Serum Lipid Levels and Suicide Attempts Within 2 Weeks in Patients With Major Depressive Disorder: Is There a Relationship?

The mediating effects of depression in sedentary behavior and the metabolic syndrome with its components

BACKGROUND

Previous studies have shown a positive association between sedentary behavior (SB) and metabolic syndrome (MetS), but no studies have assessed the mediating effect of depressive symptoms in this process.

METHODS

Participants from the 2007-2018 National Health and Nutrition Examination Survey (NHANES) were included. Multiple logistic regression analyses and restricted cubic splines (RCSs) were adopted to assess the correlations among SB duration, depressed mood and MetS. A mediation effect model was constructed to analyze whether there was a mediating effect of depressed mood on the relationship between SB duration and MetS.

RESULTS

This study included 15,944 adults (7,268 patients with MetS in total). We identified high SB duration as an independent risk factor for MetS in a regression model adjusted for relevant confounders (odds ratio (OR) = 1.29, 95% CI [1.08, 1.53]). RCS analysis revealed a nonlinear relationship between SB duration and MetS. The mediation effect analysis revealed that depressive symptoms accounted for 6.70% of the mediation effect between SB duration and MetS. Depressive symptoms were also partially mediated in the analyses with MetS subcomponents.

CONCLUSION

SB is closely associated with MetS, and this association is not only caused by SB itself but also partially mediated by depressive symptoms.

Bibliometric Analysis of Antipsychotic-induced Metabolic Disorder from 2006 to 2021 Based on WoSCC Database

BACKGROUND

With the frequent use of antipsychotics, the metabolic disorder (MetD) caused by drugs has received increasing attention. However, the mechanism of drug-induced MetD is still unclear and is being explored. Keeping abreast of the progress and trending knowledge in this area is conducive to further work.

OBJECTIVE

The aim of this study is to analyze the latest status and trends of research on antipsychoticinduced metabolic disorder (AIMetD) by bibliometric and visual analysis.

METHODS

3478 publications of AIMetD from 2006 to 2021 were retrieved from the Web of Science Core Collection database. R-biblioshiny was used for descriptive analysis, CiteSpace for cooperative network, co-citation analysis and burst detection, and VOSviewer for co-occurrence keywords was used.

RESULTS

Since 2006, the publications have been growing fluctuantly. These studies have extensive cooperation among countries/regions. The most influential country/region, institution and author are the USA, King's College London and Christoph U Correll. Analysis of references shows the largest cluster of "antipsychotic-induced metabolic dysfunction", which is an important basis for MetD. The recent contents of the burst citation are related to "glucose homeostasis" and "cardiovascular metabolism". Several bursting keywords were discerned at the forefront, including "LC-MS/MS", "major depressive disorder", "expression", and "homeostasis".

CONCLUSION

The AIMetD study is in a state of sustained development. Close cooperation between countries/ regions has promoted progress. For grasping the foundation, development, and latest trends of AIMetD, it is recommended to focus on active institutions and authors. Based on AIMetD, subdivision areas such as "LC-MS/MS", "expression", and "homeostasis" are forefronts that deserve constant attention.

Sex Differences in Suicide Attempts: A Cross-Sectional Study in Patients with First-Episode and Drug-Naïve Major Depression Disorder

Materials and Methods

A cross-sectional study was conducted on the FEDN patients with MDD, and 1,718 patients' demography information and clinical data were collected. The Hamilton Depression Scale (HAMD), Hamilton Anxiety Scale (HAMA), and Positive and Negative Syndrome Scale (PANSS) were used to evaluate symptoms of depression, anxiety, and psychotic symptoms, respectively. Thyroid hormones, lipid profile, and fasting blood glucose (FBG) were measured. A history of suicide attempt was verified based on medical records and interviews with patients and their families. A 2 × 2 ANOVA was used to compare the clinical parameters of MDD patients in the suicide attempts subgroup and the sex subgroup, as well as whether there is an interaction between these two subgroups. Univariate analysis and multivariate binary logistic regression analyses were used to assess factors associated with suicide attempts.

Results

There was no sex difference in rates of suicide attempt among FEND patients with MDD (male: 19.0% vs. female: 20.7%, χ 2 = 0.663, p=0.416). Compared to males and females without suicide attempts, those with suicide attempts had higher levels of LDL-C and lower levels of HDL-C. There was a statistically significant difference in the course of disease, educational level, and TG in the female group but not in the male group. In both male and female patients, Lg (TPOAb) and severe anxiety symptoms were found to be positively correlated with suicide attempts. In addition, in male patients, suicide attempts were positively correlated with TC and FBG, while negatively correlated with body mass index. In female patients, there was a positive correlation between the severity of depression and elevated systolic blood pressure with suicide attempts (all p < 0.05).

