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Alothman D, Lewis S, Fogarty AW, Card T, Tyrrell E. Primary care consultation patterns before suicide: a nationally representative case-control study. Br J Gen Pract 2024; 74:e426-e433. [PMID: 38331442 PMCID: PMC11157587 DOI: 10.3399/bjgp.2023.0509] [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] [Received: 09/29/2023] [Accepted: 02/01/2024] [Indexed: 02/10/2024] Open
Abstract
BACKGROUND Consultation with primary healthcare professionals may provide an opportunity to identify patients at higher suicide risk. AIM To explore primary care consultation patterns in the 5 years before suicide to identify suicide high-risk groups and common reasons for consulting. DESIGN AND SETTING This was a case-control study using electronic health records from England, 2001 to 2019. METHOD An analysis was undertaken of 14 515 patients aged ≥15 years who died by suicide and up to 40 matched live controls per person who died by suicide (n = 580 159), (N = 594 674). RESULTS Frequent consultations (>1 per month in the final year) were associated with increased suicide risk (age- and sex -adjusted odds ratio [OR] 5.88, 95% confidence interval [CI] = 5.47 to 6.32). The associated rise in suicide risk was seen across all sociodemographic groups as well as in those with and without psychiatric comorbidities. However, specific groups were more influenced by the effect of high-frequency consultation (>1 per month in the final year) demonstrating higher suicide risk compared with their counterparts who consulted once: females (adjusted OR 9.50, 95% CI = 7.82 to 11.54), patients aged 15-<45 years (adjusted OR 8.08, 95% CI = 7.29 to 8.96), patients experiencing less socioeconomic deprivation (adjusted OR 6.56, 95% CI = 5.77 to 7.46), and those with psychiatric conditions (adjusted OR 4.57, 95% CI = 4.12 to 5.06). Medication review, depression, and pain were the most common reasons for which patients who died by suicide consulted in the year before death. CONCLUSION Escalating or more than monthly consultations are associated with increased suicide risk regardless of patients' sociodemographic characteristics and regardless of the presence (or absence) of known psychiatric illnesses.
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Affiliation(s)
- Danah Alothman
- School of Medicine, University of Nottingham, Nottingham
| | - Sarah Lewis
- School of Medicine, University of Nottingham, Nottingham
| | | | - Timothy Card
- School of Medicine, University of Nottingham, Nottingham
| | - Edward Tyrrell
- School of Medicine, University of Nottingham, Nottingham
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Peltz JS, Rogge R. Unintended consequences: college students' melatonin usage, sleep disturbance, and depressive symptoms. Sleep Biol Rhythms 2024; 22:313-321. [PMID: 38962794 PMCID: PMC11217232 DOI: 10.1007/s41105-023-00506-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 11/27/2023] [Indexed: 07/05/2024]
Abstract
With such high rates of undergraduate sleep problems, students have chosen to take melatonin, an over-the-counter supplement that can facilitate sleep. Questions remain as to the effectiveness of melatonin for sleep problems, and questions have emerged about its impact on mental health. Accordingly, the current study examined how ongoing melatonin usage might impact relative changes in college students' sleep disturbance and ultimately their depressive symptoms. The two-wave (baseline and 2-month follow-up), online sample consisted of 331 undergraduates (86% female; Mage = 21.3, SD = 2.4), who reported on melatonin usage, sleep disturbance, and depressive symptoms. Controlling for sleep hygiene, socio-economic status, and gender, our model demonstrated a significant indirect effect from ongoing melatonin usage to depressive symptoms. Specifically, melatonin consumption predicted relative increases in sleep disturbance, which, in turn, predicted corresponding increases in students' depressive symptoms. Given the increasing prevalence of melatonin usage, the potential for unforeseen consequences remains high. Results suggest that the negative consequences of melatonin use can include both college students' mental health and their sleep. Given the efficacy of addressing sleep problems with cognitive or behavioral strategies, it is essential that student support services highlight alternatives to melatonin and the potential problems associated with its use.
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Affiliation(s)
- Jack S. Peltz
- State University of New York (SUNY) at Brockport, 350 New Campus Dr., Brockport, NY 14420 USA
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Yu Z, Zhu X, Li Y. The association between problematic short video use and suicidal ideation and self-injurious behaviors: the mediating roles of sleep disturbance and depression. BMC Public Health 2024; 24:1689. [PMID: 38915039 PMCID: PMC11197212 DOI: 10.1186/s12889-024-19191-5] [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] [Received: 12/12/2023] [Accepted: 06/18/2024] [Indexed: 06/26/2024] Open
Abstract
BACKGROUND Prior work suggests that problematic short video use was associated with adverse psychological, physiological, and educational outcomes. With the prevailing of short video platforms, the potential relationships between this problematic behavior and suicidal ideation and self-injurious behaviors have yet to be thoroughly examined. Besides, considering the potential dual nature of problematic short video use, particularly its positive aspects, a potential mechanism may exist linking such problematic behavior to SI and SIBs, ultimately driving individuals towards extreme outcomes. Nevertheless, such mediation paths have not been rigorously examined. Thus, the current study aimed to investigate their relationships and delve into the underlying mechanism, specifically identifying potential mediators between sleep disturbance and depression. METHODS A quantitative cross-sectional study design was employed to model data derived from a large sample of first- and second-year university students residing in mainland China (N = 1,099; Mage = 19.80 years; 51.7% male). RESULTS Results showed that problematic short video use has a dual impact on SI and SIBs. On the one hand, problematic short video use was directly related to the decreased risk of suicidal ideation, attempts, and NSSI. On the other hand, such problematic behavior was indirectly associated with the increased risk of NSSI through sleep disturbance, and it indirectly related to the elevated risk of suicidal ideation, attempts, and NSSI through depression. Besides, on the whole, problematic short video use was positively associated with NSSI but not suicidal ideation and attempts. CONCLUSIONS These findings indicated that problematic short video use had a dual impact on SI and SIBs. Consequently, it is paramount to comprehend the genuine magnitude of the influence that such problematic behavior holds over these intricate psychological conditions.
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Affiliation(s)
- Zhuojun Yu
- Department of Applied Psychology, Guangdong University of Foreign Studies, Guangzhou, China
| | - Xinxin Zhu
- Department of Psychology, 7 George Square, University of Edinburgh, Edinburgh, EH8 9JZ, UK.
| | - Yuanyuan Li
- Department of Psychology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
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Sun HL, Chen P, Bai W, Zhang L, Feng Y, Su Z, Cheung T, Ungvari GS, Cui XL, Ng CH, An FR, Xiang YT. Prevalence and network structure of depression, insomnia and suicidality among mental health professionals who recovered from COVID-19: a national survey in China. Transl Psychiatry 2024; 14:227. [PMID: 38816419 PMCID: PMC11139988 DOI: 10.1038/s41398-024-02918-8] [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: 09/13/2023] [Revised: 02/16/2024] [Accepted: 05/07/2024] [Indexed: 06/01/2024] Open
Abstract
Psychiatric syndromes are common following recovery from Coronavirus Disease 2019 (COVID-19) infection. This study investigated the prevalence and the network structure of depression, insomnia, and suicidality among mental health professionals (MHPs) who recovered from COVID-19. Depression and insomnia were assessed with the Patient Health Questionnaire (PHQ-9) and Insomnia Severity Index questionnaire (ISI7) respectively. Suicidality items comprising suicidal ideation, suicidal plan and suicidal attempt were evaluated with binary response (no/yes) items. Network analyses with Ising model were conducted to identify the central symptoms of the network and their links to suicidality. A total of 9858 COVID-19 survivors were enrolled in a survey of MHPs. The prevalence of depression and insomnia were 47.10% (95% confidence interval (CI) = 46.09-48.06%) and 36.2% (95%CI = 35.35-37.21%), respectively, while the overall prevalence of suicidality was 7.8% (95%CI = 7.31-8.37%). The key central nodes included "Distress caused by the sleep difficulties" (ISI7) (EI = 1.34), "Interference with daytime functioning" (ISI5) (EI = 1.08), and "Sleep dissatisfaction" (ISI4) (EI = 0.74). "Fatigue" (PHQ4) (Bridge EI = 1.98), "Distress caused by sleep difficulties" (ISI7) (Bridge EI = 1.71), and "Motor Disturbances" (PHQ8) (Bridge EI = 1.67) were important bridge symptoms. The flow network indicated that the edge between the nodes of "Suicidality" (SU) and "Guilt" (PHQ6) showed the strongest connection (Edge Weight= 1.17, followed by "Suicidality" (SU) - "Sad mood" (PHQ2) (Edge Weight = 0.68)). The network analysis results suggest that insomnia symptoms play a critical role in the activation of the insomnia-depression-suicidality network model of COVID-19 survivors, while suicidality is more susceptible to the influence of depressive symptoms. These findings may have implications for developing prevention and intervention strategies for mental health conditions following recovery from COVID-19.
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Affiliation(s)
- He-Li Sun
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, & Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, China
- Centre for Cognitive and Brain Sciences, University of Macau, Macao SAR, China
| | - Pan Chen
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, & Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, China
- Centre for Cognitive and Brain Sciences, University of Macau, Macao SAR, China
| | - Wei Bai
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China
| | - Ling Zhang
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Yuan Feng
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Zhaohui Su
- School of Public Health, Southeast University, Nanjing, China
| | - Teris Cheung
- School of Nursing, Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Gabor S Ungvari
- Section of Psychiatry, University of Notre Dame Australia, Fremantle, WA, Australia
- Division of Psychiatry, School of Medicine, University of Western Australia, Perth, WA, Australia
| | - Xi-Ling Cui
- Department of Business Administration, Hong Kong Shue Yan University, Hong Kong, Hong Kong SAR, China
| | - Chee H Ng
- Department of Psychiatry, The Melbourne Clinic and St Vincent's Hospital, University of Melbourne, Richmond, VIC, Australia.
| | - Feng-Rong An
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China.
| | - Yu-Tao Xiang
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, & Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, China.
- Centre for Cognitive and Brain Sciences, University of Macau, Macao SAR, China.
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Liu X, Yang Y, Liu ZZ, Jia CX. Bidirectional associations between sleep problems and suicidal thought/attempt in adolescents: A 3-wave data path analysis. J Affect Disord 2024; 350:983-990. [PMID: 38244795 DOI: 10.1016/j.jad.2024.01.153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2023] [Revised: 01/12/2024] [Accepted: 01/14/2024] [Indexed: 01/22/2024]
Abstract
PURPOSE This longitudinal data analysis examined the bidirectional relationships between sleep problems and suicidal thought (ST)/attempt (SA) in a large sample of Chinese adolescents. METHODS A total of 6995 adolescents (mean age = 14.86 years and 51.4% males) participated in a 3-wave longitudinal study of behavior and health in Shandong, China. A self-administered questionnaire and standardized scales were used to assess ST, SA, sleep duration, insomnia, daytime sleepiness, and behavioral/emotional problems in 2015 (T1), 1 year later (T2), and 2 years later (T3). Path analyses were performed without and with adjustment for covariates, including gender, grade level, chronic diseases, cigarette smoking, alcohol use, anxiety/depressive symptoms, paternal education, and family economic status. RESULTS The prevalence rates of short sleep (<7 h/night), insomnia symptoms, and daytime sleepiness were 46.9-58.8%, 16.0-19.4%, and 25.1-25.3% at T1, T2, and T3, respectively. The rates of past-year ST and SA were 9.1-12.4% and 1.6-2.4% at T1, T2, and T3, respectively. Path analyses showed that short sleep, insomnia, and daytime sleepiness predicted subsequent ST, and vice versa. Daytime sleepiness and SA predicted each other 1 year later. Sleep problems and ST/SA in the previous year significantly predicted themselves in the follow-up year. STUDY LIMITATION All data were based on self-report. CONCLUSION Short sleep, insomnia, and daytime sleepiness all had bidirectional relationships with ST. Daytime sleepiness and SA were bidirectionally linked. Our findings suggest that interventions should be taken for both night sleep disturbances and daytime sleepiness to prevent suicide. Adverse sleep outcomes in suicidal adolescents should be assessed, which can in turn increase suicide risk.
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Affiliation(s)
- Xianchen Liu
- Department of Epidemiology, School of Public Health, Cheeloo Medical College, Shandong University, Jinan 250012, China; South China Normal University School of Psychology, Guangzhou 510631, China; The University of Tennessee Health Science Center, Memphis, TN 38163, USA.
| | - Yanyun Yang
- Department of Educational Psychology and Learning Systems, Florida State University, Tallahassee, FL, USA
| | - Zhen-Zhen Liu
- School of Psychology, Northeast Normal University, Changchun 130024, China
| | - Cun-Xian Jia
- Department of Epidemiology, School of Public Health, Cheeloo Medical College, Shandong University, Jinan 250012, China
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Kim C, Bai Y, Dusing GJ, Nielsen A, Chum A. The impact of minimum wage increase on suicidal ideation in South Korea: a difference-in-differences analysis using nationally representative panel data. Soc Psychiatry Psychiatr Epidemiol 2024:10.1007/s00127-024-02646-w. [PMID: 38429540 DOI: 10.1007/s00127-024-02646-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 02/20/2024] [Indexed: 03/03/2024]
Abstract
BACKGROUND South Korea had the highest suicide rates in the OECD and one of the largest (16.4%) increases in the minimum wage in 2018. Prior studies have provided evidence that increases in minimum wage reduce suicide rates in the population, but no study examined the effects of the policy change on individual-level suicidal behaviour. METHODS Our study sample was built using the 2015-2019 waves of the Korean Welfare Panel Survey, a population-representative longitudinal survey. The sample consisted of 5146 participants, including those earning above minimum wage (control) and minimum wage earners (treatment) based on their 2018/19 earnings. The outcome of the study was suicidal ideation, which is an important precursor to other suicidal behaviours, and was captured using self-reported measures. We examined the impact of the 2018 minimum wage hike in Korea on suicidal ideation, using a difference-in-differences design. RESULTS The minimum wage increase was associated with a 1.6% points reduction (95% CI: -2.8% to -0.5%) in self-reported suicidal ideation. Stronger policy effects were shown among women and older age groups. CONCLUSIONS Our study demonstrates that public policies employing a population-based approach, such as increasing minimum wages, could serve as an effective intervention to mitigate suicidal ideation among low-income workers.
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Affiliation(s)
- Chungah Kim
- School of Kinesiology and Health Science, York University, Toronto, ON, Canada
| | - Yihong Bai
- Department of Economics, McMaster University, Hamilton, ON, Canada
- Western University Ontario, London, Canada
| | - Gabriel John Dusing
- School of Kinesiology and Health Science, York University, Toronto, ON, Canada
| | - Andrew Nielsen
- Canadian Institute for Health Information, Ottawa, ON, Canada
| | - Antony Chum
- School of Kinesiology and Health Science, York University, Toronto, ON, Canada.
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.
- MAP Centre for Urban Health Solutions, Unity Health Toronto, Toronto, ON, Canada.
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Valladares-Garrido D, Zila-Velasque JP, Santander-Hernández FM, Guevara-Morales MA, Morocho-Alburqueque N, Failoc-Rojas VE, Pereira-Victorio CJ, Vera-Ponce VJ, León-Figueroa DA, Valladares-Garrido MJ. Association between love breakup and suicidal ideation in Peruvian medical students: a cross-sectional study during the COVID-19 pandemic. Front Psychiatry 2024; 14:1287036. [PMID: 38348360 PMCID: PMC10859463 DOI: 10.3389/fpsyt.2023.1287036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Accepted: 12/08/2023] [Indexed: 02/15/2024] Open
Abstract
Objective We aimed to determine the association between a major romantic breakup and suicidal ideation in medical students from three universities in Peru. Methods A cross-sectional study was conducted during the first pandemic wave in 2021 on medical students from three universities in northern Peru. The outcome was suicidal ideation, measured with question nine of the Patient Health Questionnaire-9 (PHQ-9). Generalized Anxiety Disorder Scale-7 (GAD-7) and Insomnia Severity Index (ISI) were also used to assess mental health symptoms. The exposure was the experience of a major love breakup during the pandemic. In addition, its association with other covariates (age, sex, family members infected with COVID-19, deceased family members with COVID-19, insomnia, and anxiety, among others) was examined. Results and discussions Out of 370 students, 19.5% reported a major love breakup during the pandemic (95%CI: 15.5-23.8), and 34.3% had suicidal ideation (95%CI: 29.4-39.4). Having a major love breakup was associated with a higher prevalence of suicidal ideation (PR: 1.49, 95%CI: 1.32-1.67, p < 0.001). Moderate insomnia (PR: 2.56, 95%CI: 1.70-3.87, p < 0.001) and anxiety symptoms (PR: 1.94, 1.10-3.44, p = 0.023) were also associated with suicidal ideation. Conclusion Our study provides evidence of a significant association between a major love breakup and suicidal ideation. This finding emphasizes the need for further research to better understand this association and inform the development of effective suicide prevention policies in medical education.
