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Huang XP, Li ZQ, Wei-Zhang, Feng XM, Wang XC, Jiang ZL. Self-injury and suicide among people living with HIV/AIDS in China: a systematic review and meta-analysis. BMC Public Health 2024; 24:2248. [PMID: 39160497 PMCID: PMC11334318 DOI: 10.1186/s12889-024-19444-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 07/11/2024] [Indexed: 08/21/2024] Open
Abstract
BACKGROUND The prevalence of self-injury and suicide is higher than the general population of people living with HIV/AIDS (PLWHA). However, the results reported in existing studies are highly variable in China. The purpose of this systematic review and meta-analysis was to synthesize the currently available high-quality evidence to explore the prevalence and influence factors of self-injury and suicide among PLWHA in China. METHOD We retrieve literature written in Chinese and English through databases such as PubMed, Embase, Web of Science, Cochrane Library, SinoMed, CNKI, WanFang Database, and CQVIP from inception to 1 September 2022. Sata 16.0 software was used for analysis. RESULTS A total of 28 studies were included with a sample size of 1,433,971 and had a satisfactory quality score of ≥ 5. The prevalence among PLWHA in China were 30% for suicidal ideation (SI), 5% for suicide attempt (SA), 8% for suicide plan (SP), 7% for attempted suicide (AS), and 3‰ for completed suicide. High stigma (OR = 2.94, 95%CI: 1.90 - 4.57), depression (OR, 3.17; 95%CI, 2.20 - 4.57), anxiety (OR, 3.06; 95%CI, 2.23 - 4.20), low self-esteem (OR, 3.82, 95%CI, 2.22 - 6.57), high HIV related stress (OR, 2.53; 95%CI, 1.36 - 4.72), and unemployment (OR, 2.50; 95%CI, 1.51 - 4.15) are risk factors for SI; high social support (OR, 0.61; 95%CI, 0.44 - 0.84) and spouse infected with HIV (OR, 0.39; 95%CI, 0.21 - 0.74) are protective factors for SI; depression (OR, 1.62; 95%CI, 1.24 - 2.13), high aggression (OR, 4.66; 95%CI, 2.59 - 8.39), and more negative life events (OR, 2.51; 95%CI, 1.47 - 4.29) are risk factors for AS; high level of education (OR, 1.31; 95%CI, 1.21 - 1.43) is risk factor for CS. CONCLUSION Figures indicate that approximately one-third of PLWHA had suicidal ideation, and three out of 1,000 completed suicide in China. Positive events are protective factors for self-injury and suicide among PLWHA, while negative events are risk factors. This suggests that psychosocial support and risk assessment should be integrated into the care of PLWHA.
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Affiliation(s)
- Xiao-Ping Huang
- School of Public Health, Kunming Medical University, Kunming, Yunnan, 650500, China
| | - Zhi-Qiang Li
- School of Life science, Tsinghua University, Beijing, 100084, China
| | - Wei-Zhang
- Yunnan Provincial Infectious Disease Hospital/AIDS Care Center, Kunming, Yunnan, 650300, China
| | - Xue-Min Feng
- School of Public Health, Kunming Medical University, Kunming, Yunnan, 650500, China
| | - Xi-Cheng Wang
- Yunnan Provincial Infectious Disease Hospital/AIDS Care Center, Kunming, Yunnan, 650300, China.
| | - Zhong-Liang Jiang
- Yunnan Provincial Infectious Disease Hospital/AIDS Care Center, Kunming, Yunnan, 650300, China.
