1
|
Khalil MA, Khalifa D, Allam RM, Abdalgeleel SA, Khalaf OO. Suicide and depressive symptoms possible correlates among a sample of Egyptian physicians: observational cross-sectional study (online survey). BMC Psychiatry 2024; 24:408. [PMID: 38816711 PMCID: PMC11137965 DOI: 10.1186/s12888-024-05825-w] [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: 11/17/2023] [Accepted: 05/09/2024] [Indexed: 06/01/2024] Open
Abstract
BACKGROUND Compared to other occupations, physicians are more susceptible to depression and suicide. Suicide among physicians in some countries reached up to 1.5- to threefold higher than the general population. However, this rate was not homogenous in all countries. Most of the Egyptian studies were related to the stressful pandemic event, but the actual prevalence of depression among physicians is still under research. To the best of the researcher's knowledge, no other study has been conducted to evaluate the risk of suicide among Egyptian physicians. AIM The study aimed to screen for depressive symptoms and suicide among Egyptian physicians and to investigate the correlates associated with suicide ideations. METHODS This cross-sectional survey included Egyptian physicians recruited online by Google Forms. Depressive symptoms were screened using the Beck Depression Scale (BDI-II), while suicidal ideas were assessed using the Suicidal Ideation Attributes Scale (SIDAS). RESULTS Six hundred sixty Egyptian physicians completed the survey following a two-week pilot study between January 10 and July 16, 2023. The average age was 39.1 years, and 71.4% were married. 49.1% were medical specialists. The median daily working hours were eight, and 27.7% of the physicians attended night shifts. 22.3% had a psychiatric illness, and 34.3% had a chronic disease. Younger and single physicians of both sexes were more prone to suicide risk (p-value = 0.019 and 0.021, respectively). Those with psychiatric or chronic medical disorders had a higher suicidal risk (p-values < 0.001 and 0.004, respectively). Physicians with fewer academic degrees and those who work longer hours or night shifts had more depressive symptoms (p-values < 0.001 and 0.009, respectively). The risk of depression and suicide is almost the same in all medical specialties. The SIDAS suicide score and the Beck depression score revealed a statistically significant association (r = 0.288, p-value < 0.001). CONCLUSION Suicide risk is higher among younger, single physicians of both sexes, as well as those with psychiatric or chronic medical disorders. More depressive symptoms are seen in physicians who have more extended hours or night shifts and who have fewer academic degrees. Almost all medical specialties carry the same risk of depression and suicide. Longitudinal research is recommended for regular follow-up of suicidal thoughts and depressive symptoms.
Collapse
Affiliation(s)
- Mohamed A Khalil
- Psychiatry Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Dalia Khalifa
- Psychiatry Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Rasha Mahmoud Allam
- Cancer Epidemiology and Biostatistics Department, National Cancer Institute, Cairo University, Egypt
| | - Shaimaa Abdalaleem Abdalgeleel
- Cancer Epidemiology and Biostatistics Department, National Cancer Institute, Cairo University, Egypt
- Department of Public Health, Faculty of Applied Medical Sciences, Al-Baha University, Al-Baha, Saudi Arabia
| | - Ola Osama Khalaf
- Psychiatry Department, Faculty of Medicine, Cairo University, Cairo, Egypt.
| |
Collapse
|
2
|
Cogan AB, Persons JB, Kring AM. Using the Beck Depression Inventory to Assess Anhedonia: A Scale Validation Study. Assessment 2024; 31:431-443. [PMID: 37039528 PMCID: PMC10822059 DOI: 10.1177/10731911231164628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/12/2023]
Abstract
Anhedonia is central to several psychological disorders and a frequent target of psychosocial and pharmacological treatments. We evaluated the psychometric properties of two widely used anhedonia measures derived from the Beck Depression Inventory: a 3-item (BDI-Anh3) and a 4-item version (BDI-Anh4). We evaluated these measures in a large undergraduate sample, a community sample, and a clinical sample. Both the BDI-Anh3 and the BDI-Anh4 showed adequate internal consistency, with BDI-Anh4 performing somewhat better, across the three samples. Both measures showed good convergent and discriminant validity, even after controlling for shared variance with other items on the BDI. These findings indicate that both measures have sufficient reliability and validity to support their use by researchers and clinicians.
Collapse
Affiliation(s)
| | - Jacqueline B. Persons
- University of California, Berkeley, USA
- Oakland Cognitive Behavior Therapy Center, CA, USA
| | | |
Collapse
|
3
|
Ajayi T, Thomas A, Nikolic M, Henderson L, Zaheri A, Dwyer DS. Evolutionary conservation of putative suicidality-related risk genes that produce diminished motivation corrected by clozapine, lithium and antidepressants. Front Psychiatry 2024; 15:1341735. [PMID: 38362034 PMCID: PMC10867104 DOI: 10.3389/fpsyt.2024.1341735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Accepted: 01/17/2024] [Indexed: 02/17/2024] Open
Abstract
Background Genome wide association studies (GWAS) and candidate gene analyses have identified genetic variants and genes that may increase the risk for suicidal thoughts and behaviors (STBs). Important unresolved issues surround these tentative risk variants such as the characteristics of the associated genes and how they might elicit STBs. Methods Putative suicidality-related risk genes (PSRGs) were identified by comprehensive literature search and were characterized with respect to evolutionary conservation, participation in gene interaction networks and associated phenotypes. Evolutionary conservation was established with database searches and BLASTP queries, whereas gene-gene interactions were ascertained with GeneMANIA. We then examined whether mutations in risk-gene counterparts in C. elegans produced a diminished motivation phenotype previously connected to suicide risk factors. Results and conclusions From the analysis, 105 risk-gene candidates were identified and found to be: 1) highly conserved during evolution, 2) enriched for essential genes, 3) involved in significant gene-gene interactions, and 4) associated with psychiatric disorders, metabolic disturbances and asthma/allergy. Evaluation of 17 mutant strains with loss-of-function/deletion mutations in PSRG orthologs revealed that 11 mutants showed significant evidence of diminished motivation that manifested as immobility in a foraging assay. Immobility was corrected in some or all of the mutants with clozapine, lithium and tricyclic antidepressant drugs. In addition, 5-HT2 receptor and muscarinic receptor antagonists restored goal-directed behavior in most or all of the mutants. These studies increase confidence in the validity of the PSRGs and provide initial clues about possible mechanisms that mediate STBs.
Collapse
Affiliation(s)
- Titilade Ajayi
- Department of Pharmacology, Toxicology and Neuroscience, LSU Health Shreveport, Shreveport, LA, United States
| | - Alicia Thomas
- Department of Pharmacology, Toxicology and Neuroscience, LSU Health Shreveport, Shreveport, LA, United States
| | - Marko Nikolic
- Department of Psychiatry and Behavioral Medicine, LSU Health Shreveport, Shreveport, LA, United States
| | - Lauryn Henderson
- Department of Psychiatry and Behavioral Medicine, LSU Health Shreveport, Shreveport, LA, United States
| | - Alexa Zaheri
- Department of Psychiatry and Behavioral Medicine, LSU Health Shreveport, Shreveport, LA, United States
| | - Donard S. Dwyer
- Department of Pharmacology, Toxicology and Neuroscience, LSU Health Shreveport, Shreveport, LA, United States
- Department of Psychiatry and Behavioral Medicine, LSU Health Shreveport, Shreveport, LA, United States
| |
Collapse
|
4
|
Diaz E, Abad-Tortosa D, Ghezal M, Davin J, Lopez-Castroman J. Role of stressful life events and personality traits on the prevalence of wish to die among French physicians. Front Public Health 2024; 12:1244605. [PMID: 38322123 PMCID: PMC10844508 DOI: 10.3389/fpubh.2024.1244605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Accepted: 01/04/2024] [Indexed: 02/08/2024] Open
Abstract
Background Suicide rates are higher among physicians than in the general population. We aimed to investigate the role of stressful life events (related or not to work conditions) and personality traits on wish to die, a proxy measure of suicidal ideation. Methods This cross-sectional study took place in France from March 2018 to September 2018. Physicians completed an online questionnaire. A multiple logistic regression model estimated factors associated with wish to die. Moderated moderation models were used to assess the effect of personality traits on the relationship between stressful events and wish to die. Results 1,020 physicians completed the questionnaire. Most (75%) had endorsed a work-related stressful event and one in six (15.9%) endorsed a wish to die the year before. Wish to die was associated with burnout (OR = 2.65, 95%CI = 1.82-3.88) and work-related stressful events (OR = 2.18, 95%CI = 1.24-3.85) including interpersonal conflicts, harassment and work-overload. Emotional stability was the only personality trait associated with wish to die in the logistic regression (OR = 0.69, 95%CI = 0.59-0.82). In moderation models, we observed a significant interaction involving three personality traits-emotional stability, extraversion, and agreeableness-along with gender, influencing the impact of stressful events on the wish to die. Limitations Our study is limited by the impossibility to control for risk factors associated with suicide like psychiatric comorbidities. Conclusion Work-related stressful events significantly contribute to the manifestation of a wish to die among physicians. The impact of stressful events on the wish to die is moderated by factors such as gender and personality traits, including emotional stability and extraversion. These results are overall consistent with prior studies concerning the risk of burnout and suicide among physicians.
Collapse
Affiliation(s)
- Emmanuel Diaz
- Department of Psychiatry, Nîmes University Hospital (CHU), Nîmes, France
| | - Diana Abad-Tortosa
- Department of Psychiatry, Nîmes University Hospital (CHU), Nîmes, France
| | - Maha Ghezal
- Department of Psychiatry, Nîmes University Hospital (CHU), Nîmes, France
| | - Josephine Davin
- Department of Psychiatry, Nîmes University Hospital (CHU), Nîmes, France
| | - Jorge Lopez-Castroman
- Department of Psychiatry, Nîmes University Hospital (CHU), Nîmes, France
- IGF, CNRS-INSERM, University of Montpellier, Montpellier, France
- CIBERSAM, Madrid, Spain
- Department of Signal Theory and Communication, Universidad Carlos III, Madrid, Spain
| |
Collapse
|
5
|
Padmanathan P, Lamb D, Scott H, Stevelink S, Greenberg N, Hotopf M, Morriss R, Raine R, Rafferty AM, Madan I, Dorrington S, Wessely S, Moran P. Suicidal thoughts and behaviour among healthcare workers in England during the COVID-19 pandemic: A longitudinal study. PLoS One 2023; 18:e0286207. [PMID: 37343030 PMCID: PMC10284388 DOI: 10.1371/journal.pone.0286207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Accepted: 05/10/2023] [Indexed: 06/23/2023] Open
Abstract
BACKGROUND During the COVID-19 pandemic, concern has been raised about suicide risk among healthcare workers (HCWs). We investigated the incidence risk and prevalence of suicidal thoughts and behaviour (STB), and their relationship with occupational risk factors, among National Health Service HCWs in England between April 2020 and August 2021. METHODS In this longitudinal study, we analysed online survey data completed by 22,501 HCWs from 17 NHS Trusts at baseline (Time 1) and six months (Time 2). The primary outcome measures were suicidal ideation, suicide attempts, and non-suicidal self-injury. We used logistic regression to investigate the relationship between these outcomes and demographic characteristics and occupational factors. Results were stratified by occupational role (clinical/non-clinical). RESULTS Time 1 and Time 2 surveys were completed by 12,514 and 7,160 HCWs, respectively. At baseline, 10.8% (95% CI = 10.1%, 11.6%) of participants reported having experienced suicidal thoughts in the previous two months, whilst 2.1% (95% CI = 1.8%, 2.5%) of participants reported having attempted suicide over the same period. Among HCWs who had not experienced suicidal thoughts at baseline (and who completed the Time 2 survey), 11.3% (95%CI = 10.4%, 12.3%) reported such thoughts six months later. Six months after baseline, 3.9% (95% CI = 3.4%, 4.4%) of HCWs reported attempting suicide for the first time. Exposure to potentially morally injurious events, lack of confidence about raising safety concerns and these concerns being addressed, feeling unsupported by managers, and providing a reduced standard of care were all associated with increased suicidal ideation among HCWs during the COVID-19 pandemic. At six months, among clinicians, a lack of confidence about safety concerns being addressed, independently predicted suicidal ideation. CONCLUSION Suicidal thoughts and behaviour among healthcare workers could be reduced by improving managerial support and enhancing the ability of staff to raise safety concerns.
Collapse
Affiliation(s)
- Prianka Padmanathan
- Centre for Academic Mental Health, Population Health Sciences, University of Bristol, Bristol, United Kingdom
- Avon and Wiltshire Mental Health Partnership NHS Trust, Bristol, United Kingdom
| | - Danielle Lamb
- Department of Applied Health Research, University College London, London, United Kingdom
| | - Hannah Scott
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Sharon Stevelink
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Neil Greenberg
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Matthew Hotopf
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Richard Morriss
- The Institute of Mental Health, University of Nottingham, Nottingham, United Kingdom
| | - Rosalind Raine
- Department of Applied Health Research, University College London, London, United Kingdom
| | - Anne Marie Rafferty
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Ira Madan
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Sarah Dorrington
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Simon Wessely
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Paul Moran
- Centre for Academic Mental Health, Population Health Sciences, University of Bristol, Bristol, United Kingdom
| |
Collapse
|
6
|
Ai H, Duan L, Huang L, Luo Y, Aleman A, Xu P. Dissociated deficits of anticipated and experienced regret in at-risk suicidal individuals. Front Psychiatry 2023; 14:1121194. [PMID: 36970290 PMCID: PMC10034165 DOI: 10.3389/fpsyt.2023.1121194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2022] [Accepted: 02/16/2023] [Indexed: 03/11/2023] Open
Abstract
BackgroundsDecision-making deficits have been reported as trans-diagnostic characteristics of vulnerability to suicidal behaviors, independent of co-existing psychiatric disorders. Individuals with suicidal behaviors often regret their decision to attempt suicide and may have impairments in future-oriented processing. However, it is not clear how people with suicidal dispositions use future-oriented cognition and past experience of regret to guide decision-making. Here, we examined the processes of regret anticipation and experience in subclinical youth with and without suicidal ideation during value-based decision-making.MethodsIn total, 80 young adults with suicidal ideation and 79 healthy controls completed a computational counterfactual thinking task and self-reported measures of suicidal behaviors, depression, anxiety, impulsivity, rumination, hopelessness, and childhood maltreatment.ResultsIndividuals with suicidal ideation showed a reduced ability to anticipate regret compared to healthy controls. Specifically, suicidal ideators’ experience of regret/relief was significantly different from that of healthy controls upon obtained outcomes, while their disappointment/pleasure experience was not significantly different from healthy controls.ConclusionThese findings suggest that young adults with suicidal ideation have difficulty predicting the consequences or the future value of their behavior. Individuals with suicidal ideation showed impairments in value comparison and flat affect to retrospective rewards, whereas individuals with high suicidality showed blunted affect to immediate rewards. Identifying the counterfactual decision-making characteristics of at-risk suicidal individuals may help to elucidate measurable markers of suicidal vulnerability and identify future intervention targets.
