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González-Castro TB, Genis-Mendoza AD, López-Narváez ML, Juárez-Rojop IE, Ramos-Méndez MA, Tovilla-Zárate CA, Nicolini H. Gene Expression Analysis in Postmortem Brains from Individuals Who Died by Suicide: A Systematic Review. Brain Sci 2023; 13:906. [PMID: 37371384 DOI: 10.3390/brainsci13060906] [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: 05/04/2023] [Revised: 05/26/2023] [Accepted: 06/01/2023] [Indexed: 06/29/2023] Open
Abstract
Around the world, more the 700,000 individuals die by suicide every year. It is necessary to understand the mechanisms associated with suicidal behavior. Recently, an increase in gene expression studies has been in development. Through a systematic review, we aimed to find a candidate gene in gene expression studies on postmortem brains of suicide completers. Databases were systematically searched for published studies. We performed an online search using PubMed, Scopus and Web of Science databases to search studies up until May 2023. The terms included were "gene expression", "expressed genes", "microarray", "qRT-PCR", "brain samples" and "suicide". Our systematic review included 59 studies covering the analysis of 1450 brain tissues from individuals who died by suicide. The majority of gene expression profiles were obtained of the prefrontal cortex, anterior cingulate cortex, dorsolateral prefrontal cortex, ventral prefrontal cortex and orbital frontal cortex area. The most studied mRNAs came of genes in glutamate, γ-amino-butyric acid and polyamine systems. mRNAs of genes in the brain-derived neurotrophic factor, tropomyosin-related kinase B (TrkB), HPA axis and chemokine family were also studied. On the other hand, psychiatric comorbidities indicate that suicide by violent death can alter the profile of mRNA expression.
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Affiliation(s)
- Thelma Beatriz González-Castro
- División Académica Multidisciplinaria de Jalpa de Méndez, Universidad Juárez Autónoma de Tabasco, Jalpa de Méndez 86205, Mexico
| | - Alma Delia Genis-Mendoza
- Laboratorio de Genómica de Enfermedades Psiquiátricas y Neurodegenerativas, Instituto Nacional de Medicina Genómica, Ciudad de México 14610, Mexico
- Servicio de Atención Psiquiátrica, Hospital Psiquiátrico Infantil Dr. Juan N. Navarro, Ciudad de México 14080, Mexico
| | - María Lilia López-Narváez
- División Académica Multidisciplinaria de Comalcalco, Universidad Juárez Autónoma de Tabasco, Comalcalco 86650, Mexico
| | - Isela Esther Juárez-Rojop
- División Académica de Ciencias de la Salud, Universidad Juárez Autónoma de Tabasco, Villahermosa 86100, Mexico
| | - Miguel Angel Ramos-Méndez
- División Académica de Ciencias de la Salud, Universidad Juárez Autónoma de Tabasco, Villahermosa 86100, Mexico
| | | | - Humberto Nicolini
- Laboratorio de Genómica de Enfermedades Psiquiátricas y Neurodegenerativas, Instituto Nacional de Medicina Genómica, Ciudad de México 14610, Mexico
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Favole A, Testori C, Bergagna S, Gennero MS, Ingravalle F, Costa B, Barresi S, Curti P, Barberis F, Ganio S, Orusa R, Vallino Costassa E, Berrone E, Vernè M, Scaglia M, Palmitessa C, Gallo M, Tessarolo C, Pederiva S, Ferrari A, Lorenzi V, Fusi F, Brunelli L, Pastorelli R, Cagnotti G, Casalone C, Caramelli M, Corona C. Brain-Derived Neurotrophic Factor, Kynurenine Pathway, and Lipid-Profiling Alterations as Potential Animal Welfare Indicators in Dairy Cattle. Animals (Basel) 2023; 13:ani13071167. [PMID: 37048423 PMCID: PMC10093196 DOI: 10.3390/ani13071167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 03/16/2023] [Accepted: 03/23/2023] [Indexed: 03/29/2023] Open
Abstract
Complete animal welfare evaluation in intensive farming is challenging. With this study, we investigate new biomarkers for animal physical and mental health by comparing plasma expression of biochemical indicators in dairy cows reared in three different systems: (A) semi-intensive free-stall, (B) non-intensive tie-stall, and (C) intensive free-stall. Additionally, protein levels of mature brain-derived neurotrophic factor (mBDNF) and its precursor form (proBDNF) and indoleamine 2,3-dioxygenase (IDO1) specific activity were evaluated in brain samples collected from 12 cattle culled between 73 and 138 months of age. Alterations in plasma lipid composition and in the kynurenine pathway of tryptophan metabolism were observed in the tie-stall-reared animals. The total plasma BDNF concentration was higher in tie-stall group compared to the two free-housing groups. Brain analysis of the tie-stall animals revealed a different mBDNF/proBDNF ratio, with a higher level of proBDNF (p < 0.001). Our data are similar to previous studies on animal models of depression, which reported that inhibition of the conversion of proBDNF in its mature form and/or elevated peripheral kynurenine pathway activation may underlie cerebral biochemical changes and induce depressive-like state behavior in animals.