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Affiliation(s)
- Danai Valladares-Garrido
- Escuela de Medicina, Universidad Cesar Vallejo, Trujillo, Peru
- Oficina de Salud Ocupacional, Hospital Santa Rosa, Piura, Peru
| | - J. Pierre Zila-Velasque
- Facultad de Medicina, Universidad Nacional Daniel Alcides Carrion, Pasco, Peru
- Red Latinoamericana de Medicina en la Altitud e Investigación (REDLAMAI), Pasco, Peru
| | - Flor M. Santander-Hernández
- Escuela de Medicina, Universidad Cesar Vallejo, Piura, Peru
- Sociedad Científica de Estudiantes de Medicina, Universidad Cesar Vallejo, Piura, Peru
| | - Miguel A. Guevara-Morales
- Escuela de Medicina, Universidad Cesar Vallejo, Piura, Peru
- Sociedad Científica de Estudiantes de Medicina, Universidad Cesar Vallejo, Piura, Peru
| | - Noelia Morocho-Alburqueque
- Escuela de Medicina Humana, Facultad de Ciencias de la Salud, Universidad Nacional de Piura, Piura, Peru
| | - Virgilio E. Failoc-Rojas
- Unidad de Investigación para la Generación y Síntesis de Evidencias en Salud, Universidad San Ignacio de Loyola, Lima, Peru
| | | | - Víctor J. Vera-Ponce
- Instituto de Investigación en Ciencias Biomédicas, Universidad Ricardo Palma, Lima, Peru
- Universidad Tecnológica del Perú, Lima, Peru
| | | | - Mario J. Valladares-Garrido
- Facultad de Medicina Humana, Universidad de San Martín de Porres, Chiclayo, Peru
- South American Center for Education and Research in Public Health, Universidad Norbert Wiener, Lima, Peru
- Oficina de Epidemiología, Hospital Regional Lambayeque, Chiclayo, Peru
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Dewa LH, Broyd J, Hira R, Dudley A, Hafferty JD, Bates R, Aylin P. A service evaluation of passive remote monitoring technology for patients in a high-secure forensic psychiatric hospital: a qualitative study. BMC Psychiatry 2023; 23:946. [PMID: 38098066 PMCID: PMC10722773 DOI: 10.1186/s12888-023-05437-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: 09/12/2023] [Accepted: 12/03/2023] [Indexed: 12/17/2023] Open
Abstract
BACKGROUND Technology has the potential to remotely monitor patient safety in real-time that helps staff and without disturbing the patient. However, staff and patients' perspectives on using passive remote monitoring within an inpatient setting is lacking. The study aim was to explore stakeholders' perspectives about using Oxehealth passive monitoring technology within a high-secure forensic psychiatric hospital in the UK as part of a wider mixed-methods service evaluation. METHODS Semi-structured interviews were conducted with staff and patients with experience of using Oxehealth technology face-to-face within a private room in Broadmoor Hospital. We applied thematic analysis to the data of each participant group separately. Themes and sub-themes were integrated, finalised, and presented in a thematic map. Design, management, and analysis was meaningfully informed by both staff and patients. RESULTS Twenty-four participants were interviewed (n = 12 staff, n = 12 patients). There were seven main themes: detecting deterioration and improving health and safety, "big brother syndrome", privacy and dignity, knowledge and understanding, acceptance, barriers to use and practice issues and future changes needed. Oxehealth technology was considered acceptable to both staff and patients if the technology was used to detect deterioration and improve patient's safety providing patient's privacy was not invaded. However, overall acceptance was lower when knowledge and understanding of the technology and its camera was limited. Most patients could not understand why both physical checks through bedroom windows, and Oxehealth was needed to monitor patients, whilst staff felt Oxehealth should not replace physical checks of patients as reassures staff on patient safety. CONCLUSIONS Oxehealth technology is considered viable and acceptable by most staff and patients but there is still some concern about its possible intrusive nature. However, more support and education for new patients and staff to better understand how Oxehealth works in the short- and long-term could be introduced to further improve acceptability. A feasibility study or pilot trial to compare the impact of Oxehealth with and without physical checks may be needed.
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Affiliation(s)
- Lindsay H Dewa
- National Institute for Health Research Imperial Patient Safety Translational Research Centre, Institute of Global Health Innovation, Imperial College London, London, UK.
- School of Public Health, Imperial College London, Reynolds Building, London, W6 8RP, UK.
| | | | | | | | | | | | - Paul Aylin
- National Institute for Health Research Imperial Patient Safety Translational Research Centre, Institute of Global Health Innovation, Imperial College London, London, UK
- School of Public Health, Imperial College London, Reynolds Building, London, W6 8RP, UK
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Cutrupi F, De Luca A, Di Zazzo A, Micera A, Coassin M, Bonini S. Real Life Impact of Dry Eye Disease. Semin Ophthalmol 2023; 38:690-702. [PMID: 37095685 DOI: 10.1080/08820538.2023.2204931] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 03/21/2023] [Accepted: 03/22/2023] [Indexed: 04/26/2023]
Abstract
Dry Eye Disease (DED) is an increasingly common condition that affects between 5% and 50% of the global population. Even though DED is most frequently diagnosed in older people, it has also been diagnosed in young adults and adolescents more frequently in recent years (employees, gamers). People can experience different types of symptoms and find it challenging to read, watch TV, cook, climb stairs, and meet friends. Mild and severe dry eye can reduce quality of life similarly to mild psoriasis and moderate-to-severe angina. Furthermore, DED patients experience serious difficulties driving vehicles, especially at night, and show a decrease in work productivity, which, when combined with the relevant indirect cost that this condition produces, poses a serious challenge in our days. In addition, DED patients are more likely to develop depression and suicidal ideations and experience frequent sleep disorders. Finally, it is discussed how lifestyle changes, such as increased physical activity, blinking exercises, and a proper diet, have positive implications for the management of this condition. Our aim is to draw attention to the negative effects of dry eye in real life, which are unique to each patient, especially as they relate to the non-visual symptoms experienced by DED patients.
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Affiliation(s)
- Francesco Cutrupi
- Ophthalmology Complex Operative Unit, University Campus Bio-Medico, Rome, Italy
| | - Andrea De Luca
- Ophthalmology Complex Operative Unit, University Campus Bio-Medico, Rome, Italy
| | - Antonio Di Zazzo
- Research Laboratories in Ophthalmology, IRCCS Bietti Foundation, Rome, Italy
| | - Alessandra Micera
- Research Laboratories in Ophthalmology, IRCCS Bietti Foundation, Rome, Italy
| | - Marco Coassin
- Ophthalmology Complex Operative Unit, University Campus Bio-Medico, Rome, Italy
| | - Stefano Bonini
- Ophthalmology Complex Operative Unit, University Campus Bio-Medico, Rome, Italy
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10
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Basta M, Skourti E, Simos P, Soumaki E, Li Y, Gerostergios G, Samiotakis G, Dafermos V, Drakaki M, Papadakis N, Vgontzas AN. Associations between sleep complaints, suicidal ideation and depressive symptoms among adolescents and young adults in Greece. J Sleep Res 2023; 32:e13900. [PMID: 37039423 DOI: 10.1111/jsr.13900] [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] [Received: 06/12/2022] [Revised: 03/08/2023] [Accepted: 03/21/2023] [Indexed: 04/12/2023]
Abstract
Depression prevalence increases significantly during adolescence/early adulthood. Depression in youth may present suicidal ideation, while suicide represents the leading cause of death in this age group. Moreover, adolescents/young adults frequently report sleep complaints that may partially be due to depressive symptoms. Studies on the associations between depression, sleep complaints and suicidality in this age group are limited. We aimed to examine associations between depressive symptoms, sleep complaints and suicidal ideation in a large (n = 2771), representative sample of adolescents (age: 15-17 years, n = 512) and young adults (age: 18-24 years, n = 2259) from the general population in Greece. A telephone structured questionnaire was administered. Depressive symptoms were assessed using the modified Patient Health-7 questionnaire score, while presence of suicidal ideation and sleep complaints were assessed using the ninth and third question of Patient Health-9 questionnaire, respectively. Mediation logistic regression analysis revealed significant direct paths from depressive symptoms to sleep complaints (odds ratio [OR] 1.22, 95% confidence interval [CI] 1.19-1.24; OR 1.21, 95% CI 1.18-1.24) and suicidal ideation (OR 1.18, 95% CI 1.14-1.22; OR 1.18, 95% CI 1.14-1.22), as well as sleep complaints and suicidal ideation (OR 1.82, 95% CI 1.32-2.50; OR 1.91, 95% CI 1.33-2.76) in the total group and in young adults, respectively, but not among adolescents. Moreover, we detected a significant indirect effect of depressive symptoms on suicidal ideation mediated by sleep complaints (18.8%) in young adults. These findings support the hypothesis that treatment of sleep disturbances among youth with depression may independently further reduce suicidal risk.
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Affiliation(s)
- M Basta
- Department of Psychiatry, University Hospital of Heraklion, Crete, Greece
- Sleep Research and Treatment Center, Department of Psychiatry, Penn State University, Hershey, Pennsylvania, USA
- Department of Child and Adolescent Psychiatry, University Hospital of Heraklion, Crete, Greece
| | - E Skourti
- Department of Psychiatry, University Hospital of Heraklion, Crete, Greece
| | - P Simos
- Department of Psychiatry, University Hospital of Heraklion, Crete, Greece
- Computational Biomedicine Lab, Institute of Computer Science, Foundation for Research and Technology-Hellas, Heraklion, Greece
| | - E Soumaki
- Department of Child and Adolescent Psychiatry, University Hospital of Heraklion, Crete, Greece
| | - Y Li
- Department of Sleep Medicine, Mental Health Center of Shantou University, Shantou, Guangdong, China
| | - G Gerostergios
- Department of Child and Adolescent Psychiatry, University Hospital of Heraklion, Crete, Greece
| | - G Samiotakis
- Department of Child and Adolescent Psychiatry, University Hospital of Heraklion, Crete, Greece
| | - V Dafermos
- Department of Political Science, University of Crete, Rethymno, Greece
| | - M Drakaki
- Department of Political Science, University of Crete, Rethymno, Greece
| | - N Papadakis
- Department of Political Science, University of Crete, Rethymno, Greece
| | - A N Vgontzas
- Department of Psychiatry, University Hospital of Heraklion, Crete, Greece
- Sleep Research and Treatment Center, Department of Psychiatry, Penn State University, Hershey, Pennsylvania, USA
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11
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Virk P, Doan Q, Karim ME. Chronic physical conditions and suicidal ideation: a population-level analysis of Canadian school-attending young adults. J Ment Health 2023:1-8. [PMID: 37724374 DOI: 10.1080/09638237.2023.2245904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Accepted: 07/19/2023] [Indexed: 09/20/2023]
Abstract
BACKGROUND Students who identify with a chronic physical condition are a growing population and their conditions may be associated with poor mental well-being. AIM To compare suicidal ideation prevalence between Canadian school-attending young adults with and without a chronic physical condition. We hypothesized that students living with a chronic condition have a higher likelihood of experiencing suicidal ideation. METHODS A cross-sectional study was conducted using a nationally representative sample of 2297 Canadian school-attending young adults (ages 15-29 years) from the 2012-13 Canadian Community Health Survey-Mental Health (CCHS-MH). Survey-weighted logistic regression and sensitivity analyses were performed to estimate the likelihood of experiencing suicidal ideation between students with and without a chronic physical condition. RESULTS Approximately 14.3% (n = 329) students experienced suicidal ideation at some point. Students living with a physical chronic condition demonstrated 1.65 (95% CI: 1.14, 2.39) times higher odds of experiencing suicidal ideation, compared to students not living with a chronic physical condition. CONCLUSIONS Suicide prevention and health promotion are important considerations for campus health providers and administrators when planning services and accommodations for students living with chronic physical conditions.
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Affiliation(s)
- Punit Virk
- School of Population and Public Health, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Quynh Doan
- School of Population and Public Health, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
- BC Children's Hospital Research Institute, Vancouver, British Columbia, Canada
- Department of Pediatrics, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Mohammad Ehsanul Karim
- School of Population and Public Health, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
- Centre for Health Evaluation and Outcome Sciences, Providence Health Care, Vancouver, British Columbia, Canada
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12
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Joseph VA, Kreski NT, Keyes KM. Sleep deprivation and suicide risk among minoritized US adolescents. BMC Psychiatry 2023; 23:638. [PMID: 37653474 PMCID: PMC10472686 DOI: 10.1186/s12888-023-05074-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 08/02/2023] [Indexed: 09/02/2023] Open
Abstract
OBJECTIVES To assess (1) the prevalence of suicide ideation/behavior among adolescents with short sleep by race/ethnicity and (2) the association between sleep duration and suicidal ideation and behavior among American youth by race/ethnicity from 2007 to 2019. METHODS Data were drawn from the Youth Risk Behavior Surveillance System (YRBSS). Logistic regression analyses were used to assess the relationship between sleep duration and suicidal ideation/behavior. RESULTS Overall, suicide ideation/behavior increased among U.S. adolescents of all racial groups from 2007 to 2019. Adjusting for race/ethnicity, sexual identity, age, sex, substance use, trauma, and bullying, those with short sleep had approximately twice the odds [OR: 1.92 (95% CI: 1.65, 2.23)] of suicide ideation/consideration compared to those with long sleep. Stratified analyses indicated that Black students with short sleep had higher odds of making a suicide plan (OR = 1.51, 95% C.I.: 1.27, 1.79) compared with Black students with long sleep. A similar pattern was observed across other racial/ethnic groups (e.g., Hispanic: (OR = 1.74, 95% C.I.: 1.53, 1.97). CONCLUSION Emphasis on suicide interventions is of the essence, especially with increasing rates. Sleep duration significantly predicts suicide risk among all adolescents. Additional research is needed to assess factors that predict suicide among minoritized adolescents, specifically Black and Hispanic adolescents.
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Affiliation(s)
- Victoria A Joseph
- Department of Epidemiology, Columbia University Mailman School of Public Health, 722 W 168th St, New York, NY, 10032, USA.
| | - Noah T Kreski
- Department of Epidemiology, Columbia University Mailman School of Public Health, 722 W 168th St, New York, NY, 10032, USA
| | - Katherine M Keyes
- Department of Epidemiology, Columbia University Mailman School of Public Health, 722 W 168th St, New York, NY, 10032, USA
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13
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Kleiman EM, Glenn CR, Liu RT. The use of advanced technology and statistical methods to predict and prevent suicide. NATURE REVIEWS PSYCHOLOGY 2023; 2:347-359. [PMID: 37588775 PMCID: PMC10426769 DOI: 10.1038/s44159-023-00175-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/13/2023] [Indexed: 08/18/2023]
Abstract
In the past decade, two themes have emerged across suicide research. First, according to meta-analyses, the ability to predict and prevent suicidal thoughts and behaviours is weaker than would be expected for the size of the field. Second, review and commentary papers propose that technological and statistical methods (such as smartphones, wearables, digital phenotyping and machine learning) might become solutions to this problem. In this Review, we aim to strike a balance between the pessimistic picture presented by these meta-analyses and the optimistic picture presented by review and commentary papers about the promise of advanced technological and statistical methods to improve the ability to understand, predict and prevent suicide. We divide our discussion into two broad categories. First, we discuss the research aimed at assessment, with the goal of better understanding or more accurately predicting suicidal thoughts and behaviours. Second, we discuss the literature that focuses on prevention of suicidal thoughts and behaviours. Ecological momentary assessment, wearables and other technological and statistical advances hold great promise for predicting and preventing suicide, but there is much yet to do.
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Affiliation(s)
- Evan M. Kleiman
- Department of Psychology, Rutgers, The State University of New Jersey, Piscataway, NJ, USA
| | | | - Richard T. Liu
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
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14
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Gomes S, Ramalhete C, Ferreira I, Bicho M, Valente A. Sleep Patterns, Eating Behavior and the Risk of Noncommunicable Diseases. Nutrients 2023; 15:nu15112462. [PMID: 37299426 DOI: 10.3390/nu15112462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Revised: 05/22/2023] [Accepted: 05/22/2023] [Indexed: 06/12/2023] Open
Abstract
Sleep is extremely important for the homeostasis of the organism. In recent years, various studies have been carried out to address factors related to sleep patterns and their influence on food choices, as well as on the onset of chronic noncommunicable diseases. The aim of this article is to provide a scientific literature review on the possible role of sleep patterns on eating behavior and the risk of noncommunicable diseases. A search was performed on Medline (PubMed interface) using several keywords (e.g., "Factors Influencing Sleep" OR "Sleep and Chronic Diseases"). Articles published between 2000 and the present date that relate sleep to cyclic metabolic processes and changes in eating behavior were selected. Changes in sleep patterns are increasingly detected today, and these modifications are mainly caused by work and lifestyle conditions as well as a growing dependence on electronic devices. Sleep deprivation and the resultant short sleep duration lead to an increased appetite via an increase in the hunger hormone (ghrelin) and a decrease in the satiety hormone (leptin). Nowadays, sleep is undervalued, and thus often impaired, with consequences for the performance of various body systems. Sleep deprivation alters physiological homeostasis and influences eating behavior as well as the onset of chronic diseases.