Collapse
Affiliation(s)
- Hui Ai
- Institute of Applied Psychology, Tianjin University, Tianjin, China
- Academy of Medical Engineering and Translational Medicine, Tianjin University, Tianjin, China
| | - Lian Duan
- Shenzhen Key Laboratory of Affective and Social Neuroscience, Center for Brain Disorders and Cognitive Sciences, Shenzhen University, Shenzhen, China
- *Correspondence: Lian Duan, ; Pengfei Xu,
| | - Lin Huang
- Shenzhen Key Laboratory of Affective and Social Neuroscience, Center for Brain Disorders and Cognitive Sciences, Shenzhen University, Shenzhen, China
| | - Yuejia Luo
- Shenzhen Key Laboratory of Affective and Social Neuroscience, Center for Brain Disorders and Cognitive Sciences, Shenzhen University, Shenzhen, China
- Beijing Key Laboratory of Applied Experimental Psychology, National Demonstration Center for Experimental Psychology Education (BNU), Faculty of Psychology, Beijing Normal University, Beijing, China
- Center for Emotion and Brain, Shenzhen Institute of Neuroscience, Shenzhen, China
| | - André Aleman
- Shenzhen Key Laboratory of Affective and Social Neuroscience, Center for Brain Disorders and Cognitive Sciences, Shenzhen University, Shenzhen, China
- Section Cognitive Neuroscience, Department of Biomedical Sciences of Cells and Systems, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Pengfei Xu
- Beijing Key Laboratory of Applied Experimental Psychology, National Demonstration Center for Experimental Psychology Education (BNU), Faculty of Psychology, Beijing Normal University, Beijing, China
- Center for Emotion and Brain, Shenzhen Institute of Neuroscience, Shenzhen, China
- *Correspondence: Lian Duan, ; Pengfei Xu,
| |
Collapse
|
7
|
Bhatia G, Sharma P, Pal A, Parmar A. The silent epidemic: Death by suicide among physicians. Asia Pac Psychiatry 2023; 15:e12522. [PMID: 36482514 DOI: 10.1111/appy.12522] [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: 09/23/2022] [Accepted: 11/30/2022] [Indexed: 12/14/2022]
Abstract
Suicidal deaths among physicians have been on a steady rise in the past few decades, despite being a part of the healthcare system, training for early identification and easy access to treatment services. While there is no doubt that this warrants concern at individual, institutional, and community levels, physician suicide remains an under-researched topic. We examine the correlates of suicidal deaths among physicians along with risks and protective factors conferred to physicians as a population and emphasize the need for preventive and risk-reduction initiatives that are specifically tailored for physicians and the healthcare provider community.
Collapse
Affiliation(s)
- Gayatri Bhatia
- Department of Psychiatry, All India Institute of Medical Sciences, Rajkot, India
| | - Pawan Sharma
- Department of Psychiatry, Patan Academy of Health Sciences, Lalitpur, Nepal
| | - Arghya Pal
- Department of Psychiatry, All India Institute of Medical Sciences, Raebareli, India
| | - Arpit Parmar
- Department of Psychiatry, All India Institute of Medical Sciences, Bhubaneswar, India
| |
Collapse
|
8
|
Gillissie ES, Le GH, Rhee TG, Cao B, Rosenblat JD, Mansur RB, Ho RC, McIntyre RS. Evaluating Anhedonia as a risk factor in suicidality: A meta-analysis. J Psychiatr Res 2023; 158:209-215. [PMID: 36603315 DOI: 10.1016/j.jpsychires.2022.12.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 12/11/2022] [Accepted: 12/19/2022] [Indexed: 12/24/2022]
Abstract
Previous studies have evaluated the relationship between anhedonia and suicidality; however, to our knowledge, there has been no quantitative synthesis evaluating the foregoing association to date. Herein, this meta-analysis aims to provide a quantitative synthesis of the extant literature reporting on the association between levels of anhedonia across all dimensions (e.g., anticipatory, consummatory) amongst individuals endorsing suicidality. Online databases (i.e., PubMed, PsycINFO, Google Scholar) were searched from inception to 13 June 2022. Studies which assessed an aspect of suicidality (i.e., ideation, attempts) and a validated anhedonia scale were included. The risk of bias was assessed using the ROBINS-1 tool, and the quality of the sources was evaluated using GRADE criteria. The results of the studies were quantitatively synthesized using Pearson's r effect sizes via a random-effects meta-analysis. A total of 20 studies and 11,212 individuals were included in the final quantitative synthesis. Overall, results indicate that anhedonia has a significant and moderate correlation with suicidality in general and psychiatric populations (r = 0.31, p < 0.001 and r = 0.32, p < 0.001 respectively). Sub-analysis suggests a larger effect of anticipatory and consummatory interpersonal anhedonia (r = 0.40, p < 0.001). The identification of increased levels of anhedonia in individuals with suicidality indicates that anhedonia may be a core risk factor for suicidal ideation and behaviours. Future studies should endeavour to develop a comprehensive risk assessment encompassing all domains of anhedonia which can be utilized in a primary care setting as a potential prevention strategy for suicidal behaviours and outcomes.
Collapse
Affiliation(s)
- Emily S Gillissie
- Mood Disorder Psychopharmacology Unit, University Health Network, University of Toronto, Toronto, ON, Canada
| | - Gia Han Le
- Mood Disorder Psychopharmacology Unit, University Health Network, University of Toronto, Toronto, ON, Canada; Brain and Cognition Discovery Foundation, Toronto, ON, Canada
| | - Taeho Greg Rhee
- Department of Psychiatry, School of Medicine, Yale University, New Haven, CT, USA; VA New England Mental Illness, Research, Education and Clinical Center (MIRECC), VA Connecticut Healthcare System, West Haven, CT, USA; Department of Public Health Sciences, School of Medicine, University of Connecticut, Farmington, CT, USA
| | - Bing Cao
- Key Laboratory of Cognition and Personality, Faculty of Psychology, Ministry of Education, Southwest University, Chongqing, 400715, PR China
| | - Joshua D Rosenblat
- Mood Disorder Psychopharmacology Unit, University Health Network, University of Toronto, Toronto, ON, Canada; Institute of Medical Science, University of Toronto, Toronto, ON, Canada; Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Rodrigo B Mansur
- Mood Disorder Psychopharmacology Unit, University Health Network, University of Toronto, Toronto, ON, Canada; Institute of Medical Science, University of Toronto, Toronto, ON, Canada; Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Roger C Ho
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, 119228, Singapore; Institute of Health Innovation and Technology (iHealthtech), National University of Singapore, Singapore, 117599, Singapore
| | - Roger S McIntyre
- Mood Disorder Psychopharmacology Unit, University Health Network, University of Toronto, Toronto, ON, Canada; Institute of Medical Science, University of Toronto, Toronto, ON, Canada; Department of Psychiatry, University of Toronto, Toronto, ON, Canada; Department of Pharmacology and Toxicology, University of Toronto, Toronto, ON, Canada; Brain and Cognition Discovery Foundation, Toronto, ON, Canada.
| |
Collapse
|
9
|
Mohamed MY, Elbatrawy AN, Mahmoud DAM, Mohamed MM, Rabie ES. Depression and suicidal ideations in relation to occupational stress in a sample of Egyptian medical residents. Int J Soc Psychiatry 2023; 69:14-22. [PMID: 35166153 DOI: 10.1177/00207640211061981] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Medical students, interns, and residents have higher rates of depression than the general population, according to previous literature. OBJECTIVE The objectives of this paper were to determine the rate of depression and its severity in a group of Egyptian residents of Ain Shams University hospitals. METHODS This is a cross-sectional comparative study that took place in El-Demerdash Hospital from March 1, 2019 to September 1, 2020, with 220 Egyptian residents of Ain Shams University Hospitals participating. RESULTS The socioeconomic stress scale had a statistically significant relationship with depression scores (p value = .008) and suicide scores (p-value = .010), according to the findings. Additionally, there was a statistically significant relationship between suicide scores and depression scores (p-value = .001). The relationship between obstetrics and gynecology and high suicide risk was statistically significant (p value = .010), with obstetrics and gynecology having the highest percentage of high suicide risk (10 out of 19 residents, 52.63%), followed by pediatrics with 4 out of 11 residents (36.36%). CONCLUSION The pediatrics department had the highest percentage of residents who were depressed, while the obstetrics and gynecology department had the highest suicide risk. Feeling underpaid, disruption of home life, having insufficient time, being concerned about keeping skills up to date, and having a large volume of work were also found to be the most stressful aspects of residency.
Collapse
Affiliation(s)
- Mohamed Youssef Mohamed
- Okasha's Institute of Psychiatry, A WPA Collaborating Center for Mental Health Research & Training, Ain Shams University, Cairo, Egypt
| | - Amira Naseeb Elbatrawy
- Okasha's Institute of Psychiatry, A WPA Collaborating Center for Mental Health Research & Training, Ain Shams University, Cairo, Egypt
| | - Dalia Abdel Moneim Mahmoud
- Okasha's Institute of Psychiatry, A WPA Collaborating Center for Mental Health Research & Training, Ain Shams University, Cairo, Egypt
| | - Mohamed Maged Mohamed
- Okasha's Institute of Psychiatry, A WPA Collaborating Center for Mental Health Research & Training, Ain Shams University, Cairo, Egypt
| | - Eman S Rabie
- Okasha's Institute of Psychiatry, A WPA Collaborating Center for Mental Health Research & Training, Ain Shams University, Cairo, Egypt
| |
Collapse
|
10
|
Hein M, Dekeuleneer FX, Hennebert O, Skrjanc D, Oudart E, Mungo A, Rotsaert M, Loas G. Relationships between Recent Suicidal Ideation and Recent, State, Trait and Musical Anhedonias in Depression. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16147. [PMID: 36498219 PMCID: PMC9740342 DOI: 10.3390/ijerph192316147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 11/18/2022] [Accepted: 11/29/2022] [Indexed: 06/17/2023]
Abstract
The aim of the study was to explore in depression the relationship between recent suicidal ideation and the different anhedonias taking into account the severity of depression. Recent studies have suggested that recent change of anhedonia and not state or trait anhedonia is associated with recent suicidal ideations even when the level of depression is controlled. Three samples were used (74 severe major depressives, 43 outpatients with somatic disorders presenting mild or moderate depression and 36 mild or moderate depressives hospitalized in the intensive coronary unit). Recent change of anhedonia was rated by the anhedonia subscale of the Beck Depression Inventory (BDI-II), state anhedonia by the Snaith-Hamilton Pleasure Scale (SHAPS), trait anhedonia by the TEPS (Temporal Experience of Pleasure Scale), musical anhedonia by the BMRQ (Barcelona Music Reward Questionnaire), social recent change of anhedonia by the SLIPS (Specific Loss of Interest and Pleasure Scale), the severity of depression by the BDI-II and the distinction between melancholic and non-melancholic was found using a subscale of the BDI-II. Bivariate and multivariate regression analyses were performed in each sample. In severe major depressives and, notably, in melancholia, recent suicidal ideation was associated with trait anhedonia; however, in mild or moderate depression, recent suicidal ideation was associated with recent change of anhedonia. Musical anhedonia and social recent change of anhedonia were not associated with recent suicidal ideation. Trait anhedonia could be, in severe depression, a strong predictor of recent suicidal ideation.
Collapse
Affiliation(s)
- Matthieu Hein
- Department of Psychiatry, Laboratory of Psychiatric Research (ULB 266), Cliniques Universitaires de Bruxelles, Université Libre de Bruxelles (ULB), 1070 Bruxelles, Belgium
| | - François-Xavier Dekeuleneer
- Department of Psychiatry, Laboratory of Psychiatric Research (ULB 266), Cliniques Universitaires de Bruxelles, Université Libre de Bruxelles (ULB), 1070 Bruxelles, Belgium
| | - Olivier Hennebert
- Department of Psychiatry, Laboratory of Psychiatric Research (ULB 266), Cliniques Universitaires de Bruxelles, Université Libre de Bruxelles (ULB), 1070 Bruxelles, Belgium
| | - Dephine Skrjanc
- Department of Psychiatry, Laboratory of Psychiatric Research (ULB 266), Cliniques Universitaires de Bruxelles, Université Libre de Bruxelles (ULB), 1070 Bruxelles, Belgium
| | - Emilie Oudart
- Department of Psychiatry, Laboratory of Psychiatric Research (ULB 266), Cliniques Universitaires de Bruxelles, Université Libre de Bruxelles (ULB), 1070 Bruxelles, Belgium
| | - Anaïs Mungo
- Department of Child Psychiatry, Laboratory of Psychiatric Research (ULB 266), Cliniques Universitaires de Bruxelles, Université Libre de Bruxelles (ULB), 1070 Bruxelles, Belgium
| | - Marianne Rotsaert
- Department of Psychology, Université Libre de Bruxelles (ULB), 1070 Bruxelles, Belgium
| | - Gwenolé Loas
- Department of Psychiatry, Laboratory of Psychiatric Research (ULB 266), Cliniques Universitaires de Bruxelles, Université Libre de Bruxelles (ULB), 1070 Bruxelles, Belgium
| |
Collapse
|
11
|
Liu X, Liu M, Li H, Mo L, Liu X. Transition from Depression to Suicidal Attempt in Young Adults: The Mediation Effect of Self-Esteem and Interpersonal Needs. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14342. [PMID: 36361235 PMCID: PMC9656722 DOI: 10.3390/ijerph192114342] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 10/26/2022] [Accepted: 11/01/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Depression increases the risk of suicide. Depression and suicide attempts are significantly impacted by low self-esteem and interpersonal needs (i.e., thwarted belongingness (TB) and perceived burdensomeness (PB)). More research is required to clarify how these factors affected the change from depression to suicidal attempts, which would dramatically lower the suicide fatality rate. We sought to examine the mediating roles of self-esteem, TB, and PB in Chinese young adults, since previous research shows that self-esteem has a strong relationship with TB, while TB and PB have strong relationships with suicide attempts. METHODS Measures on depression, interpersonal needs, and attempted suicide were completed by a sample of 247 Chinese social media users who had stated suicidal ideation online. RESULTS The findings showed that people who attempted suicide had significantly higher levels of TB and PB. Suicidal attempts were also impacted by depression via the mediational chains, which included self-esteem, TB, and PB. CONCLUSIONS Our findings might contribute to the expansion of the interpersonal theory of suicide and have an impact on effective suicide prevention.