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Mofatteh M, Mashayekhi MS, Arfaie S, Chen Y, Malhotra AK, Alvi MA, Sader N, Antonick V, Fatehi Hassanabad M, Mansouri A, Das S, Liao X, McIntyre RS, Del Maestro R, Turecki G, Cohen-Gadol AA, Zadeh G, Ashkan K. Suicidal ideation and attempts in brain tumor patients and survivors: A systematic review. Neurooncol Adv 2023; 5:vdad058. [PMID: 37313501 PMCID: PMC10259251 DOI: 10.1093/noajnl/vdad058] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023] Open
Abstract
Background Subsequent to a diagnosis of a brain tumor, psychological distress has been associated with negative effects on mental health as well as suicidality. The magnitude of such impact has been understudied in the literature. We conducted a systematic review to examine the impact of a brain tumor on suicidality (both ideation and attempts). Methods In accordance with the PRISMA guidelines, we searched for relevant peer-reviewed journal articles on PubMed, Scopus, and Web of Science databases from inception to October 20, 2022. Studies investigating suicide ideation and/or attempt among patients with brain tumors were included. Results Our search yielded 1,998 articles which were screened for eligibility. Seven studies consisting of 204,260 patients were included in the final review. Four studies comprising 203,906 patients (99.8%) reported elevated suicidal ideation and suicide attempt incidence compared with the general population. Prevalence of ideation and attempts ranged from 6.0% to 21.5% and 0.03% to 3.33%, respectively. Anxiety, depression, pain severity, physical impairment, glioblastoma diagnosis, male sex, and older age emerged as the primary risk factors associated with increased risk of suicidal ideation and attempts. Conclusion Suicidal ideation and attempts are increased in patients and survivors of brain tumors compared to the general population. Early identification of patients exhibiting these behaviors is crucial for providing timely psychiatric support in neuro-oncological settings to mitigate potential harm. Future research is required to understand pharmacological, neurobiological, and psychiatric mechanisms that predispose brain tumor patients to suicidality.
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Affiliation(s)
- Mohammad Mofatteh
- Corresponding Author: Mohammad Mofatteh, PhD, MPH, MSc, PGCert TLHE, BSc (Hons), School of Medicine, Dentistry and Biomedical Sciences, Queen’s University Belfast, 97 Lisburn Road, Belfast BT9 7BL, United Kingdom ()
| | - Mohammad Sadegh Mashayekhi
- Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
- Neuro International Collaboration (NIC), Vancouver, British Columbia, Canada
| | - Saman Arfaie
- Department of Neurology and Neurosurgery, McGill University, Montreal, Quebec, Canada
- Department of Molecular and Cell Biology, University of California Berkeley, California, USA
- Neuro International Collaboration (NIC), Montreal, Quebec, Canada
| | - Yimin Chen
- Department of Neurology, Foshan Sanshui District People’s Hospital, Foshan, China
- Neuro International Collaboration (NIC), Foshan, China
| | - Armaan K Malhotra
- Division of Neurosurgery, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Mohammed Ali Alvi
- Division of Neurosurgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada
- Department of Neurologic Surgery, Mayo Clinic, Rochester, MN, USA
- Neuro International Collaboration (NIC), Toronto, Ontario, Canada
| | - Nicholas Sader
- Division of Neurosurgery, University of Calgary, Alberta, Canada
- Neuro International Collaboration (NIC), Calgary, Alberta, Canada
| | - Violet Antonick
- University of Vermont, Burlington, Vermont, USA
- Neuro International Collaboration (NIC), Vermont, USA
| | | | - Alireza Mansouri
- Department of Neurosurgery, Penn State Milton S. Hershey Medical Center, Hershey, Pennsylvania, USA
| | - Sunit Das
- Division of Neurosurgery, St. Michael’s Hospital, Toronto, Ontario, Canada
| | - Xuxing Liao
