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Cailhol L, Marcoux M, Mathur A, Yrondi A, Birmes P. Predictors of prospective suicide attempts in a group at risk of personality disorder following self-poisoning. Front Psychiatry 2023; 14:1084730. [PMID: 37363177 PMCID: PMC10289019 DOI: 10.3389/fpsyt.2023.1084730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Accepted: 05/16/2023] [Indexed: 06/28/2023] Open
Abstract
Background Patients with personality disorder (PD) are at risk for suicidal behavior and are frequently admitted for this reason to emergency departments. In this context, researchers have tried to identify predictors of their suicidal acts, however, the studies have been mostly retrospective, and uncertainty remains. To prospectively explore factors associated with suicide attempts (SA) in individuals screened for PD from the ecological context of emergencies. Methods Patients were recruited from two emergency departments after a self-poisoning episode (n = 310). PDQ-4+ (risk of PD), TAS-20 (alexithymia), SIS (suicidal intent), H (hopelessness), BDI-13 (depression), AUDIT (alcohol consumption), and MINI (comorbidity) questionnaires were completed. SA over the subsequent two years were identified by mailed questionnaires and hospitals' active files. Logistic regression analyses were performed. Results Having a previous suicidal attempt was linked to a 2.7 times higher chance of recurrence after 6 months, whereas the TAS-20 showed a 1.1 times higher risk at 18 months (OR = 1.1) and the BDI at 24 months (OR = 1.2). Each one-unit increment in TAS-20 and BDI-13 scores increased the risk of SA by 9.8 and 20.4% at 18 and 24 months, respectively. Conclusion Some clinical features, such as alcohol dependence, suicide intent, and hopelessness, may not be reliable predictors of SA among PD patients. However, in the short term, previous SA and, in the long term, depression and alexithymia may be the most robust clinical predictors to consider in our sample of patients with self-poisoning SA.Clinical trial registration: [ClinicalTrials.gov], NCT00641498 24/03/2008 [#2006-A00450-51].
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Affiliation(s)
- Lionel Cailhol
- Department of Psychiatry, Institut Universitaire de Santé Mentale de Montréal, CIUSSS of East Montreal, University of Montreal, Montreal, QC, Canada
| | - Mariève Marcoux
- Department of Psychology, University of Montreal, Montreal, QC, Canada
| | - Anjali Mathur
- Department of Brief therapy, University Hospital Center of Toulouse (CHU Toulouse), Toulouse, Occitanie, France
| | - Antoine Yrondi
- Department of Psychiatry and Medical Psychology, University Hospital Center of Toulouse (CHU Toulouse), Expert Centre for Treatment-Resistant Depression FondaMental, ToNIC Toulouse NeuroImaging Centre, Toulouse University, Toulouse, Occitanie, France
| | - Philippe Birmes
- Department of Psychiatry, Psychotherapies and Art Therapy, University Hospital Center of Toulouse (CHU Toulouse), ToNIC Toulouse NeuroImaging Centre, Toulouse University, Toulouse, Occitanie, France
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Amerio A, Natale A, Gnecco GB, Lechiara A, Verrina E, Bianchi D, Fusar-Poli L, Costanza A, Serafini G, Amore M, Aguglia A. The Role of Gender in Patients with Borderline Personality Disorder: Differences Related to Hopelessness, Alexithymia, Coping Strategies, and Sensory Profile. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:medicina59050950. [PMID: 37241182 DOI: 10.3390/medicina59050950] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 05/08/2023] [Accepted: 05/12/2023] [Indexed: 05/28/2023]
Abstract
Background and Objectives: Gender differences are poorly investigated in patients with borderline personality disorder (BPD), although they could be useful in determining the most appropriate pharmacological and non-pharmacological treatment. The aim of the present study was to compare sociodemographic and clinical characteristics and the emotional and behavioral dimensions (such as coping, alexithymia, and sensory profile) between males and females with BPD. Material and Methods: Two hundred seven participants were recruited. Sociodemographic and clinical variables were collected through a self-administered questionnaire. The Adolescent/Adult Sensory Profile (AASP), Beck Hopelessness Scale (BHS), Coping Orientation to Problems Experienced (COPE), and Toronto Alexithymia Scale (TAS-20) were administered. Results: Male patients with BPD showed more involuntary hospitalizations and greater use of alcohol and illicit substances compared to females. Conversely, females with BPD reported more frequent medication abuse than males. Furthermore, females had high levels of alexithymia and hopelessness. Regarding coping strategies, females with BPD reported higher levels of "restraint coping" and "use of instrumental social support" at COPE. Finally, females with BPD had higher scores in the Sensory Sensitivity and Sensation Avoiding categories at the AASP. Conclusions: Our study highlights gender differences in substance use, emotion expression, future vision, sensory perception, and coping strategies in patients with BPD. Further gender studies may clarify these differences and guide the development of specific and differential treatments in males and females with BPD.