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Edwards AC, Singh M, Peterson RE, Webb BT, Gentry AE. Associations between polygenic liability to psychopathology and non-suicidal versus suicidal self-injury. Am J Med Genet B Neuropsychiatr Genet 2024; 195:e32982. [PMID: 38551161 PMCID: PMC11438949 DOI: 10.1002/ajmg.b.32982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Revised: 03/01/2024] [Accepted: 03/19/2024] [Indexed: 09/30/2024]
Abstract
Little is known about how non-suicidal and suicidal self-injury are differentially genetically related to psychopathology and related measures. This research was conducted using the UK Biobank Resource, in participants of European ancestry (N = 2320 non-suicidal self-injury [NSSI] only; N = 2648 suicide attempt; 69.18% female). We compared polygenic scores (PGS) for psychopathology and other relevant measures within self-injuring individuals. Logistic regressions and likelihood ratio tests (LRT) were used to identify PGS that were differentially associated with these outcomes. In a multivariable model, PGS for anorexia nervosa (odds ratio [OR] = 1.07; 95% confidence intervals [CI] 1.01; 1.15) and suicidal behavior (OR = 1.06; 95% CI 1.00; 1.12) both differentiated between NSSI and suicide attempt, while the PGS for other phenotypes did not. The LRT between the multivariable and base models was significant (Chi square = 11.38, df = 2, p = 0.003), and the multivariable model explained a larger proportion of variance (Nagelkerke's pseudo-R2 = 0.028 vs. 0.025). While NSSI and suicidal behavior are similarly genetically related to a range of mental health and related outcomes, genetic liability to anorexia nervosa and suicidal behavior is higher among those reporting a suicide attempt than those reporting NSSI-only. Further elucidation of these distinctions is necessary, which will require a nuanced assessment of suicidal versus non-suicidal self-injury in large samples.
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Affiliation(s)
- Alexis C. Edwards
- Department of Psychiatry, Virginia Commonwealth University School of Medicine, Richmond, VA, US 23298
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA, US 23298
| | - Madhurbain Singh
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA, US 23298
- Department of Human and Molecular Genetics, Virginia Commonwealth University School of Medicine, Richmond, VA, US 23298
| | - Roseann E. Peterson
- Department of Psychiatry, Virginia Commonwealth University School of Medicine, Richmond, VA, US 23298
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA, US 23298
- Department of Psychiatry and Behavioral Sciences, Institute for Genomics in Health, SUNY Downstate Health Sciences University, Brooklyn, NY, US 11205
| | - Bradley T. Webb
- Department of Psychiatry, Virginia Commonwealth University School of Medicine, Richmond, VA, US 23298
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA, US 23298
- GenOmics, Bioinformatics, and Translational Research Center, Biostatistics and Epidemiology Division, RTI International, Research Triangle Park, NC, US
| | - Amanda E. Gentry
- Department of Psychiatry, Virginia Commonwealth University School of Medicine, Richmond, VA, US 23298
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA, US 23298
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Sun K, Li A, Li Y, Xie J, Tong Y, Ma J, Wu Y. A cross-sectional study of non-suicidal self-injury in a Chinese adolescent inpatient cohort. Front Psychiatry 2023; 14:1109334. [PMID: 37293407 PMCID: PMC10244503 DOI: 10.3389/fpsyt.2023.1109334] [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: 11/27/2022] [Accepted: 05/05/2023] [Indexed: 06/10/2023] Open
Abstract
Background Non-suicidal self-injury (NSSI) is a significant predictor of completed suicide and is increasingly recognized as a serious public health concern. Multiple factors, including social, familial, mental, and genetic factors could influence the occurrence of this behavior. Identifying the early risk factors is important for screening and preventing this behavior. Methods Here, we recruited a total of 742 adolescent inpatient participants from a mental health center and conducted a series of diagnostic interviews and questionnaires to assess NSSI behavior and other events. Bivariate analysis was used to detect differences between groups in NSSI and non-NSSI. Then, binary logistic regression was fitted to identify predictors of NSSI as a function of these questionnaire scores. Results Of the 742 adolescents examined, a total of 382 (51.5%) participants engaged in NSSI. Bivariate analysis showed that age, gender, depression, anxiety, insomnia, and childhood trauma was significantly associated with NSSI. Logistic regression results suggested that females had 2.43 higher odds of engaging in NSSI when compared to their male counterparts (OR = 3.43, 95%CI = 2.09-5.74, p = 1.70 × 10-6). Depression was a primary risk predictor for NSSI with each additional increase in symptoms of depression increasing the odds of engaging in NSSI by 18% (OR = 1.18, 95%CI = 1.12-1.25, p = 2.25 × 10-8). Conclusion More than half of the adolescent inpatients with psychiatric disorders have NSSI experience. Depression and gender were the risk factors for NSSI. Age at a specific range had a high prevalence of NSSI.
