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Liu J, Zhang G, Jia F, Yuan H, Wang Q, Li C, Yang R, Yue Y, Zhang X, Ye G, Li Z, Du X, Zhang X. U-shaped association between fasting blood glucose and suicide attempts in Chinese patients with first-episode drug-naïve major depressive disorder. BMC Psychiatry 2024; 24:382. [PMID: 38773479 PMCID: PMC11110297 DOI: 10.1186/s12888-024-05818-9] [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: 03/29/2023] [Accepted: 05/06/2024] [Indexed: 05/23/2024] Open
Abstract
BACKGROUND Evidence regarding the relationship between fasting blood glucose (FBG) and suicide attempts (SA) in patients with major depressive disorder (MDD) was limited. Therefore, the objective of this research was to investigate whether FBG was independently related to SA in Chinese patients with first-episode drug-naïve (FEDN) MDD after adjusting for other covariates. METHODS The present study was a cross-sectional study. A total of 1718 participants (average age: 34.9 ± 12.4 years, 65.8% females) with FEDN MDD were involved in a hospital in China from September 2016 to December 2018. Multiple logistic regression analysis and smooth curve fitting were used to estimate the association between FBG and the risk of SA. The threshold effect was examined by the two-piecewise linear regression model. Interaction and stratified analyses were conducted according to sex, education, marital status, comorbid anxiety, and psychotic symptoms. RESULTS The prevalence of SA in patients with FEDN MDD was 20.1%. The result of fully adjusted binary logistic regression showed FBG was positively associated with the risk of SA (odds ratio (OR) = 1.62, 95% CI: 1.13-2.32). Smoothing plots also revealed a nonlinear relationship between FBG and SA, with the inflection point of FBG being 5.34 mmol/l. The effect sizes and the confidence intervals on the left and right sides of the inflection point were 0.53 (0.32-0.88, P = 0.014) and 1.48 (1.04-2.10, P = 0.030), respectively. CONCLUSIONS A U-shaped relationship between FBG and SA in FEDN MDD patients was found, with the lowest risk of SA at a FBG of 5.34 mmol/l, indicating that both the lower and higher FBG levels may lead to an increased risk of SA.
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Affiliation(s)
- Junjun Liu
- Nanjing Meishan Hospital, Nanjing, 210041, PR China
- Department of Psychiatry, Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, 215137, PR China
- Medical College of Soochow University, Suzhou, 215137, PR China
| | - Guangya Zhang
- Department of Psychiatry, Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, 215137, PR China
| | - Fengnan Jia
- Department of Psychiatry, Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, 215137, PR China
- Medical College of Soochow University, Suzhou, 215137, PR China
| | | | - Qingyuan Wang
- Clinical Medical Department, the Second Clinical Medical College, Nanjing Medical University, Nanjing, 211166, PR China
| | - Chuanwei Li
- Department of Psychiatry, Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, 215137, PR China
| | - Ruchang Yang
- Department of Psychiatry, Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, 215137, PR China
- Medical College of Soochow University, Suzhou, 215137, PR China
| | - Yan Yue
- Department of Psychiatry, Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, 215137, PR China
- Medical College of Soochow University, Suzhou, 215137, PR China
| | - Xiaobin Zhang
- Department of Psychiatry, Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, 215137, PR China
| | - Gang Ye
- Department of Psychiatry, Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, 215137, PR China
| | - Zhe Li
- Department of Psychiatry, Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, 215137, PR China
| | - Xiangdong Du
- Department of Psychiatry, Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, 215137, PR China.
- Medical College of Soochow University, Suzhou, 215137, PR China.
| | - Xiangyang Zhang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, 16 Lincui Road, Chaoyang District, Beijing, 100101, PR China.
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Daneshmand M, Kashefizadeh M, Soleimani M, Mirzaei S, Tayim N. Network analysis of depression, cognitive functions, and suicidal ideation in patients with diabetes: an epidemiological study in Iran. Acta Diabetol 2024; 61:609-622. [PMID: 38366164 DOI: 10.1007/s00592-024-02234-z] [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: 11/28/2023] [Accepted: 01/02/2024] [Indexed: 02/18/2024]
Abstract
AIMS The main aim of this study was to assess the prevalence of suicidal ideation and previous suicide attempts among Iranian patients diagnosed with Type-1 diabetes (T1D) and Type-2 diabetes (T2D). Additionally, the study sought to estimate the network structure of depressive symptoms and cognitive functions. METHODS 1073 patients participated in the current study. We used Patient Health Questionnaire-9 (PHQ-9), Ask Suicide-Screening Questionnaire, diabetes-related factors, and a battery of cognitive functions tasks to estimate network structures. Also, suicidal ideations and suicide attempts prevalence have been estimated. Statistical analyses were performed using R-studio software, including mixed-graphical models (MGMs) for undirected effects and Directed Acyclic Graphs (DAGs) for directed effects. RESULTS The prevalence of suicidal ideation was 29.97% in T1D and 26.81% in T2D (p < 0.05). The history of suicide attempts was higher in T1D (10.78%) compared to T2D (8.36%) (p < 0.01). In the MRF networks for T1D, suicidal ideation was directly linked to 'feeling guilt (PHQ.6)', 'Suicide (PHQ.9)', HbA1c, and FBS, while the Inhibition node was directly related to suicidal ideation. The DAGs suggested connections between 'depression', HbA1c, and 'inhibition' with suicidal ideation, along with a link between the current family history of suicide attempts and the patient's history of suicide attempts. For T2D, the MRF networks indicated direct links between suicidal ideation and 'anhedonia (PHQ.1)', 'suicide (PHQ.9)', age, being female, and BMI, with inhibition also being directly related to suicidal ideation. The DAGs revealed connections between 'depression', age, and 'inhibition' with suicidal ideation, as well as links between being female or single/divorced and the patient's history of suicide attempts. CONCLUSION The findings suggest that suicide ideation is highly prevalent in patients with diabetes, and these symptoms should be carefully monitored in these patients.