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Affiliation(s)
- Andrea Amerio
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Section of Psychiatry, University of Genoa, 16132 Genoa, Italy
- IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy
| | - Antimo Natale
- Department of Psychiatry, Adult Psychiatry Service (APS), University Hospitals of Geneva (HUG), 1205 Geneva, Switzerland
| | - Giovanni Battista Gnecco
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Section of Psychiatry, University of Genoa, 16132 Genoa, Italy
| | - Alessio Lechiara
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Section of Psychiatry, University of Genoa, 16132 Genoa, Italy
| | - Edoardo Verrina
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Section of Psychiatry, University of Genoa, 16132 Genoa, Italy
| | - Davide Bianchi
- Department of Mental Health and Pathological Addictions, Lavagna Local Health Authority, 16033 Lavagna, Italy
| | - Laura Fusar-Poli
- Department of Brain and Behavioral Sciences, University of Pavia, 27100 Pavia, Italy
| | - Alessandra Costanza
- Department of Psychiatry, Adult Psychiatry Service (APS), University Hospitals of Geneva (HUG), 1205 Geneva, Switzerland
- Department of Psychiatry, Faculty of Medicine, Geneva University (UNIGE), 1211 Geneva, Switzerland
- Department of Psychiatry, Faculty of Biomedical Sciences, University of Italian Switzerland (USI), 6900 Lugano, Switzerland
| | - Gianluca Serafini
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Section of Psychiatry, University of Genoa, 16132 Genoa, Italy
- IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy
| | - Mario Amore
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Section of Psychiatry, University of Genoa, 16132 Genoa, Italy
| | - Andrea Aguglia
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Section of Psychiatry, University of Genoa, 16132 Genoa, Italy
- IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy
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Magnani L, Carmisciano L, dell'Orletta F, Bettinardi O, Chiesa S, Imbesi M, Limonta G, Montagna E, Turone I, Martinasso D, Aguglia A, Serafini G, Amore M, Amerio A, Costanza A, Sibilla F, Calcagno P, Patti S, Molino G, Escelsior A, Trabucco A, Marzano L, Brunato D, Ravelli AA, Cappucciati M, Fiocchi R, Guerzoni G, Maravita D, Macchetti F, Mori E, Paglia CA, Roscigno F, Saginario A. Linguistic profile automated characterisation in pluripotential clinical high-risk mental state (CHARMS) conditions: methodology of a multicentre observational study. BMJ Open 2023; 13:e066642. [PMID: 36948562 PMCID: PMC10040055 DOI: 10.1136/bmjopen-2022-066642] [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] [Indexed: 03/24/2023] Open
Abstract
INTRODUCTION Language is usually considered the social vehicle of thought in intersubjective communications. However, the relationship between language and high-order cognition seems to evade this canonical and unidirectional description (ie, the notion of language as a simple means of thought communication). In recent years, clinical high at-risk mental state (CHARMS) criteria (evolved from the Ultra-High-Risk paradigm) and the introduction of the Clinical Staging system have been proposed to address the dynamicity of early psychopathology. At the same time, natural language processing (NLP) techniques have greatly evolved and have been successfully applied to investigate different neuropsychiatric conditions. The combination of at-risk mental state paradigm, clinical staging system and automated NLP methods, the latter applied on spoken language transcripts, could represent a useful and convenient approach to the problem of early psychopathological distress within a transdiagnostic risk paradigm. METHODS AND ANALYSIS Help-seeking young people presenting psychological distress (CHARMS+/- and Clinical Stage 1a or 1b; target sample size for both groups n=90) will be assessed through several psychometric tools and multiple speech analyses during an observational period of 1-year, in the context of an Italian multicentric study. Subjects will be enrolled in different contexts: Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Section of Psychiatry, University of Genoa-IRCCS Ospedale Policlinico San Martino, Genoa, Italy; Mental Health Department-territorial mental services (ASL 3-Genoa), Genoa, Italy; and Mental Health Department-territorial mental services (AUSL-Piacenza), Piacenza, Italy. The conversion rate to full-blown psychopathology (CS 2) will be evaluated over 2 years of clinical observation, to further confirm the predictive and discriminative value of CHARMS criteria and to verify the possibility of enriching them with several linguistic features, derived from a fine-grained automated linguistic analysis of speech. ETHICS AND DISSEMINATION The methodology described in this study adheres to ethical principles as formulated in the Declaration of Helsinki and is compatible with International Conference on Harmonization (ICH)-good clinical practice. The research protocol was reviewed and approved by two different ethics committees (CER Liguria approval code: 591/2020-id.10993; Comitato Etico dell'Area Vasta Emilia Nord approval code: 2022/0071963). Participants will provide their written informed consent prior to study enrolment and parental consent will be needed in the case of participants aged less than 18 years old. Experimental results will be carefully shared through publication in peer-reviewed journals, to ensure proper data reproducibility. TRIAL REGISTRATION NUMBER DOI:10.17605/OSF.IO/BQZTN.