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Affiliation(s)
- Ke Sun
- Department of Child and Adolescent Psychiatry, Wuhan Mental Health Center, Wuhan, Hubei, China
| | - Anni Li
- Department of Child and Adolescent Psychiatry, Wuhan Mental Health Center, Wuhan, Hubei, China
| | - Yichen Li
- Department of Child and Adolescent Psychiatry, Wuhan Mental Health Center, Wuhan, Hubei, China
| | - Jun Xie
- Department of Child and Adolescent Psychiatry, Wuhan Mental Health Center, Wuhan, Hubei, China
| | - Yonghao Tong
- Department of Child and Adolescent Psychiatry, Wuhan Mental Health Center, Wuhan, Hubei, China
| | - Jun Ma
- Department of Child and Adolescent Psychiatry, Wuhan Mental Health Center, Wuhan, Hubei, China
- Affiliated Wuhan Mental Health Center, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Yong Wu
- Research Center for Mental Health and Neuroscience, Wuhan Mental Health Center, Wuhan, Hubei, China
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Yan H, Yue W. Risk factors, theoretical models, and biological mechanisms of nonsuicidal self-injury: a brief review. INTERDISCIPLINARY NURSING RESEARCH 2023; 2:112-120. [PMID: 37645376 PMCID: PMC10461723 DOI: 10.1097/nr9.0000000000000023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 06/07/2023] [Indexed: 08/31/2023]
Abstract
Nonsuicidal self-injury (NSSI) refers to the direct, deliberate infliction of harm to one's body tissue without the intention to die. The prevalence of NSSI has increased significantly globally in recent years and has become an important public health problem affecting the health of people, especially adolescents. The occurrence of NSSI in adolescents is the result of the interaction of different factors. Many scholars have proposed various theoretical models to explain the mechanism of NSSI behavior based on previous research on the influencing factors of NSSI. Moreover, advances have been made in genetic and neuroimaging mechanisms related to NSSI. Understanding the genetic and neuroimaging mechanisms of NSSI is important for both describing and treating the disorder. This literature review discusses the progress made on the risk factors, theoretical models, and biological mechanisms of NSSI.
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Affiliation(s)
- Huiru Yan
- School of Nursing and Sixth Hospital, Peking University, Beijing, China
- Institute of Mental Health, Peking University Sixth Hospital and Research Unit of Diagnosis and Treatment of Mood Cognitive Disorder of Chinese Academy of Medical Sciences, Beijing, China
- National Clinical Research Center for Mental Disorders and NHC Key Laboratory of Mental Health and (Peking University Sixth Hospital), Beijing, China
| | - Weihua Yue
- Institute of Mental Health, Peking University Sixth Hospital and Research Unit of Diagnosis and Treatment of Mood Cognitive Disorder of Chinese Academy of Medical Sciences, Beijing, China
- National Clinical Research Center for Mental Disorders and NHC Key Laboratory of Mental Health and (Peking University Sixth Hospital), Beijing, China
- PKU-IDG/McGovern Institute for Brain Research, Peking University, Beijing, China
- Chinese Institute for Brain Research, Beijing, China
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5
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Piarulli FM, Margari A, Margari F, Matera E, Croce F, Furente F, Gabellone A, Petruzzelli MG. Do Cortisol and Dehydroepiandrosterone Influence Motivational Factors for Non-Suicidal Self-Injury in Female Adolescents? J Clin Med 2023; 12:jcm12051924. [PMID: 36902709 PMCID: PMC10003553 DOI: 10.3390/jcm12051924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 02/26/2023] [Accepted: 02/27/2023] [Indexed: 03/06/2023] Open
Abstract
Non-suicidal self-injury (NSSI) is a significant public health issue that particularly affects female adolescents usually emerging during puberty, with a subsequent reduction and even remission in the phenomenon later in life. The dysregulation of the hormonal stress response, particularly cortisol and dehydroepiandrosterone sulfate (DHEA-S), whose levels increase markedly during pubertal adrenarche, has been associated with the development and maintenance of a wide range of emotional disorders. Our study aims to investigate whether different cortisol-DHEA-S response patterns could be associated with the main motivational moderators to engage NSSI as well as with urgency and motivation to stop NSSI in a sample of female adolescents. We found significant correlations between stress hormones and several factors that support and sustain NSSI, specifically: cortisol levels and distressing/upsetting urge (r = 0.39 and a p = 8.94 × 10-3) and sensation seeking (r = -0.32 and a p = 0.04), as well as cortisol/DHEA-s ratio and external emotion regulation (r = 0.40 and a p = 0.01) and desire to stop NSSI (r = 0.40 and a p = 0.01). Cortisol and DHEA-S may play a role in NSSI through the regulation of stress responses and affective states. Such results could have implications for the development of new and improved treatment and prevention plans for NSSI.