Collapse
Affiliation(s)
- Xingyun Liu
- Key Laboratory of Adolescent Cyberpsychology and Behavior, Ministry of Education, Key Laboratory of Human Development and Mental Health of Hubei Province, School of Psychology, Central China Normal University, Wuhan 430079, China
| | - Miao Liu
- Key Laboratory of Adolescent Cyberpsychology and Behavior, Ministry of Education, Key Laboratory of Human Development and Mental Health of Hubei Province, School of Psychology, Central China Normal University, Wuhan 430079, China
| | - He Li
- CAS Key Laboratory of Behavioral Science, Institute of Psychology, Chinese Academy of Sciences, Beijing 100101, China
| | - Liuling Mo
- CAS Key Laboratory of Behavioral Science, Institute of Psychology, Chinese Academy of Sciences, Beijing 100101, China
| | - Xiaoqian Liu
- CAS Key Laboratory of Behavioral Science, Institute of Psychology, Chinese Academy of Sciences, Beijing 100101, China
| |
Collapse
|
12
|
Zheng W, Gu LM, Yang XH, Zhou YL, Wang CY, Lan XF, Zhang B, Ning YP. Association of anhedonia and suicidal ideation in patients with treatment-refractory depression after intravenous ketamine infusions. Int J Psychiatry Clin Pract 2022:1-6. [PMID: 36309806 DOI: 10.1080/13651501.2022.2138444] [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] [Indexed: 10/31/2022]
Abstract
OBJECTIVES Accumulating evidence suggests that the effects of ketamine administered intravenously at subanaesthetic doses on both anhedonic symptoms and suicidal ideation occur independently of depressive symptoms in major depressive disorder (MDD) and bipolar disorder (BD). This study sought to determine the relationship between anhedonia and suicidal ideation after serial ketamine infusions. METHODS A total of 79 subjects with either treatment-refractory MDD (n = 60) or BD (n = 19) were included in a clinical ketamine study. The Montgomery-Åsberg Depression Rating Scale (MADRS) anhedonia factor and the first five items of the Scale for Suicidal Ideations (SSI-Part I) were used to assess anhedonia symptoms and suicidal ideation, respectively. RESULTS At baseline, anhedonia, as measured by the MADRS, was not significantly associated with suicidal ideation or specific suicide-related ideation as measured by SSI-Part I (all p's > 0.05). Only the 'wish to die' and 'desire to make a suicide attempt' items were positively associated with anhedonia at two weeks after the sixth ketamine infusion, which was independent of the reductions in depressive symptoms (all p's < 0.05). CONCLUSION Anhedonia as measured by the MADRS appeared to not be positively related to suicidal ideation after serial ketamine infusions.KEY POINTSSerial ketamine (0.5 mg/kg) infusions have shown quick and dramatic antisuicidal and antianhedonic effects in patients with depression.The association between anhedonia and suicidal ideation after serial ketamine infusions is unclear.Anhedonia appeared to not be positively related to suicidal ideation after serial ketamine infusions.
Collapse
Affiliation(s)
- Wei Zheng
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Li-Mei Gu
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Xin-Hu Yang
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Yan-Ling Zhou
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Cheng-Yu Wang
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Xiao-Feng Lan
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Bin Zhang
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Yu-Ping Ning
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China.,The First School of Clinical Medicine, Southern Medical University, Guangzhou, Guangdong, China
| |
Collapse
|
13
|
Sood MM, Rhodes E, Talarico R, Gérin-Lajoie C, Simon C, Spilg E, McFadden T, Kyeeremanteng K, T Myran D, Grubic N, Tanuseputro P. Suicide and Self-Harm Among Physicians in Ontario, Canada. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2022; 67:778-786. [PMID: 35548955 PMCID: PMC9510996 DOI: 10.1177/07067437221099774] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Studies of occupation-associated suicide suggest physicians may be at a higher risk of suicide compared to nonphysicians. We set out to assess the risk of suicide and self-harm among physicians and compare it to nonphysicians. METHODS We conducted a population-based, retrospective cohort study using registration data from the College of Physicians and Surgeons of Ontario from 1990 to 2016 with a follow-up to 2017, linked to Ontario health administrative databases. Using age- and sex-standardized rates and inverse probability-weighted, cause-specific hazards regression models, we compared rates of suicide, self-harm, and a composite of either event among all newly registered physicians to nonphysician controls. RESULTS Among 35,989 physicians and 6,585,197 nonphysicians, unadjusted suicide events (0.07% vs. 0.11%) and rates (9.44 vs. 11.55 per 100,000 person-years) were similar. Weighted analyses found a hazard ratio of 1.05 (95% confidence interval: 0.69 to 1.60). Self-harm requiring health care was lower among physicians (0.22% vs. 0.46%; hazard ratio: 0.65, 95% confidence interval: 0.52 to 0.82), as was the composite of suicide or self-harm (hazard ratio: 0.70, 95% confidence interval: 0.57 to 0.86). The composite of suicide or self-harm was associated with a history of a mood or anxiety disorder (odds ratio: 2.84, 95% confidence interval: 1.17 to 6.87), an outpatient mental health visit in the past year (odds ratio: 3.08, 95% confidence interval: 1.34 to 7.10) and psychiatry visit in the preceding year (odds ratio: 3.87, 95% confidence interval: 1.67 to 8.95). INTERPRETATION Physicians in Ontario are at a similar risk of suicide deaths and a lower risk of self-harm requiring health care relative to nonphysicians. Risk factors associated with suicide or self-harm may help inform prevention programs.
Collapse
Affiliation(s)
- Manish M Sood
- Department of Medicine, University of Ottawa, Ottawa, Canada.,Division of Nephrology, Department of Medicine, the Ottawa Hospital, Ottawa, Canada
| | - Emily Rhodes
- 10055The Ottawa Hospital Research Institute, Ottawa, Canada
| | - Robert Talarico
- Institute for Clinical Evaluative Sciences, Ontario, Canada.,10055The Ottawa Hospital Research Institute, Ottawa, Canada
| | - Caroline Gérin-Lajoie
- 27389Canadian Medical Association, Physician Wellness and Medical Culture Team, Ottawa, Canada
| | - Christopher Simon
- 27389Canadian Medical Association, Physician Wellness and Medical Culture Team, Ottawa, Canada
| | - Edward Spilg
- Department of Medicine, University of Ottawa, Ottawa, Canada.,10055The Ottawa Hospital Research Institute, Ottawa, Canada
| | - Taylor McFadden
- 27389Canadian Medical Association, Physician Wellness and Medical Culture Team, Ottawa, Canada
| | - Kwadwo Kyeeremanteng
- Department of Medicine, University of Ottawa, Ottawa, Canada.,10055The Ottawa Hospital Research Institute, Ottawa, Canada
| | - Daniel T Myran
- Institute for Clinical Evaluative Sciences, Ontario, Canada.,10055The Ottawa Hospital Research Institute, Ottawa, Canada.,Department of Family Medicine, University of Ottawa, Ottawa, Canada
| | - Nicholas Grubic
- Institute for Clinical Evaluative Sciences, Ontario, Canada.,10055The Ottawa Hospital Research Institute, Ottawa, Canada
| | - Peter Tanuseputro
- Department of Medicine, University of Ottawa, Ottawa, Canada.,10055The Ottawa Hospital Research Institute, Ottawa, Canada
| |
Collapse
|
14
|
The effect of ketamine on anhedonia: improvements in dimensions of anticipatory, consummatory, and motivation-related reward deficits. Psychopharmacology (Berl) 2022; 239:2011-2039. [PMID: 35292831 DOI: 10.1007/s00213-022-06105-9] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2021] [Accepted: 02/23/2022] [Indexed: 10/18/2022]
Abstract
Anhedonia is a common, persistent, and disabling condition. However, available therapeutics primarily focus on the reduction of depressive and negative symptoms rather than amelioration of deficits in positive affect. As such, extant drug treatments remain largely ineffective in treating symptoms of anhedonia. Ketamine is a rapid-acting and novel therapeutic treatment for treatment-resistant depression, which has also been demonstrated to attenuate symptoms of anhedonia. However, the literature on the anti-anhedonic effects of ketamine is limited-especially within independent dimensions of this symptom domain. Herein, this review examined the impact of ketamine treatment on anhedonia and its dimensions on anticipatory, consummatory, and motivation-related reward deficits. Overall, the findings have shown a trend towards symptom reduction and/or improvements in anhedonia and their respective subdomains, in both human and preclinical studies, as well as its potential to provide additional benefit in reducing suicidality and improving quality-of-life. Although further research is required in understanding the long-term efficacy and mechanism, ketamine may provide an effective and rapid-acting therapeutic in an otherwise unmet domain.
Collapse
|
15
|
Yang X, Yuan X, Liu G, Harrision P. The Specific Roles of Loss of Interest and Loss of Pleasure in Recent Suicidal Ideation. Arch Suicide Res 2022; 26:861-870. [PMID: 33135588 DOI: 10.1080/13811118.2020.1838981] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
BACKGROUND Evidence suggests that recent changes in anhedonia may be more predictive of suicidal ideation than either state or trait anhedonia alone. However, the individual role that anhedonia symptoms play in suicidality is not yet well established. METHODS This study investigated whether state, trait, and recent changes in anhedonia predicted recent suicidal ideation, using cross-sectional data from two independent samples, one non-clinical (n = 2,138) and one clinical (n = 859), using binary logistic regression analyses. RESULTS In Study 1, loss of interest in people and loss of pleasure were associated with recent suicidal ideation independent of other depression symptoms, state and trait anhedonia. In Study 2, loss of interest in people, loss of interest in sex, and work inhibition were associated with recent suicidal ideation. In both studies, recent changes in anhedonia was uniquely associated with recent suicidal ideation. CONCLUSIONS These results indicate that recent changes in anhedonia and particularly the social aspect of the Loss of Interest in People item could be a significant risk factor in suicidal ideation.
Collapse
|
16
|
Gilbert JR, Wusinich C, Zarate CA. A Predictive Coding Framework for Understanding Major Depression. Front Hum Neurosci 2022; 16:787495. [PMID: 35308621 PMCID: PMC8927302 DOI: 10.3389/fnhum.2022.787495] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 02/14/2022] [Indexed: 12/17/2022] Open
Abstract
Predictive coding models of brain processing propose that top-down cortical signals promote efficient neural signaling by carrying predictions about incoming sensory information. These "priors" serve to constrain bottom-up signal propagation where prediction errors are carried via feedforward mechanisms. Depression, traditionally viewed as a disorder characterized by negative cognitive biases, is associated with disrupted reward prediction error encoding and signaling. Accumulating evidence also suggests that depression is characterized by impaired local and long-range prediction signaling across multiple sensory domains. This review highlights the electrophysiological and neuroimaging evidence for disrupted predictive processing in depression. The discussion is framed around the manner in which disrupted generative predictions about the sensorium could lead to depressive symptomatology, including anhedonia and negative bias. In particular, the review focuses on studies of sensory deviance detection and reward processing, highlighting research evidence for both disrupted generative predictions and prediction error signaling in depression. The role of the monoaminergic and glutamatergic systems in predictive coding processes is also discussed. This review provides a novel framework for understanding depression using predictive coding principles and establishes a foundational roadmap for potential future research.
Collapse
Affiliation(s)
- Jessica R. Gilbert
- Experimental Therapeutics and Pathophysiology Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, United States
| | | | | |
Collapse
|
17
|
Abstract
Suicide is a leading cause of death, and presently, there is no definitive clinical indicator of future suicide behaviors. Anhedonia, a transdiagnostic symptom reflecting diminished ability to experience pleasure, has recently emerged as a risk factor for suicidal thoughts and behaviors (STBs). This overview, therefore, has the following aims. First, prior research relating anhedonia to STBs will be reviewed, with a particular focus on clarifying whether anhedonia is more closely associated with suicidal thoughts versus behaviors. Second, the National Institute of Mental Health's Research Domain Criteria Positive Valence Systems provide a useful heuristic to probe anhedonia across different units of analysis, including clinical symptoms, behaviors, neural mechanisms, and molecular targets. Accordingly, anhedonia-related constructs linked to STBs will be detailed as well as promising next steps for future research. Third, although anhedonia is not directly addressed in leading suicide theories, this review will provide potential inroads to explore anhedonia within diathesis-stress and interpersonal suicide frameworks. Last, novel approaches to treat anhedonia as a means of reducing STBs will be examined.
Collapse
Affiliation(s)
- Randy P Auerbach
- Department of Psychiatry, Columbia University, New York, NY, USA.
- New York State Psychiatric Institute, New York, NY, USA.