- Department of Neurosurgery, Foshan Sanshui District People’s Hospital, Foshan, China
- Department of Surgery of Cerebrovascular Diseases, Foshan First People’s Hospital, Foshan, China
| | - Roger S McIntyre
- Neuro International Collaboration (NIC), Toronto, Ontario, Canada
- Mood Disorder Psychopharmacology Unit, University Health Network, University of Toronto, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
- Brain and Cognition Discovery Foundation, Toronto, Ontario, Canada
| | - Rolando Del Maestro
- Neuro International Collaboration (NIC), Montreal, Quebec, Canada
- Neurosurgical Simulation and Artificial Intelligence Learning Centre, Department of Neurology & Neurosurgery, Montreal Neurological Institute and Hospital, McGill University, Montreal, Quebec, Canada
| | - Gustavo Turecki
- McGill Group for Suicide Studies, Douglas Hospital Research Center, Montreal, Canada
- Department of Psychiatry, McGill University, Montreal, Quebec, Canada
| | - Aaron A Cohen-Gadol
- The Neurosurgical Atlas, Carmel, Indiana, USA
- Department of Neurological Surgery, Indiana University, Indianapolis, Indiana, USA
- Neuro International Collaboration (NIC), Indiana, USA
| | - Gelareh Zadeh
- Division of Neurosurgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Keyoumars Ashkan
- Neuro International Collaboration (NIC), London, UK
- Department of Neurosurgery, King’s College Hospital NHS Foundation Trust, London, UK
- Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, UK
- King’s Health Partners Academic Health Sciences Centre, London, UK
- School of Biomedical Engineering and Imaging Sciences, Faculty of Life Sciences and Medicine, King’s College London, UK
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Pérez V, Elices M, Toll A, Bobes J, López-Solà C, Díaz-Marsá M, Grande I, López-Peña P, Rodríguez-Vega B, Ruiz-Veguilla M, de la Torre-Luque A. The Suicide Prevention and Intervention Study (SURVIVE): Study protocol for a multisite cohort study with nested randomized-controlled trials. SPANISH JOURNAL OF PSYCHIATRY AND MENTAL HEALTH 2023; 16:16-23. [PMID: 33301997 DOI: 10.1016/j.rpsm.2020.11.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 11/23/2020] [Accepted: 11/24/2020] [Indexed: 10/22/2022]
Abstract
INTRODUCTION Suicide is one of the leading causes of avoidable death. Gathering national data on suicidal behaviour incidence is crucial to develop evidence-based public policies. The study has two primary objectives: (1) to determine the incidence of suicide attempts in Spain and related risk factors, and (2) to analyze the efficacy of secondary prevention programmes to prevent suicide re-attempting in comparison to treatment as usual (TAU). MATERIALS AND METHODS Multisite, coordinated, cohort study with three nested randomized controlled trials. A cohort of 2000 individuals (age >=12) with suicidal behaviour will be recruited at ten sites distributed across Spain. Assessments will be conducted within 10 days of the suicide attempt (V0-baseline visit) and after 12 months (V4-last visit) and will include clinician reported and participant reported outcomes (PROs). Between V0 and V4, PROs will be collected remotely every three months (V1, V2 and V3). Optatively, cohort participants will participate in three nested randomized-controlled-trials (RCTs) evaluating different secondary prevention interventions: Participants aged 18 years and older will be randomly allocated to: Telephone-based Management+TAU vs. TAU or iFightDepression-Survive+TAU vs. TAU. Participants aged between 12 and 18 years will be allocated to a specific intervention for youths: Self Awareness of Mental Health+TAU vs. TAU. RESULTS This study will provide interesting data to estimate suicide attempt incidence in Spain. and will provide evidence on three. CONCLUSIONS Evidence on three potentially efficacious interventions for individuals at high risk of suicide will be obtained, and this could improve the treatment given to these individuals. TRIAL REGISTRATION NCT04343703.