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Affiliation(s)
- Francesco Maria Piarulli
- Department of Translational Biomedicine and Neurosciences (DiBraiN), University “A. Moro”, 7016 Bari, Italy
| | - Anna Margari
- Department of Translational Biomedicine and Neurosciences (DiBraiN), University “A. Moro”, 7016 Bari, Italy
| | - Francesco Margari
- Department of Translational Biomedicine and Neurosciences (DiBraiN), University “A. Moro”, 7016 Bari, Italy
| | - Emilia Matera
- Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe-J), University “A. Moro”, 7016 Bari, Italy
- Correspondence:
| | - Federica Croce
- Department of Translational Biomedicine and Neurosciences (DiBraiN), University “A. Moro”, 7016 Bari, Italy
| | - Flora Furente
- Department of Translational Biomedicine and Neurosciences (DiBraiN), University “A. Moro”, 7016 Bari, Italy
| | - Alessandra Gabellone
- Department of Translational Biomedicine and Neurosciences (DiBraiN), University “A. Moro”, 7016 Bari, Italy
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A systematic review of predictors of suicidal thoughts and behaviors among autistic adults: Making the case for the role of social connection as a protective factor. Clin Psychol Rev 2023; 99:102235. [PMID: 36459876 DOI: 10.1016/j.cpr.2022.102235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 09/21/2022] [Accepted: 11/23/2022] [Indexed: 11/29/2022]
Abstract
Autistic adults are a high-risk population for suicidal thoughts and behaviors (STBs). Accordingly, this systematic review aims to review the prevalence of STBs among autistic adults, review the risk and protective factors for STBs in autistic adults, and formulate a disorder-specific conceptualization of risk in this population. We systematically searched PsycINFO and Google Scholar for all studies published prior to March 28th, 2022. We included empirical articles focused on autistic adults, ages 18 years and older, reporting on suicide-related outcomes. In total, 45 peer-reviewed empirical articles were included in the current systematic review. The most frequently studied factors in relation to suicide risk among autistic adults were interpersonal constructs (42.4% of total studies looking at risk/protective factors) and depressive symptoms (36.4% of total studies looking at risk/protective factors). We conclude by summarize two key content areas: exploring social and interpersonal constructs and better understanding the role of depressive symptoms in autism. As researchers continue to explore STBs among autistic adults, it will be necessary to addressing the overreliance on autistic symptoms instead of autism diagnoses, measurement issues of STBs, and a need for treatment adaptations.