- Division of Clinical Developmental Neuroscience, Sackler Institute, New York, NY, USA.
| | - David Pagliaccio
- Department of Psychiatry, Columbia University, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
| | | |
Collapse
|
18
|
Kakarala SE, Prigerson HG. Covid-19 and Increased Risk of Physician Suicide: A Call to Detoxify the U.S. Medical System. Front Psychiatry 2022; 13:791752. [PMID: 35222114 PMCID: PMC8864162 DOI: 10.3389/fpsyt.2022.791752] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Accepted: 01/14/2022] [Indexed: 11/21/2022] Open
Abstract
Suicide among physicians is a longstanding problem, with risk factors exacerbated by the coronavirus disease 2019 (COVID-19) pandemic. In this article, we explore suicidal thoughts and behaviors among physicians and risk factors created or intensified by the work environment, such as overwork and loss of autonomy. We discuss the ways in which the COVID-19 pandemic has made the medical work environment more stressful (e.g. greater exposure to traumatic experiences and employment insecurity) and, consequently, elevated physician suicide risk. We also review evidence that the medical system in the United States has not adequately protected physicians' mental health. Lack of confidentiality, stigma, cost, and time, as well as intrusive medical licensing applications, remain barriers to physicians seeking help. Work pressures imposed by insurance companies and financial incentives to increase revenue while cutting costs compound physicians' work stress. We conclude that system-wide changes to the practice of medicine and policies regarding healthcare delivery are needed to improve physicians' work environments, as is research addressing the impact of the interventions to reduce their suicidal risk. The proposed changes, and greater access to timely and confidential mental health services amid and in the aftermath of the pandemic, may prove promising approaches to reduce physicians' suicide risk.
Collapse
Affiliation(s)
- Sophia E Kakarala
- Cornell Center for Research on End-of-Life Care, Department of Medicine, Weill Cornell Medicine, New York, NY, United States
| | - Holly G Prigerson
- Cornell Center for Research on End-of-Life Care, Department of Medicine, Weill Cornell Medicine, New York, NY, United States.,Department of Medicine, Weill Cornell Medicine, New York, NY, United States
| |
Collapse
|
19
|
Malone TL, Zhao Z, Liu TY, Song PXK, Sen S, Scott LJ. Prediction of suicidal ideation risk in a prospective cohort study of medical interns. PLoS One 2021; 16:e0260620. [PMID: 34855821 PMCID: PMC8639060 DOI: 10.1371/journal.pone.0260620] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Accepted: 11/12/2021] [Indexed: 11/19/2022] Open
Abstract
The purpose of this study was to identify individual and residency program factors associated with increased suicide risk, as measured by suicidal ideation. We utilized a prospective, longitudinal cohort study design to assess the prevalence and predictors of suicidal ideation in 6,691 (2012-2014 cohorts, training data set) and 4,904 (2015 cohort, test data set) first-year training physicians (interns) at hospital systems across the United States. We assessed suicidal ideation two months before internship and then quarterly through intern year. The prevalence of reported suicidal ideation in the study population increased from 3.0% at baseline to a mean of 6.9% during internship. 16.4% of interns reported suicidal ideation at least once during their internship. In the training dataset, a series of baseline demographic (male gender) and psychological factors (high neuroticism, depressive symptoms and suicidal ideation) were associated with increased risk of suicidal ideation during internship. Further, prior quarter psychiatric symptoms (depressive symptoms and suicidal ideation) and concurrent work-related factors (increase in self-reported work hours and medical errors) were associated with increased risk of suicidal ideation. A model derived from the training dataset had a predicted area under the Receiver Operating Characteristic curve (AUC) of 0.83 in the test dataset. The suicidal ideation risk predictors analyzed in this study can help programs and interns identify those at risk for suicidal ideation before the onset of training. Further, increases in self-reported work hours and environments associated with increased medical errors are potentially modifiable factors for residency programs to target to reduce suicide risk.
Collapse
Affiliation(s)
- Tyler L. Malone
- Department of Biostatistics School of Public Health, University of Michigan, Ann Arbor, Michigan, United States of America
- Center for Statistical Genetics, University of Michigan, Ann Arbor, Michigan, United States of America
| | - Zhou Zhao
- Michigan Neuroscience Institute, University of Michigan, Ann Arbor, Michigan, United States of America
| | - Tzu-Ying Liu
- Department of Biostatistics School of Public Health, University of Michigan, Ann Arbor, Michigan, United States of America
| | - Peter X. K. Song
- Department of Biostatistics School of Public Health, University of Michigan, Ann Arbor, Michigan, United States of America
| | - Srijan Sen
- Michigan Neuroscience Institute, University of Michigan, Ann Arbor, Michigan, United States of America
| | - Laura J. Scott
- Department of Biostatistics School of Public Health, University of Michigan, Ann Arbor, Michigan, United States of America
- Center for Statistical Genetics, University of Michigan, Ann Arbor, Michigan, United States of America
| |
Collapse
|
20
|
Vai B, Mazza MG, Cazzetta S, Calesella F, Aggio V, Lorenzi C, Zanardi R, Poletti S, Colombo C, Benedetti F. Higher Interleukin 13 differentiates patients with a positive history of suicide attempts in major depressive disorder. JOURNAL OF AFFECTIVE DISORDERS REPORTS 2021. [DOI: 10.1016/j.jadr.2021.100254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
|
21
|
Guo Y, Ji Y, Huang Y, Jin M, Lin Y, Chen Y, Zhang L, Zhu C, Yu F, Wang K. The Relationship Between Suicidal Ideation and Parental Attachment Among Adolescents: The Mediator of Anhedonia and Peer Attachment. Front Psychol 2021; 12:727088. [PMID: 34733205 PMCID: PMC8558217 DOI: 10.3389/fpsyg.2021.727088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Accepted: 08/26/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Previous studies had shown that poor quality of early parental attachment is a risk factor for suicide, but few have focus on the mechanism between suicidal ideation and parental attachment. The aim of this study was to explore how parental attachment, anhedonia, and peer attachment were associated with suicidal ideation in adolescents. Method: Participants were enrolled in middle schools, in Hefei, Anhui, China. All participants completed socio-demographic characteristic and standard assessments on parental attachment, peer attachment, anhedonia, and suicidal ideation by paper surveys. The effect of parental attachment on suicidal ideation mediated by anhedonia and peer attachment was analyzed by a structural equation model (SEM) using SPSS AMOS 23.0. Results: The SEM analysis revealed that the standard total effect of parental attachment on suicidal ideation was −0.137 (Z=−27.00, 95% confidence interval [CI; −0.147, −0.127], p<0.001), with a direct effect of parental attachment on suicidal ideation of −0.107 (Z=−21.40, 95% CI [−0.117, −0.098], p<0.001), while the indirect effects were−0.002 (Z=−3.33, 95% CI [−0.003, −0.002], p<0.001) in the pathway of parental attachment-anhedonia-peer attachment-suicidal ideation, −0.019 (Z=−19.00, 95%CI [−0.022, −0.017], p<0.001) in the pathway of parental attachment-anhedonia-suicidal ideation, and−0.008 (Z=−7.00, 95% CI [−0.010, −0.007], p<0.001) in the pathway of parental attachment-peer attachment-suicidal ideation. Conclusion: The study suggested that parental attachment could directly influence suicidal ideation and indirectly influence suicidal ideation via anhedonia and peer attachment. The results emphasized the importance of attachment in infancy and verified the feasibility of intervention on anhedonia and peer attachment to prevent suicidal ideation.
Collapse
Affiliation(s)
- Yaru Guo
- Institute of Mental Health and Psychological Science, Anhui Medical University, Hefei, China
| | - Yifu Ji
- Psychiatry Department of Hefei Fourth People's Hospital, Hefei, China
| | - Yunheng Huang
- Institute of Mental Health and Psychological Science, Anhui Medical University, Hefei, China
| | - Man Jin
- Anhui Xinyu Psychological Service, Hefei, China
| | - Yanting Lin
- Institute of Mental Health and Psychological Science, Anhui Medical University, Hefei, China
| | - Yun Chen
- Anhui Xinyu Psychological Service, Hefei, China
| | - Lei Zhang
- Department of Mental Health and Psychological Science, Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Anhui Medical University, Hefei, China
| | - Chunyan Zhu
- Department of Mental Health and Psychological Science, Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Anhui Medical University, Hefei, China
| | - Fengqiong Yu
- Department of Mental Health and Psychological Science, Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Anhui Medical University, Hefei, China
| | - Kai Wang
- Psychiatry Department of Hefei Fourth People's Hospital, Hefei, China
| |
Collapse
|
22
|
Solibieda A, Rotsaert M, Loas G. The Interpersonal-Psychological Theory of Suicide in Medical Students: Comparisons of Individuals without Suicidality, Ideators, and Planners. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182111526. [PMID: 34770040 PMCID: PMC8583021 DOI: 10.3390/ijerph182111526] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Revised: 10/26/2021] [Accepted: 10/31/2021] [Indexed: 11/17/2022]
Abstract
The aim of this study was to explore the interpersonal–psychological theory of suicide (IPTS) in medical students. Higher levels of thwarted belongingness and perceived burdensomeness were expected in medical students with suicidality compared with medical students without suicidality, and a high level of acquired capability was expected in planners compared with ideators. Recruited for the study were 178 undergraduate medical students at the Université Libre de Bruxelles (ULB): 95 subjects without suicidality, 24 subjects with lifetime suicidality, 28 subjects with recent suicidal ideation, and 26 planners. An ad hoc questionnaire evaluated the risk of suicide as well as the “Suicidal thoughts and wishes” item of the BDI-II. The Interpersonal Needs Questionnaire (INS) measured thwarted belongingness (TB) and perceived burdensomeness (PB). The Acquired Capability for Suicide Scale (ACSS) measured notably fearlessness of death or pain tolerance and depression was rated using the revised version of the Beck Depression Inventory (BDI). Cognitive–affective symptoms of depression (CA-BDI) were assessed using six items of the BDI. Analyses of variance showed significant differences between groups for TB and PB but not for ACSS. Analyses of covariance, controlling for the CA-BDI scores, confirmed the significance of differences in TB and PB. Post hoc tests showed that (1) high levels of TB were characteristic of subjects with recent suicidal ideation and planners compared with subjects without suicidality; and (2) high levels of PB were characteristic of planners compared with the three other groups. Among the three characteristics of the IPTS, PB could be a strong predictor of severe suicide risk in medical students.
Collapse
Affiliation(s)
- Alice Solibieda
- Department of Psychiatry & Laboratory of Psychiatric Research (ULB 266), Cliniques Universitaires de Bruxelles, Université Libre de Bruxelles (ULB), 1070 Bruxelles, Belgium;
| | - Marianne Rotsaert
- Department of Psychology & Laboratory of Psychiatric Research (ULB 266), Department of Psychiatry, Cliniques Universitaires de Bruxelles, Université Libre de Bruxelles (ULB), 1070 Bruxelles, Belgium;
| | - Gwenolé Loas
- Department of Psychiatry & Laboratory of Psychiatric Research (ULB 266), Cliniques Universitaires de Bruxelles, Université Libre de Bruxelles (ULB), 1070 Bruxelles, Belgium;
- Correspondence:
| |
Collapse
|
23
|
Machine Learning-Based Definition of Symptom Clusters and Selection of Antidepressants for Depressive Syndrome. Diagnostics (Basel) 2021; 11:diagnostics11091631. [PMID: 34573974 PMCID: PMC8468112 DOI: 10.3390/diagnostics11091631] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 09/03/2021] [Accepted: 09/03/2021] [Indexed: 12/30/2022] Open
Abstract
The current polythetic and operational criteria for major depression inevitably contribute to the heterogeneity of depressive syndromes. The heterogeneity of depressive syndrome has been criticized using the concept of language game in Wittgensteinian philosophy. Moreover, “a symptom- or endophenotype-based approach, rather than a diagnosis-based approach, has been proposed” as the “next-generation treatment for mental disorders” by Thomas Insel. Understanding the heterogeneity renders promise for personalized medicine to treat cases of depressive syndrome, in terms of both defining symptom clusters and selecting antidepressants. Machine learning algorithms have emerged as a tool for personalized medicine by handling clinical big data that can be used as predictors for subtype classification and treatment outcome prediction. The large clinical cohort data from the Sequenced Treatment Alternatives to Relieve Depression (STAR*D), Combining Medications to Enhance Depression Outcome (CO-MED), and the German Research Network on Depression (GRND) have recently began to be acknowledged as useful sources for machine learning-based depression research with regard to cost effectiveness and generalizability. In addition, noninvasive biological tools such as functional and resting state magnetic resonance imaging techniques are widely combined with machine learning methods to detect intrinsic endophenotypes of depression. This review highlights recent studies that have used clinical cohort or brain imaging data and have addressed machine learning-based approaches to defining symptom clusters and selecting antidepressants. Potentially applicable suggestions to realize machine learning-based personalized medicine for depressive syndrome are also provided herein.
Collapse
|
24
|
Choi KS, Kim S, Kim BH, Jeon HJ, Kim JH, Jang JH, Jeong B. Deep graph neural network-based prediction of acute suicidal ideation in young adults. Sci Rep 2021; 11:15828. [PMID: 34349156 PMCID: PMC8338980 DOI: 10.1038/s41598-021-95102-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Accepted: 07/06/2021] [Indexed: 02/07/2023] Open
Abstract
Precise remote evaluation of both suicide risk and psychiatric disorders is critical for suicide prevention as well as for psychiatric well-being. Using questionnaires is an alternative to labor-intensive diagnostic interviews in a large general population, but previous models for predicting suicide attempts suffered from low sensitivity. We developed and validated a deep graph neural network model that increased the prediction sensitivity of suicide risk in young adults (n = 17,482 for training; n = 14,238 for testing) using multi-dimensional questionnaires and suicidal ideation within 2 weeks as the prediction target. The best model achieved a sensitivity of 76.3%, specificity of 83.4%, and an area under curve of 0.878 (95% confidence interval, 0.855-0.899). We demonstrated that multi-dimensional deep features covering depression, anxiety, resilience, self-esteem, and clinico-demographic information contribute to the prediction of suicidal ideation. Our model might be useful for the remote evaluation of suicide risk in the general population of young adults for specific situations such as the COVID-19 pandemic.