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Affiliation(s)
- Sofia Gomes
- ATLÂNTICA-University Institute, 2730-036 Barcarena, Portugal
| | - Cátia Ramalhete
- ATLÂNTICA-University Institute, 2730-036 Barcarena, Portugal
- Research Institute for Medicines (iMed.ULisboa), Faculty of Pharmacy, Universidade de Lisboa, Av. Prof. Gama Pinto, 1649-003 Lisbon, Portugal
| | - Isabel Ferreira
- ATLÂNTICA-University Institute, 2730-036 Barcarena, Portugal
- Ecogenetics and Human Health Research Group, Environmental Health Institute (ISAMB), Associate Laboratory TERRA, Faculty of Medicine (FMUL), University of Lisbon, 1649-028 Lisbon, Portugal
| | - Manuel Bicho
- Ecogenetics and Human Health Research Group, Environmental Health Institute (ISAMB), Associate Laboratory TERRA, Faculty of Medicine (FMUL), University of Lisbon, 1649-028 Lisbon, Portugal
- Instituto de Investigação Científica Bento da Rocha Cabral, Calçada Bento da Rocha Cabral 14, 1250-012 Lisbon, Portugal
| | - Ana Valente
- ATLÂNTICA-University Institute, 2730-036 Barcarena, Portugal
- Ecogenetics and Human Health Research Group, Environmental Health Institute (ISAMB), Associate Laboratory TERRA, Faculty of Medicine (FMUL), University of Lisbon, 1649-028 Lisbon, Portugal
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15
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Maruani J, Molière F, Godin O, Yrondi A, Bennabi D, Richieri R, El-Hage W, Allauze E, Anguill L, Bouvard A, Camus V, Dorey JM, Etain B, Fond G, Genty JB, Haffen E, Holtzmann J, Horn M, Kazour F, Nguon AS, Petrucci J, Rey R, Stephan F, Vaiva G, Walter M, Lejoyeux M, Leboyer M, Llorca PM, Courtet P, Aouizerate B, Geoffroy PA. Diurnal symptoms of sleepiness and dysfunction predict future suicidal ideation in a French cohort of outpatients (FACE-DR) with treatment resistant depression: A 1-year prospective study about sleep markers. J Affect Disord 2023; 329:369-378. [PMID: 36842655 DOI: 10.1016/j.jad.2023.02.106] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 02/19/2023] [Accepted: 02/20/2023] [Indexed: 02/26/2023]
Abstract
BACKGROUND Patients suffering from treatment-resistant depression (TRD) are at risk of suicide. Sleep and circadian rhythm alterations are widely recognized as core symptoms of major depressive disorder and are associated with suicidal ideation. Thus, sleep and circadian rhythm alterations may be targeted to prevent suicide. METHODS Patients were recruited from a prospective cohort of the French network of TRD expert centers. Mood, sleep and circadian rhythms were assessed at baseline; suicidal risk was assessed both at baseline and during a one-year follow-up with standardized subjective questionnaires. RESULTS Excessive daytime sleepiness (adjusted odds ratio aOR = 1.7(1-3.3), p = 0.04) and daytime dysfunction (aOR = 1.81(1.16-2.81), p = 0.0085) increased the risk of suicidal thoughts over the one-year follow-up period in patients with TRD after adjustment on age, gender, depression, trauma, anxiety, impulsivity, current daily tobacco smoking and body mass index. Hypnotics intake is associated with a reduced risk of suicidal ideation at one-year follow-up after the same adjustments (OR = 0.73(0.56-0.95), p = 0.019). Other associations between sleep quality or circadian rhythms and suicidal ideations at either baseline or one year did not remain significant in multivariate analyses after the same adjustments. LIMITATIONS Sleep assessments were based on self-reported questionnaires rather than objective measures. CONCLUSIONS Daytime sleepiness and dysfunction are predictors of suicidal ideations, whereas hypnotics intake is associated with a reduced risk of suicidal ideations. Diurnal symptoms of sleep disturbances are therefore red flags to target for preventing suicide in depressed patients, and hypnotics seem efficient in preventing suicide for patients with TRD.
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Affiliation(s)
- Julia Maruani
- Fondation FondaMental, Creteil, France; Département de psychiatrie et d'addictologie, AP-HP, GHU Paris Nord, DMU Neurosciences, Hôpital Bichat - Claude Bernard, F-75018 Paris, France; Université de Paris, NeuroDiderot, Inserm, FHU I2-D2, F-75019 Paris, France.
| | - Fanny Molière
- Fondation FondaMental, Creteil, France; Department of Emergency Psychiatry and Acute Care, CHU Montpellier, INSERM U1061, Montpellier University, Montpellier, France
| | - Ophelia Godin
- Fondation FondaMental, Creteil, France; INSERM, IMRB, Translational Neuropsychiatry, Fondation FondaMental, 94000 Créteil, France
| | - Antoine Yrondi
- Fondation FondaMental, Creteil, France; Service de Psychiatrie et de Psychologie Médicale de l'adulte (Department of Psychiatry and Adult Medical Psychology), Centre Expert Dépression Résistante FondaMental (FondaMental Advanced Centre of Expertise in Resistant Depression, CHU de Toulouse (University Hospital Centre), Hôpital Purpan, ToNIC Toulouse NeuroImaging Centre, Université de Toulouse (Toulouse University), INSERM, UPS, Toulouse, France
| | - Djamila Bennabi
- Fondation FondaMental, Creteil, France; Service de Psychiatrie, Centre Expert Dépression Résistante FondaMental, CIC-1431 INSERM, CHU de Besançon, Laboratoire de Recherches Intégratives en Neurosciences et Psychologie Cognitive UR-LINC 481, Neurosciences, Université de Bourgogne Franche Comté, Besançon, France
| | - Raphaelle Richieri
- Fondation FondaMental, Creteil, France; Aix Marseille Univ, CNRS, Centrale Marseille, Institut Fresnel, Marseille, France
| | - Wissan El-Hage
- Fondation FondaMental, Creteil, France; CHRU de Tours, UMR 1253, iBrain, Université de Tours, Inserm, Tours, France
| | - Etienne Allauze
- Fondation FondaMental, Creteil, France; Université Clermont Auvergne, CMP-B CHU, CNRS, Clermont Auvergne INP, Institut Pascal, F-63000 Clermont-Ferrand, France
| | - Loic Anguill
- Fondation FondaMental, Creteil, France; Service de Psychiatrie et de Psychologie Médicale de l'adulte (Department of Psychiatry and Adult Medical Psychology), Centre Expert Dépression Résistante FondaMental (FondaMental Advanced Centre of Expertise in Resistant Depression, CHU de Toulouse (University Hospital Centre), Hôpital Purpan, ToNIC Toulouse NeuroImaging Centre, Université de Toulouse (Toulouse University), INSERM, UPS, Toulouse, France
| | - Alexandra Bouvard
- Fondation FondaMental, Creteil, France; Pôle de Psychiatrie Générale et Universitaire (Department of General and University Academic Psychiatry Cluster), Centre de référence régional des pathologies anxieuses et de la dépression (Regional reference center for the management and treatment of anxiety and depressive disorders), Centre Expert Dépression Résistante FondaMental (FondaMental Advan-ced Centre of Expertise in Resistant Depression), CH Charles Perrens, Bordeaux, Laboratoire Nutrition et Neurobiologie intégrée (Integrated Nutrition and Neurobiology Laboratory) (UMR INRAE 1286), Université de Bordeaux (Bordeaux University), France
| | - Vincent Camus
- Fondation FondaMental, Creteil, France; CHRU de Tours, UMR 1253, iBrain, Université de Tours, Inserm, Tours, France
| | - Jean-Michel Dorey
- Fondation FondaMental, Creteil, France; INSERM U1028; CNRS UMR5292; University Lyon 1; Lyon Neuroscience Research Centre; Psychiatric Disorders: from Resistance to Response ΨR2 Team; Centre Hospitalier Le Vinatier (Hospital Centre); F-69678, France
| | - Bruno Etain
- Fondation FondaMental, Creteil, France; Université Paris Cité et AP-HP.Nord, GHU Lariboisière-Fernand Widal, Département de Psychiatrie et de Médecine Addictologique et Fondation Fondamental, Paris, France
| | - Guillaume Fond
- Fondation FondaMental, Creteil, France; Aix-Marseille Univ, School of medicine - La Timone Medical Campus, EA 3279: Department of Epidemiology and Health Economics, Clinical Research Unit, Direction de la Recherche en Santé, 27 Boulevard Jean Moulin, 13005 Marseille, France
| | - Jean-Baptiste Genty
- Fondation FondaMental, Creteil, France; AP-HP, Hôpital Henri Mondor, Département Médico-Universitaire de Psychiatrie et d'Addictologie (DMU IMPACT), Fédération Hospitalo-Universitaire de Médecine de Précision (FHU ADAPT); Université Paris Est Créteil, INSERM U955, IMRB, Laboratoire Neuro-Psychiatrie translationnelle, Fondation FondaMental, F-94010 Créteil, France
| | - Emmanuel Haffen
- Fondation FondaMental, Creteil, France; Service de Psychiatrie, Centre Expert Dépression Résistante FondaMental, CIC-1431 INSERM, CHU de Besançon, Laboratoire de Recherches Intégratives en Neurosciences et Psychologie Cognitive UR-LINC 481, Neurosciences, Université de Bourgogne Franche Comté, Besançon, France
| | - Jérôme Holtzmann
- Fondation FondaMental, Creteil, France; Service Hospitalo-Universitaire de Psychiatrie, CHU Grenoble Alpes, Université Grenoble Alpes, Inserm, U1216, Grenoble Institut Neurosciences (Institute of Neurosciences), 38000 Grenoble, France
| | - Mathilde Horn
- Fondation FondaMental, Creteil, France; Service de Psychiatrie adulte (Department of Adult Psychiatry), Centre Expert Dépression Résistante FondaMental, CHRU de Lille, Hôpital Fontan 1, Lille, France
| | - François Kazour
- Fondation FondaMental, Creteil, France; CHRU de Tours, UMR 1253, iBrain, Université de Tours, Inserm, Tours, France
| | - Anne-Sophie Nguon
- Fondation FondaMental, Creteil, France; Service Hospitalo-Universitaire de Psychiatrie, CHU Grenoble Alpes, Université Grenoble Alpes, Inserm, U1216, Grenoble Institut Neurosciences (Institute of Neurosciences), 38000 Grenoble, France
| | - Jean Petrucci
- Fondation FondaMental, Creteil, France; AP-HP, Hôpital Henri Mondor, Département Médico-Universitaire de Psychiatrie et d'Addictologie (DMU IMPACT), Fédération Hospitalo-Universitaire de Médecine de Précision (FHU ADAPT); Université Paris Est Créteil, INSERM U955, IMRB, Laboratoire Neuro-Psychiatrie translationnelle, Fondation FondaMental, F-94010 Créteil, France
| | - Romain Rey
- Fondation FondaMental, Creteil, France; INSERM U1028; CNRS UMR5292; University Lyon 1; Lyon Neuroscience Research Centre; Psychiatric Disorders: from Resistance to Response ΨR2 Team; Centre Hospitalier Le Vinatier (Hospital Centre); F-69678, France
| | - Florian Stephan
- Fondation FondaMental, Creteil, France; Service Hospitalo-Universitaire de Psychiatrie Générale et de Réhabilitation Psycho Sociale 29G01 et 29G02 (University Hospital Department of General Psychiatry and Psychosocial Rehabilitation), Centre Expert Depression Résistante FondaMental, EA 7479, URCI, CHRU de Brest, Hôpital de Bohars, Brest, France
| | - Guillaume Vaiva
- Fondation FondaMental, Creteil, France; Service de Psychiatrie adulte (Department of Adult Psychiatry), Centre Expert Dépression Résistante FondaMental, CHRU de Lille, Hôpital Fontan 1, Lille, France; Centre National de Ressources et Résilience pour les psychotraumatismes (Cn2r Lille Paris), Lille, France
| | - Michel Walter
- Fondation FondaMental, Creteil, France; Service Hospitalo-Universitaire de Psychiatrie Générale et de Réhabilitation Psycho Sociale 29G01 et 29G02 (University Hospital Department of General Psychiatry and Psychosocial Rehabilitation), Centre Expert Depression Résistante FondaMental, EA 7479, URCI, CHRU de Brest, Hôpital de Bohars, Brest, France
| | | | - Michel Lejoyeux
- Département de psychiatrie et d'addictologie, AP-HP, GHU Paris Nord, DMU Neurosciences, Hôpital Bichat - Claude Bernard, F-75018 Paris, France; Université de Paris, NeuroDiderot, Inserm, FHU I2-D2, F-75019 Paris, France; GHU Paris, Psychiatry & Neurosciences, 1 rue Cabanis, 75014 Paris, France
| | - Marion Leboyer
- Fondation FondaMental, Creteil, France; AP-HP, Hôpital Henri Mondor, Département Médico-Universitaire de Psychiatrie et d'Addictologie (DMU IMPACT), Fédération Hospitalo-Universitaire de Médecine de Précision (FHU ADAPT); Université Paris Est Créteil, INSERM U955, IMRB, Laboratoire Neuro-Psychiatrie translationnelle, Fondation FondaMental, F-94010 Créteil, France
| | - Pierre-Michel Llorca
- Fondation FondaMental, Creteil, France; Université Clermont Auvergne, CMP-B CHU, CNRS, Clermont Auvergne INP, Institut Pascal, F-63000 Clermont-Ferrand, France
| | - Philippe Courtet
- Fondation FondaMental, Creteil, France; Department of Emergency Psychiatry and Acute Care, CHU Montpellier, INSERM U1061, Montpellier University, Montpellier, France
| | - Bruno Aouizerate
- Fondation FondaMental, Creteil, France; Pôle de Psychiatrie Générale et Universitaire (Department of General and University Academic Psychiatry Cluster), Centre de référence régional des pathologies anxieuses et de la dépression (Regional reference center for the management and treatment of anxiety and depressive disorders), Centre Expert Dépression Résistante FondaMental (FondaMental Advan-ced Centre of Expertise in Resistant Depression), CH Charles Perrens, Bordeaux, Laboratoire Nutrition et Neurobiologie intégrée (Integrated Nutrition and Neurobiology Laboratory) (UMR INRAE 1286), Université de Bordeaux (Bordeaux University), France
| | - Pierre A Geoffroy
- Fondation FondaMental, Creteil, France; Département de psychiatrie et d'addictologie, AP-HP, GHU Paris Nord, DMU Neurosciences, Hôpital Bichat - Claude Bernard, F-75018 Paris, France; Université de Paris, NeuroDiderot, Inserm, FHU I2-D2, F-75019 Paris, France; CNRS UPR 3212, Institute for Cellular and Integrative Neurosciences, 5 rue Blaise Pascal, 67000 Strasbourg, France; GHU Paris, Psychiatry & Neurosciences, 1 rue Cabanis, 75014 Paris, France.
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16
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Kinkel-Ram SS, Grunewald W, Bodell LP, Smith AR. Unsound sleep, wound-up mind: a longitudinal examination of acute suicidal affective disturbance features among an eating disorder sample. Psychol Med 2023; 53:1518-1526. [PMID: 34348803 DOI: 10.1017/s003329172100310x] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
BACKGROUND Suicide is one of the most commonly reported causes of death in individuals with eating disorders. However, the mechanisms underlying the suicide and disordered eating link are largely unknown, and current assessments are still unable to accurately predict future suicidal thoughts and behaviors. The purpose of this study is to test the utility of two promising proximal risk factors, sleep quality and agitation, in predicting suicidal ideation in a sample of individuals with elevated suicidal thoughts and behaviors, namely those with eating disorders. METHODS Women (N = 97) receiving treatment at an eating disorder treatment center completed weekly questionnaires assessing suicidal ideation, agitation, and sleep. General linear mixed models examined whether agitation and/or sleep quality were concurrently or prospectively associated with suicidal ideation across 12 weeks of treatment. RESULTS There was a significant interaction between within-person agitation and sleep quality on suicidal ideation [B(s.e.) = -0.02(0.01), p < 0.05], such that on weeks when an individual experienced both higher than their average agitation and lower than their average sleep quality, they also experienced their highest levels of suicidal ideation. However, neither agitation nor sleep quality prospectively predicted suicidal ideation. CONCLUSIONS This study was the first to examine dynamic associations between interpersonal constructs and suicidal ideation in individuals with eating disorders. Results suggest that ongoing assessment for overarousal symptoms, such as agitation and poor sleep quality, in individuals with eating disorders may be warranted in order to manage suicidal ideation among this vulnerable population.