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Affiliation(s)
- Luca Magnani
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Section of Psychiatry, University of Genoa, Genoa, Italy
| | - Luca Carmisciano
- Department of Health Sciences (DISSAL), Section of Biostatistics, University of Genoa, Genoa, Italy
| | - Felice dell'Orletta
- Italian Natural Language Processing Lab, Institute of Computational Linguistics "Antonio Zampolli", CNR di Pisa, Pisa, Italy
| | - Ornella Bettinardi
- Department of Mental Health and Pathological Addictions, Piacenza Local Authority, Piacenza, Italy
| | - Silvia Chiesa
- Department of Mental Health and Pathological Addictions, Piacenza Local Authority, Piacenza, Italy
| | - Massimiliano Imbesi
- Department of Mental Health and Pathological Addictions, Piacenza Local Authority, Piacenza, Italy
| | - Giuliano Limonta
- Department of Mental Health and Pathological Addictions, Piacenza Local Authority, Piacenza, Italy
| | - Elisa Montagna
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Section of Psychiatry, University of Genoa, Genoa, Italy
| | - Ilaria Turone
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Section of Psychiatry, University of Genoa, Genoa, Italy
| | - Dario Martinasso
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Section of Psychiatry, University of Genoa, Genoa, Italy
| | - Andrea Aguglia
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Section of Psychiatry, University of Genoa, Genoa, Italy
| | - Gianluca Serafini
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Section of Psychiatry, University of Genoa, Genoa, Italy
| | - Mario Amore
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Section of Psychiatry, University of Genoa, Genoa, Italy
| | - Andrea Amerio
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Section of Psychiatry, University of Genoa, Genoa, Italy
| | - Alessandra Costanza
- Department of Psychiatry, Faculty of Medicine, University of Geneva (UNIGE), Geneva, Switzerland
- Department of Psychiatry, Service of Adult Psychiatry (SPA), University Hospital of Geneva (HUG), Geneva, Switzerland
| | - Francesca Sibilla
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Section of Psychiatry, University of Genoa, Genoa, Italy
| | - Pietro Calcagno
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Section of Psychiatry, University of Genoa, Genoa, Italy
| | - Sara Patti
- Department of Mental Health and Pathological Addictions, Genoa Local Authority, Genoa, Liguria, Italy
| | - Gabriella Molino
- Department of Mental Health and Pathological Addictions, Genoa Local Authority, Genoa, Liguria, Italy
| | - Andrea Escelsior
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Section of Psychiatry, University of Genoa, Genoa, Italy
| | - Alice Trabucco
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Section of Psychiatry, University of Genoa, Genoa, Italy
| | - Lisa Marzano
- Departement of Psychology, School of Science and Technology, Middlesex University, London, UK
| | - Dominique Brunato
- Italian Natural Language Processing Lab, Institute of Computational Linguistics "Antonio Zampolli", CNR di Pisa, Pisa, Italy
| | - Andrea Amelio Ravelli
- Italian Natural Language Processing Lab, Institute of Computational Linguistics "Antonio Zampolli", CNR di Pisa, Pisa, Italy
| | - Marco Cappucciati
- Department of Mental Health and Pathological Addictions, Piacenza Local Authority, Piacenza, Italy
- Early Psychosis: Interventions and Clinical-Detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, Kings College London, London, UK
| | - Roberta Fiocchi
- Department of Mental Health and Pathological Addictions, Piacenza Local Authority, Piacenza, Italy
| | - Gisella Guerzoni
- Department of Mental Health and Pathological Addictions, Piacenza Local Authority, Piacenza, Italy
| | - Davide Maravita
- Department of Mental Health and Pathological Addictions, Piacenza Local Authority, Piacenza, Italy
| | - Fabio Macchetti
- Department of Mental Health and Pathological Addictions, Piacenza Local Authority, Piacenza, Italy
| | - Elisa Mori