Collapse
Affiliation(s)
- Kyu Sung Choi
- grid.37172.300000 0001 2292 0500Graduate School of Medical Science and Engineering, Korea Advanced Institute for Science and Technology (KAIST), 291 Daehak-ro, Yuseong-gu, Daejeon, 34141 Republic of Korea
| | - Sunghwan Kim
- grid.37172.300000 0001 2292 0500Graduate School of Medical Science and Engineering, Korea Advanced Institute for Science and Technology (KAIST), 291 Daehak-ro, Yuseong-gu, Daejeon, 34141 Republic of Korea
| | - Byung-Hoon Kim
- grid.15444.300000 0004 0470 5454Department of Psychiatry, Yonsei University College of Medicine, Seoul, Republic of Korea ,grid.37172.300000 0001 2292 0500Department of Bio and Brain Engineering, Korea Advanced Institute for Science and Technology (KAIST), Daejeon, Republic of Korea
| | - Hong Jin Jeon
- grid.264381.a0000 0001 2181 989XDepartment of Psychiatry, Depression Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Jong-Hoon Kim
- grid.256155.00000 0004 0647 2973Department of Psychiatry, Gil Medical Center, Gachon University College of Medicine, Gachon University, Incheon, Republic of Korea ,grid.256155.00000 0004 0647 2973Neuroscience Research Institute, Gachon Advanced Institute for Health Science and Technology, Gachon University, Incheon, Republic of Korea
| | - Joon Hwan Jang
- grid.31501.360000 0004 0470 5905Department of Human Systems Medicine, Seoul National University College of Medicine, 103 Daehak-ro, Jongro-gu, Seoul, 03080 Republic of Korea
| | - Bumseok Jeong
- grid.37172.300000 0001 2292 0500Graduate School of Medical Science and Engineering, Korea Advanced Institute for Science and Technology (KAIST), 291 Daehak-ro, Yuseong-gu, Daejeon, 34141 Republic of Korea ,grid.37172.300000 0001 2292 0500KAIST Institute for Health Science and Technology, Korea Advanced Institute for Science and Technology (KAIST), Daejeon, Republic of Korea ,grid.37172.300000 0001 2292 0500KAIST Clinic Pappalardo Center, Korea Advanced Institute for Science and Technology (KAIST), Daejeon, Republic of Korea
| |
Collapse
|
25
|
Solibieda A, Rotsaert M, Loas G. Relationship Between Recent Change of Anhedonia and Suicidal Ideation Taking Into Account the Severity and the Acuteness of Suicidal Ideation As Well As the Specific Roles of Loss of Pleasure and Loss of Interest in People: A Study on Medical Students. OMEGA-JOURNAL OF DEATH AND DYING 2021:302228211037300. [PMID: 34344253 DOI: 10.1177/00302228211037300] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The aim of the study was to explore the relationships between recent changes of anhedonia or particular symptoms of recent changes of anhedonia and suicidal ideation taking into account the severity of suicidal ideations. In a group of 173 medical students, scores of the anhedonia subscale (ANH-BDI) of the BDI-II (i.e. 4 anhedonia items: loss of pleasure, loss of interest, loss of energy and loss of interest in sex) were compared between 95 subjects without suicidality, 24 subjects with life-time suicidal ideation, 28 subjects with recent suicidal ideation and 26 planners. Analyses of covariance (ANCOVA) were performed referring to groups as independent variables, the cognitive-affective subscale (CA-BDI) of the BDI-II as a covariate, the ANH-BDI and each of the four anhedonia items as dependent variables. High levels of loss of interest characterized planners when compared to the other three groups. Loss of interest could be associated with recent and severe suicidal ideation.
Collapse
Affiliation(s)
- Alice Solibieda
- Department of Psychiatry & Laboratory of Psychiatric Research (ULB 266), Cliniques Universitaires de Bruxelles, Université Libre de Bruxelles, Belgium
| | - Marianne Rotsaert
- Department of Psychiatry & Laboratory of Psychiatric Research (ULB 266), Cliniques Universitaires de Bruxelles, Université Libre de Bruxelles, Belgium
| | - Gwenolé Loas
- Department of Psychiatry & Laboratory of Psychiatric Research (ULB 266), Cliniques Universitaires de Bruxelles, Université Libre de Bruxelles, Belgium
| |
Collapse
|
26
|
Antonelli-Salgado T, Monteiro GMC, Marcon G, Roza TH, Zimerman A, Hoffmann MS, Cao B, Hauck S, Brunoni AR, Passos IC. Loneliness, but not social distancing, is associated with the incidence of suicidal ideation during the COVID-19 outbreak: a longitudinal study. J Affect Disord 2021; 290:52-60. [PMID: 33991946 PMCID: PMC9754761 DOI: 10.1016/j.jad.2021.04.044] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 04/21/2021] [Accepted: 04/23/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Although social distancing is necessary to decrease COVID-19 dissemination, it might also be associated with suicidal ideation. Therefore, we analyzed the impact of social distancing and loneliness in suicidal ideation. METHODS We performed two waves of a snowball sample, web-based survey in Brazil (W1: from May 6th to June 6th, 2020; W2: from June 6th to July 6th, 2020). We assessed whether risk factors related to social relationships (loneliness, living alone, not leaving home, and the number of days practicing social distancing) at W1 were associated with suicidal ideation at W1 and W2 using multiple regression models. Analyses were adjusted for sociodemographic, mental health, and lifestyle variables. RESULTS A total of 1,674 (18-75 years old; 86.5% females) were included in our longitudinal sample. Living alone (OR: 1.16; 95%CI = 1.03 - 1.30; p=0.015), number of days practicing social distancing (OR: 1.002; 95%CI = 1.000 - 1.004; p=0.027), and loneliness (OR: 1.49; 95%CI = 1.32 - 1.68; p<0.001) were associated with suicidal ideation in the cross-sectional analysis of W1. Only loneliness (OR= 2.12; 95%CI = 1.06 - 4.24; p = 0.033) remained significant as a risk factor to suicidal ideation in the longitudinal analysis between both waves. LIMITATION Snowball, convenience sample design limits outcome estimates. Assessments were not objectively performed. CONCLUSION Loneliness was consistently associated with the incidence of suicidal ideation, while other variables, such as living alone, not leaving home, and the number of days practicing social distancing, were not. Measures to overcome loneliness are therefore necessary to reduce suicidal ideation during pandemics.
Collapse
Affiliation(s)
- Thyago Antonelli-Salgado
- Laboratory of Molecular Psychiatry, Centro de Pesquisa Experimental (CPE) and Centro de Pesquisa Clínica (CPC), Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil,Instituto Nacional de Ciência e Tecnologia Translacional em Medicina (INCT-TM), Porto Alegre, RS, Brazil,Universidade Federal do Rio Grande do Sul, School of Medicine, Graduate Program in Psychiatry and Behavioral Sciences, Department of Psychiatry, Porto Alegre, RS, Brazil
| | - Gabriela Massaro Carneiro Monteiro
- Laboratory of Molecular Psychiatry, Centro de Pesquisa Experimental (CPE) and Centro de Pesquisa Clínica (CPC), Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil,Instituto Nacional de Ciência e Tecnologia Translacional em Medicina (INCT-TM), Porto Alegre, RS, Brazil,Universidade Federal do Rio Grande do Sul, School of Medicine, Graduate Program in Psychiatry and Behavioral Sciences, Department of Psychiatry, Porto Alegre, RS, Brazil
| | - Grasiela Marcon
- Laboratory of Molecular Psychiatry, Centro de Pesquisa Experimental (CPE) and Centro de Pesquisa Clínica (CPC), Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil,Instituto Nacional de Ciência e Tecnologia Translacional em Medicina (INCT-TM), Porto Alegre, RS, Brazil,Universidade Federal da Fronteira Sul, School of Medicine, Department of Psychiatry, Chapecó, SC, Brazil
| | - Thiago Henrique Roza
- Laboratory of Molecular Psychiatry, Centro de Pesquisa Experimental (CPE) and Centro de Pesquisa Clínica (CPC), Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil,Instituto Nacional de Ciência e Tecnologia Translacional em Medicina (INCT-TM), Porto Alegre, RS, Brazil,Universidade Federal do Rio Grande do Sul, School of Medicine, Graduate Program in Psychiatry and Behavioral Sciences, Department of Psychiatry, Porto Alegre, RS, Brazil
| | - Aline Zimerman
- Laboratory of Molecular Psychiatry, Centro de Pesquisa Experimental (CPE) and Centro de Pesquisa Clínica (CPC), Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil,Instituto Nacional de Ciência e Tecnologia Translacional em Medicina (INCT-TM), Porto Alegre, RS, Brazil,Universidade Federal do Rio Grande do Sul, School of Psychology, Porto Alegre, RS, Brazil
| | - Maurício Scopel Hoffmann
- Universidade Federal do Rio Grande do Sul, School of Medicine, Graduate Program in Psychiatry and Behavioral Sciences, Department of Psychiatry, Porto Alegre, RS, Brazil,Universidade Federal de Santa Maria, Avenida Roraima 1000, building 26, office 1446, Santa Maria 97105-900, Brazil,Care Policy and Evaluation Centre, London School of Economics and Political Science, Houghton Street, London WC2A 2AE United Kingdom
| | - Bo Cao
- Department of Psychiatry, Faculty of Medicine & Dentistry University of Alberta, Edmonton, Alberta T6G 2B7, Canada
| | - Simone Hauck
- Universidade Federal do Rio Grande do Sul, School of Medicine, Graduate Program in Psychiatry and Behavioral Sciences, Department of Psychiatry, Porto Alegre, RS, Brazil,Psychodynamic Psychiatry Research Lab, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil
| | - André Russowsky Brunoni
- Departments of Internal Medicine and Psychiatry, Faculdade de Medicina da Universidade de São Paulo (USP), São Paulo, Brazil
| | - Ives Cavalcante Passos
- Laboratory of Molecular Psychiatry, Centro de Pesquisa Experimental (CPE) and Centro de Pesquisa Clínica (CPC), Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil; Instituto Nacional de Ciência e Tecnologia Translacional em Medicina (INCT-TM), Porto Alegre, RS, Brazil; Universidade Federal do Rio Grande do Sul, School of Medicine, Graduate Program in Psychiatry and Behavioral Sciences, Department of Psychiatry, Porto Alegre, RS, Brazil.
| |
Collapse
|
27
|
Yang X, Tian K, Wang D, Liu G, Liu X, Harrison P. State Anhedonia and Suicidal Ideation in Adolescents. CRISIS 2021; 42:247-254. [DOI: 10.1027/0227-5910/a000712] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Abstract. Background: Recent work suggests that state anhedonia and its social aspect of loss of interest in people was an important predictor of suicidal ideation in adults. Aim: The current study investigated the relationship between state anhedonia, trait anhedonia, suicidal ideation, and suicide attempts in adolescents. Method: State anhedonia was assessed using the anhedonia subscale from the Child Mood and Feelings Questionnaire, while trait social anhedonia was assessed using the Adolescent Anticipatory and Consummatory Interpersonal Pleasure Scale and the Temporal Experience of Pleasure Scale. Results: Results indicated that state anhedonia was associated with suicidal ideation but not associated with past suicide attempts after controlling for depressive symptoms. Academic stressful events moderated the relationship between state anhedonia and suicidal ideation. Symptom-level analyses revealed that loss of interest in friends was most highly predictive of suicidal ideation compared with the other anhedonia components. Limitations: The current investigation was limited by its reliance on student samples and data from a single time point. Conclusion: The current study indicated that state anhedonia and its social component may be more informative of near-term suicidal ideation than trait anhedonia in adolescents.
Collapse
Affiliation(s)
- Xinhua Yang
- Department of Psychology, Hunan Agricultural University, Changsha, PR China
- Centre for Affective Disorders, Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Kai Tian
- Department of Psychology, Hunan Agricultural University, Changsha, PR China
| | - Dongfang Wang
- Department of Psychology, Hunan Agricultural University, Changsha, PR China
| | - Guangya Liu
- Department of Psychiatry, Brains Hospital of Hunan Province, Changsha, PR China
| | - Xiaoqun Liu
- Xiangya School of Public Health, Central South University, Changsha, PR China
| | - Phillippa Harrison
- Centre for Affective Disorders, Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| |
Collapse
|
28
|
Mortier P, Vilagut G, Ferrer M, Serra C, Molina JD, López‐Fresneña N, Puig T, Pelayo‐Terán JM, Pijoan JI, Emparanza JI, Espuga M, Plana N, González‐Pinto A, Ortí‐Lucas RM, de Salázar AM, Rius C, Aragonès E, del Cura‐González I, Aragón‐Peña A, Campos M, Parellada M, Pérez‐Zapata A, Forjaz MJ, Sanz F, Haro JM, Vieta E, Pérez‐Solà V, Kessler RC, Bruffaerts R, Alonso J. Thirty-day suicidal thoughts and behaviors among hospital workers during the first wave of the Spain COVID-19 outbreak. Depress Anxiety 2021; 38:528-544. [PMID: 33393724 PMCID: PMC8246904 DOI: 10.1002/da.23129] [Citation(s) in RCA: 54] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 11/20/2020] [Accepted: 12/05/2020] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Healthcare workers are a key occupational group at risk for suicidal thoughts and behaviors (STB). We investigated the prevalence and correlates of STB among hospital workers during the first wave of the Spain COVID-19 outbreak (March-July 2020). METHODS Data come from the baseline assessment of a cohort of Spanish hospital workers (n = 5450), recruited from 10 hospitals just after the height of the coronavirus disease 2019 (COVID-19) outbreak (May 5-July 23, 2020). Web-based self-report surveys assessed 30-day STB, individual characteristics, and potentially modifiable contextual factors related to hospital workers' work and financial situation. RESULTS Thirty-day STB prevalence was estimated at 8.4% (4.9% passive ideation only, 3.5% active ideation with or without a plan or attempt). A total of n = 6 professionals attempted suicide in the past 30 days. In adjusted models, 30-day STB remained significantly associated with pre-pandemic lifetime mood (odds ratio [OR] = 2.92) and anxiety disorder (OR = 1.90). Significant modifiable factors included a perceived lack of coordination, communication, personnel, or supervision at work (population-attributable risk proportion [PARP] = 50.5%), and financial stress (PARP = 44.1%). CONCLUSIONS AND RELEVANCE Thirty-day STB among hospital workers during the first wave of the Spain COVID-19 outbreak was high. Hospital preparedness for virus outbreaks should be increased, and strong governmental policy response is needed to increase financial security among hospital workers.