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7
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Colbert SMC, Mullins N, Chan G, Meyers JL, Schulman J, Kuperman S, Lai D, Nurnberger J, Plawecki MH, Kamarajan C, Anokhin AP, Bucholz KK, Hesselbrock V, Edenberg HJ, Kramer J, Dick DM, Porjesz B, Agrawal A, Johnson EC. Polygenic Contributions to Suicidal Thoughts and Behaviors in a Sample Ascertained for Alcohol Use Disorders. Complex Psychiatry 2023; 9:11-23. [PMID: 38058956 PMCID: PMC10697665 DOI: 10.1159/000529164] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 01/03/2023] [Indexed: 12/08/2023] Open
Abstract
Introduction Suicidal thoughts and behaviors have partially distinct genetic etiologies. Methods We used PRS-CS to create polygenic risk scores (PRSs) from GWAS of non-suicidal self-injury, broad-sense self-harm ideation, nonfatal suicide attempt, death by suicide, and depression. Using mixed-effect models, we estimated whether these PRSs were associated with a range of suicidal thoughts and behaviors in the Collaborative Study on the Genetics of Alcoholism (N = 7,526). Results All PRSs were significantly associated with suicidal ideation and suicide attempt (betas = 0.08-0.44, false discovery rate [FDR] <0.023). All PRSs except non-suicidal self-injury PRS were associated with active suicidal ideation (betas = 0.14-0.22, FDR <0.003). Several associations remained significant in models where all significant PRSs were included as simultaneous predictors, and when all PRSs predicted suicide attempt, the PRS together explained 6.2% of the variance in suicide attempt. Significant associations were also observed between some PRSs and persistent suicidal ideation, non-suicidal self-injury, compounded suicide attempt, and desire to die. Conclusion Our findings suggest that PRS for depression does not explain the entirety of the variance in suicidal thoughts and behaviors, with PRS specifically for suicidal thoughts and behaviors making additional and sometimes unique contributions.
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Affiliation(s)
- Sarah M C Colbert
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | - Niamh Mullins
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Grace Chan
- Mount Sinai Clinical Intelligence Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Jacquelyn L Meyers
- Department of Psychiatry, University of Connecticut, Farmington, CT, USA
- Department of Psychiatry and Behavioral Sciences, SUNY Downstate Health Sciences University, Brooklyn, NY, USA
| | - Jessica Schulman
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Samuel Kuperman
- Henri Begleiter Neurodynamics Lab, SUNY Downstate Health Sciences University, Brooklyn, NY, USA
| | - Dongbing Lai
- Department of Psychiatry, University of Iowa Carver College of Medicine, Iowa City, IA, USA
| | - John Nurnberger
- Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, IN, USA
- Department of Psychiatry, University of Iowa Carver College of Medicine, Iowa City, IA, USA
| | - Martin H Plawecki
- Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Chella Kamarajan
- Department of Psychiatry, University of Connecticut, Farmington, CT, USA
- Department of Psychiatry and Behavioral Sciences, SUNY Downstate Health Sciences University, Brooklyn, NY, USA
| | - Andrey P Anokhin
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | - Kathleen K Bucholz
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | - Victor Hesselbrock
- Mount Sinai Clinical Intelligence Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Howard J Edenberg
- Department of Psychiatry, University of Iowa Carver College of Medicine, Iowa City, IA, USA
- Department of Psychiatry and Stark Neurosciences Research Institute, Indiana University School of Medicine, Indianapolis, IN, USA
| | - John Kramer
- Henri Begleiter Neurodynamics Lab, SUNY Downstate Health Sciences University, Brooklyn, NY, USA
| | - Danielle M Dick
- Department of Biochemistry and Molecular Biology, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Bernice Porjesz
- Department of Psychiatry, University of Connecticut, Farmington, CT, USA
- Department of Psychiatry and Behavioral Sciences, SUNY Downstate Health Sciences University, Brooklyn, NY, USA
| | - Arpana Agrawal
- Department of Psychiatry, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA
| | - Emma C Johnson
- Department of Psychiatry, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA
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Combined effects of nitric oxide synthase 3 genetic variant and childhood emotional abuse on earlier onset of suicidal behaviours. Prog Neuropsychopharmacol Biol Psychiatry 2022; 119:110617. [PMID: 35988847 DOI: 10.1016/j.pnpbp.2022.110617] [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: 04/26/2022] [Revised: 07/28/2022] [Accepted: 08/14/2022] [Indexed: 11/22/2022]
Abstract
