographic characteristics associated with suicidal ideation in depressed outpatients. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2013; 58:113-22. [PMID: 23442899 DOI: 10.1177/070674371305800209] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To identify clinical and sociodemographic characteristics associated with suicidal ideation (SI) among patients seeking care for depression in routine primary and psychiatric care settings. METHODS We examined data from 4041 treatment-seeking outpatients with major depressive disorder (MDD) to compare baseline sociodemographic and clinical characteristics of those with and without SI, and the presence or absence of baseline depressive symptoms and psychiatric comorbidities in those with SI. RESULTS SI was significantly (P < 0.01) associated with numerous sociodemographic characteristics (that is, lower level of education, Caucasian or African American, male, unemployed, and treated in psychiatric care) and clinical features (that is, previous suicide attempt, younger age of MDD onset, greater baseline depressive symptom severity, greater number of depressive symptoms, and presence of agoraphobia and [or] generalized anxiety disorder). Elevated levels of SI at baseline were associated with decreased remission rates. CONCLUSIONS Consistent with past findings, increased rates of SI were associated with greater depressive symptom severity as well as other features suggestive of severity of illness. Our results confirm previous findings of associations between SI and panic and (or) phobic symptoms and anxiety, but did not confirm previous findings of an association between SI and alcohol or drug use and (or) dependence. While selective serotonin reuptake inhibitor monotherapy appeared significantly helpful in reducing SI during the course of treatment, the presence of SI at baseline was found to be a associated with decreased treatment response, with patients reporting SI at the start of treatment being less likely to achieve remission. CLINICAL TRIAL REGISTRATION NUMBER Sequenced Treatment Alternatives to Relieve Depression, NCT00021528.
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Affiliation(s)
- Madhukar H Trivedi
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA.
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Moon SS, Park SM. Risk factors for suicidal ideation in Korean middle-aged adults: the role of socio-demographic status. Int J Soc Psychiatry 2012; 58:657-63. [PMID: 22231659 DOI: 10.1177/0020764011433626] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND The investigations of the risk factors for suicidal ideation among middle-aged adults may be especially important for predicting suicidal actions, given the steep increase in suicide among Koreans aged 45-54. Few studies have sought to investigate the effect of socio-demographic status on suicidal ideation among middle-aged adults. OBJECTIVE This study investigated the influence of socio-demographic status on suicidal ideation among middle-aged adults in South Korea. METHODS The sample consisted of middle-aged men (n = 3,214) and middle-aged women (n = 4,087) aged 40-64 years who had participated in the 2005 cross-sectional Seoul Citizens Health and Social Indicators Survey. Using multiple logistic regression analysis, we examined the effect of socio-demographic status, health behaviours and health status on suicidal ideation in middle-aged adults. RESULTS The outstanding finding was that suicidal ideation was most prevalent among middle-aged women who engaged in manual labour (i.e. blue-collar workers) (OR = 2.77, 95% CI = 1.20-6.42). The absence of a spouse was significantly associated with suicidal ideation among middle-aged men (OR = 2.10, 95% CI = 1.30-3.40). CONCLUSIONS The effect of enhanced security related to stable employment was strongest among middle-aged women in blue-collar jobs, and the effect of intensive counselling services was strongest among divorced or widowed middle-aged men.
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Affiliation(s)
- Sang-Sik Moon
- Faculty of Health Administration, Hanyang Women's University, Seoul, Republic of Korea
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Eikelenboom M, Smit JH, Beekman ATF, Penninx BWJH. Do depression and anxiety converge or diverge in their association with suicidality? J Psychiatr Res 2012; 46:608-15. [PMID: 22340981 DOI: 10.1016/j.jpsychires.2012.01.025] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2011] [Revised: 01/17/2012] [Accepted: 01/24/2012] [Indexed: 10/28/2022]
Abstract
Depressive disorders have been strongly linked to suicidality, but the association with anxiety disorders is less well established. This exploratory study aims to examine whether anxiety and depressive disorders are both independent risk factors for suicidal ideation and attempted suicide, and additionally examined the role of specific clinical characteristics (disorder type, severity, duration, onset age) in suicidality. Data are from 1693 persons with a current (6-month) CIDI based depressive or anxiety disorder and 644 healthy controls participating in the baseline measurement of the Netherlands Study of Depression and Anxiety, which is an existing dataset. Suicidal ideation in the week prior to baseline and attempted suicide ever in life were assessed. Results showed that compared to persons with only an anxiety disorder, persons with a depressive disorder were at significantly higher risk to have current suicidal ideation or a history of attempted suicide. When examining the association between type of disorder and suicidality the odds ratio for MDD was significantly higher than those for the separate anxiety disorders. Although depression and anxiety severity were univariate risk indicators for suicidal ideation and attempted suicide, only depression severity remained a risk indicator for suicidal ideation and attempted suicide in multivariate analyses. Additional risk indicators were an early age at disorder onset for both suicidal ideation and attempted suicide, male gender for suicidal ideation and lower education for attempted suicide. These findings suggest that although anxiety and depression tend to converge in many important areas, they appear to diverge with respect to suicidality.