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Affiliation(s)
| | | | - Lindsay P Bodell
- Department of Psychology, Western University, London, Ontario, Canada
| | - April R Smith
- Department of Psychology, Auburn University, Auburn, Alabama, USA
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17
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Post-Discharge Suicide among High-Risk Psychiatric Inpatients: Risk factors and warnings signs. JOURNAL OF AFFECTIVE DISORDERS REPORTS 2023. [DOI: 10.1016/j.jadr.2023.100506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2023] Open
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18
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Smith L, Shin JI, López Sánchez GF, Kostev K, Jacob L, Tully MA, Butler L, Barnett Y, Veronese N, Soysal P, Abduljabbar AS, Haro JM, Koyanagi A. Physical multimorbidity, suicidal ideation, and suicide attempts among adults aged ≥50 years from low- and middle-income countries. Int J Geriatr Psychiatry 2023; 38:e5873. [PMID: 36683020 PMCID: PMC10108020 DOI: 10.1002/gps.5873] [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: 10/30/2022] [Accepted: 01/09/2023] [Indexed: 01/15/2023]
Abstract
OBJECTIVES The association between physical multimorbidity and suicidal ideation or suicide attempts among older adults from low- and middle-income countries (LMICs) is largely unknown. We aimed to assess this association as well as its mediators using nationally representative data from six LMICs. METHODS Cross-sectional, community-based data from the Study on Global Aging and Adult Health were analyzed. A total of 11 chronic physical conditions were assessed. Self-reported information on past 12-month suicidal ideation and suicide attempts was also collected. Multivariable logistic regression and mediation analyses were conducted. RESULTS The final sample consisted of 34,129 adults aged ≥50 years (mean [SD] age 62.4 (16.0) years; maximum age 114 years; 52.1% females). In the overall sample, physical multimorbidity was associated with increased odds for suicidal ideation (OR = 2.99; 95% CI = 2.06-4.34) and suicide attempts (OR = 2.79; 95% CI = 1.58-4.95), with the association being stronger in males than females. The association between multimorbidity and suicidal ideation or suicide attempts was largely mediated by pain/discomfort (mediated% 33.3%-44.2%), sleep/energy (28.2%-33.8%), and mobility limitations (26.6%-34.8%). CONCLUSIONS Physical multimorbidity among older adults in LMICs was associated with a substantially increased risk for suicidal ideation and suicide attempts. Addressing the identified mediators in people with physical multimorbidity may aid in the prevention of suicidal ideation and suicide attempts.
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Affiliation(s)
- Lee Smith
- Centre for Health, Performance, and Wellbeing, Anglia Ruskin University, Cambridge, UK
| | - Jae Il Shin
- Department of Pediatrics, Yonsei University College of Medicine, Seodaemun-gu, Seoul, Korea
| | - Guillermo F López Sánchez
- Division of Preventive Medicine and Public Health, Department of Public Health Sciences, School of Medicine, University of Murcia, Murcia, Spain
| | - Karel Kostev
- Philipps University of Marburg, Marburg, Germany
| | - Louis Jacob
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, ISCIII, Sant Boi de Llobregat, Barcelona, Spain.,Faculty of Medicine, University of Versailles Saint-Quentin-en-Yvelines, Montigny-le-Bretonneux, France
| | - Mark A Tully
- School of Medicine, Ulster University, Londonderry, UK
| | - Laurie Butler
- Centre for Health, Performance, and Wellbeing, Anglia Ruskin University, Cambridge, UK
| | - Yvonne Barnett
- Centre for Health, Performance, and Wellbeing, Anglia Ruskin University, Cambridge, UK
| | - Nicola Veronese
- Geriatrics Section, Department of Internal Medicine, University of Palermo, Palermo, Italy
| | - Pinar Soysal
- Department of Geriatric Medicine, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey
| | | | - Josep Maria Haro
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, ISCIII, Sant Boi de Llobregat, Barcelona, Spain.,King Saud University, Riyadh, Saudi Arabia
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, ISCIII, Sant Boi de Llobregat, Barcelona, Spain.,ICREA, Barcelona, Spain
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19
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Self-reported sleep quality and mental health mediate the relationship between chronic diseases and suicidal ideation among Chinese medical students. Sci Rep 2022; 12:18835. [PMID: 36336709 PMCID: PMC9637738 DOI: 10.1038/s41598-022-23207-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2021] [Accepted: 10/26/2022] [Indexed: 11/08/2022] Open
Abstract
High prevalence and strong associations of chronic disease, poor sleep quality, poor mental health, and suicidal ideation (SI) have been reported worldwide. However, the underlying mechanism remains unexamined. The participants were 2646 Chinese medical college students with an average age of 20.13 years. Pittsburgh Sleep Quality Index, the Kessler Psychological Distress Scale, and SI was evaluated. The lifetime SI, past 12-month SI, and chronic disease prevalence rates were 10.0%, 8.4%, and 4.6%, respectively. The results of logistic regression analysis in this study found that chronic disease, self-reported poor sleep quality, poor mental health, gender and scholarship were associated with lifetime SI. Similar results were also found for 12-month SI with an exception of region. This result indicated that the effects of chronic diseases on the SI were mediated by self-reported sleep quality and mental health. Physical diseases, sleep-related concerns, and mental health issues need to be addressed through a multidisciplinary team approach and various delivery systems to prevent SI among medical college students.
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20
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Lampinen LA, Zheng S, Taylor JL, Adams RE, Pezzimenti F, Asarnow LD, Bishop SL. Patterns of sleep disturbances and associations with depressive symptoms in autistic young adults. Autism Res 2022; 15:2126-2137. [PMID: 36082844 PMCID: PMC9677950 DOI: 10.1002/aur.2812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 08/19/2022] [Indexed: 12/15/2022]
Abstract
Autistic individuals are at an increased risk for both sleep disturbances and depression. While studies in the general population and in autistic adults have drawn general links between sleep disturbances and mental health, few studies have examined the extent to which specific sleep problems may be implicated in the extremely high rates of depression among autistic adults. This study aimed to describe the patterns of sleep disturbances in autistic young adults, and their associations with depressive symptoms while controlling for relevant demographic factors. A sample of 304 legally independent adults (age 18-35 years old) with a childhood diagnosis of autism spectrum disorder self-reported on their average sleep behaviors during the past week and depressive symptoms on the Beck Depressive Inventory-II. A significant proportion (86.01%) of autistic young adults experienced at least one of the primary sleep disturbances of interest, including short total sleep time (39.59%), poor sleep efficiency (60.07%), and delayed sleep phase (36.18%). Additionally, lower sleep efficiency and delayed sleep phase were both associated with higher depressive symptoms. The associations between sleep and depressive symptoms identified in our study suggest that sleep treatments may hold potential for ameliorating depressive symptoms in autistic adults who also experience sleep problems. Further research using daily sleep diaries and objective measures of sleep behaviors, as well as longitudinal studies, are needed to understand how changes in sleep may relate to changes in depressive symptoms in autistic adults.
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Affiliation(s)
- Linnea A Lampinen
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, California, USA
| | - Shuting Zheng
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, California, USA
| | - Julie Lounds Taylor
- Department of General Pediatrics, Vanderbilt University Medical Center. One Magnolia Circle, Nashville, Tennessee, USA
| | - Ryan E Adams
- Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - Florencia Pezzimenti
- Department of General Pediatrics, Vanderbilt University Medical Center. One Magnolia Circle, Nashville, Tennessee, USA
| | - Lauren D Asarnow
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, California, USA
| | - Somer L Bishop
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, California, USA
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21
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Grant CW, Wilton AR, Kaddurah-Daouk R, Skime M, Biernacka J, Mayes T, Carmody T, Wang L, Lazaridis K, Weinshilboum R, Bobo WV, Trivedi MH, Croarkin PE, Athreya AP. Network science approach elucidates integrative genomic-metabolomic signature of antidepressant response and lifetime history of attempted suicide in adults with major depressive disorder. Front Pharmacol 2022; 13:984383. [PMID: 36263124 PMCID: PMC9573988 DOI: 10.3389/fphar.2022.984383] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Accepted: 08/15/2022] [Indexed: 11/13/2022] Open
Abstract
Background: Individuals with major depressive disorder (MDD) and a lifetime history of attempted suicide demonstrate lower antidepressant response rates than those without a prior suicide attempt. Identifying biomarkers of antidepressant response and lifetime history of attempted suicide may help augment pharmacotherapy selection and improve the objectivity of suicide risk assessments. Towards this goal, this study sought to use network science approaches to establish a multi-omics (genomic and metabolomic) signature of antidepressant response and lifetime history of attempted suicide in adults with MDD. Methods: Single nucleotide variants (SNVs) which associated with suicide attempt(s) in the literature were identified and then integrated with a) p180-assayed metabolites collected prior to antidepressant pharmacotherapy and b) a binary measure of antidepressant response at 8 weeks of treatment using penalized regression-based networks in 245 'Pharmacogenomics Research Network Antidepressant Medication Study (PGRN-AMPS)' and 103 'Combining Medications to Enhance Depression Outcomes (CO-MED)' patients with major depressive disorder. This approach enabled characterization and comparison of biological profiles and associated antidepressant treatment outcomes of those with (N = 46) and without (N = 302) a self-reported lifetime history of suicide attempt. Results: 351 SNVs were associated with suicide attempt(s) in the literature. Intronic SNVs in the circadian genes CLOCK and ARNTL (encoding the CLOCK:BMAL1 heterodimer) were amongst the top network analysis features to differentiate patients with and without a prior suicide attempt. CLOCK and ARNTL differed in their correlations with plasma phosphatidylcholines, kynurenine, amino acids, and carnitines between groups. CLOCK and ARNTL-associated phosphatidylcholines showed a positive correlation with antidepressant response in individuals without a prior suicide attempt which was not observed in the group with a prior suicide attempt. Conclusion: Results provide evidence for a disturbance between CLOCK:BMAL1 circadian processes and circulating phosphatidylcholines, kynurenine, amino acids, and carnitines in individuals with MDD who have attempted suicide. This disturbance may provide mechanistic insights for differential antidepressant pharmacotherapy outcomes between patients with MDD with versus without a lifetime history of attempted suicide. Future investigations of CLOCK:BMAL1 metabolic regulation in the context of suicide attempts may help move towards biologically-augmented pharmacotherapy selection and stratification of suicide risk for subgroups of patients with MDD and a lifetime history of attempted suicide.
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Affiliation(s)
- Caroline W. Grant
- Department of Molecular Pharmacology and Experimental Therapeutics, Mayo Clinic, Rochester, MN, United States
| | - Angelina R. Wilton
- Department of Molecular Pharmacology and Experimental Therapeutics, Mayo Clinic, Rochester, MN, United States
- Department of Molecular and Integrative Physiology, University of Illinois at Urbana-Champaign, Urbana, IL, United States
| | - Rima Kaddurah-Daouk
- Department of Psychiatry and Behavioral Sciences, Department of Medicine, Duke Institute for Brain Sciences, Duke University, Durham, NC, United States
| | - Michelle Skime
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, United States
| | - Joanna Biernacka
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, United States
| | - Taryn Mayes
- Peter O’Donnell Jr. Brain Institute and the Department of Psychiatry at the University of Texas Southwestern Medical Center, Dallas, TX, United States
| | - Thomas Carmody
- Department Population and Data Sciences, University of Texas Southwestern Medical Center, Dallas, TX, United States
| | - Liewei Wang
- Department of Molecular Pharmacology and Experimental Therapeutics, Mayo Clinic, Rochester, MN, United States
| | - Konstantinos Lazaridis
- Department of Internal Medicine, Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, United States
| | - Richard Weinshilboum
- Department of Molecular Pharmacology and Experimental Therapeutics, Mayo Clinic, Rochester, MN, United States
| | - William V. Bobo
- Department of Psychiatry and Psychology, Mayo Clinic, Jacksonville, FL, United States
| | - Madhukar H. Trivedi
- Peter O’Donnell Jr. Brain Institute and the Department of Psychiatry at the University of Texas Southwestern Medical Center, Dallas, TX, United States
| | - Paul E. Croarkin
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, United States
| | - Arjun P. Athreya
- Department of Molecular Pharmacology and Experimental Therapeutics, Mayo Clinic, Rochester, MN, United States
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, United States
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22
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Carruthers SP, Lee SJ, Sankaranarayanan A, Sumner PJ, Toh WL, Tan EJ, Neill E, Van Rheenen TE, Gurvich C, Rossell SL. Psychosis and Hopelessness Mediate the Relationship Between Reduced Sleep and Suicidal Ideation in Schizophrenia Spectrum Disorders. Arch Suicide Res 2022; 26:1862-1879. [PMID: 34225564 DOI: 10.1080/13811118.2021.1944412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE Suicide is a major cause of death amongst individuals with schizophrenia spectrum disorders (SSD). Despite numerous risk factors being identified, accurate prediction of suicidality and provision of tailored and effective treatment is difficult. One factor that may warrant particular attention as a contributor to increased psychopathology and suicidality in SSD is disturbed sleep. Sleep disturbances have been reliably linked to greater levels of suicidal ideation and are highly prevalent amongst individuals with SSD. This study aimed to examine if reduced sleep duration and psychopathology are associated with increased suicidal ideation. METHOD One-hundred and eighteen adults with chronic SSD living within the community participated in this cross-sectional study. Psychosis symptoms were assessed using the Positive and Negative Syndrome Scale. Items 4 and 10 from the Montgomery-Asperg Depression Rating Scale and Item 2 from the Calgary Depression Scale for Schizophrenia were used to assess reduced sleep duration, current suicidal ideation, and hopelessness, respectively. All measures were rated concurrently. RESULTS A hierarchical logistic regression revealed that greater acute sleep disturbances were associated with increased suicidal ideation and this relationship was found to be uniquely mediated by both positive symptom severity and hopelessness. CONCLUSION These results suggest that individuals with SSD who exhibited disrupted or disordered sleep, positive symptoms and/or hopelessness should be routinely screened for suicidal thinking. Furthermore, interventions that effectively target sleep disruptions may provide much-needed action against suicidal ideation.HIGHLIGHTSReduced sleep found to be associated with increased suicidal ideationThis was uniquely mediated by both hopelessness and positive symptomsMore regular screening of sleep problems in schizophrenia is needed.
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23
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Rogers ML, Bafna A, Galynker I. Comparative clinical utility of screening for Suicide Crisis Syndrome versus suicidal ideation in relation to suicidal ideation and attempts at one-month follow-up. Suicide Life Threat Behav 2022; 52:866-875. [PMID: 35441411 DOI: 10.1111/sltb.12870] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 02/03/2022] [Accepted: 04/05/2022] [Indexed: 12/19/2022]
Abstract
INTRODUCTION Suicidal ideation (SI) has numerous limitations in predicting suicidal behavior. The Suicide Crisis Syndrome (SCS) is proposed as an alternative method of detecting risk. This study compares the relative utility of SI and SCS in statistically predicting SI and behaviors at one-month follow-up. METHODS 382 psychiatric patients (98 inpatients, 284 outpatients) completed baseline measures and provided information about suicide-related outcomes one month later. Participants were grouped based on responses to measures assessing SCS and SI. RESULTS Rates of follow-up suicidal behavior were significantly higher among those reporting both SCS and SI (22.2%) than those reporting SI alone (6.0%) or neither SCS nor SI (0.9%). SCS alone (8.3%) had descriptively, but not statistically, higher rates of suicidal behavior than those with neither SCS nor SI, and did not differ from SI alone and the combination of SCS and SI. Those reporting SI-with and without SCS-had higher levels of follow-up suicidal thoughts than those without SI. CONCLUSION The SCS was equivalent to SI, and incrementally informative alongside SI, in detecting individuals at risk of future suicidal behavior, whereas SI was more strongly related to future SI than SCS. The combination of SCS and SI may be clinically useful in detecting individuals who are at risk for suicide.