Marked heterogeneity in suicide attempters has been observed, with earlier onset being linked to stronger heritability, more childhood maltreatment. Nitric oxide signalling system might be implicated in this relationship through its role in the stress response/adaptation. This study examined how NOS genetic variants and childhood maltreatment were associated with age at first suicide attempt (SA). Adult patients with SA history (N = 414) filled in the Childhood Trauma Questionnaire, and six functionally relevant NOS2 and NOS3 polymorphisms were genotyped. Analyses included χ2, Mann-Whitney U tests, Kendall's regression, multivariate linear and Cox survival regressions, and a moderation analysis. The NOS3 promotor 27-bp variable number tandem repeat (VNTR) bb homozygous state and childhood emotional abuse were independently associated with earlier age at first SA, which was robust after controlling for confounders [regression coefficient - 3.975, 95% CI -6.980 - (-0.970), p = 0.010, and - 1.088, 95% CI -2.172 - (-0.004), p = 0.049]. No interaction was observed. In the Cox proportional hazards model for age at first SA, the hazard ratio for patients with childhood emotional abuse and NOS3 27-bp VNTR bb was 0.533 (95% CI 0.394-0.720, p < 0.001) compared to patients without. Intermediate scores were observed with either only the risk genotype or only childhood emotional abuse. A graded relationship was also observed for repeated SA, family history of SA, and severe SA history. These results are preliminary due to a low statistical power and call for replication and further characterization of the role of nitric oxide system in the susceptibility to early-onset SB.
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Goodman D, Pletch A, Paul P, Anderson E, Kverno K. Nonsuicidal Self-Injury: A Nurse-Led Quality Improvement Project to Address Self-Harm. J Psychosoc Nurs Ment Health Serv 2022; 60:7-10. [PMID: 35244492 DOI: 10.3928/02793695-20220208-02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Nonsuicidal self-injury (NSSI) behaviors, such as cutting, scratching, or more severe injuries, are frequently comorbid with neurodevelopmental, intellectual, trauma, personality, and major depressive disorders, complicating treatment and placing added care burdens on hospital nursing staff and advanced practice nurses. Although specific psychopharmacological treatment guidelines and approved medications for NSSI are non-existent, patients are treated with medications approved for co-morbid disorders and behavioral interventions targeting intrapersonal (poor emotional self-regulation) and interpersonal (communication of distress) functions. The current article describes a nurse-led quality improvement project, using the Plan-Do-Study-Act cycle, in a case example. Outcomes include improved staff competencies and policies, yet we remain challenged in implementing planned actions that add additional time burdens to already stretched care providers. [Journal of Psychosocial Nursing and Mental Health Services, 60(3), 7-10.].
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Kalman JL, Yoshida T, Andlauer TFM, Schulte EC, Adorjan K, Alda M, Ardau R, Aubry JM, Brosch K, Budde M, Chillotti C, Czerski PM, DePaulo RJ, Forstner A, Goes FS, Grigoroiu-Serbanescu M, Grof P, Grotegerd D, Hahn T, Heilbronner M, Hasler R, Heilbronner U, Heilmann-Heimbach S, Kapelski P, Kato T, Kohshour MO, Meinert S, Meller T, Nenadić I, Nöthen MM, Novak T, Opel N, Pawlak J, Pfarr JK, Potash JB, Reich-Erkelenz D, Repple J, Richard-Lepouriel H, Rietschel M, Ringwald KG, Rouleau G, Schaupp S, Senner F, Severino G, Squassina A, Stein F, Stopkova P, Streit F, Thiel K, Thomas-Odenthal F, Turecki G, Twarowska-Hauser J, Winter A, Zandi PP, Kelsoe JR, Falkai P, Dannlowski U, Kircher T, Schulze TG, Papiol S. Investigating the phenotypic and genetic associations between personality traits and suicidal behavior across major mental health diagnoses. Eur Arch Psychiatry Clin Neurosci 2022; 272:1611-1620. [PMID: 35146571 PMCID: PMC9653330 DOI: 10.1007/s00406-021-01366-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Accepted: 11/24/2021] [Indexed: 12/18/2022]
Abstract
Personality traits influence risk for suicidal behavior. We examined phenotype- and genotype-level associations between the Big Five personality traits and suicidal ideation and attempt in major depressive, bipolar and schizoaffective disorder, and schizophrenia patients (N = 3012) using fixed- and random-effects inverse variance-weighted meta-analyses. Suicidal ideations were more likely to be reported by patients with higher neuroticism and lower extraversion phenotypic scores, but showed no significant association with polygenic load for these personality traits. Our findings provide new insights into the association between personality and suicidal behavior across mental illnesses and suggest that the genetic component of personality traits is unlikely to have strong causal effects on suicidal behavior.