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Affiliation(s)
- Merijn Eikelenboom
- Department of Psychiatry, VU University Medical Center, Amsterdam, The Netherlands.
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Park SM, Cho SI, Moon SS. Factors associated with suicidal ideation: role of emotional and instrumental support. J Psychosom Res 2010; 69:389-97. [PMID: 20846540 DOI: 10.1016/j.jpsychores.2010.03.002] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2009] [Revised: 02/25/2010] [Accepted: 03/02/2010] [Indexed: 10/19/2022]
Abstract
OBJECTIVES Suicidal ideation is an important phase in the suicidal process, preceding suicide attempts and completed suicide. Weak social ties and low support from friends or relatives have been significantly associated with suicidal ideation. This study investigated the relationship between social support and suicidal ideation among young and middle-aged adults in Korea. METHODS The Seoul Citizens Health and Social Indicators Survey conducted face-to-face interviews with 10,922 self-reporting adults. Questions were asked to assess suicidal ideation, and several questions focused on social support, social networks, health behaviors, and health status. RESULTS The strongest association in middle-aged adults was that between suicidal ideation and lack of social support. Poor emotional support significantly influenced suicidal ideation in middle-aged men, whereas lack of instrumental support significantly affected suicidal thoughts in middle-aged women, after controlling for sociodemographic factors, health behaviors, and health status. High alcohol use, functional limitations, and stress were related to suicidal thoughts in young adults, whereas depressive feelings had the strongest association with suicidal ideation in middle-aged women. CONCLUSIONS Social support is a crucial independent correlate of suicidal ideation, especially in middle-aged adults in an urban community setting. This study shows that it is essential to provide gender-specific social support to prevent suicide.
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Affiliation(s)
- Sang-Mi Park
- School of Public Health and Institute of Health and Environment, Seoul National University, Chongro-ku, Seoul, Republic of Korea
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Predictors of suicidal ideation in depressive primary care patients. J Affect Disord 2010; 125:124-7. [PMID: 20083311 DOI: 10.1016/j.jad.2009.12.008] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2009] [Revised: 11/23/2009] [Accepted: 12/04/2009] [Indexed: 11/23/2022]
Abstract
BACKGROUND Suicidal ideation is common in patients suffering from depression, but it often remains undetected. General practitioners play an important role in the management of depression and suicidality. The aim of this study was to identify predictors for suicidal ideation in patients with major depression in primary health care. METHOD We conducted a cross-sectional study. Patients were recruited from 74 primary care practices in Germany. Data was collected between April 2005 and July 2006. We calculated a binary logistic regression model to evaluate whether depression severity (Patient Health Questionnaire, PHQ-9), physical pain (SF-36 Physical Pain Scale), physical comorbidity, intake of antidepressant medication, sex and age were predictors of suicidal ideation. RESULTS We enrolled 626 patients, aged 18 to 80 with major depression. Depression severity (OR 1.16 per unit PHQ-9 score, 95% CI 1.09-1.22, p<0.001) and male sex (OR 1.71, 95% CI 1.13-2.58, p=0.012) were associated with suicidal ideation, while absence of pain (OR 0.99 per unit SF-36 Physical Pain Scale, 95% CI 0.98-1.00, p=0.004) and older age (>60) compared to the reference group aged 40 to 60 (OR 0.55, 95% CI 0.35-0.86, p=0.009) were protective factors. LIMITATIONS This cross-sectional study allows the generation of hypotheses. CONCLUSIONS Depression severity is a predictor for suicidal ideation in primary care patients with major depression. In addition, physical pain appears to be a predictor. Results should be confirmed using a prospective study design.