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Affiliation(s)
- Megan L Rogers
- Icahn School of Medicine at Mount Sinai, Mount Sinai Beth Israel, New York, New York, USA
| | - Anokhi Bafna
- Icahn School of Medicine at Mount Sinai, Mount Sinai Beth Israel, New York, New York, USA
| | - Igor Galynker
- Icahn School of Medicine at Mount Sinai, Mount Sinai Beth Israel, New York, New York, USA
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24
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Goldstein TR, Franzen PL. A Comprehensive Review of the Literature on Sleep Difficulties and Suicidality in Youth to Inform an Integrative Developmental Model and Future Directions. CURRENT SLEEP MEDICINE REPORTS 2022; 8:1-19. [PMID: 36274826 PMCID: PMC9586157 DOI: 10.1007/s40675-022-00222-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/17/2022] [Indexed: 12/16/2022]
Abstract
Purpose of Review Suicide is currently the second leading cause of death among youth. Identification of modifiable near-term risk factors can inform suicide prevention strategies. One promising, readily assessed factor is sleep. We critically review the literature on sleep and suicidal thoughts and behaviors among youth. Recent Findings Most studies examining the youth sleep-suicidality relationship are from epidemiological samples in which both sleep problems and suicidality were assessed over variable timeframes using limited items from scales not designed to measure these constructs. Nonetheless, these data overwhelmingly support an association between suicidality and a range of sleep difficulties (e.g., insomnia, short/long sleep, weekend oversleep), above and beyond depressive symptoms. Limited studies include clinical samples or prospective designs. We review potential mechanisms and present a developmentally-informed integrative model. Summary Literature supports a clear association between sleep difficulties and youth suicidality. Future directions include prospective longitudinal studies and targeted prevention efforts.
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Affiliation(s)
- Tina R Goldstein
- Western Psychiatric Hospital and the Center for Sleep and Circadian Science, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Peter L Franzen
- Western Psychiatric Hospital and the Center for Sleep and Circadian Science, University of Pittsburgh School of Medicine, Pittsburgh, PA
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25
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Tavakoli P, Lanthier M, Porteous M, Boafo A, De Koninck J, Robillard R. Sleep architecture and emotional inhibition processing in adolescents hospitalized during a suicidal crisis. Front Psychiatry 2022; 13:920789. [PMID: 36072454 PMCID: PMC9441873 DOI: 10.3389/fpsyt.2022.920789] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Accepted: 07/26/2022] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Suicide is the second leading cause of death in adolescents. Sleep disturbances could alter inhibitory processes and contribute to dangerous behaviors in this critical developmental period. Adolescents in suicidal crisis have been shown to have lighter sleep compared to healthy controls. Additionally, suicidal adolescents have lower neural resources mobilized by emotionally charged inhibition processing. The present exploratory study aimed to determine how sleep architecture in suicidal adolescents may relate to inhibition processing in response to emotional stimuli. METHODS Ten adolescents between 12 and 17 years of age with a diagnosis of major depressive disorder and who attempted suicide were recruited while hospitalized for a suicidal crisis in a psychiatric inpatient unit. Event-related potentials (ERPs) were recorded prior to bedtime during a Go/NoGo task involving pictures of sad, happy, and neutral faces. Polysomnography was then recorded throughout the night. Pearson correlations were conducted to investigate how inhibition performance and ERP parameters reflecting inhibition processing (i.e., P3d and N2d derived from difference waveform calculated as NoGo minus Go trials) relate to sleep architecture. RESULTS Poorer inhibition accuracy in response to emotional stimuli was significantly correlated with shorter REM sleep latency, higher REM sleep, and more frequent nocturnal awakenings. The P3d in response to sad faces was negatively correlated with NREM2 sleep and positively correlated with NREM3 sleep. No such association with the P3d was found for happy or neutral stimuli. There were no significant correlations for the N2d. CONCLUSION Altered sleep in adolescents with depression who are in a suicidal crisisis associated with behavioral inhibition difficulties and fewer neural resources mobilized by inhibitory processes in emotionally charged contexts. This highlights the importance of addressing sleep disturbances while managing suicidal crises in adolescents.
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Affiliation(s)
- Paniz Tavakoli
- Sleep Research Unit, Institute of Mental Health Research at the Royal, University of Ottawa, Ottawa, ON, Canada
| | - Malika Lanthier
- Sleep Research Unit, Institute of Mental Health Research at the Royal, University of Ottawa, Ottawa, ON, Canada.,School of Psychology, University of Ottawa, Ottawa, ON, Canada
| | - Meggan Porteous
- Sleep Research Unit, Institute of Mental Health Research at the Royal, University of Ottawa, Ottawa, ON, Canada.,School of Psychology, University of Ottawa, Ottawa, ON, Canada
| | - Addo Boafo
- Mental Health Program, Children's Hospital of Eastern Ontario, Ottawa, ON, Canada
| | | | - Rebecca Robillard
- Sleep Research Unit, Institute of Mental Health Research at the Royal, University of Ottawa, Ottawa, ON, Canada.,School of Psychology, University of Ottawa, Ottawa, ON, Canada
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26
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Kim JM, Kim JW, Kang HJ, Choi W, Ryu S, Lee JY, Kim SW, Kim JC, Chun BJ, Shin IS, Ahn Y, Jeong MH. Serotonin modifies the impact of sleep disturbance on suicidality in patients with acute coronary syndrome. Front Psychiatry 2022; 13:1046715. [PMID: 36451764 PMCID: PMC9702559 DOI: 10.3389/fpsyt.2022.1046715] [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: 09/17/2022] [Accepted: 10/20/2022] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND This study investigated the associations of sleep disturbance and serum serotonin levels with suicidal ideation, and evaluated the potential modifying effects of serotonin on these associations in patients with the acute coronary syndrome (ACS). METHODS In total, 969 ACS patients were recruited from a tertiary university hospital in Korea within 2 weeks of disease onset and evaluated in terms of sleep disturbance (using the Leeds Sleep Evaluation Questionnaire), serum serotonin levels, and suicidal ideation (using the "suicidal thoughts" item of the Montgomery-Åsberg Depression Rating Scale). Covariates included sociodemographics, depression, vascular risk factors, and disease severity. After 1 year, 711 patients were re-evaluated in terms of suicidal ideation. Logistic regression analysis was performed with adjustment for covariates. RESULTS Sleep disturbance was significantly associated with suicidal ideation at baseline and follow-up. Serum serotonin showed no such association but modified the association of sleep disturbance with suicidal ideation such that it was significant only in the lower serum serotonin group, with significant interaction terms obtained after adjustment for relevant covariates. CONCLUSION Evaluating sleep disturbance and serum serotonin levels could improve the accuracy of clinical predictions of suicidal ideation in the acute and chronic phases of ACS.
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Affiliation(s)
- Jae-Min Kim
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, South Korea
| | - Ju-Wan Kim
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, South Korea
| | - Hee-Ju Kang
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, South Korea
| | - Wonsuk Choi
- Department of Internal Medicine, Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Hwasun, South Korea
| | - Seunghyong Ryu
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, South Korea
| | - Ju-Yeon Lee
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, South Korea
| | - Sung-Wan Kim
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, South Korea
| | - Jung-Chul Kim
- Department of Surgery, Chonnam National University Medical School and Hospital, Gwangju, South Korea
| | - Byung Jo Chun
- Department of Emergency Medicine, Chonnam National University Medical School, Gwangju, South Korea
| | - Il-Seon Shin
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, South Korea
| | - Youngkeun Ahn
- Department of Cardiology, Chonnam National University Medical School, Gwangju, South Korea
| | - Myung Ho Jeong
- Department of Cardiology, Chonnam National University Medical School, Gwangju, South Korea
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27
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Faccini J, Joshi V, Graziani P, Del-Monte J. Non-Constructive Ruminations, Insomnia and Nightmares: Trio of Vulnerabilities to Suicide Risk. Nat Sci Sleep 2022; 14:433-441. [PMID: 35321356 PMCID: PMC8935486 DOI: 10.2147/nss.s339567] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Accepted: 12/19/2021] [Indexed: 01/20/2023] Open
Abstract
OBJECTIVE Nightmare distress, nightmare frequency and anxiety are related to suicidal risk. Ruminations are a factor maximizing the risk of suicide. Research has identified two types of ruminations: constructive ruminations and non-constructive ruminations. As per our knowledge, no study has verified the links between non-constructive ruminations and sleep disorders and their role in the development of suicidal risk. We aimed to highlight the impact of non-constructive ruminations on nightmares, anxiety and insomnia in the development of suicidal risk. METHODS A total of 429 French participants responded to an anonymous online survey using the Qualtrics® software. To assess variables, we used the Mini Cambridge-Exeter Repetitive Thought Scale, the Suicide Behaviors Questionnaire-Revised, the Nightmare Distress Questionnaire, the Beck Anxiety Inventory, and the Sleep Condition Indicator. Nightmare frequency was assessed by subjective evaluation through a question. We tested the possible effects of confounding variables such as age, gender, marital status and depression (Beck Depression Inventory-II). RESULTS Nightmare frequency was found to mediate the link between anxiety and suicidal risk (32.9%). Nightmare distress (37%) and non-constructive thoughts (48%) were also seen to mediate this link. Additionally, we found a moderating effect of insomnia on the link between non-constructive ruminations and suicidal risk (Z = 7.42, p < 0.001). CONCLUSION Our results showed that the frequency of nightmares, distress and non-constructive ruminations are closely related to suicidal risk. The interoperability between these elements and insomnia has thus been newly explored. The processes related to nightmares and suicidal risk as well as the underlying cognitive processes between sleep disorders and suicidal risk have been shed light upon.
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Affiliation(s)
- Julie Faccini
- University of Nîmes, LSP Laboratory, Aix-Marseille University, Marseille, France
| | - Vrutti Joshi
- University of Nîmes, LSP Laboratory, Aix-Marseille University, Marseille, France
| | - Pierluigi Graziani
- University of Nîmes, LSP Laboratory, Aix-Marseille University, Marseille, France
| | - Jonathan Del-Monte
- University of Nîmes, LSP Laboratory, Aix-Marseille University, Marseille, France
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Scoggins D, Khan AS, Dai H. Hierarchical Analysis of Disparities in Suicidal Outcomes With Intersection of Sexual Minority and Gender Among U.S. Youth, 2017. HEALTH EDUCATION & BEHAVIOR 2021; 49:569-583. [PMID: 34628973 DOI: 10.1177/10901981211045933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Sexual minority youth have a higher risk of suicidal behaviors than their straight peers. Despite this alarming trend, there is limited information on how health-risk factors are systematically associated with suicidal outcomes in relation to the intersection of sex and sexual orientation identity. Data from the 2017 Youth Risk Behavior Survey (Grades 9-12, N = 14,108) were analyzed to examine three distinct suicidal outcomes (i.e., suicidal ideation, suicide planning, and suicide attempt). Separate hierarchical logistic regression models were performed to gradually adjust for influencing factors in examining the association between suicidal outcomes and sexual orientation identity (i.e., heterosexual, gay/lesbian, bisexual, and unsure), stratified by self-reported sex. There exist significant differences in youth suicidal behaviors based on sexual orientation identity and sex: lesbians (adjusted odds ratio [AOR] = 2.7, 95% CI [1.5, 5.0]), bisexual girls (AOR = 1.9, 95% CI [1.3, 2.6]) and bisexual boys (AOR = 2.6, 95% CI [1.3, 5.2]) had higher odds of suicide attempts than their straight peers. Unsure boys and girls also reported higher risks of suicidal ideation and suicide plan as compared with their straight peers. Having a very short sleep duration, reporting ever use of illicit drugs, being bullied, and feeling sad/hopeless were associated with elevated risks of suicidality across males and females. This study identified potential disparities in suicidal outcomes by sexual orientation identity as well as factors that attenuate or strengthen this relationship in a representative sample of adolescents across the United States. An improved understanding of the differences in suicidal outcomes will serve as an opportunity to ameliorate any potential inequalities and improve sexual minority youth' health outcomes.
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Affiliation(s)
| | - Ali S Khan
- University of Nebraska Medical Center, Omaha, NE, USA
| | - Hongying Dai
- University of Nebraska Medical Center, Omaha, NE, USA
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29
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Ng APP, Chin WY, Wan EYF, Chen J, Lau CS. Prevalence of depression and suicide ideation in Hong Kong doctors: a cross-sectional study. Sci Rep 2021; 11:19366. [PMID: 34588512 PMCID: PMC8481547 DOI: 10.1038/s41598-021-98668-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Accepted: 09/14/2021] [Indexed: 11/18/2022] Open
Abstract
Depression amongst physicians can lead to poor individual and institutional outcomes. This study examined the prevalence and factors associated with depression and suicidal ideation amongst doctors in Hong Kong. Doctors who graduated from medical school at the University of Hong Kong between 1995 and 2014 were invited to participate in a survey measuring depressive symptoms, suicidal ideation and thoughts of self-harm, lifestyle behaviours, career satisfaction and socio-demographic characteristics. Data collection occurred between January and April 2016. The prevalence of screened-positive depression was 16.0% and 15.3% of respondents reported having suicidal ideation. Amongst those with positive depression screening scores, less than half reported having a diagnosed mood disorder. Sleeping fewer hours was associated with higher depression scores (P < 0.001) and an increased odds of meeting the cut-off for depression (P < 0.001). Factors associated with suicidal ideation included being unmarried (P = 0.012) and sleeping fewer hours (P = 0.022). Hong Kong doctors appear to have high rates of undiagnosed depression, and high levels of depressive symptoms and suicidal ideations. There is a need for greater awareness of the morbidity due to depression and to promote better mental health help-seeking among physicians. Barriers to mental health help-seeking need to be addressed and appropriate resources allocated to reduce suffering.
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Affiliation(s)
- Amy Pui Pui Ng
- Department of Family Medicine and Primary Care, The University of Hong Kong-Shenzhen Hospital, 1 Haiyuan 1st Rd, Futian District, Shenzhen, 518053, Guangdong Province, China.,Department of Family Medicine and Primary Care, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 3/F., 161 Main Street, Ap Lei Chau Clinic, Ap Lei Chau, Hong Kong, Hong Kong SAR
| | - Weng Yee Chin
- Department of Family Medicine and Primary Care, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 3/F., 161 Main Street, Ap Lei Chau Clinic, Ap Lei Chau, Hong Kong, Hong Kong SAR. .,Li Ka Shing Faculty of Medicine, Bau Institute of Medical and Health Sciences Education, The University of Hong Kong, 21 Sassoon Road, Pok Fu Lam, Hong Kong, Hong Kong SAR.
| | - Eric Yuk Fai Wan
- Department of Family Medicine and Primary Care, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 3/F., 161 Main Street, Ap Lei Chau Clinic, Ap Lei Chau, Hong Kong, Hong Kong SAR.,Department of Pharmacology and Pharmacy, LKS Faculty of Medicine, HKU, 2/F, Laboratory Block, 21 Sassoon Road, Pok Fu Lam, Hong Kong, Hong Kong SAR
| | - Julie Chen
- Department of Family Medicine and Primary Care, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 3/F., 161 Main Street, Ap Lei Chau Clinic, Ap Lei Chau, Hong Kong, Hong Kong SAR.,Li Ka Shing Faculty of Medicine, Bau Institute of Medical and Health Sciences Education, The University of Hong Kong, 21 Sassoon Road, Pok Fu Lam, Hong Kong, Hong Kong SAR
| | - Chak Sing Lau
- Department of Medicine Hong Kong, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Queen Mary Hospital, Room 405B, 4/F, Professorial Block, 102 Pok Fu Lam Road, Pok Fu Lam, Hong Kong, Hong Kong SAR
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Dolsen EA, Prather AA, Lamers F, Penninx BWJH. Suicidal ideation and suicide attempts: associations with sleep duration, insomnia, and inflammation. Psychol Med 2021; 51:2094-2103. [PMID: 32321599 DOI: 10.1017/s0033291720000860] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND Sleep disturbance has been consistently identified as an independent contributor to suicide risk. Inflammation has emerged as a potential mechanism linked to both sleep disturbance and suicide risk. This study tested associations between sleep duration, insomnia, and inflammation on suicidal ideation (SI) and history of a suicide attempt (SA). METHODS Participants included 2329 adults with current or remitted depression and/or anxiety enrolled in the Netherlands Study of Depression and Anxiety. Sleep duration, insomnia, past week SI, and SA were assessed with self-report measures. Plasma levels of C-reactive protein, interleukin-6, and tumor necrosis factor-α were obtained. RESULTS Short sleep duration (⩽6 h) compared to normal sleep duration (7-9 h) was associated with reporting a prior SA, adjusting for covariates [adjusted odds ratio (AOR) 1.68, 95% CI 1.13-2.51]. A higher likelihood of SI during the past week was observed for participants with long sleep duration (⩾10 h) compared to normal sleep duration (AOR 2.22, 95% CI 1.02-4.82), more insomnia symptoms (AOR 1.44, 95% CI 1.14-1.83), and higher IL-6 (AOR 1.31, 95% CI 1.02-1.68). Mediation analyses indicated that the association between long sleep duration and SI was partially explained by IL-6 (AOR 1.02, 95% CI 1.00-1.05). CONCLUSIONS These findings from a large sample of adults with depression and/or anxiety provide evidence that both short and long sleep duration, insomnia symptoms, and IL-6 are associated with the indicators of suicide risk. Furthermore, the association between long sleep duration and SI may operate through IL-6.