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Affiliation(s)
- Mojgan Daneshmand
- Department of Psychology, Islamic Azad University, Rodhen Branch, Rudehen, Iran
| | | | - Masoumeh Soleimani
- Department of Psychology, Adiban Institute of Higher Education, Garmsar, Iran
| | | | - Natalie Tayim
- Department of Psychology, School of Social Sciences and Humanities, Doha Institute for Graduate Studies, Doha, Qatar
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Zara S, Kruse J, Brähler E, Sachser C, Fegert JM, Ladwig KH, Ernst M, Kampling H. Suicidal ideation in patients with diabetes and childhood abuse - The mediating role of personality functioning: Results of a German representative population-based study. Diabetes Res Clin Pract 2024; 210:111635. [PMID: 38521129 DOI: 10.1016/j.diabres.2024.111635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 03/16/2024] [Accepted: 03/20/2024] [Indexed: 03/25/2024]
Abstract
AIMS Suicidal ideation (SID) in patients with diabetes mellitus is increasingly acknowledged. Still, the underlying mechanisms are unclear. We examined SID prevalences in patients with diabetes, its association with different types of abuse, and a mediating effect of personality functioning. METHODS In a representative population sample (N = 2,515), diabetes, SID, abuse (ICAST-R), personality functioning (OPD-SQS), and depression/anxiety (PHQ-4) were assessed by self-report. Statistical analyses comprised Chi2-Tests, logistic regression and mediation analyses. RESULTS The prevalence of SID (21.8 %) was three fold higher in patients with diabetes compared to the general population. Abuse further increased the likelihood to report SID in diabetes patients (sexual: 48.1 % vs. 18.2 %; χ2(1) = 12.233, p <.001; emotional: 35.7 % vs. 15.7 %; χ2(1) = 10.892, p <.001). A dose-response relationship between the number of abuse experiences and SID was observed (one abuse experience: OR = 1.138, 95 %-CI [0.433, 2.990], p =.793, >2 abuse experiences: OR = 2.693, 95 %-CI [1.278, 5.675], p =.009). Impaired personality functioning had an indirect effect on the association between emotional abuse and SID (b = 0.25, 95 %-CI [0.037, 0.551]). CONCLUSIONS Diabetes patients experience increased SID prevalences, especially those with emotional or sexual abuse. In individuals with a history of emotional abuse, impaired personality functioning partly explained SID and should therefore be considered and addressed in this patient group.
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Affiliation(s)
- Sandra Zara
- Department of Psychosomatic Medicine and Psychotherapy, Justus Liebig University Giessen, Germany.