Conclusion

Our study showed that there is no sex difference in the prevalence of suicide attempts in FEDN patients with MDD and there are differences in factors related to suicide attempts between male and female MDD patients.

Prevalence and related factors of first-time suicide attempts in the past 14 days in Chinese adult patients with first-episode drug-naïve major depressive disorder

Background

This study aimed to identify socio-demographic, physiologic, and psychologic related factors of the first-time suicide attempt (FSA) in the past 14 days in Chinese adult patients with first-episode drug-naïve (FEDN) major depressive disorder (MDD).

Methods

A total of 1718 adult patients with FEDN MDD were enrolled in this cross-sectional survey. Depression, anxiety symptoms, and suicide attempts were assessed. Additionally, biological samples were collected and measured, while Logistic regression analysis was employed to explore the risk factors for FSA in the past 14 days among FEDN MDD patients.

Results

Among suicide attempters, 12.11% (208 out of 1718) reported experiencing FSA in the past 14 days. Logistic regression analysis showed that the risk factors for FSA included more severe anxiety symptoms (OR=1.37, 95%CI: 1.28-1.48, p<0.001), higher levels of total cholesterol (TC) (OR=1.42, 95%CI: 1.13-1.77, p=0.003), and elevated thyroid-stimulating hormone (TSH) (OR=1.13, 95%CI: 1.03-1.25, p=0.01). The regression model exhibited good discriminatory power for FSA with an area under the curve (AUC) of 0.82.

Conclusion

FEDN MDD patients with more severe anxiety and higher levels of TSH and TC are more likely to develop FSA in the past 14 days. These factors are risk factors for short-term (in the past 14 days) FSA and may serve as indicators for early intervention.

Prevalence of suicide attempts and correlates among first-episode and untreated major depressive disorder patients with comorbid dyslipidemia of different ages of onset in a Chinese Han population: a large cross-sectional study

BACKGROUND

Patients with dyslipidemia are at increased risk for suicide, especially those with major depressive disorder (MDD). Few studies have investigated the independent effects of suicide attempts on comorbid dyslipidemia in patients with MDD. Moreover, there are no comparisons of differences in factors associated with suicide attempts among patients with MDD with dyslipidemia at different ages of onset. The aim of this study was to investigate the prevalence of suicide attempts and associated variables in first episode and untreated patients with MDD with comorbid dyslipidemia at different ages of onset.

METHODS

We recruited 1718 patients with first-episode untreated MDD in this study. Demographical and clinical data were collected, and lipid profiles, thyroid function, and blood glucose levels were measured. The Hamilton Depression Scale 17 (HAMD-17), Hamilton Anxiety Scale (HAMA), Clinical Global Impression Severity Scale (CGI), and Positive and Negative Syndrome Scale (PANSS) positive subscale were assessed for depression, anxiety and illness severity, as well as psychotic symptoms, respectively.

RESULTS

The percentage of patients with MDD with comorbid dyslipidemia was 61% (1048/1718). Among patients with MDD with comorbid dyslipidemia, the incidence of suicide attempts was 22.2% (170/765) for early adulthood onset and 26.5% (75/283) for mid-adulthood onset. Independent factors associated with suicide attempts in early adulthood onset patients with MDD with dyslipidemia were as follows: HAMA score (B = 0.328, P < 0.0001, OR = 1.388), Suspicion /persecution (B = -0.554, P = 0.006, OR = 0.575), CGI (B = 0.878, P < 0.0001, OR = 2.406), systolic blood pressure (B = 0.048, P = 0.004, OR = 1.049), hallucinatory behavior (B = 0.334, P = 0.025, OR = 1.397), and TPOAb (B = 0.003, p < 0.0001, OR = 1.003). Independent factors associated with suicide attempts in mid-adulthood onset patients with MDD with comorbid dyslipidemia were as follows: HAMA score (B = 0.182, P < 0.0001, OR = 1.200), CGI (B = 1.022, P < 0.0001, OR = 2.778), and TPOAb (B = 0.002, P = 0.009, OR = 1.002).

CONCLUSION

Our findings suggest an elevated risk of suicide attempts in patients with MDD with comorbid dyslipidemia. The incidence of suicide attempts was similar in the early- and mid-adulthood onset subgroups among patients with MDD with dyslipidemia, but the factors associated with suicide attempts were different in these two subgroups.

Clinical symptoms, thyroid dysfunction, and metabolic disturbances in first-episode drug-naïve major depressive disorder patients with suicide attempts: A network perspective

BACKGROUNDS

Co-occurrence of thyroid dysfunction, metabolic disturbances, and worsening clinical symptoms in major depressive disorder (MDD) patients with suicidal attempts (SA) are common. However, their relationship in SA patients remains unexplored. We aimed to (1) determine the independent association of thyroid dysfunction, clinical symptoms, and metabolic disturbances with SA; and (2) identify their interactions in SA patients via the network approach.