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Affiliation(s)
- Emily A Dolsen
- Department of Psychology, University of California, Berkeley, 2121 Berkeley Way, Berkeley, CA94720, USA
| | - Aric A Prather
- Department of Psychiatry, University of California San Francisco, San Francisco, CA94118, USA
| | - Femke Lamers
- Department of Psychiatry, Amsterdam Neuroscience and Amsterdam Public Health Research Institutes, Amsterdam UMC, Vrije Universiteit, Amsterdam, The Netherlands
| | - Brenda W J H Penninx
- Department of Psychiatry, Amsterdam Neuroscience and Amsterdam Public Health Research Institutes, Amsterdam UMC, Vrije Universiteit, Amsterdam, The Netherlands
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Tucker RP, Cramer RJ, Langhinrichsen-Rohling J, Rodriguez-Cue R, Rasmussen S, Oakey-Frost N, Franks CM, Cunningham CCA. Insomnia and suicide risk: a multi-study replication and extension among military and high-risk college student samples. Sleep Med 2021; 85:94-104. [PMID: 34298228 DOI: 10.1016/j.sleep.2021.06.032] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 05/31/2021] [Accepted: 06/21/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVE/BACKGROUND A clear link between insomnia concerns and suicidal ideation has been shown in a variety of populations. These investigations failed to use a theoretical lens in understanding this relationship. Research within the veteran population has demonstrated that feelings of thwarted belongingness (TB), but not perceived burdensomeness (PB), mediate the insomnia and suicidal ideation relationship. Using two high risk samples, the present investigation replicated and extended this line of inquiry to include interpersonal hopelessness about TB, a key component of the Interpersonal Psychological Theory of Suicide. METHODS/RESULTS/CONCLUSIONS Using medical record review and survey data, study 1 replicated the finding that TB is a stronger explanatory factor of the insomnia to suicidal ideation/suicide risk relationship in a sample of N = 200 treatment-seeking active-duty personnel. Study 2 found that insomnia symptoms had an indirect effect on suicidal ideation through TB and PB but not interpersonal hopelessness in a sample of N = 151 college students with a history of suicidal thoughts and/or behaviors. TB was the only mediator of the insomnia-suicide attempt likelihood link and insomnia to clinically significant suicide risk screening status. Limitations include cross-sectional design of both studies and the lack of formal diagnoses of insomnia. Implications and future research directions are discussed.
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Affiliation(s)
| | | | | | | | | | | | - Capt Michael Franks
- US Public Health Service, Naval Medical Center Psychology Training Programs, Navy Medicine Readiness and Training Command Portsmouth, Portsmouth, VA, 23708, USA
| | - Capt Craig A Cunningham
- Nursing Research and Consultation Services, Navy Medicine Readiness and Training Command Portsmouth, Portsmouth, VA, 23708, USA
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Batterham PJ, Werner-Seidler A, Calear AL, McCallum S, Gulliver A. Specific aspects of sleep disturbance associated with suicidal thoughts and attempts. J Affect Disord 2021; 282:574-579. [PMID: 33440302 DOI: 10.1016/j.jad.2020.12.150] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Revised: 09/08/2020] [Accepted: 12/24/2020] [Indexed: 01/21/2023]
Abstract
OBJECTIVE Previous research suggests that sleep disturbance is associated with suicidal ideation and suicide attempt. However, few studies have accounted for the presence of multiple mental disorders and interpersonal factors associated with suicide risk. Furthermore, limited research has examined which aspects of sleep disturbance are most strongly associated with suicidal thoughts and attempts. METHOD A large community-based sample of Australian adults (n = 3,618; 81% female; 37% reporting ideation) completed a comprehensive survey assessing suicidal thoughts and behaviours, sleep disturbance, common mental disorders and interpersonal risk factors. Sleep disturbance was assessed using the 6-item PROMIS sleep disturbance scale and suicidality was measured using the Psychiatric Symptom Frequency Scale. Analyses were adjusted for age, sex, perceived burdensomeness, thwarted belongingness, and clinical caseness for six mental disorders, including major depression. RESULTS After accounting for mental health, demographic and interpersonal characteristics, increasing sleep disturbance was significantly associated with higher odds of both suicidal ideation (OR=1.17 for one-SD increase in PROMIS-SD), and suicide attempt (OR=1.33 for one-SD increase in PROMIS-SD). Of the specific indicators of sleep disturbance, only sleep onset (difficulties falling asleep) had a significant independent association with both suicidal ideation (p < 0.001) and suicide attempt (p = 0.047). CONCLUSIONS Sleep disturbance is independently associated with greater risk of suicidal thoughts and behaviours. Sleep disturbance is highly modifiable, so sleep interventions for people with suicide risk and sleep problems may provide an effective and efficient approach to suicide prevention in the community.
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Affiliation(s)
- Philip J Batterham
- Centre for Mental Health Research, The Australian National University, Canberra, Australia.
| | | | - Alison L Calear
- Centre for Mental Health Research, The Australian National University, Canberra, Australia
| | - Sonia McCallum
- Centre for Mental Health Research, The Australian National University, Canberra, Australia
| | - Amelia Gulliver
- Centre for Mental Health Research, The Australian National University, Canberra, Australia
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Rohr JC, Rufino KA, Alfano CA, Patriquin MA. Sleep disturbance in patients in an inpatient hospital mediates relationship between PTSD and suicidal ideation. J Psychiatr Res 2021; 133:174-180. [PMID: 33348251 DOI: 10.1016/j.jpsychires.2020.12.039] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Revised: 11/12/2020] [Accepted: 12/09/2020] [Indexed: 10/22/2022]
Abstract
A common reason for admission to inpatient psychiatric units is suicidal ideation. Growing evidence of the link between sleep disturbance and suicidal ideation brings an interest in greater clarity of the pathways; this paper focused on post-traumatic stress disorder (PTSD), which carries increased risk for both sleep disturbance and suicidal ideation, as well as sex differences in those pathways. Patients were 2822 inpatients studied at admission to an inpatient psychiatric hospital and mediation analyses were used to examine pathways of interest. There was an indirect effect of PTSD on suicidal ideation through sleep disturbances for the entire sample and for men and women separately. The effect for men was larger than that for women, suggesting a stronger effect for sleep disturbance in the relationship for men. For women only, the direct effect between PTSD and suicidal ideation remained significant after mediation. Sleep disturbance plays an important role in the relationship between PTSD and suicidal ideation. Early identification of sleep disturbance in inpatients and targeted focus of sleep in conjunction with resolving trauma-related symptoms may help reduce suicidal ideation. This may be especially true of men; the indirect effect was smaller for women, suggesting that sleep disturbance should be addressed in conjunction with other PTSD symptoms likely leading to suicidal ideation.
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Affiliation(s)
- Jessica C Rohr
- The Menninger Clinic, 12301 S. Main St., Houston TX 77035, USA; Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, 1977 Butler Blvd., Houston TX 77030, USA.
| | - Katrina A Rufino
- The Menninger Clinic, 12301 S. Main St., Houston TX 77035, USA; Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, 1977 Butler Blvd., Houston TX 77030, USA; The University of Houston Downtown, 1 Main St., Houston TX 77002, USA
| | - Candice A Alfano
- Sleep and Anxiety Center of Houston, University of Houston, 4505 Cullen Blvd., Houston TX 77204, USA
| | - Michelle A Patriquin
- The Menninger Clinic, 12301 S. Main St., Houston TX 77035, USA; Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, 1977 Butler Blvd., Houston TX 77030, USA; Michaeld E. DeBakey Veterans Affairs Medical Center, 2002 Holcombe Blvd, Houston, TX, 77030, USA
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Hershner S, Jansen EC, Gavidia R, Matlen L, Hoban M, Dunietz GL. Associations Between Transgender Identity, Sleep, Mental Health and Suicidality Among a North American Cohort of College Students. Nat Sci Sleep 2021; 13:383-398. [PMID: 33762860 PMCID: PMC7982442 DOI: 10.2147/nss.s286131] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2020] [Accepted: 01/29/2021] [Indexed: 12/20/2022] Open
Abstract
PURPOSE The purpose of this study is to examine the associations between transgender identity, sleep, and mental health among a North American cohort of cisgender and transgender college students. PARTICIPANTS AND METHODS This cross-sectional study surveyed 221,549 North American college students from the 2016-2017 American College Health Association-National College Health Assessment II. Bivariate and multivariable analysis examined associations among transgender identity and outcomes of insomnia symptoms, daytime sleepiness, sleep disorder diagnoses and treatments. Mental health outcomes included mood symptoms, suicidal behaviors, anxiety and depression diagnoses and treatments. RESULTS Transgender identity was reported by 1.6% (n=3471) of United States (US) and 1.7% (n=717) Canadian students, respectively. Mean age was 22.5 ±6. Transgender college students have an increased prevalence of daytime sleepiness, insomnia symptoms, diagnoses and/or treatment of insomnia and other sleep disorders as compared to cisgender college students. Mental Health symptoms are more prevalent with a 2-fold increase in depression and anxiety and nearly a 4-fold increase in suicide attempts among transgender students. A higher burden of mood symptoms exists among transgender college students in the US in comparison to Canadian students. CONCLUSION Transgender college students have an alarmingly high rate of mood, sleep disturbances and sleep diagnoses, and suicidality. Colleges and universities must provide sufficient resources to address the sleep and mental health needs of transgender students. Institutions must adopt gender affirming policies that promote an inclusive environment. Increased allocation of resources and adoption of policies that enhance the physical and mental health of transgender students could improve sleep, mood, and potentially lower the suicide risk among a population that often experiences health inequities.
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Affiliation(s)
- Shelley Hershner
- Sleep Disorders Center, Department of Neurology, University of Michigan, Ann Arbor, MI, USA
| | - Erica C Jansen
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Ronald Gavidia
- Sleep Disorders Center, Department of Neurology, University of Michigan, Ann Arbor, MI, USA
| | - Lisa Matlen
- Department of Pediatrics; Sleep Disorder Center, University of Michigan, Ann Arbor, MI, USA
| | - Mary Hoban
- American College Health Association, Research Office, Silver Spring, MD, USA
| | - Galit Levi Dunietz
- Sleep Disorders Center, Department of Neurology, University of Michigan, Ann Arbor, MI, USA
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Abstract
Sleep disturbances, particularly insomnia, nightmares, and excessive daytime sleepiness (EDS), are significant, proximal, and modifiable risk factors for suicidal ideation and behaviors (SIB) and could be targeted for preventative interventions. In this chapter, we review the evidence supporting the association of insomnia, nightmares, and EDS with SIB. We also describe these sleep disturbances in the general population, as well as their association with psychiatric disorders. A PubMed search was conducted to identify the relevant literature. Insomnia is very frequent across mental disorders, but SIB patients are particularly exposed. Specific interventions focused on insomnia are useful in contending suicidal ideation. Nightmares seem to constitute an independent risk factor for SIB, beyond insomnia, particularly in young people and when experienced frequently. The evidence regarding the association of EDS and SIB is less clear and probably explained by the reduction of health-related quality of life and comorbid depression. The mechanisms underlying the relationship between sleep disturbances and SIB as well as the role of potential confounders and future perspectives in this field are also discussed.
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Affiliation(s)
- Jorge Lopez-Castroman
- PSNREC, University of Montpellier, INSERM, Montpellier, France. .,Nimes University Hospital, Nimes, France. .,CIBERSAM, Madrid, Spain.
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36
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Bajaj S, Blair KS, Schwartz A, Dobbertin M, Blair RJR. Worry and insomnia as risk factors for depression during initial stages of COVID-19 pandemic in India. PLoS One 2020; 15:e0243527. [PMID: 33301508 PMCID: PMC7728274 DOI: 10.1371/journal.pone.0243527] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Accepted: 11/23/2020] [Indexed: 12/21/2022] Open
Abstract
The biggest nationwide COVID-19 pandemic lockdown worldwide was enforced in India for an initial period of 21-days. Emerging evidence suggests that pandemic situations and associated lockdowns have an adverse impact on sleep and mental health. However, prediction of sleep health from sociodemographic characteristics and the public’s worry during the initial stages of the COVID-19 pandemic has not been extensively explored so far. It’s also unclear whether sleep outcomes mediate the association between worry and mental health during pandemic situations. A web-survey (N = 391) on sociodemographic characteristics, COVID-19 related worry, sleep health (insomnia and daytime sleepiness), and depression was conducted during the initial 21-days of the COVID-19 stringent lockdown in India. Multiple regression analyses showed that variables, including sex, age, income level, and worry score, contributed to the significant regression equation for insomnia but not for daytime sleepiness. Specifically, the female, younger, lower income, and highly worried populations contributed significantly more than the male, elderly, higher income, and less worried populations, respectively, to the prediction of insomnia. Mediation analyses showed that insomnia, but not daytime sleepiness, fully mediated the relationship between worry score and severity of depressive symptoms. We provide evidence that the female, younger, lower income, and worried populations may be at higher risk for insomnia during pandemic situations. Current evidence gives hope that improving sleep may reduce depressive symptoms during a pandemic situation. This underscores the importance of the implementation of effective public health policies in conjunction with strategical responses to the COVID-19 pandemic.
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Affiliation(s)
- Sahil Bajaj
- Multimodal Clinical Neuroimaging Laboratory (MCNL), Center for Neurobehavioral Research, Boys Town National Research Hospital, Boys Town, NE, United States of America
- Program for Trauma and Anxiety (PTAC), Center for Neurobehavioral Research, Boys Town National Research Hospital, Boys Town, NE, United States of America
- * E-mail:
| | - Karina S. Blair
- Multimodal Clinical Neuroimaging Laboratory (MCNL), Center for Neurobehavioral Research, Boys Town National Research Hospital, Boys Town, NE, United States of America
- Program for Trauma and Anxiety (PTAC), Center for Neurobehavioral Research, Boys Town National Research Hospital, Boys Town, NE, United States of America
| | - Amanda Schwartz
- Multimodal Clinical Neuroimaging Laboratory (MCNL), Center for Neurobehavioral Research, Boys Town National Research Hospital, Boys Town, NE, United States of America
- Program for Trauma and Anxiety (PTAC), Center for Neurobehavioral Research, Boys Town National Research Hospital, Boys Town, NE, United States of America
| | - Matthew Dobbertin
- Multimodal Clinical Neuroimaging Laboratory (MCNL), Center for Neurobehavioral Research, Boys Town National Research Hospital, Boys Town, NE, United States of America
- Program for Trauma and Anxiety (PTAC), Center for Neurobehavioral Research, Boys Town National Research Hospital, Boys Town, NE, United States of America
| | - R. James R. Blair
- Multimodal Clinical Neuroimaging Laboratory (MCNL), Center for Neurobehavioral Research, Boys Town National Research Hospital, Boys Town, NE, United States of America
- Program for Trauma and Anxiety (PTAC), Center for Neurobehavioral Research, Boys Town National Research Hospital, Boys Town, NE, United States of America
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37
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Song Y, Rhee SJ, Lee H, Kim MJ, Shin D, Ahn YM. Comparison of Suicide Risk by Mental Illness: a Retrospective Review of 14-Year Electronic Medical Records. J Korean Med Sci 2020; 35:e402. [PMID: 33289369 PMCID: PMC7721561 DOI: 10.3346/jkms.2020.35.e402] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Accepted: 09/16/2020] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Korea is one of the countries with the highest rate of suicide, while suicidality is known to be closely related to mental illnesses. The study aimed to evaluate the suicide rates in psychiatric patients, to compare it to that of the general population, and to investigate the differences among psychiatric diagnoses and comorbidities. METHODS Medical records and mortality statistics of psychiatric patients at Seoul National University Hospital from 2003 to 2017 were reviewed. The standardized mortality ratio (SMR) for suicide was calculated to compare the psychiatric patients with the general population. The diagnosis-specific standardized mortality rate and hazard ratio (HR) were adjusted by age, sex, and psychiatric comorbidity (i.e., personality disorder and/or pain disorder). RESULTS A total of 40,692 survivors or non-suicidal deaths and 597 suicidal death were included. The suicide rate among psychiatric patients was 5.13-fold higher than that of the general population. Psychotic disorder had the highest SMR (13.03; 95% confidence interval [CI], 11.23-15.03), followed by bipolar disorder (10.26; 95% CI, 7.97-13.00) and substance-related disorder (6.78; 95% CI, 4.14-10.47). In survival analysis, psychotic disorder had the highest HR (4.16; 95% CI, 2.86-6.05), which was further increased with younger age, male sex, and comorbidity of personality disorder. CONCLUSION All psychiatric patients are at a higher risk of suicide compared to the general population, and the risk is highest for those diagnosed with psychotic disorder.