Collapse
Affiliation(s)
- Philippe Mortier
- Health Services Research UnitIMIM‐Institut Hospital del Mar d'Investigacions MèdiquesBarcelonaSpain,CIBER Epidemiología y Salud Pública (CIBERESP)MadridSpain
| | - Gemma Vilagut
- Health Services Research UnitIMIM‐Institut Hospital del Mar d'Investigacions MèdiquesBarcelonaSpain,CIBER Epidemiología y Salud Pública (CIBERESP)MadridSpain
| | - Montse Ferrer
- Health Services Research UnitIMIM‐Institut Hospital del Mar d'Investigacions MèdiquesBarcelonaSpain,CIBER Epidemiología y Salud Pública (CIBERESP)MadridSpain,Universitat Autònoma de Barcelona (UAB)BarcelonaSpain
| | - Consol Serra
- CIBER Epidemiología y Salud Pública (CIBERESP)MadridSpain,Parc de Salut Mar PSMARBarcelonaSpain,CiSAL‐Centro de Investigación en Salud LaboralIMIM/UPFBarcelonaSpain
| | - Juan D. Molina
- Villaverde Mental Health Center, Clinical Management Area of Psychiatry and Mental Health, Psychiatric ServiceHospital Universitario 12 de OctubreMadridSpain,Research Institute Hospital 12 de Octubre (i+12)MadridSpain,Faculty of Health SciencesFrancisco de Vitoria UniversityMadridSpain,CIBER Salud Mental (CIBERSAM)MadridSpain
| | | | - Teresa Puig
- Universitat Autònoma de Barcelona (UAB)BarcelonaSpain,Department of Epidemiology and Public HealthHospital de la Santa Creu i Sant PauBarcelonaSpain,Biomedical Research Institute Sant Pau (IIB Sant Pau)BarcelonaSpain,CIBER Enfermedades Cardiovasculares (CIBERCV)MadridSpain
| | | | - José I. Pijoan
- CIBER Epidemiología y Salud Pública (CIBERESP)MadridSpain,Hospital Universitario Cruces/OSI EECBilbaoSpain
| | - José I. Emparanza
- CIBER Epidemiología y Salud Pública (CIBERESP)MadridSpain,Hospital Universitario DonostiaSan SebastiánSpain
| | - Meritxell Espuga
- Occupational Health ServiceHospital Universitari Vall d'HebronBarcelonaSpain
| | - Nieves Plana
- CIBER Epidemiología y Salud Pública (CIBERESP)MadridSpain,Príncipe de Asturias University HospitalAlcalá de HenaresMadridSpain
| | - Ana González‐Pinto
- CIBER Salud Mental (CIBERSAM)MadridSpain,Hospital Universitario Araba‐SantiagoVitoria‐GasteizSpain
| | - Rafael M. Ortí‐Lucas
- CIBER Salud Mental (CIBERSAM)MadridSpain,Hospital Clínic UniversitariValenciaSpain
| | | | - Cristina Rius
- CIBER Salud Mental (CIBERSAM)MadridSpain,Agència de Salut Pública de BarcelonaBarcelonaSpain
| | - Enric Aragonès
- Institut d'Investigació en Atenció Primària IDIAP Jordi GolBarcelonaSpain,Atenció Primària Camp de TarragonaInstitut Català de la SalutTarragonaSpain
| | - Isabel del Cura‐González
- Research Unit, Primary Care ManagementMadrid Health ServiceMadridSpain,Department of Medical Specialities and Public HealthKing Juan Carlos UniversityMadridSpain,Fundación Investigación e Innovación Biosanitaria de APComunidad de MadridMadridSpain
| | - Andrés Aragón‐Peña
- Fundación Investigación e Innovación Biosanitaria de APComunidad de MadridMadridSpain,Epidemiology UnitRegional Ministry of Health, Community of MadridMadridSpain
| | - Mireia Campos
- Service of Prevention of Labor RisksMedical Emergencies System, Generalitat de CatalunyaBarcelonaSpain
| | - Mara Parellada
- CIBER Salud Mental (CIBERSAM)MadridSpain,Hospital General Universitario Gregorio MarañónMadridSpain
| | | | - Maria João Forjaz
- National Center of EpidemiologyInstituto de Salud Carlos III (ISCIII)MadridSpain,Health Services Research Network on Chronic Diseases (REDISSEC)MadridSpain
| | - Ferran Sanz
- Research Progamme on Biomedical Informatics (GRIB)Hospital del Mar Medical Research Institute (IMIM)BarcelonaSpain,Department of Experimental and Health SciencesPompeu Fabra UniversityBarcelonaSpain,Instituto Nacional de Bioinformatica—ELIXIR‐ESMadridSpain
| | - Josep M. Haro
- Universitat Autònoma de Barcelona (UAB)BarcelonaSpain,CIBER Salud Mental (CIBERSAM)MadridSpain,Parc Sanitari Sant Joan de DéuBarcelonaSpain
| | - Eduard Vieta
- CIBER Salud Mental (CIBERSAM)MadridSpain,Hospital Clínic, University of Barcelona, IDIBAPSBarcelonaSpain
| | - Víctor Pérez‐Solà
- Universitat Autònoma de Barcelona (UAB)BarcelonaSpain,Parc de Salut Mar PSMARBarcelonaSpain,CIBER Salud Mental (CIBERSAM)MadridSpain
| | - Ronald C. Kessler
- Department of Health Care PolicyHarvard Medical SchoolBostonMassachusettsUSA
| | - Ronny Bruffaerts
- Center for Public Health PsychiatryUniversitair Psychiatrisch Centrum, KU LeuvenLeuvenBelgium
| | - Jordi Alonso
- Health Services Research UnitIMIM‐Institut Hospital del Mar d'Investigacions MèdiquesBarcelonaSpain,CIBER Epidemiología y Salud Pública (CIBERESP)MadridSpain,Department of Experimental and Health SciencesPompeu Fabra UniversityBarcelonaSpain
| | | |
Collapse
|
29
|
Xu X, Wang W, Chen J, Ai M, Shi L, Wang L, Hong S, Zhang Q, Hu H, Li X, Cao J, Lv Z, Du L, Li J, Yang H, He X, Chen X, Chen R, Luo Q, Zhou X, Tan J, Tu J, Jiang G, Han Z, Kuang L. Suicidal and self-harm ideation among Chinese hospital staff during the COVID-19 pandemic: Prevalence and correlates. Psychiatry Res 2021; 296:113654. [PMID: 33360965 PMCID: PMC7836678 DOI: 10.1016/j.psychres.2020.113654] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2020] [Accepted: 12/13/2020] [Indexed: 01/08/2023]
Abstract
The COVID-19 pandemic put global medical systems under massive pressure for its uncertainty, severity, and persistence. For detecting the prevalence of suicidal and self-harm ideation (SSI) and its related risk factors among hospital staff during the COVID-19 pandemic, this cross-sectional study collected the sociodemographic data, epidemic-related information, the psychological status and need, and perceived stress and support from 11507 staff in 46 hospitals by an online survey from February 14 to March 2, 2020. The prevalence of SSI was 6.47%. Hospital staff with SSI had high family members or relatives infected number and the self-rated probability of infection. Additionally, they had more perceived stress, psychological need, and psychological impact. On the contrary, hospital staff without SSI reported high self-rated health, willingness to work in a COVID-19 ward, confidence in defeating COVID-19, and perceived support. Furthermore, they reported better marital or family relationship, longer sleep hours, and shorter work hours. The infection of family members or relatives, poor marital status, poor self-rated health, the current need for psychological intervention, perceived high stress, perceived low support, depression, and anxiety were independent factors to SSI. A systematic psychological intervention strategy during a public health crisis was needed for the hospital staff's mental well-being.
Collapse
Affiliation(s)
- Xiaoming Xu
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
| | - Wo Wang
- Mental Health Center, University-Town Hospital of Chongqing Medical University, Chongqing 401331, China
| | - Jianmei Chen
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
| | - Ming Ai
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
| | - Lei Shi
- Mental Health Center, University-Town Hospital of Chongqing Medical University, Chongqing 401331, China
| | - Lixia Wang
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
| | - Su Hong
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
| | - Qi Zhang
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
| | - Hua Hu
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
| | - Xuemei Li
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
| | - Jun Cao
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
| | - Zhen Lv
- Mental Health Center, University-Town Hospital of Chongqing Medical University, Chongqing 401331, China
| | - Lian Du
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
| | - Jing Li
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
| | - Handan Yang
- Mental Health Center, University-Town Hospital of Chongqing Medical University, Chongqing 401331, China
| | - Xiaoting He
- Mental Health Center, University-Town Hospital of Chongqing Medical University, Chongqing 401331, China
| | - Xiaorong Chen
- Mental Health Center, University-Town Hospital of Chongqing Medical University, Chongqing 401331, China
| | - Ran Chen
- Mental Health Center, University-Town Hospital of Chongqing Medical University, Chongqing 401331, China
| | - Qinghua Luo
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
| | - Xinyu Zhou
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
| | - Jian Tan
- Chongqing Changshou Mental Health Center, Chongqing 401220, China
| | - Jing Tu
- Chongqing Iron and Steel General Hospital, Chongqing 400037, China
| | - Guanghua Jiang
- Chongqing Changshou Mental Health Center, Chongqing 401220, China
| | - Zhiqin Han
- Chongqing Changshou Mental Health Center, Chongqing 401220, China
| | - Li Kuang
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China,Mental Health Center, University-Town Hospital of Chongqing Medical University, Chongqing 401331, China,Corresponding author at: Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Youyi Road, Yuzhong District, Chongqing 400016, China
| |
Collapse
|
30
|
La théorie interpersonnelle du suicide. Présentation et application dans la compréhension des idées suicidaires chez l’étudiant en médecine : étude dans un groupe de 178 étudiants. ANNALES MEDICO-PSYCHOLOGIQUES 2021. [DOI: 10.1016/j.amp.2020.04.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
|
31
|
Kautzky A, Möller H, Dold M, Bartova L, Seemüller F, Laux G, Riedel M, Gaebel W, Kasper S. Combining machine learning algorithms for prediction of antidepressant treatment response. Acta Psychiatr Scand 2021; 143:36-49. [PMID: 33141944 PMCID: PMC7839691 DOI: 10.1111/acps.13250] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Revised: 06/29/2020] [Accepted: 10/12/2020] [Indexed: 12/13/2022]
Abstract
OBJECTIVES Predictors for unfavorable treatment outcome in major depressive disorder (MDD) applicable for treatment selection are still lacking. The database of a longitudinal multicenter study on 1079 acutely depressed patients, performed by the German research network on depression (GRND), allows supervised and unsupervised learning to further elucidate the interplay of clinical and psycho-sociodemographic variables and their predictive impact on treatment outcome phenotypes. EXPERIMENTAL PROCEDURES Treatment response was defined by a change of HAM-D 17-item baseline score ≥50% and remission by the established threshold of ≤7, respectively, after up to eight weeks of inpatient treatment. After hierarchical symptom clustering and stratification by treatment subtypes (serotonin reuptake inhibitors, tricyclic antidepressants, antipsychotic, and lithium augmentation), prediction models for different outcome phenotypes were computed with random forest in a cross-center validation design. In total, 88 predictors were implemented. RESULTS Clustering revealed four distinct HAM-D subscores related to emotional, anxious, sleep, and appetite symptoms, respectively. After feature selection, classification models reached moderate to high accuracies up to 0.85. Highest accuracies were observed for the SSRI and TCA subgroups and for sleep and appetite symptoms, while anxious symptoms showed poor predictability. CONCLUSION Our results support a decisive role for machine learning in the management of antidepressant treatment. Treatment- and symptom-specific algorithms may increase accuracies by reducing heterogeneity. Especially, predictors related to duration of illness, baseline depression severity, anxiety and somatic symptoms, and personality traits moderate treatment success. However, prospectives application of machine learning models will be necessary to prove their value for the clinic.