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Wolitzky-Taylor KB, Castriotta N, Lenze EJ, Stanley MA, Craske MG. Anxiety disorders in older adults: a comprehensive review. Depress Anxiety 2010; 27:190-211. [PMID: 20099273 DOI: 10.1002/da.20653] [Citation(s) in RCA: 354] [Impact Index Per Article: 25.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
This review aims to address issues unique to older adults with anxiety disorders in order to inform potential changes in the DSM-V. Prevalence and symptom expression of anxiety disorders in late life, as well as risk factors, comorbidity, cognitive decline, age of onset, and treatment efficacy for older adults are reviewed. Overall, the current literature suggests: (a) anxiety disorders are common among older age individuals, but less common than in younger adults; (b) overlap exists between anxiety symptoms of younger and older adults, although there are some differences as well as limitations to the assessment of symptoms among older adults; (c) anxiety disorders are highly comorbid with depression in older adults; (d) anxiety disorders are highly comorbid with a number of medical illnesses; (e) associations between cognitive decline and anxiety have been observed; (f) late age of onset is infrequent; and (g) both pharmacotherapy and CBT have demonstrated efficacy for older adults with anxiety. The implications of these findings are discussed and recommendations for the DSM-V are provided, including extending the text section on age-specific features of anxiety disorders in late life and providing information about the complexities of diagnosing anxiety disorders in older adults.
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Endler NS, Macrodimitris SD, Kocovski NL. Anxiety and Depression: Congruent, Separate, or Both?1. ACTA ACUST UNITED AC 2007. [DOI: 10.1111/j.1751-9861.2003.tb00084.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Abdel-Khalek A, Lester D. The psychometric properties and correlates of the Reynolds' suicide ideation questionnaire with Kuwaiti and American students. Arch Suicide Res 2007; 11:309-19. [PMID: 17558616 DOI: 10.1080/13811110600896236] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
In samples of Kuwaiti (n=460) and American (n=273) college students, the Reynolds Suicide Ideation Questionnaire (SIQ) proved to have good internal consistency and concurrent validity with measures of anxiety, optimism, pessimism, death obsession, obsession-compulsion, and ego-grasping. The SIQ was factorially complex in both samples, but the eight critical items showed a similar two-factor pattern in both samples. It is important to note that in spite of the great differences between Kuwait and US students and their cultures, the findings were quite similar. By and large, the psychological correlates of the SIQ may have cross-cultural generality.
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Sokero P, Eerola M, Rytsälä H, Melartin T, Leskelä U, Lestelä-Mielonen P, Isometsä E. Decline in suicidal ideation among patients with MDD is preceded by decline in depression and hopelessness. J Affect Disord 2006; 95:95-102. [PMID: 16780959 DOI: 10.1016/j.jad.2006.04.028] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2006] [Revised: 04/21/2006] [Accepted: 04/24/2006] [Indexed: 11/20/2022]
Abstract
BACKGROUND Suicidal ideation is likely to represent a phase preceding suicidal acts among most suicidal patients with major depressive disorder (MDD). Factors predicting reversal of the suicidal process are unknown. Our aim was to test the hypothesis that a decline in suicidal ideation is preceded by a decline in hopelessness among patients with MDD. METHOD Of the 269 Vantaa Depression Study patients with DSM-IV MDD, 103 patients scored > or = 6 points at baseline on the Scale for Suicidal Ideation (SSI). Seventy of these patients were followed-up weekly either until they scored zero points on the SSI, or up to 26 weeks. RESULTS The median duration for a decline of suicidal ideation to zero was 2.2 months after baseline. The level of baseline suicidal ideation, depressive symptoms, and the presence of any personality disorder predicted duration of suicidal ideation. A decline in both depression (BDI) and hopelessness (HS) independently predicted a decline in suicidal ideation. LIMITATIONS Due to study design, we do not know if suicidal ideation relapsed after the first time the patient reached zero score in the SSI. CONCLUSIONS Among patients with major depressive disorder having suicidal ideation, the decline in suicidal ideation is independently predicted by preceding declines in the levels of both depressive symptoms as well as hopelessness. The findings are consistent with possible causal roles of declines in depression and hopelessness in reversing the suicidal process.
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Affiliation(s)
- Petteri Sokero
- Department of Mental Health and Alcohol Research, National Public Health Institute, Helsinki, Finland
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Hakko H, Koponen P, Viilo K, Särkioja T, Meyer-Rochow VB, Räsänen P, Timonen M. Alcohol-related suicides in victims with a history of hospital-treated depression. Am J Addict 2006; 14:455-63. [PMID: 16257882 DOI: 10.1080/10550490500247131] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
Victims of suicides are frequently known to have suffered from depression and alcohol-related disorders, but whether these disorders exert different impacts on the period of survival following last hospitalizations have remained unknown. We surveyed 1,585 suicide victims from northern Finland and assigned them to one of three groups, based on lifetime history of depression, alcohol-related disorders, and both together. We then compared survival times in the three groups. Survival times in depressed alcoholic and non-alcoholic males were significantly shorter than those of males with alcohol-related disorders alone. Depressed but non-alcoholic suicide victims had more commonly used violent methods, had less often been under the influence of alcohol, and had had more psychotic disorders than the rest. It is apparently important in clinical practice to recognize the increased risk of suicide soon after hospital discharge not only in depressed patients, but also in those with a history of both depression and alcohol-related disorders.