| | - Johannes Kruse
- Department of Psychosomatic Medicine and Psychotherapy, Justus Liebig University Giessen, Germany; Department for Psychosomatic Medicine and Psychotherapy, Medical Center of the Philipps University Marburg, Baldingerstrasse, 35043 Marburg, Germany; German Center for Diabetes Research (DZD), München 85764, Neuherberg, Germany
| | - Elmar Brähler
- Department of Psychosomatic Medicine and Psychotherapy, Johannes Gutenberg University, Mainz, Germany; Integrated Research and Treatment Center for Adiposity Diseases, Behavioral Medicine Research Unit, University Medical Center Leipzig, Germany
| | - Cedric Sachser
- Department of Child and Adolescent Psychiatry/Psychotherapy, University of Ulm, Ulm, Germany; German Center for Mental Health (DZPG), partner site Ulm, Germany
| | - Jörg M Fegert
- Department of Child and Adolescent Psychiatry/Psychotherapy, University of Ulm, Ulm, Germany; German Center for Mental Health (DZPG), partner site Ulm, Germany
| | - Karl-Heinz Ladwig
- German Center for Diabetes Research (DZD), München 85764, Neuherberg, Germany; Department of Psychosomatic Medicine and Psychotherapy, Klinikum Rechts der Isar, Technische Universität München, Munich, Germany
| | - Mareike Ernst
- Department of Clinical Psychology, Psychotherapy and Psychoanalysis, Department of Psychology, University of Klagenfurt, Klagenfurt am Wörthersee, Austria
| | - Hanna Kampling
- Department of Psychosomatic Medicine and Psychotherapy, Justus Liebig University Giessen, Germany
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Jung H. Mental health status of individuals with diabetes in Korea before and during the COVID-19 pandemic: a comparison of data from the Korean national health and nutrition examination surveys of 2018-2019 and 2020-2021. BMJ Open 2023; 13:e074080. [PMID: 37827739 PMCID: PMC10582921 DOI: 10.1136/bmjopen-2023-074080] [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: 03/27/2023] [Accepted: 09/25/2023] [Indexed: 10/14/2023] Open
Abstract
OBJECTIVES This study aimed to compare the mental health status of patients with diabetes before and after the COVID-19 pandemic and to determine the effect of COVID-19 on their mental health status. This study was the first to investigate the relationship between diabetes and mental health in the Korean population during the COVID-19 pandemic. DESIGN This retrospective cross-sectional study investigated the prevalence of mental health problems before (2018-2019) and during (2020-2021) the COVID-19 pandemic in individuals with diabetes aged 40 years or older who participated in the Korea National Health and Nutrition Examination Survey. Mental health problems were assessed using self-reported experiences of depression diagnosis, stress perception and suicide ideation. Depression was assessed using the Patient Health Questionnaire-9 (PHQ-9). Clinically significant depression requiring treatment was determined using an optimal cut-off score of 10 out of a total of 27 points. PARTICIPANTS There were 824 men and 763 women in the 2018-2019 survey and 882 men and 887 women in 2020-2021. RESULTS In the unadjusted analysis, women had a statistically significantly higher prevalence of suicide ideation in 2020-2021 (2.9, 95% CI: 1.5 to 4.2) than in 2018-2019 (1.0, 95% CI: 0.4 to 1.7, but p<0.0067). There was no statistically significant difference in both men and women in 2018-2019 after adjusting for age, education, economic activity, hypoglycaemic drug intake or insulin injection, current alcohol consumption, hypertension and hypercholesterolaemia. A comparison of the results of the PHQ-9 survey conducted in 2018-2019 and 2020-2021 found no statistically significant difference in the prevalence of depressive disorder among both men and women. CONCLUSIONS Long-term, retrospective observations and studies on the effects of COVID-19 on the mental health of patients with diabetes should be conducted in the future.
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Affiliation(s)
- Hyejin Jung
- Department of Meridian & Acupoint, College of Korean Medicine, Kyung Hee University, Seoul, Korea (the Republic of)
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Tang Z, Fan X, Feng Z, Han B, Guo N. Case Report: Rhabdomyolysis secondary to vildagliptin overdose in a suicidal attempt: A case report and brief literature review. Front Pharmacol 2022; 13:955162. [PMID: 36034881 PMCID: PMC9399431 DOI: 10.3389/fphar.2022.955162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Accepted: 07/12/2022] [Indexed: 11/18/2022] Open
Abstract
Rhabdomyolysis is a life-threatening syndrome associated with direct or indirect muscle damage that is rarely reported with dipeptidyl peptidase (DPP)-4 inhibitors. Here we presented a case in which a 58-year-old female suffered from severe swelling and pain in bilateral lower limbs and oliguria after a suicidal vildagliptin overdose. Drug-induced rhabdomyolysis and drug-induced liver injury were diagnosed based on laboratory and radiological findings. The patient was treated with fluid resuscitation, insulin, electrolyte replacement, diuretics, urine alkalizing agents, anticoagulants, antioxidants, and 24-h bedside ECG monitoring and suicide prevention. After 20 days of hospitalization and close monitoring, the patient was discharged without sequelae. Risk factors, diagnostic criteria, disease mechanisms, and outcomes were also discussed. This case illustrated that overdose of oral anti-diabetic medications may result in clinically significant adverse events, such as rhabdomyolysis in this case with a DPP-4 inhibitor. Although the incidence is low, special attention should be paid to intentional or accidental exposure to anti-diabetic medications during suicide attempts, especially in depressed patients with diabetes.
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Affiliation(s)
- Zhijia Tang
- Minhang Hospital & Department of Clinical Pharmacy, School of Pharmacy, Fudan University, Shanghai, China
| | - Xiaofang Fan
- Department of Endocrinology, Minhang Hospital, Shanghai, China
| | - Zhen Feng
- Minhang Hospital & Department of Clinical Pharmacy, School of Pharmacy, Fudan University, Shanghai, China
| | - Bing Han
- Minhang Hospital & Department of Clinical Pharmacy, School of Pharmacy, Fudan University, Shanghai, China
- *Correspondence: Bing Han, ; Nan Guo,
| | - Nan Guo
- Minhang Hospital & Department of Clinical Pharmacy, School of Pharmacy, Fudan University, Shanghai, China
- *Correspondence: Bing Han, ; Nan Guo,
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