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Affiliation(s)
- Yoojin Song
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Korea
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Korea
| | - Sang Jin Rhee
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Korea
| | - Hyunju Lee
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Korea
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Korea
| | - Min Ji Kim
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Korea
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Korea
| | - Daun Shin
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Korea
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Korea
| | - Yong Min Ahn
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Korea
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Korea
- Institute of Human Behavioral Medicine, Seoul National University Medical Research Center, Seoul, Korea.
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38
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Soares FC, Hardman CM, Rangel Junior JFB, Bezerra J, Petribú K, Mota J, de Barros MVG, Lima RA. Secular trends in suicidal ideation and associated factors among adolescents. ACTA ACUST UNITED AC 2020; 42:475-480. [PMID: 32491043 PMCID: PMC7524424 DOI: 10.1590/1516-4446-2019-0783] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Accepted: 01/26/2020] [Indexed: 01/20/2023]
Abstract
Objectives: Suicide is one of the leading causes of death in adolescence, and the second most common cause of death among young people. The objective of this study was to identify trends in suicidal ideation by sex and ascertain factors associated with this outcome. Methods: Secular trend study with statewide coverage conducted at 5-year intervals, with 4,207 adolescents (2006), 6,264 adolescents (2011) and 6,026 adolescents (2016). Logistic regression was used to evaluate the secular trend of suicidal ideation. Multilevel logistic regressions evaluated the factors associated with suicidal ideation in the survey conducted in 2016. Results: There was a positive trend in suicidal ideation prevalence in 2016 compared to the prevalence in 2006 and 2011, in both boys and girls. Low social support, poor sleep quality, and low parental supervision were associated with suicidal ideation in boys and girls. Exposure to violence and bullying was associated with suicidal ideation only in girls. TV time and computer and videogame time were not associated with suicidal ideation in boys or girls. Conclusion: There is an alarming trend of increased suicidal ideation in adolescents. Several dimensions were associated with suicidal ideation in adolescents, especially social support, sleep quality, and parental supervision.
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Affiliation(s)
- Fernanda C Soares
- Escola de Educação Física, Programa de Pós-Graduação em Educação Física, Grupo de Pesquisa em Estilos de Vida e Saúde (GPES), Universidade de Pernambuco (UPE), Recife, PE, Brazil
| | - Carla M Hardman
- Programa de Pós-Graduação em Educação Física, Universidade Federal de Pernambuco, (UFPE), Recife, PE, Brazil
| | - João F B Rangel Junior
- Escola de Educação Física, Programa de Pós-Graduação em Educação Física, Grupo de Pesquisa em Estilos de Vida e Saúde (GPES), Universidade de Pernambuco (UPE), Recife, PE, Brazil
| | - Jorge Bezerra
- Escola de Educação Física, Programa de Pós-Graduação em Educação Física, Grupo de Pesquisa em Estilos de Vida e Saúde (GPES), Universidade de Pernambuco (UPE), Recife, PE, Brazil
| | - Kátia Petribú
- Faculdade de Ciências Médicas, UPE, Recife, PE, Brazil
| | - Jorge Mota
- Centro de Investigação em Atividade Física, Saúde e Lazer (CIAFEL), Faculdade de Desporto, Universidade do Porto, Porto, Portugal
| | - Mauro V G de Barros
- Escola de Educação Física, Programa de Pós-Graduação em Educação Física, Grupo de Pesquisa em Estilos de Vida e Saúde (GPES), Universidade de Pernambuco (UPE), Recife, PE, Brazil
| | - Rodrigo A Lima
- Escola de Educação Física, Programa de Pós-Graduação em Educação Física, Grupo de Pesquisa em Estilos de Vida e Saúde (GPES), Universidade de Pernambuco (UPE), Recife, PE, Brazil.,Institut für Sportwissenschaft, Karl-Franzens-Universität Graz, Graz, Austria
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Schriver E, Lieblich S, AlRabiah R, Mowery DL, Brown LA. Identifying risk factors for suicidal ideation across a large community healthcare system. J Affect Disord 2020; 276:1038-1045. [PMID: 32763588 DOI: 10.1016/j.jad.2020.07.047] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2019] [Revised: 05/14/2020] [Accepted: 07/05/2020] [Indexed: 11/17/2022]
Abstract
BACKGROUND Suicide is the tenth leading cause of death in the United States. Several studies have leveraged electronic health record (EHR) data to predict suicide risk in veteran and military samples; however, few studies have investigated suicide risk factors in a large-scale community health population. METHODS Clinical data was queried for 9,811 patients from the Penn Medicine Health System who had completed a Patient Health Questionnaire-9 (PHQ-9) documented in the EHR between January 2017 and June 2019. Patient demographics, PHQ-9 scores, and psychiatric comorbidities were extracted from the EHR. Univariate and multivariable logistic regressions were applied to determine significant risk factors associated with suicide ideation responses from the PHQ-9. RESULTS One-quarter (25.8%% of patients endorsed suicide ideation. Univariate analysis found 22 risk factors of suicide ideation. Multivariable logistic regression found significant positive associations (Odds Ratio, (95% Confidence Interval)) with the following: younger ages less than 18 years: 2.1, (1.69, 2.60) and 19-24 years: 1.55, (1.29, 1.87)), single marital status (1.22, (1.08, 1.38)), African American (1.22, (1.08, 1.38)), non-commercial insurance (1.16, (1.03, 1.31)), multiple comorbidities (1 comorbidity (1.65, (1.32, 2.07); 2 comorbidities (2.07, (1.61, 2.64)), 3+ comorbidities (2.49, (1.87, 3.33))), bipolar disorders (Type I: 1.38, (1.14, 1.67) and Type II: 1.94, (1.52, 2.49)), depressive disorders (1.70, (1.49, 1.94)), obsessive compulsive disorder (OCD) (1.43, (1.08, 1.90)), and stress disorders (1.53, (1.33, 1.76)). CONCLUSION Community EHR information can be used to predict suicidal ideation. This information can be used to design tools for identifying patients at risk for suicide in real-time.
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Affiliation(s)
- Emily Schriver
- Data Analytics Center, Penn Medicine; Institute for Biomedical Informatics, University of Pennsylvania
| | | | - Reem AlRabiah
- Department of Psychiatry, University of Pennsylvania
| | - Danielle L Mowery
- Institute for Biomedical Informatics, University of Pennsylvania; Department of Biostatistics, Epidemiology, & Informatics, University of Pennsylvania
| | - Lily A Brown
- Department of Psychiatry, University of Pennsylvania.
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40
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Liu RT, Steele SJ, Hamilton JL, Do QBP, Furbish K, Burke TA, Martinez AP, Gerlus N. Sleep and suicide: A systematic review and meta-analysis of longitudinal studies. Clin Psychol Rev 2020; 81:101895. [PMID: 32801085 PMCID: PMC7731893 DOI: 10.1016/j.cpr.2020.101895] [Citation(s) in RCA: 80] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Revised: 07/06/2020] [Accepted: 08/05/2020] [Indexed: 12/13/2022]
Abstract
The current review provides a quantitative synthesis of the empirical literature on sleep disturbance as a risk factor for suicidal thoughts and behaviors (STBs). A systematic search of PsycINFO, MEDLINE, and the references of prior reviews resulted in 41 eligible studies included in this meta-analysis. Sleep disturbance, including insomnia, prospectively predicted STBs, yielding small-to-medium to medium effect sizes for these associations. Complicating interpretation of these findings however, is that few studies of suicidal ideation and suicide attempts, as well as none of suicide deaths, assessed short-term risk (i.e., employed follow-up assessments of under a month). Such studies are needed to evaluate current conceptualizations of sleep dysregulation as being involved in acute risk for suicidal behavior. This want of short-term risk studies also suggests that current clinical recommendations to monitor sleep as a potential warning sign of suicide risk has a relatively modest empirical basis, being largely driven by cross-sectional or retrospective research. The current review ends with recommendations for generating future research on short-term risk and greater differentiation between acute and chronic aspects of sleep disturbance, and by providing a model of how sleep disturbance may confer risk for STBs through neuroinflammatory and stress processes and associated impairments in executive control.
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Affiliation(s)
- Richard T Liu
- Massachusetts General Hospital, Boston, MA, United States of America; Department of Psychiatry, Harvard Medical School, Boston, MA, United States of America.
| | - Stephanie J Steele
- Department of Psychology, Williams College, Williamstown, MA, United States of America
| | - Jessica L Hamilton
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States of America
| | - Quyen B P Do
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, United States of America
| | - Kayla Furbish
- Department of Psychology, Boston University, Boston, MA, United States of America
| | - Taylor A Burke
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, United States of America
| | - Ashley P Martinez
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, United States of America
| | - Nimesha Gerlus
- Duke University School of Medicine, Durham, NC, United States of America
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Miller GF, DePadilla L, Jones SE, Bartholow BN, Sarmiento K, Breiding MJ. The Association Between Sports- or Physical Activity-Related Concussions and Suicidality Among US High School Students, 2017. Sports Health 2020; 13:187-197. [PMID: 32845815 DOI: 10.1177/1941738120939913] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND This study examined the association between sports- or physical activity-related concussions and having seriously considered attempting suicide, made a suicide plan, or attempted suicide (ie, suicidality), and tested potential moderators of the association. HYPOTHESIS Risk factors such as persistent feelings of sadness or hopelessness, low academic grades, few hours of sleep, and current alcohol or marijuana use will increase the odds of suicidality among those who self-reported sports- or physical activity-related concussions, while protective factors such as physical activity and having played on a sports team will decrease the odds. STUDY DESIGN Cross-sectional study. LEVEL OF EVIDENCE Level 4. METHODS This study used data from the 2017 Youth Risk Behavior Survey, a biennial, school-based, nationally representative survey of US students in grade levels 9 to 12 (N = 14,765). Logistic regression models examined associations between self-reported sports- or physical activity-related concussions and suicidality among the students, and whether physical activity, having played on a sports team, persistent feelings of sadness or hopelessness, academic grades, hours of sleep, or current alcohol or marijuana use moderated those associations. RESULTS Sports- or physical activity-related concussions were found to be associated with suicidality. The associations remained significant in models that adjusted for demographic characteristics, and they did not appear to be moderated by physical activity, having played on sports team, academic grades, or sleep. CONCLUSIONS Given the findings of this study and others, health care providers are advised to ask students who have experienced a concussion about their emotional well-being as part of their symptom-based assessment, using validated, age- appropriate concussion symptom scales. Comprehensively assessing students who have experienced a sports- or physical activity-related concussion for persistent feelings of sadness or hopelessness may alert providers to thoughts of suicidal ideation and will allow for earlier intervention. CLINICAL RELEVANCE If thoughts of suicide are discovered among adolescents with a concussion, or if other risk factors are observed, referrals to medical and mental health providers for a more comprehensive assessment may be warranted.
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Affiliation(s)
- Gabrielle F Miller
- Division of Injury Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Lara DePadilla
- Division of Overdose Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Sherry Everett Jones
- Division of Adolescent and School Health, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Brad N Bartholow
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Kelly Sarmiento
- Division of Injury Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Matthew J Breiding
- Division of Injury Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
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Rugo KF, Tabares JV, Crowell SE, Baucom BR, Rudd MD, Bryan CJ. The role of depression and suicidal cognitions as contributors to suicide risk among active duty soldiers reporting symptoms of posttraumatic stress disorder. J Affect Disord 2020; 265:333-341. [PMID: 32090757 DOI: 10.1016/j.jad.2020.01.095] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Revised: 11/12/2019] [Accepted: 01/20/2020] [Indexed: 11/17/2022]
Abstract
BACKGROUND Military suicide rates have risen across all service branches, with the overall rate surpassing that of the general population for the first time in history in 2008. Service members with posttraumatic stress disorder (PTSD) are at a substantially higher risk for suicidal ideation, suicide attempts, and death by suicide than their peers without PTSD. While the link between PTSD and suicide is well established in the literature, less is known about the precise nature of that connection. Several constructs have been implicated as potential mediators of this relation, such as depression, alcohol use, suicidal cognitions, and sleep disturbance. Yet, to our knowledge, these constructs have never been examined simultaneously in a single model to determine mediational influence for suicide risk among soldiers with PTSD. METHODS A sample of 172 active duty Army soldiers completed a series of measures targeting the aforementioned constructs. Data were analyzed using mediation model analyses. RESULTS Suicidal cognitions fully mediated the relation between PTSD symptoms and current suicide risk severity. The indirect effect for suicidal cognitions was significantly larger than indirect effects for alcohol use, depression, and sleep disturbance. Exploratory analyses suggest serial mediation of the relation between PTSD and current suicide risk by depression and suicidal cognitions. LIMITATIONS These results should be interpreted within the context of study limitations, to include use of self-report data and inability to firmly establish temporal sequencing assumed in mediation. CONCLUSIONS Implications of this study include the improvement of suicide risk assessment and individualized treatment planning for suicidal military personnel with PTSD.
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Affiliation(s)
- Kelsi F Rugo
- National Center for Veterans Studies, The University of Utah, Salt Lake City, UT, USA; Department of Psychology, The University of Utah, Salt Lake City, UT, USA.
| | - Jeffrey V Tabares
- National Center for Veterans Studies, The University of Utah, Salt Lake City, UT, USA; Department of Psychology, The University of Utah, Salt Lake City, UT, USA
| | - Sheila E Crowell
- Department of Psychology, The University of Utah, Salt Lake City, UT, USA
| | - Brian R Baucom
- Department of Psychology, The University of Utah, Salt Lake City, UT, USA
| | - M David Rudd
- National Center for Veterans Studies, The University of Utah, Salt Lake City, UT, USA; Department of Psychology, University of Memphis, Memphis, TN, USA
| | - Craig J Bryan
- National Center for Veterans Studies, The University of Utah, Salt Lake City, UT, USA; Department of Psychology, The University of Utah, Salt Lake City, UT, USA
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Grove JL, Smith TW, Carlson SE, Bryan CJ, Crowell SE, Czajkowski L, Williams PG, Parkhurst K. Prospective association between suicide cognitions and emotional responses to a laboratory stressor: The mediating role of nightly subjective sleep quality. J Affect Disord 2020; 265:77-84. [PMID: 31957695 DOI: 10.1016/j.jad.2020.01.060] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Revised: 01/08/2020] [Accepted: 01/14/2020] [Indexed: 11/18/2022]
Abstract
BACKGROUND Sleep is a reliable correlate of suicidal thoughts and behaviors (STBs), yet few studies have directly examined negative affect in the context of this association. The present study combined daily experience methods with a laboratory paradigm to investigate suicide cognitions as a predictor of emotional responses to environmental stressors, and tested the role of nightly sleep parameters. METHOD 72 participants (Mage = 24.25; 41 with a recent history of suicide ideation and 31 without a history of STBs) completed a four-day study. Suicide cognitions were measured on the first day, and actigraphy-based sleep duration and fragmentation, and morning ratings of prior night subjective sleep quality (SSQ) were subsequently measured over three consecutive nights. Participants returned on the fourth day to complete the Trier Social Stress Task, where self-report changes in negative affect immediately post-task (i.e., reactivity) and five minutes post-task (i.e., recovery) were observed. RESULTS Regression analyses indicated that suicide cognitions predicted negative affect reactivity and recovery. Simple mediation analyses revealed that SSQ partially mediated the relation between suicide cognitions and negative affect recovery (especially shame), but not reactivity. No significant associations were observed for the actigraphy-based sleep parameters. LIMITATIONS Just three nights of actigraphy-based data collection. A single item was used to measure SSQ. CONCLUSIONS Suicide cognitions predict negative affective responses to situational stressors and SSQ may have a key role in this effect, especially the duration of negative emotional reactions. Hence, sleep and emotional reactivity may be potential targets for suicide prevention efforts.