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Affiliation(s)
- Helinä Hakko
- Department of Psychiatry, Oulu University Hospital, PO Box 26, FIN-90029 OYS, Finland.
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Dunner DL, Lipschitz A, Pitts CD, Davies JT. Efficacy and tolerability of controlled-release paroxetine in the treatment of severe depression: Post hoc analysis of pooled data from a subset of subjects in four double-blind clinical trials. Clin Ther 2005; 27:1901-11. [PMID: 16507376 DOI: 10.1016/j.clinthera.2005.12.013] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/31/2005] [Indexed: 10/25/2022]
Abstract
OBJECTIVES The aims of this work were to assess the efficacy and tolerability of controlled-release paroxetine (paroxetine CR) in the treatment of outpatients with severe major depressive disorder (MDD). METHODS This was a retrospective analysis of pooled data from 4 previously published, double-blind, randomized, placebo-controlled, 8- to 12-week outpatient studies of paroxetine CR (12.5-62.5 mg) in MDD. However, the studies were designed to assess the efficacy of paroxetine CR overall, rather than specifically in those with severe MDD. Subjects were categorized according to their baseline mean 17-item Hamilton Depression Rating Scale (HAMD-17) total score as having severe (> or =25) or nonsevere (<25) depression. Changes in depressive symptomatology were assessed, based on the mean change from baseline in HAMD-17 total scores and the proportion of responders (> or =50% reduction from baseline in HAMD-17 total scores or Clinical Global Impression [CGI] of Improvement scores of 1 or 2), for each study and pooled across the studies. The pooled analysis of data also assessed the proportion of patients achieving remission (HAMD-17 total score < or =7 or CGI-Improvement score of 1) at last-observation-carried-forward end point. RESULTS A total of 1083 subjects participated in the 4 studies; 303 had severe MDD (paroxetine CR, n = 174; placebo, n = 129). Among the patients with severe MDD, most were women, had a mean HAMD-17 score between 26.3 and 27.7, and had a mean CGI of Severity score between 4.5 and 4.9. In 3 studies, the mean age of such participants was between 35 and 43 years. However, the fourth study was an evaluation in late-life depression in which the mean age was 71.3 years in the paroxetine CR group and 70.0 years in the placebo group. In the overall pooled sample, significantly greater improvements in depressive symptoms were observed among those with severe MDD who were treated with paroxetine CR compared with those who received placebo (HAMD-17 total treatment difference, -4.37 [95% CI, -6.31 to -2.42; P < 0.001]). The odds of CGI-Improvement response were also significantly higher for patients receiving paroxetine CR than those receiving placebo, regardless of baseline depressive symptomatology (severe MDD: odds ratio [OR], 2.42 [95% CI, 1.50-3.91; P < 0.001]; nonsevere MDD: OR, 1.63 [95% CI, 1.21-2.19; P < 0.002] ). Withdrawal rates due to adverse events were 9.8% versus 5.4% (severe) and 5.2% versus 4.5% (nonsevere), paroxetine CR versus placebo, respectively. CONCLUSIONS This post hoc analysis of pooled data suggests that paroxetine CR was effective and well tolerated in these outpatients with severe MDD.
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Affiliation(s)
- David L Dunner
- Center for Anxiety and Depression, University of Washington, Seattle, Washington 98105-6099, USA.