Collapse
Affiliation(s)
- Alexander Kautzky
- Department of Psychiatry and PsychotherapyMedical University of ViennaViennaAustria
| | - Hans‐Juergen Möller
- Department of Psychiatry and PsychotherapyLudwig‐Maximilians‐Q3 University MunichMunichGermany
| | - Markus Dold
- Department of Psychiatry and PsychotherapyMedical University of ViennaViennaAustria
| | - Lucie Bartova
- Department of Psychiatry and PsychotherapyMedical University of ViennaViennaAustria
| | - Florian Seemüller
- Department of Psychiatry and PsychotherapyLudwig‐Maximilians‐Q3 University MunichMunichGermany,Department of Psychiatry and Psychotherapykbo‐Lech‐Mangfall‐KlinikGarmisch‐PartenkirchenGermany
| | - Gerd Laux
- Department of Psychiatry and Psychotherapykbo‐Inn‐Salzach‐KlinikumWasserburgGermany
| | - Michael Riedel
- Department of Psychiatry and PsychotherapyLudwig‐Maximilians‐Q3 University MunichMunichGermany,Department of PsychiatrySächsisches KrankenhausRodewischGermany
| | - Wolfgang Gaebel
- Department of Psychiatry and PsychotherapyMedical FacultyHeinrich‐Heine‐UniversityDüsseldorfGermany
| | - Siegfried Kasper
- Department of Psychiatry and PsychotherapyMedical University of ViennaViennaAustria
| |
Collapse
|
32
|
Dong M, Zhou FC, Xu SW, Zhang Q, Ng CH, Ungvari GS, Xiang YT. Prevalence of suicide-related behaviors among physicians: A systematic review and meta-analysis. Suicide Life Threat Behav 2020; 50:1264-1275. [PMID: 33025630 DOI: 10.1111/sltb.12690] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2020] [Accepted: 06/28/2020] [Indexed: 11/27/2022]
Abstract
OBJECTIVE Suicide is a major cause of premature death among physicians, but the prevalence of suicide-related behaviors (including suicidal ideation, SI and suicide attempt, SA) is inconsistent across studies. This meta-analysis aimed to estimate the prevalence of suicide-related behaviors among physicians and its associated factors. METHODS PubMed, EMBASE, PsycINFO, and Cochrane library databases were systematically searched from commencement date to August 14, 2018. Eligible studies on the prevalence of suicide-related behaviors among physicians were included. RESULTS Thirty-five eligible studies with 70,368 physicians were included. The lifetime prevalence of SI was 17.4% (95% CI: 13.8%-21.8%), while the 1-year prevalence was 8.6% (95% CI: 7.1%-10.3%), 6-month prevalence was 11.9% (95% CI: 2.7%-39.2%), and 1-month prevalence was 8.6% (95% CI: 5.6%-13.0%). The lifetime prevalence of SA was 1.8% (95% CI: 0.9%-3.7%), while the 1-year prevalence was 0.3% (95% CI: 0.1%-0.8%). Subgroup analyses revealed that geographic region was significantly associated with lifetime and 1-year prevalence of SI, while sample size was significantly associated with 1-month prevalence of SI. CONCLUSIONS This meta-analysis found a relatively high prevalence of suicide-related behaviors, particularly lifetime SI, among physicians. Appropriate preventive and treatment measures should be implemented to reduce the risk of suicide-related behaviors in this population.
Collapse
Affiliation(s)
- Min Dong
- Guangdong Mental Health Center, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Fu-Chun Zhou
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital & The Advanced Innovation Center for Human Brain Protection, School of Mental Health, Capital Medical University, Beijing, China
| | - Shi-Wei Xu
- The First Clinical College, Changsha Medical University, Changsha, China
| | - Qinge Zhang
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital & The Advanced Innovation Center for Human Brain Protection, School of Mental Health, Capital Medical University, Beijing, China
| | - Chee H Ng
- Department of Psychiatry, The Melbourne Clinic and St Vincent's Hospital, University of Melbourne, Richmond, Vic., Australia
| | - Gabor S Ungvari
- Division of Psychiatry, School of Medicine, University of Western Australia, Perth, WA, Australia.,University of Notre Dame Australia, Fremantle, WA, Australia
| | - Yu-Tao Xiang
- Unit of Psychiatry, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao, SAR, China.,Center for Cognition and Brain Sciences, University of Macau, Macao, SAR, China.,Institute of Advanced Studies in Humanities and Social Sciences, University of Macau, Macao, SAR, China
| |
Collapse
|
33
|
Yang X, Wang D, Liu S, Liu G, Harrison P. Stress and Suicidal Ideation: The Role of State or Trait Anhedonia in a Moderated Mediation Model. Suicide Life Threat Behav 2020; 50:502-514. [PMID: 31750566 DOI: 10.1111/sltb.12605] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Accepted: 10/14/2019] [Indexed: 01/17/2023]
Abstract
BACKGROUND Recent works suggested taking into account the severity and the type of anhedonia when examining suicidal ideation. The present study investigated a moderated mediation model addressing the psychosocial mechanisms that account for the association between state or trait anhedonia and suicidal ideation. METHODS State anhedonia was assessed using the Snaith-Hamilton Pleasure Scale, while trait anhedonia was assessed using the Temporal Experience of Pleasure Scale. A total number of 1,361 of undergraduates completed questionnaires at three different times, with one-year intervals. RESULTS The direct effect of stress on suicidal ideation was significantly greater for those students who had lower trait anticipatory and consummatory anhedonia, whereas the indirect effect from stress on suicidal ideation through depression was significantly greater for those who had higher state anhedonia. Moreover, trait consummatory anhedonia moderated the relationship between stress and suicidal ideation after one year, and trait anticipatory anhedonia moderated the relationship between stress and suicidal ideation after two years. CONCLUSIONS Low levels of trait anhedonia were associated with elevated suicidal ideation, while high levels of state anhedonia were associated with elevated suicidal ideation. Trait consummatory anhedonia was associated with short-term suicidal ideation, while trait anticipatory anhedonia was associated with long-term suicidal ideation.
Collapse
Affiliation(s)
- Xinhua Yang
- Department of Psychology, College of Education, Hunan Agricultural University, Changsha, Hunan, China.,Centre for Affective Disorders, Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Dongfang Wang
- Department of Psychology, College of Education, Hunan Agricultural University, Changsha, Hunan, China
| | - Sixun Liu
- Department of Psychology, College of Education, Hunan Agricultural University, Changsha, Hunan, China
| | - Guangya Liu
- Department of psychiatry, Hunan Brains Hospital, Changsha, Hunan, China
| | - Phillippa Harrison
- Centre for Affective Disorders, Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| |
Collapse
|
34
|
Yang X, Liu S, Wang D, Liu G, Harrison P. Differential effects of state and trait social anhedonia on suicidal ideation at 3-months follow up. J Affect Disord 2020; 262:23-30. [PMID: 31706156 DOI: 10.1016/j.jad.2019.10.056] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Revised: 09/11/2019] [Accepted: 10/28/2019] [Indexed: 01/30/2023]
Abstract
BACKGROUND Recent work suggests that the social component of anhedonia is more associated with suicide ideation than the other component of pleasure. The present study investigated the differential effects of state and trait social anhedonia on suicidal ideation across two undergraduate samples based on the Interpersonal Theory and Three-Step Theory of Suicide. METHODS State social anhedonia was assessed with a single item (Loss of Interest in People) extracted from the Beck Depression Inventory, while trait social anhedonia was assessed using the Anticipatory and Consummatory Interpersonal Pleasure Scale. Suicidal ideation was re-administered at a 3-month follow-up. RESULTS In Study 1, higher state social anhedonia was associated with greater levels of suicidal ideation, while trait social anhedonia moderated the relationship between thwarted belongingness, perceived burdensomeness and suicidal ideation. In Study 2, state social anhedonia was margin significant predictor of suicidal ideation, while trait social anhedonia moderated the relationship between psychological pain and suicidal ideation. CONCLUSIONS These findings confirmed the presence of two different effects on suicidal ideation in state and trait social anhedonia: state social anhedonia directly was associated with suicidal ideation, while trait social anhedonia was indirectly related through their effects on other risk factors of suicidality.
Collapse
Affiliation(s)
- Xinhua Yang
- Department of Psychology, Institute of Education, Rural Children and Adolescents Research Center for Health Promotion, Hunan Agricultural University, Changsha, Hunan, China; Centre for Affective Disorders, Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Sixun Liu
- Department of Psychology, Institute of Education, Rural Children and Adolescents Research Center for Health Promotion, Hunan Agricultural University, Changsha, Hunan, China
| | - Dongfang Wang
- Department of Psychology, Institute of Education, Rural Children and Adolescents Research Center for Health Promotion, Hunan Agricultural University, Changsha, Hunan, China
| | - Guangya Liu
- Department of psychiatry, Brains Hospital of Hunan province, Changsha, Hunan, China
| | - Phillippa Harrison
- Centre for Affective Disorders, Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
| |
Collapse
|
35
|
Yang X, Wang D, Liu S, Liu G, Harrison P. Trajectories of state anhedonia and recent changes in anhedonia in college students: Associations with other psychiatric syndromes. J Affect Disord 2020; 262:337-343. [PMID: 31735407 DOI: 10.1016/j.jad.2019.11.043] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Revised: 09/20/2019] [Accepted: 11/09/2019] [Indexed: 01/25/2023]
Abstract
BACKGROUND Recent works suggest recent changes in anhedonia may be specifically predictive of key elements of psychopathology. The present study aimed to identify the trajectories of state anhedonia and recent changes in anhedonia, and to investigate their associations with other psychiatric syndromes over time. METHODS A total of 859 college students were assessed at three time points. State anhedonia was assessed using the Snaith Hamilton Pleasure Scale and recent changes in anhedonia were assessed with a subscale extracted from the Symptom Check-List-90. The Latent Growth Curve Modelling analysis was used to analyze trajectories. Associations with anhedonia were investigated with logistic regression models. RESULTS Three state anhedonia trajectories and two recent changes in anhedonia trajectories were identified. The decreasing trajectory was the most prevalent class in both two types of anhedonia. Depression and suicidal ideation predicted recent changes in anhedonia whereas other psychiatric syndromes predicted state anhedonia. CONCLUSIONS The current study highlighted the development trajectories of different measures of anhedonia. The results showed that the relationships between anhedonia and psychiatric syndromes were different according to the kind of anhedonia.
Collapse
Affiliation(s)
- Xinhua Yang
- Department of Psychology, Institute of Education, Hunan Agricultural University, No. 1 Nongda Road, Changsha, Hunan 410128, China.
| | - Dongfang Wang
- Department of Psychology, Institute of Education, Hunan Agricultural University, No. 1 Nongda Road, Changsha, Hunan 410128, China.
| | - Sixun Liu
- Department of Psychology, Institute of Education, Hunan Agricultural University, No. 1 Nongda Road, Changsha, Hunan 410128, China.
| | - Guangya Liu
- Department of psychiatry, Brains Hospital of Hunan Province, Changsha, Hunan, China.
| | - Phillippa Harrison
- Centre for Affective Disorders, Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
| |
Collapse
|
36
|
Kasimova LN, Svyatogor MV. [Angedonia in the structure of affective disorders: therapeutic opportunities]. Zh Nevrol Psikhiatr Im S S Korsakova 2019; 119:116-122. [PMID: 31851182 DOI: 10.17116/jnevro2019119111116] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Anhedonia is one of the core features of depression. The article considers the place of anhedonia in the structure of affective disorders, its influence on the prognosis and effectiveness of therapy. The authors stress that various manifestations of anhedonia must be considered in correlation with the basic ability to feel pleasure. Therapy of anhedonia is not always effective. According to literature, agomelatin occupies a leading position among the drugs that reduce anhedonia.
Collapse
Affiliation(s)
- L N Kasimova
- Privolzhsky Research Medical University, N.Novgorod, Russia
| | - M V Svyatogor
- Privolzhsky Research Medical University, N.Novgorod, Russia
| |
Collapse
|
37
|
Dutheil F, Aubert C, Pereira B, Dambrun M, Moustafa F, Mermillod M, Baker JS, Trousselard M, Lesage FX, Navel V. Suicide among physicians and health-care workers: A systematic review and meta-analysis. PLoS One 2019; 14:e0226361. [PMID: 31830138 PMCID: PMC6907772 DOI: 10.1371/journal.pone.0226361] [Citation(s) in RCA: 225] [Impact Index Per Article: 45.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Accepted: 11/24/2019] [Indexed: 12/14/2022] Open
Abstract
Background Medical-related professions are at high suicide risk. However, data are contradictory and comparisons were not made between gender, occupation and specialties, epochs of times. Thus, we conducted a systematic review and meta-analysis on suicide risk among health-care workers. Method The PubMed, Cochrane Library, Science Direct and Embase databases were searched without language restriction on April 2019, with the following keywords: suicide* AND (« health care worker* » OR physician* OR nurse*). When possible, we stratified results by gender, countries, time, and specialties. Estimates were pooled using random-effect meta-analysis. Differences by study-level characteristics were estimated using stratified meta-analysis and meta-regression. Suicides, suicidal attempts, and suicidal ideation were retrieved from national or local specific registers or case records. In addition, suicide attempts and suicidal ideation were also retrieved from questionnaires (paper or internet). Results The overall SMR for suicide in physicians was 1.44 (95CI 1.16, 1.72) with an important heterogeneity (I2 = 93.9%, p<0.001). Female were at higher risk (SMR = 1.9; 95CI 1.49, 2.58; and ES = 0.67; 95CI 0.19, 1.14; p<0.001 compared to male). US physicians were at higher risk (ES = 1.34; 95CI 1.28, 1.55; p <0.001 vs Rest of the world). Suicide decreased over time, especially in Europe (ES = -0.18; 95CI -0.37, -0.01; p = 0.044). Some specialties might be at higher risk such as anesthesiologists, psychiatrists, general practitioners and general surgeons. There were 1.0% (95CI 1.0, 2.0; p<0.001) of suicide attempts and 17% (95CI 12, 21; p<0.001) of suicidal ideation in physicians. Insufficient data precluded meta-analysis on other health-care workers. Conclusion Physicians are an at-risk profession of suicide, with women particularly at risk. The rate of suicide in physicians decreased over time, especially in Europe. The high prevalence of physicians who committed suicide attempt as well as those with suicidal ideation should benefits for preventive strategies at the workplace. Finally, the lack of data on other health-care workers suggest to implement studies investigating those occupations.