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Affiliation(s)
- Jeremy L Grove
- Rutgers, State University of New Jersey 53 Avenue E, Piscataway, NJ 08854.USA.
| | | | | | - Craig J Bryan
- University of Utah USA; National Center for Veterans Studies USA
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Boggs JM, Lindrooth RC, Battaglia C, Beck A, Ritzwoller DP, Ahmedani BK, Rossom RC, Lynch FL, Lu CY, Waitzfelder BE, Owen-Smith AA, Simon GE, Anderson HD. Association between suicide death and concordance with benzodiazepine treatment guidelines for anxiety and sleep disorders. Gen Hosp Psychiatry 2020; 62:21-27. [PMID: 31765794 PMCID: PMC7001528 DOI: 10.1016/j.genhosppsych.2019.11.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Revised: 10/04/2019] [Accepted: 11/12/2019] [Indexed: 12/29/2022]
Abstract
OBJECTIVE Guidelines for management of anxiety and sleep disorders emphasize antidepressant medications and/or psychotherapy as first/second-line and benzodiazepines as third-line treatments. We evaluated the association between suicide death and concordance with benzodiazepine guidelines. METHODS Retrospective case-control study of patients with anxiety and/or sleep disorders from health systems across 8 U.S. states within the Mental Health Research Network. Suicide death cases were matched to controls on year and health system. Appropriate benzodiazepine prescribing defined as: no monotherapy, no long duration, and/or age < 65 years. The association between guideline concordance and suicide death was evaluated, adjusting for diagnostic and treatment covariates. RESULTS Sample included 6960 patients with anxiety disorders (2363 filled benzodiazepine) and 6215 with sleep disorders (1237 filled benzodiazepine). Benzodiazepine guideline concordance was associated with reduced odds for suicide in patients with anxiety disorders (OR = 0.611, 95% CI = 0.392-0.953, p = 0.03) and was driven by shorter duration of benzodiazepine use with concomitant psychotherapy or antidepressant medication. The association of benzodiazepine guideline concordance with suicide death did not meet statistical significance in the sleep disorder group (OR = 0.413, 95% CI = 0.154-1.11, p = 0.08). CONCLUSIONS We found reduced odds for suicide in those with anxiety disorders who filled benzodiazepines in short-moderate duration with concomitant psychotherapy or antidepressant treatment.
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Affiliation(s)
- Jennifer M Boggs
- Institute for Health Research, Kaiser Permanente Colorado, Denver, CO, United States of America; Department of Health Systems, Management, and Policy, Colorado School of Public Health, University of Colorado Anschutz Medical Campus.
| | - Richard C Lindrooth
- Department of Health Systems, Management, and Policy, Colorado School of Public Health, University of Colorado Anschutz Medical Campus
| | - Catherine Battaglia
- Department of Health Systems, Management, and Policy, Colorado School of Public Health, University of Colorado Anschutz Medical Campus; Department of Veterans Affairs (VA) Eastern Colorado Health Care System, Aurora, CO, United States of America
| | - Arne Beck
- Institute for Health Research, Kaiser Permanente Colorado, Denver, CO, United States of America; Department of Health Systems, Management, and Policy, Colorado School of Public Health, University of Colorado Anschutz Medical Campus
| | - Debra P Ritzwoller
- Institute for Health Research, Kaiser Permanente Colorado, Denver, CO, United States of America; Department of Health Systems, Management, and Policy, Colorado School of Public Health, University of Colorado Anschutz Medical Campus
| | - Brian K Ahmedani
- Center for Health Policy and Health Services Research, Henry Ford Health System, Detroit, MI, United States of America; Behavioral Health Services, Henry Ford Health System, Detroit, MI, United States of America
| | - Rebecca C Rossom
- HealthPartners Institute, Bloomington, MN, United States of America
| | - Frances L Lynch
- Kaiser Permanente Center for Integrated Health Care Research, Honolulu, HI, United States of America
| | - Christine Y Lu
- Department of Population Medicine, Harvard Medical School, Harvard Pilgrim Health Care Institute, Boston, MA, United States of America
| | - Beth E Waitzfelder
- Kaiser Permanente Center for Health Research, Honolulu, HI, United States of America
| | - Ashli A Owen-Smith
- School of Public Health, Georgia State University, Atlanta, GA, United States of America; Center for Research and Evaluation, Kaiser Permanente Georgia, Atlanta, GA, United States of America
| | - Gregory E Simon
- Kaiser Permanente Washington Health Research Institute, Seattle, WA, United States of America
| | - Heather D Anderson
- Department of Clinical Pharmacy, Skaggs School of Pharmacy and Pharmaceutical Sciences, University of Colorado, Denver, CO, United States of America
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Ara T, Rahman MM, Hossain MA, Ahmed A. Identifying the Associated Risk Factors of Sleep Disturbance During the COVID-19 Lockdown in Bangladesh: A Web-Based Survey. Front Psychiatry 2020; 11:580268. [PMID: 33093839 PMCID: PMC7527420 DOI: 10.3389/fpsyt.2020.580268] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2020] [Accepted: 08/25/2020] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Bangladesh, a developing country with a lower-middle-income and one of the world's most densely populated areas, has been severely affected by COVID-19. This global epidemic is not only affecting the physical health of the patients but also causing severe psychological effects among those who have not yet been infected. Sleep disturbance is one of the key symptoms of major depression and one of the proven risk factors for suicide. The objective of this study is to identify the risk factors associated with sleep disturbance which has developed as a general impact of COVID-19 and new normal life during the lockdown (a measure to control the spread of COVID-19) in Bangladesh. METHODS Demographic characteristics, COVID-19, and lockdown related information have been collected from 1,128 individuals by conducting a web-based survey. Respondent's perspective regarding sleep disturbance during COVID-19 lockdown is considered as the outcome of interest which is dichotomous. Descriptive statistics methods have been applied to explore the distribution of respondent's demographic characteristics. Pearson's chi-square tests have been performed to relate the sleep disturbance status of the respondents to their demographic, personal, and COVID-19 related information. Furthermore, a multivariable logistic regression model has been adopted to identify the significant association of sleep disturbance with the demographic, COVID-19, and lockdown related information of respondents during the COVID-19 lockdown in Bangladesh. FINDINGS The prevalence of sleep disturbance during the COVID-19 lockdown is found to be higher among participants aged 31-40 years. Gender disparity has also been observed in favor of male participants, whereas no significant regional heterogeneity has been found. Working from home or doing online classes during the lockdown has been found as a potential predictive factor of sleep disturbance. Losing a job has been considered as an adverse economic effect of COVID-19, which also induces sleep disturbance. Perception regarding the risk of getting infected and anxiety triggered the chance of developing sleep disturbance. The sleeping schedule is also found as a risk factor for sleep disturbance. CONCLUSION Evidence-based policies are required to combat psychological challenges that have arisen due to COVID-19, primarily targeting the groups who are largely suffering from sleep disturbance.
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Affiliation(s)
- Tasnim Ara
- Institute of Statistical Research and Training, University of Dhaka, Dhaka, Bangladesh
| | - Md Mahabubur Rahman
- Institute of Statistical Research and Training, University of Dhaka, Dhaka, Bangladesh
| | - Md Abir Hossain
- Department of Chemical and Food Engineering, Dhaka University of Engineering and Technology, Gazipur, Bangladesh
| | - Amir Ahmed
- Department of Nutrition and Food Engineering, Daffodil International University, Dhaka, Bangladesh
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Changes in psychological inflexibility as a potential mediator of longitudinal links between college students’ sleep problems and depressive symptoms. JOURNAL OF CONTEXTUAL BEHAVIORAL SCIENCE 2020. [DOI: 10.1016/j.jcbs.2019.12.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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Wang HE, Campbell-Sills L, Kessler RC, Sun X, Heeringa SG, Nock MK, Ursano RJ, Jain S, Stein MB. Pre-deployment insomnia is associated with post-deployment post-traumatic stress disorder and suicidal ideation in US Army soldiers. Sleep 2019; 42:5228726. [PMID: 30508139 DOI: 10.1093/sleep/zsy229] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2018] [Indexed: 01/22/2023] Open
Abstract
Study Objectives Insomnia is prevalent among military personnel and may increase risk of mental disorders and suicidal ideation. This study examined associations of pre-deployment insomnia with post-deployment post-traumatic stress disorder (PTSD) and suicidal ideation among US Army soldiers. Methods Soldiers from three Brigade Combat Teams completed surveys 1-2 months before deploying to Afghanistan in 2012 (T0), on return from deployment (T1), 3 months later (T2), and 9 months later (T3). Logistic regression was performed to estimate associations of pre-deployment (T0) insomnia with post-deployment (T2 or T3) PTSD and suicidal ideation among respondents who completed surveys at all waves (n = 4645). A hierarchy of models incorporated, increasing controls for pre-deployment risk factors and deployment experiences. Results Pre-deployment insomnia was associated with increased risk of post-deployment PTSD (adjusted odds ratio [AOR] = 3.14, 95% confidence interval [CI] = 2.58% to 3.82%, p < .0005) and suicidal ideation (AOR = 2.78, 95% CI = 2.07% to 3.74%, p < .0005) in models adjusting for sociodemographic characteristics and prior deployment history. Adjustment for other pre-deployment risk factors and deployment experiences attenuated these associations; however, insomnia remained significantly associated with post-deployment PTSD (AOR = 1.50, 95% CI = 1.19% to 1.89%, p = .001) and suicidal ideation (AOR = 1.43, 95% CI = 1.04% to 1.95%, p = .027). Subgroup models showed that pre-deployment insomnia was associated with incident PTSD (AOR = 1.55, 95% CI = 1.17% to 2.07%, p = .003) and suicidal ideation (AOR = 1.67, 95% CI = 1.16% to 2.40%, p = .006) among soldiers with no pre-deployment history of these problems. Conclusions Pre-deployment insomnia contributed to prediction of post-deployment PTSD and suicidal ideation in Army soldiers, suggesting that detection of insomnia could facilitate targeting of risk mitigation programs. Future studies should investigate whether treatment of insomnia helps prevent PTSD and suicidal ideation among deployed service members.
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Affiliation(s)
- Hohui E Wang
- Department of Psychiatry, University of California San Diego, La Jolla, CA
| | | | - Ronald C Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, MA
| | - Xiaoying Sun
- Department of Family Medicine and Public Health, University of California San Diego, La Jolla, CA
| | - Steven G Heeringa
- Institute for Social Research, University of Michigan, Ann Arbor, MI
| | - Matthew K Nock
- Department of Psychology, Harvard University, Cambridge, MA
| | - Robert J Ursano
- Center for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University of the Health Sciences, Bethesda, MD
| | - Sonia Jain
- Department of Family Medicine and Public Health, University of California San Diego, La Jolla, CA
| | - Murray B Stein
- Department of Psychiatry, University of California San Diego, La Jolla, CA.,Department of Family Medicine and Public Health, University of California San Diego, La Jolla, CA.,VA San Diego Healthcare System, San Diego, CA
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D'Ambrosio S, Castelnovo A, Guglielmi O, Nobili L, Sarasso S, Garbarino S. Sleepiness as a Local Phenomenon. Front Neurosci 2019; 13:1086. [PMID: 31680822 PMCID: PMC6813205 DOI: 10.3389/fnins.2019.01086] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Accepted: 09/26/2019] [Indexed: 12/13/2022] Open
Abstract
Sleep occupies a third of our life and is a primary need for all animal species studied so far. Nonetheless, chronic sleep restriction is a growing source of morbidity and mortality in both developed and developing countries. Sleep loss is associated with the subjective feeling of sleepiness and with decreased performance, as well as with detrimental effects on general health, cognition, and emotions. The ideas that small brain areas can be asleep while the rest of the brain is awake and that local sleep may account for at least some of the cognitive and behavioral manifestations of sleepiness are making their way into the scientific community. We herein clarify the different ways sleep can intrude into wakefulness, summarize recent scientific advances in the field, and offer some hypotheses that help framing sleepiness as a local phenomenon.
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Affiliation(s)
- Sasha D'Ambrosio
- Dipartimento di Scienze Biomediche e Cliniche "L. Sacco", Università Degli Studi di Milano, Milan, Italy
| | - Anna Castelnovo
- Sleep and Epilepsy Center, Neurocenter of Southern Switzerland, Civic Hospital (EOC) of Lugano, Lugano, Switzerland
| | - Ottavia Guglielmi
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal/Child Sciences, University of Genoa, Genoa, Italy
| | - Lino Nobili
- Department of Neuroscience (DINOGMI), University of Genoa, Genoa, Italy.,IRCCS, Child Neuropsychiatry Unit, Giannina Gaslini Institute, Genoa, Italy
| | - Simone Sarasso
- Dipartimento di Scienze Biomediche e Cliniche "L. Sacco", Università Degli Studi di Milano, Milan, Italy
| | - Sergio Garbarino
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal/Child Sciences, University of Genoa, Genoa, Italy
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Farahani FV, Fafrowicz M, Karwowski W, Douglas PK, Domagalik A, Beldzik E, Oginska H, Marek T. Effects of Chronic Sleep Restriction on the Brain Functional Network, as Revealed by Graph Theory. Front Neurosci 2019; 13:1087. [PMID: 31680823 PMCID: PMC6807652 DOI: 10.3389/fnins.2019.01087] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Accepted: 09/27/2019] [Indexed: 12/30/2022] Open
Abstract
Sleep is a complex and dynamic process for maintaining homeostasis, and a lack of sleep can disrupt whole-body functioning. No organ is as vulnerable to the loss of sleep as the brain. Accordingly, we examined a set of task-based functional magnetic resonance imaging (fMRI) data by using graph theory to assess brain topological changes in subjects in a state of chronic sleep restriction, and then identified diurnal variability in the graph-theoretic measures. Task-based fMRI data were collected in a 1.5T MR scanner from the same participants on two days: after a week of fully restorative sleep and after a week with 35% sleep curtailment. Each day included four scanning sessions throughout the day (at approximately 10:00 AM, 2:00 PM, 6:00 PM, and 10:00 PM). A modified spatial cueing task was applied to evaluate sustained attention. After sleep restriction, the characteristic path length significantly increased at all measurement times, and small-worldness significantly decreased. Assortativity, a measure of network fault tolerance, diminished over the course of the day in both conditions. Local graph measures were altered primarily across the limbic system (particularly in the hippocampus, parahippocampal gyrus, and amygdala), default mode network, and visual network.
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Affiliation(s)
- Farzad V Farahani
- Computational Neuroergonomics Laboratory, Department of Industrial Engineering & Management Systems, University of Central Florida, Orlando, FL, United States
| | - Magdalena Fafrowicz
- Department of Cognitive Neuroscience and Neuroergonomics, Institute of Applied Psychology, Jagiellonian University, Kraków, Poland
| | - Waldemar Karwowski
- Computational Neuroergonomics Laboratory, Department of Industrial Engineering & Management Systems, University of Central Florida, Orlando, FL, United States
| | - Pamela K Douglas
- Institute for Simulation and Training, University of Central Florida, Orlando, FL, United States.,Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, United States
| | - Aleksandra Domagalik
- Brain Imaging Core Facility, Malopolska Centre of Biotechnology, Jagiellonian University, Kraków, Poland
| | - Ewa Beldzik
- Department of Cognitive Neuroscience and Neuroergonomics, Institute of Applied Psychology, Jagiellonian University, Kraków, Poland
| | - Halszka Oginska
- Department of Cognitive Neuroscience and Neuroergonomics, Institute of Applied Psychology, Jagiellonian University, Kraków, Poland
| | - Tadeusz Marek
- Department of Cognitive Neuroscience and Neuroergonomics, Institute of Applied Psychology, Jagiellonian University, Kraków, Poland
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50
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Cogan CM, Lee JY, Cranston CC, Pruiksma KE, Rhudy JL, Davis JL. The impact of exposure, relaxation, and rescripting therapy for post-trauma nightmares on suicidal ideation. J Clin Psychol 2019; 75:2095-2105. [PMID: 31468547 DOI: 10.1002/jclp.22852] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVE This study investigated whether a brief psychotherapy for post-trauma nightmares (exposure, relaxation, and rescripting therapy [ERRT]), reduced suicidal ideation (SI). We hypothesized that: (a) nightmare frequency and severity, post-traumatic stress disorder (PTSD), depression, and sleep quality would be related to SI at pretreatment; (b) SI would decrease from pre- to post-treatment; and (c) the decrease in SI would remain after controlling for change in PTSD and depression. METHOD Seventy-five individuals exposed to a traumatic event and who experienced frequent nightmares (minimum one per week) participated in ERRT. Participants were not required to have a psychological diagnosis. Thirty percent endorsed SI at pretreatment. RESULTS Depression and PTSD were related to SI at pretreatment. SI decreased following treatment; however, the third hypothesis was not supported. CONCLUSION Results suggest brief psychotherapy targeting post-trauma nightmares may decrease SI. More research is necessary to determine what factors contribute to decreases in SI.
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Affiliation(s)
- Chelsea M Cogan
- Department of Psychology, The University of Tulsa, Tulsa, Oklahoma
| | - Jenny Y Lee
- Department of Psychology, The University of Tulsa, Tulsa, Oklahoma
| | - Christopher C Cranston
- Department of Psychiatry & Behavioral Sciences, Division of Medical Psychology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Kristi E Pruiksma
- Department of Psychiatry, The University of Texas Health Science Center at San Antonio, San Antonio, Texas
| | - Jamie L Rhudy
- Department of Psychology, The University of Tulsa, Tulsa, Oklahoma
| | - Joanne L Davis
- Department of Psychology, The University of Tulsa, Tulsa, Oklahoma
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