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Affiliation(s)
- Janos L. Kalman
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Nussbaumstr. 7, 80336 Munich, Germany ,Department of Psychiatry and Psychotherapy, University Hospital Munich, Munich, Germany ,International Max Planck Research School for Translational Psychiatry, Munich, Germany
| | - Tomoya Yoshida
- National Center for Global Health and Medicine, Tokyo, Japan
| | - Till F. M. Andlauer
- Department of Neurology, Klinikum Rechts Der Isar, School of Medicine, Technical University of Munich, Munich, Germany ,Global Computational Biology and Data Sciences, Boehringer Ingelheim Pharma GmbH & Co. KG, 88397 Biberach an der Riß, Germany
| | - Eva C. Schulte
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Nussbaumstr. 7, 80336 Munich, Germany ,Department of Psychiatry and Psychotherapy, University Hospital Munich, Munich, Germany
| | - Kristina Adorjan
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Nussbaumstr. 7, 80336 Munich, Germany ,Department of Psychiatry and Psychotherapy, University Hospital Munich, Munich, Germany
| | - Martin Alda
- Department of Psychiatry, Dalhousie University, Halifax, Canada
| | - Raffaela Ardau
- Unit of Clinical Pharmacology, University Hospital Agency of Cagliari, Cagliari, Italy
| | - Jean-Michel Aubry
- Department of Psychiatry, Geneva University Hospitals, Geneva, Switzerland ,Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Katharina Brosch
- Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany ,Center for Mind, Brain and Behavior, University of Marburg, Marburg, Germany
| | - Monika Budde
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Nussbaumstr. 7, 80336 Munich, Germany
| | - Caterina Chillotti
- Unit of Clinical Pharmacology, University Hospital Agency of Cagliari, Cagliari, Italy
| | - Piotr M. Czerski
- Department of Psychiatric Genetics, Poznan University of Medical Sciences, Poznan, Poland
| | - Raymond J. DePaulo
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD USA
| | - Andreas Forstner
- Centre for Human Genetics, University of Marburg, Marburg, Germany ,Institute of Human Genetics, School of Medicine &, University of Bonn, University Hospital Bonn, Bonn, Germany ,Institute of Neuroscience and Medicine (INM-1), Research Centre Jülich, Jülich, Germany
| | - Fernando S. Goes
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD USA
| | | | - Paul Grof
- Mood Disorders Clinic of Ottawa, Ottawa, ON Canada ,Department of Psychiatry, University of Toronto, Toronto, ON Canada
| | - Dominik Grotegerd
- Institute for Translational Psychiatry, University of Munster, Munster, Germany
| | - Tim Hahn
- Institute for Translational Psychiatry, University of Munster, Munster, Germany
| | - Maria Heilbronner
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Nussbaumstr. 7, 80336 Munich, Germany
| | - Roland Hasler
- Department of Psychiatry, Geneva University Hospitals, Geneva, Switzerland
| | - Urs Heilbronner
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Nussbaumstr. 7, 80336 Munich, Germany
| | - Stefanie Heilmann-Heimbach
- Institute of Human Genetics, School of Medicine &, University of Bonn, University Hospital Bonn, Bonn, Germany
| | - Pawel Kapelski
- Department of Psychiatric Genetics, Poznan University of Medical Sciences, Poznan, Poland
| | - Tadafumi Kato
- Department of Psychiatry and Behavioral Science, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Mojtaba Oraki Kohshour
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Nussbaumstr. 7, 80336 Munich, Germany ,Department of Immunology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Susanne Meinert
- Institute for Translational Psychiatry, University of Munster, Munster, Germany ,Institute for Translational Neuroscience, University of Münster, Munster, Germany
| | - Tina Meller
- Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany ,Center for Mind, Brain and Behavior, University of Marburg, Marburg, Germany