Collapse
Affiliation(s)
- Frédéric Dutheil
- Université Clermont Auvergne, CNRS, LaPSCo, Physiological and Psychosocial Stress, CHU Clermont-Ferrand, University Hospital of Clermont-Ferrand, Occupational and Preventive Medicine, WittyFit, Clermont-Ferrand, France
- Australian Catholic University, Faculty of Health, School of Exercise Science, Melbourne, Victoria, Australia
- * E-mail:
| | - Claire Aubert
- Université de Versailles Saint-Quentin-en-Yvelines, Faculty of Health Science Simone Veil, Versailles, France
| | - Bruno Pereira
- CHU Clermont-Ferrand, University Hospital of Clermont-Ferrand, Biostatistics Unit, the Clinical Research and Innovation Direction, Clermont-Ferrand, France
| | - Michael Dambrun
- Université Clermont Auvergne, CNRS, LaPSCo, Physiological and Psychosocial Stress, Clermont-Ferrand, France
| | - Fares Moustafa
- CHU Clermont-Ferrand, University Hospital of Clermont-Ferrand, Emergency, Clermont-Ferrand, France
| | - Martial Mermillod
- Univ. Grenoble Alpes, Univ. Savoie Mont Blanc, CNRS, LPNC, Grenoble, France
- Institut Universitaire de France, Paris, France
| | - Julien S. Baker
- Centre for Health and Exercise Science Research, Department of Sport, Physical Education and Health, Hong Kong Baptist University, Kowloon Tong, Hong Kong
| | - Marion Trousselard
- French Armed Forces Biomedical Research Institute-IRBA, Neurophysiology of Stress, Neuroscience and Operational Constraint Department, Brétigny-sur-Orge, France
| | - François-Xavier Lesage
- University of Montpellier, Laboratory Epsylon EA, Dynamic of Human Abilities & Health Behaviors, CHU Montpellier, University Hospital of Montpellier, Occupational and Preventive Medicine, Montpellier, France
| | - Valentin Navel
- CHU Clermont-Ferrand, University Hospital of Clermont-Ferrand, Ophthalmology, Clermont-Ferrand, France
| |
Collapse
|
38
|
Spano MC, Lorusso M, Pettorruso M, Zoratto F, Di Giuda D, Martinotti G, di Giannantonio M. Anhedonia across borders: Transdiagnostic relevance of reward dysfunction for noninvasive brain stimulation endophenotypes. CNS Neurosci Ther 2019; 25:1229-1236. [PMID: 31638332 PMCID: PMC6834920 DOI: 10.1111/cns.13230] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2019] [Revised: 09/15/2019] [Accepted: 09/29/2019] [Indexed: 12/25/2022] Open
Abstract
INTRODUCTION Anhedonia is a transdiagnostic psychopathological dimension, consisting in the impaired ability to experience pleasure. In order to further our understanding of its neural correlates and to explore its potential relevance as a predictor of treatment response, in this article we systematically reviewed studies involving anhedonia and neuromodulation interventions, across different disorders. METHODS We included seven studies fulfilling inclusion/exclusion criteria and involving different measures of anticipatory and consummatory anhedonia, as well as different noninvasive brain stimulation interventions (transcranial magnetic stimulation and transcranial direct current stimulation). Studies not exploring hedonic measures or not involving neuromodulation intervention were excluded. RESULTS All the included studies entailed the use of rTMS protocols in one of the diverse prefrontal targets. The limited amount of studies and the heterogeneity of stimulation protocols did not allow to draw any conclusion with regard to the efficacy of rTMS in the treatment of transnosographic anhedonia. A potential for anhedonia in dissecting possible endophenotypes of different psychopathological conditions preliminarily emerged. CONCLUSIONS Anhedonia is an underexplored condition in neuromodulation trials. It may represent a valuable transdiagnostic dimension that requires further examination in order to discover new clinical predictors for treatment response.
Collapse
Affiliation(s)
- Maria Chiara Spano
- Department of Neuroscience, Imaging and Clinical SciencesUniversity “G. d’Annunzio” of Chieti‐PescaraChietiItaly
| | - Marco Lorusso
- Department of Neuroscience, Imaging and Clinical SciencesUniversity “G. d’Annunzio” of Chieti‐PescaraChietiItaly
| | - Mauro Pettorruso
- Department of Neuroscience, Imaging and Clinical SciencesUniversity “G. d’Annunzio” of Chieti‐PescaraChietiItaly
| | - Francesca Zoratto
- Reference Centre for Behavioural Sciences and Mental HealthIstituto Superiore di SanitàRomeItaly
| | - Daniela Di Giuda
- Fondazione Policlinico Universitario A. Gemelli IRCCSRomaItaly
- Università Cattolica del Sacro CuoreRomaItaly
| | - Giovanni Martinotti
- Department of Neuroscience, Imaging and Clinical SciencesUniversity “G. d’Annunzio” of Chieti‐PescaraChietiItaly
- Department of Pharmacy, Pharmacology and Clinical ScienceUniversity of HertfordshireHertsUK
| | - Massimo di Giannantonio
- Department of Neuroscience, Imaging and Clinical SciencesUniversity “G. d’Annunzio” of Chieti‐PescaraChietiItaly
| |
Collapse
|
39
|
Bonanni L, Gualtieri F, Lester D, Falcone G, Nardella A, Fiorillo A, Pompili M. Can Anhedonia Be Considered a Suicide Risk Factor? A Review of the Literature. MEDICINA-LITHUANIA 2019; 55:medicina55080458. [PMID: 31405085 PMCID: PMC6723513 DOI: 10.3390/medicina55080458] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Revised: 07/25/2019] [Accepted: 08/06/2019] [Indexed: 01/19/2023]
Abstract
Background and Objectives: At present, data collected from the literature about suicide and anhedonia are controversial. Some studies have shown that low levels of anhedonia are associated with serious suicide attempts and death by suicide, while other studies have shown that high levels of anhedonia are associated with suicide. Materials and Methods: For this review, we searched PubMed, Medline, and ScienceDirect for clinical studies published from 1 January 1990 to 31 December 2018 with the following search terms used in the title or in the abstract: “anhedonia AND suicid*.” We obtained a total of 155 articles; 133 items were excluded using specific exclusion criteria, the remaining 22 articles included were divided into six groups based on the psychiatric diagnosis: mood disorders, schizophrenia spectrum disorders, post-traumatic stress disorder (PTSD), other diagnoses, attempted suicides, and others (healthy subjects). Results: The results of this review reveal inconsistencies. Some studies reported that high anhedonia scores were associated with suicidal behavior (regardless of the diagnosis), while other studies found that low anhedonia scores were associated with suicidal behavior, and a few studies reported no association. The most consistent association between anhedonia and suicidal behavior was found for affective disorders (7 of 7 studies reported a significant positive association) and for PTSD (3 of 3 studies reported a positive association). In the two studies of patients with schizophrenia, one found no association, and one found a negative association. For patients who attempted suicide (undiagnosed), one study found a positive association, one a positive association only for depressed attempters, and one a negative association. Conclusions: We found the most consistent positive association for patients with affective disorders and PTSD, indicating that the assessment of anhedonia may be useful in the evaluation of suicidal risk.
Collapse
Affiliation(s)
- Luca Bonanni
- Psychiatry Residency Training Program, Faculty of Medicine and Psychology, Sapienza University of Rome, 00189 Rome, Italy
| | - Flavia Gualtieri
- Psychiatry Residency Training Program, Faculty of Medicine and Psychology, Sapienza University of Rome, 00189 Rome, Italy
| | - David Lester
- Psychology Program, Stockton University, Galloway, NJ 08205, USA
| | - Giulia Falcone
- Psychiatry Residency Training Program, Faculty of Medicine and Psychology, Sapienza University of Rome, 00189 Rome, Italy
| | - Adele Nardella
- Psychiatry Residency Training Program, Faculty of Medicine and Psychology, Sapienza University of Rome, 00189 Rome, Italy
| | - Andrea Fiorillo
- Department of Psychiatry, University of Campania Luigi Vanvitelli, 80138 Naples, Italy
| | - Maurizio Pompili
- Department of Neurosciences, Mental Health and Sensory Organs, Suicide Prevention Center, Sant'Andrea Hospital, Sapienza University of Rome, 00189 Rome, Italy.
| |
Collapse
|
40
|
Suicidal ideations among medical students: The role of anhedonia and type D personality. PLoS One 2019; 14:e0217841. [PMID: 31226120 PMCID: PMC6588207 DOI: 10.1371/journal.pone.0217841] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2018] [Accepted: 05/20/2019] [Indexed: 11/29/2022] Open
Abstract
Background The relationships between hedonic deficits, type D personality and suicidal ideation were explored in a group of medical students. Methods In a cross-sectional study, 382 medical students filled out several questionnaires measuring suicide risk, depression (using the Beck Depression Inventory, i.e. BDI), type D personality (using the type D personality scale-14, i.e. DS-14) and anhedonia (using the anhedonia subscale of the BDI, the Snaith Hamilton Pleasure Scale, the Anticipatory and Consummatory subscales of the Physical Anhedonia Scale). Results State anhedonia and, in particular, recent change of state anhedonia and not trait anhedonia was significantly associated with suicidal ideation, specifically when depression was controlled for. Negative affectivity component of type D personality and anhedonia were independent predictors of suicidal ideation even when depression was controlled for. Loss of pleasure and not loss of interest was a significant predictor of suicidal ideation. Conclusions Change of state anhedonia and its component of loss of pleasure measuring dissatisfaction in life could be a risk factor of suicidal ideation in medical students. Dissatisfaction, particularly in the medical course, could be a strong predictor of suicidal ideation in medical students.
Collapse
|
41
|
Potential Protein Target to Therapeutically Restore Positive Mood States in Depression. eNeuro 2019; 6:eN-RHL-0105-19. [PMID: 30937359 PMCID: PMC6439205 DOI: 10.1523/eneuro.0105-19.2019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Accepted: 03/19/2019] [Indexed: 11/23/2022] Open
Abstract
Highlighted Research Paper:Disorders of the Nervous System Highlighted Research Paper: p11 in Cholinergic Interneurons of the Nucleus Accumbens Is Essential for Dopamine Responses to Rewarding Stimuli, by Y. Hanada, Y. Kawahara, Y. N. Ohnishi, T. Shuto, M. Kuroiwa, N. Sotogaku, P. Greengard, Y. Sagi, and A. Nishi.
Collapse
|
42
|
Predicting Predischarge Anhedonia Among Inpatients With Schizophrenia and Schizoaffective Disorders: A Large-scale Analysis. J Nerv Ment Dis 2019; 207:12-21. [PMID: 30575703 DOI: 10.1097/nmd.0000000000000923] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
This study sought to evaluate predischarge anhedonia level and its predictors in 125 inpatients with schizophrenia and schizoaffective disorders. Consecutively admitted inpatients were assessed before discharge from the hospital using the Specific Loss of Interest and Pleasure Scale (SLIPS) and a battery of measures for clinical and psychosocial variables. When symptoms, distress, and social anhedonia scores were controlled, the SLIPS score inversely correlated with self-constructs, social support, quality of life, recovery, and unmet needs. Using two cutoff points of the data set of SLIPS, we identified three groups: 19 (15.2%) patients reported "no loss of pleasure"; 46 (36.8%), "some loss of pleasure"; and 60 (48.0%), "marked diminishment of pleasure." The SLIPS score is predicted by sensitivity, unmet needs, deficient interpersonal pleasure, poor quality of life, and friend support. The study underlines the importance of assessing anhedonia and related psychosocial factors in patients with serious mental illness.
Collapse
|
43
|
Hawes M, Galynker I, Barzilay S, Yaseen ZS. Anhedonia and suicidal thoughts and behaviors in psychiatric outpatients: The role of acuity. Depress Anxiety 2018; 35:1218-1227. [PMID: 30107636 DOI: 10.1002/da.22814] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Revised: 06/16/2018] [Accepted: 07/01/2018] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Anhedonia-impairment related to the experience of pleasure-has been identified as a potential risk factor for suicide, with some mixed findings. The current study sought to clarify the role of acuity of anhedonia in the relationship between anhedonia and suicidal thoughts and behaviors by comparing acutely and chronically anhedonic subjects on severity of suicidal ideation (SI) and suicide attempt (SA) history. METHODS Psychiatric outpatients (N = 395) were administered the Columbia Suicide Severity Rating Scale, the Beck Scale for Suicidal Ideation and a modified version of the Snaith-Hamilton Pleasure Scale (SHPS); SI measures were readministered at a 1-month follow-up (N = 289, 73%). Participants were classified as acutely anhedonic, chronically anhedonic and nonanhedonic based on their responses to the SHPS at initial assessment. RESULTS Controlling for symptoms of anxiety and depression, acute anhedonia was cross-sectionally and prospectively associated with greater severity of SI compared to the nonanhedonic group; no differences in severity of SI were found between the chronically anhedonic and nonanhedonic group at either time point. Anhedonia grouping was not associated with SA history. CONCLUSION Changes in capacity to experience pleasure may be more informative of near-term SI than typically low pleasure levels. Future investigation should focus on the relationship between acute anhedonia and imminent suicidal behavior.
Collapse
Affiliation(s)
- Mariah Hawes
- Department of Psychiatry, Mount Sinai Beth Israel Medical Center, New York, New York
| | - Igor Galynker
- Department of Psychiatry, Mount Sinai Beth Israel Medical Center, New York, New York
| | - Shira Barzilay
- Department of Psychiatry, Mount Sinai Beth Israel Medical Center, New York, New York
| | - Zimri S Yaseen
- Department of Psychiatry, Mount Sinai Beth Israel Medical Center, New York, New York
| |
Collapse
|
44
|
The association between suicidal ideation and lifetime suicide attempts is strongest at low levels of depression. Psychiatry Res 2018; 270:324-328. [PMID: 30292084 DOI: 10.1016/j.psychres.2018.09.061] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2018] [Revised: 09/26/2018] [Accepted: 09/26/2018] [Indexed: 11/21/2022]
Abstract
Suicidal ideation and depression alone are poor predictors of subsequent engagement in suicidal behavior. Evidence suggests, however, that the lethargy associated with depression may serve as a protective factor against suicide attempts. The purpose of this study was to examine whether suicidal ideation and depression symptoms interact in relation to lifetime suicide attempts among a sample of psychiatric outpatients. A sample of 739 psychiatric outpatients (Mage = 27.26, 60.8% female, 73.3% White/European American) from a university-affiliated clinic completed a battery of self-report measures prior to their initial intake appointments. Consistent with hypotheses, a significant interaction emerged between suicidal ideation and depression symptoms in association with lifetime suicide attempts, such that the relationship between suicidal ideation and lifetime suicide attempts was strongest at low, as opposed to high, levels of depression. These findings align with previous research suggesting that lethargy may be a protective factor against suicide attempts, and conversely, that heightened arousal may serve as a suicide risk factor. Our results also point to a configuration of suicidal ideation and depression symptoms that might reflect higher suicide risk.
Collapse
|