METHODS

1718 FEDN MDD patients were recruited. Depressive, anxiety, and psychotic symptoms were assessed by the Hamilton Rating Scale for Depression (HAMD), the Hamilton Rating Scale for Anxiety (HAMA), and the Positive and Negative Syndrome Subscale positive subscale, respectively. The serum levels of thyroid hormones and other metabolic parameters were assessed. Logistic regression model was applied to determine the correlates of SA. Network analysis was applied to determine the interaction between thyroid dysfunction, clinical symptoms, and metabolic disturbances.

RESULTS

SA patients had significant worse metabolic disturbances, thyroid dysfunction, and clinical symptoms than non-SA patients. Thyroid peroxidases antibody, thyroid stimulating hormone (TSH), HAMD scores, HAMA scores, and systolic blood pressure was independently associated with SA. Network analysis suggested that TSH was the hub of the network, exhibiting substantial associations with metabolic disturbances, anxiety, and psychotic symptoms in SA patients.

CONCLUSIONS

Our work highlights the predominant role of serum TSH levels in the pathophysiology of SA. Regular thyroid function tests might help early detect SA. Targeting increased TSH levels may help reduce metabolic disturbances and clinical symptoms in SA patients.

Risk factors for suicidal attempt in patients with the melancholic subtype of depressive disorder: Implication for nursing care

The incidence of suicide in patients with depressive order is much higher than other population. We aimed to evaluate the current status and risk of suicidal attempt in patients with the melancholic subtype of depressive disorder, to provide evidence for the clinical management and nursing care of depressive disorder. Patients diagnosed as the melancholic subtype of depressive disorder and treated in our hospital from June 1, 2018 to August 31, 2021 were included. The characteristics of included patients were collected and analyzed. Pearson correlation analysis and logistic regression analysis with odd ratio and 95% confidence interval were conducted to analyze the influencing factors of suicidal attempt in patients with the melancholic subtype of depressive disorder. A total of 446 patients with melancholic subtype of depressive disorder were included, the incidence of suicidal attempt was 18.83%. Pearson correlation analysis indicated that gender (R = 0.611), alcohol drinking (R = 0.719), living situation (R = 0.812), number of previous admission to hospital (R = 0.547), sleep disorder (R = 0.612) and frequent depressive episodes (R = 0.559) were all correlated with the suicidal attempt in patients with melancholic subtype of depressive disorder (all P < 0.05). Logistic regression analysis showed that female (OR 3.115, 95%CI 2.493-3.906), alcohol drinking(OR 1.946, 95%CI 1.684-2.763), living alone (OR 2.401, 95%CI 1.915-3.008), number of previous admission to hospital ≥ 3 (OR 2.342, 95%CI 1.601-2.742), sleep disorder (OR 1.821, 95%CI 1.328-2.215) and frequent depressive episodes (OR 3.128, 95%CI 2.421-3.779) were the independent risk factors of suicidal attempt (all P < 0.05). Suicidal attempt is common in the patients with melancholic subtype of depressive disorder, and there are many related risk factors for suicidal attempt in patients with the melancholic subtype of depressive disorder.

Association of thyroid-stimulating hormone and lipid levels with suicide attempts among adolescents with major depressive disorder in China

OBJECTIVES

Evidence suggested that thyroid-stimulating hormone (TSH) and lipid levels were associated with major depressive disorder (MDD). However, its role in suicide attempts in adolescents with MDD was unclear. This investigation was to probe into the relationship between TSH, lipid levels, and attempted suicide in adolescents with MDD.

METHODS

A total of 179 adolescents with MDD were included from January 2021 to January 2022. Socio-demographic data and clinical data were obtained through self-made questionnaires. TSH and lipid levels were analyzed by a recognized laboratory. The Epidemiological Studies Depression Scale (CES-D) was used to assess the severity of depression. Questions about whether there was a behavior of suicide attempts were completed through conversation interviews.

RESULTS

Results showed that the CES-D total score, TSH, and low-density lipoprotein cholesterol (LDL-C) of suicide attempters were significantly higher than those of non-suicide attempters. Ordinary family relationships were more likely to attempt suicide than good family relationships. The CES-D total score, ordinary family relationships, TSH and LDL-C were still significant in binary logistic regression, with an adjusted odds ratio (OR) of 1.04, 3.42, 5.14, and 1.76, respectively. The area under the receiver operating characteristic (ROC) curve showed that the area under the ROC curve (AUC) ranged from 0.60 to 0.74.

CONCLUSION

Suicide attempts are common among adolescents with MDD and were associated with CES-D total score, ordinary family relationships, TSH, and LDL-C. Given the association between suicide attempts and TSH and LDL-C, the dynamic changes in TSH and LDL-C levels should be detected regularly.