| | - Igor Nenadić
- Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany ,Center for Mind, Brain and Behavior, University of Marburg, Marburg, Germany
| | - Markus M. Nöthen
- Institute of Human Genetics, School of Medicine &, University of Bonn, University Hospital Bonn, Bonn, Germany
| | - Tomas Novak
- National Institute of Mental Health, Klecany, Czech Republic ,3Rd Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Nils Opel
- Institute for Translational Psychiatry, University of Munster, Munster, Germany
| | - Joanna Pawlak
- Department of Psychiatric Genetics, Poznan University of Medical Sciences, Poznan, Poland
| | - Julia-Katharina Pfarr
- Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany ,Center for Mind, Brain and Behavior, University of Marburg, Marburg, Germany
| | - James B. Potash
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD USA
| | - Daniela Reich-Erkelenz
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Nussbaumstr. 7, 80336 Munich, Germany
| | - Jonathan Repple
- Institute for Translational Psychiatry, University of Munster, Munster, Germany
| | | | - Marcella Rietschel
- Department of Genetic Epidemiology in Psychiatry, Medical Faculty Mannheim, Central Institute of Mental Health, Heidelberg University, Mannheim, Germany
| | - Kai G. Ringwald
- Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany ,Center for Mind, Brain and Behavior, University of Marburg, Marburg, Germany
| | - Guy Rouleau
- Montreal Neurological Institute, McGill University, Montreal, Canada
| | - Sabrina Schaupp
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Nussbaumstr. 7, 80336 Munich, Germany
| | - Fanny Senner
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Nussbaumstr. 7, 80336 Munich, Germany ,Department of Psychiatry and Psychotherapy, University Hospital Munich, Munich, Germany
| | - Giovanni Severino
- Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy
| | - Alessio Squassina
- Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy
| | - Frederike Stein
- Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany ,Center for Mind, Brain and Behavior, University of Marburg, Marburg, Germany
| | - Pavla Stopkova
- National Institute of Mental Health, Klecany, Czech Republic ,3Rd Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Fabian Streit
- Department of Genetic Epidemiology in Psychiatry, Medical Faculty Mannheim, Central Institute of Mental Health, Heidelberg University, Mannheim, Germany
| | - Katharina Thiel
- Institute for Translational Psychiatry, University of Munster, Munster, Germany
| | | | - Gustavo Turecki
- The Douglas Research Centre, McGill University, Montreal, Canada
| | | | - Alexandra Winter
- Institute for Translational Psychiatry, University of Munster, Munster, Germany
| | - Peter P. Zandi
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD USA
| | - John R. Kelsoe
- Department of Psychiatry, University of California San Diego, La Jolla, CA USA
| | | | - Peter Falkai
- Department of Psychiatry and Psychotherapy, University Hospital Munich, Munich, Germany
| | - Udo Dannlowski
- Institute for Translational Psychiatry, University of Munster, Munster, Germany
| | - Tilo Kircher
- Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany ,Center for Mind, Brain and Behavior, University of Marburg, Marburg, Germany
| | - Thomas G. Schulze
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Nussbaumstr. 7, 80336 Munich, Germany ,Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD USA ,Department of Psychiatry and Behavioral Sciences, SUNY Upstate Medical University, Syracuse, NY USA
| | - Sergi Papiol
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Nussbaumstr. 7, 80336 Munich, Germany ,Department of Psychiatry and Psychotherapy, University Hospital Munich, Munich, Germany ,Centro de Investigación Biomedica en Red de Salud Mental (CIBERSAM), Barcelona, Spain
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