- Department of Mental Health and Pathological Addictions, Piacenza Local Authority, Piacenza, Italy
| | - Chiara Anna Paglia
- Department of Mental Health and Pathological Addictions, Piacenza Local Authority, Piacenza, Italy
| | - Federica Roscigno
- Department of Mental Health and Pathological Addictions, Piacenza Local Authority, Piacenza, Italy
| | - Antonio Saginario
- Department of Mental Health and Pathological Addictions, Piacenza Local Authority, Piacenza, Italy
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Amano M, Katayama N, Umeda S, Terasawa Y, Tabuchi H, Kikuchi T, Abe T, Mimura M, Nakagawa A. The effect of cognitive behavioral therapy on future thinking in patients with major depressive disorder: A randomized controlled trial. Front Psychiatry 2023; 14:997154. [PMID: 36761867 PMCID: PMC9905738 DOI: 10.3389/fpsyt.2023.997154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Accepted: 01/05/2023] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND Pessimistic thinking about the future is one of the cardinal symptoms of major depression. Few studies have assessed changes in pessimistic thinking after undergoing cognitive behavioral therapy (CBT). A randomized clinical trial (RCT) was conducted with patients diagnosed with major depressive disorder (MDD) to determine whether receiving a course of CBT affects pessimistic future thinking using a future thinking task. METHODS Thirty-one patients with MDD were randomly assigned to either CBT (n = 16) or a talking control (TC) (n = 15) for a 16-week intervention. The main outcomes were the change in response time (RT) and the ratio of the responses for positive valence, measured by the future thinking task. Secondary outcomes included the GRID-Hamilton Depression Rating Scale, the Beck Depression Inventory-Second Edition (BDI-II), the Dysfunctional Attitude Scale (DAS), and the word fluency test (WFT). RESULTS Regarding the main outcomes, the CBT group showed reduced RT for the positive valence (within-group Cohen's d = 0.7, p = 0.012) and negative valence (within-group Cohen's d = 0.6, p = 0.03) in the distant future condition. The ratio of positive valence responses in both groups for all temporal conditions except for the distant past condition increased within group (distant future: CBT: Cohen's d = 0.5, p = 0.04; TC: Cohen's d = 0.8, p = 0.008; near future: CBT: Cohen's d = 1.0, p < 0.001; TC: Cohen's d = 1.1, p = 0.001; near past: CBT: Cohen's d = 0.8, p = 0.005; TC: Cohen's d = 1.0, p = 0.002). As for secondary outcomes, the CBT group showed greater improvement than the TC group regarding the need for social approval as measured by the DAS (p = 0.012). CONCLUSION Patients with MDD who received CBT showed a reduced RT for the positive and negative valence in the distant future condition. RT in the future thinking task for depressed patients may be a potential objective measure for the CBT treatment process. Because the present RCT is positioned as a pilot RCT, a confirmatory trial with a larger number of patients is warranted to elucidate the CBT treatment process that influences future thinking. CLINICAL TRIAL REGISTRATION https://center6.umin.ac.jp/cgi-open-bin/icdr_e/ctr_view.cgi?recptno=R000021028, identifier UMIN000018155.
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Affiliation(s)
- Mizuki Amano
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Nariko Katayama
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Satoshi Umeda
- Department of Psychology, Faculty of Letters, Keio University, Tokyo, Japan
| | - Yuri Terasawa
- Department of Psychology, Faculty of Letters, Keio University, Tokyo, Japan
| | - Hajime Tabuchi
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Toshiaki Kikuchi
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Takayuki Abe
- Graduate School of Data Science, Yokohama City University, Yokohama, Japan
| | - Masaru Mimura
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Atsuo Nakagawa
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan.,Department of Neuropsychiatry, St. Marianna University School of Medicine, Kawasaki, Japan
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