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Sonawalla SB, Farabaugh A, Johnson MW, Morray M, Delgado ML, Pingol MG, Rosenbaum JF, Fava M. Fluoxetine treatment of depressed patients with comorbid anxiety disorders. J Psychopharmacol 2002; 16:215-9. [PMID: 12236627 DOI: 10.1177/026988110201600304] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Major depression with comorbid anxiety disorder is associated with poor antidepressant outcome compared to major depression without comorbid anxiety disorder. The purpose of our study was to assess changes in severity of both depressive and anxiety symptoms in outpatients with major depression with comorbid anxiety disorder following fluoxetine treatment. We enrolled 123 outpatients (mean age 38.9 +/- 10.8 years; 49% women) with major depressive disorder accompanied by one or more current comorbid anxiety disorders in our study. Patients were treated openly with fluoxetine 20 mg/day for 8 weeks. Efficacy assessments included the 17-item Hamilton Rating Scale for Depression (HAM-D) and the patient-rated Symptom Questionnaire (SQ) Scales for Depression and Anxiety. The mood and anxiety disorder modules of the Structured Clinical Interview for DSM-III-R were administered at screen and endpoint. We used 'intent-to-treat' analysis in examining all patients assigned to treatment and completing the baseline visit. The mean number of comorbid anxiety disorders per patient was 1.5 +/- 0.68. The mean HAM-D-17 score and mean Clinical Global Impressions-Severity scores decreased significantly from baseline to endpoint (week 8) following fluoxetine treatment (p < 0.0001). There were significant decreases in all four SQ scale scores, from baseline to endpoint: depression, anxiety, somatic symptoms and anger-hostility (p < 0.0001). Fifty-three percent of patients (n = 65) were depression responders (i.e. > or = 50% decrease in HAM-D-17 score at endpoint) and 46% (n = 57) were remitters (HAM-D-17 < or = 7 at endpoint). Patients with panic disorder had significantly higher baseline HAM-D-17 scores compared to those without panic disorder (p < 0.01). Patients with comorbid obsessive-compulsive disorder (OCD) were significantly less likely to be responders to fluoxetine at endpoint (> or = 50% decrease in HAM-D-17) and to be remitters (HAM-D-17 score of s 7 at endpoint) compared to patients without comorbid OCD (p < 0.01). Of the 41 patients on whom endpoint Structured Clinical Interview for DSM-III-R modules for anxiety disorders were available, 49% (n = 20) no longer met criteria for one or more of their anxiety disorder diagnoses at endpoint. Our preliminary findings suggest that fluoxetine is effective in treating outpatients with major depression with comorbid anxiety disorders, with a significant effect on both depression and anxiety symptoms. Further double-blind, placebo-controlled trials are required in larger samples to confirm our findings.
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Affiliation(s)
- Shamsah B Sonawalla
- Depression Clinical and Research Program, Massachusetts General Hospital, Harvard Medical School, Boston 02114, USA.
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Suicidal and Death Ideation in Older Primary Care Patients With Depression, Anxiety, and At-Risk Alcohol Use. THE AMERICAN JOURNAL OF GERIATRIC PSYCHIATRY 2002. [DOI: 10.1097/00019442-200207000-00008] [Citation(s) in RCA: 110] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Zubenko GS, Hughes HB, Stiffler JS, Zubenko WN, Kaplan BB. Genome survey for susceptibility loci for recurrent, early-onset major depression: results at 10cM resolution. AMERICAN JOURNAL OF MEDICAL GENETICS 2002; 114:413-22. [PMID: 11992563 DOI: 10.1002/ajmg.10381] [Citation(s) in RCA: 54] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Recurrent (two or more episodes), early-onset (first episode at < or = 25 years) major depressive disorder (RE-MDD) is a strongly familial condition (lambda(first-degree relatives) = 8) whose malignant effects have a significant negative impact on the health and longevity of patients and their family members. The goal of this study was to identify candidate susceptibility loci that influence the development of RE-MDD. We completed a systematic survey of the human genome, conducted at an average resolution of 10 cM, for the identification of simple sequence tandem repeat polymorphisms (SSTRPs) that target susceptibility genes for RE-MDD by virtue of linkage disequilibrium. The efficiency of our association study was enhanced by genotyping pools of DNA from 100 adults with RE-MDD and 100 adult controls who had no personal or family history of mental disorders. Both groups included equal numbers of Caucasian men and women and were matched as closely as possible for age and ethnicity. Allelic associations with RE-MDD were observed for 19 of the 387 SSTRPs in the CHLC Human Screening Set/Weber Version 9. Sixteen of the 19 candidate susceptibility loci revealed significant allelic associations with RE-MDD in men (n = 7) or women (n = 9), but not in both sexes. Evidence for both risk and protective alleles was detected. Two of the candidate susceptibility loci reside within several Mb of loci previously reported-megabases to be linked to "comorbid alcoholism and depression" in families of individuals with alcoholism and to a broadly defined affected phenotype that included recurrent major depression in the families of patients with bipolar disorder. Although it has been suggested that the genes that influence risk for MDD in the two sexes may not be entirely the same, the results of our study suggest that sex specificity of susceptibility loci for RE-MDD may be the rule rather than the exception. The observed preponderance of sex-specific susceptibility loci for RE-MDD suggests that there may be important differences in the molecular pathophysiology of RE-MDD in men and women. Alternatively, our findings may reflect the existence of sex-specific differences in the molecular mechanisms that determine resilience to endogenous or environmental depressogenic stimuli.
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Affiliation(s)
- George S Zubenko
- Department of Psychiatry, University of Pittsburgh, School of Medicine, Pittsburgh, Pennsylvania, USA.
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