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Affiliation(s)
- Víctor Pérez
- Institut de Neuropsiquiatria i Addicions, Hospital del Mar, Barcelona, Spain; Department of Psychiatry and Forensic Medicine, Autonomous University of Barcelona, Barcelona, Spain; Hospital del Mar Medical Research Institute, IMIM, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
| | - Matilde Elices
- Hospital del Mar Medical Research Institute, IMIM, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain.
| | - Alba Toll
- Institut de Neuropsiquiatria i Addicions, Hospital del Mar, Barcelona, Spain; Department of Psychiatry and Forensic Medicine, Autonomous University of Barcelona, Barcelona, Spain; Hospital del Mar Medical Research Institute, IMIM, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
| | - Julio Bobes
- Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain; Department of Psychiatry, Universidad de Oviedo, Oviedo, Spain; Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain; Servicio de Salud del Principado de Asturias (SESPA), Oviedo, Spain; Department of Psychology, Universidad de Oviedo, Oviedo, Spain
| | - Clara López-Solà
- Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain; Mental Health Department, Parc Taulí Hospital Universitari, Neuroscience and Mental Health Research Area, Institut d' Investigació I Innovació ParcTaulí (I3PT), Sabadell, Spain; Department of Clinical and Health Psychology, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Marina Díaz-Marsá
- Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain; Hospital Clínico San Carlos, Madrid, Spain; Universidad Complutense de Madrid, Madrid, Spain
| | - Iria Grande
- Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain; Barcelona Bipolar Disorders and Depressive Unit, Hospital Clinic, Institute of Neurosciences, University of Barcelona, IDIBAPS, Spain
| | - Purificación López-Peña
- Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain; Hospital Universitario Araba-Santiago, Instituto de Investigación Sanitaria Bioaraba, Universidad del País Vasco, Spain
| | - Beatriz Rodríguez-Vega
- La Paz University Hospital, Madrid, Spain; Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain; Autonomous University of Madrid (UAM), Madrid, Spain
| | - Miguel Ruiz-Veguilla
- Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain; Hospital Virgen del Rocio de Sevilla, Spain; IBIS, Universidad de Sevilla, Spain
| | - Alejandro de la Torre-Luque
- Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain; Universidad Complutense de Madrid, Madrid, Spain
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Serafini G, Costanza A, Aguglia A, Amerio A, Trabucco A, Escelsior A, Sher L, Amore M. The Role of Inflammation in the Pathophysiology of Depression and Suicidal Behavior: Implications for Treatment. Med Clin North Am 2023; 107:1-29. [PMID: 36402492 DOI: 10.1016/j.mcna.2022.09.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Depression and suicidal behavior are 2 complex psychiatric conditions of significant public health concerns due to their debilitating nature. The need to enhance contemporary treatments and preventative approaches for these illnesses not only calls for distillation of current views on their pathogenesis but also provides an impetus for further elucidation of their novel etiological determinants. In this regard, inflammation has recently been recognized as a potentially important contributor to the development of depression and suicidal behavior. This review highlights key evidence that supports the presence of dysregulated neurometabolic and immunologic signaling and abnormal interaction with microbial species as putative etiological hallmarks of inflammation in depression as well as their contribution to the development of suicidal behavior. Furthermore, therapeutic insights addressing candidate mechanisms of pathological inflammation in these disorders are proposed.
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Affiliation(s)
- Gianluca Serafini
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health DINOGMI, Section of Psychiatry, University of Genoa, Genoa, Italy; IRCCS Ospedale Policlinico San Martino, Largo Rosanna Benzi 10, Genoa 16132, Italy.
| | - Alessandra Costanza
- Department of Psychiatry, Faculty of Medicine, University of Geneva (UNIGE), Geneva, Switzerland, Faculty of Biomedical Sciences, Università della Svizzera Italiana (USI), Lugano, Switzerland; Department of Psychiatry, Faculty of Biomedical Sciences, University of Italian Switzerland (USI), Lugano, Switzerland
| | - Andrea Aguglia
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health DINOGMI, Section of Psychiatry, University of Genoa, Genoa, Italy; IRCCS Ospedale Policlinico San Martino, Largo Rosanna Benzi 10, Genoa 16132, Italy
| | - Andrea Amerio
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health DINOGMI, Section of Psychiatry, University of Genoa, Genoa, Italy; IRCCS Ospedale Policlinico San Martino, Largo Rosanna Benzi 10, Genoa 16132, Italy
| | - Alice Trabucco
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health DINOGMI, Section of Psychiatry, University of Genoa, Genoa, Italy
| | - Andrea Escelsior
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health DINOGMI, Section of Psychiatry, University of Genoa, Genoa, Italy; IRCCS Ospedale Policlinico San Martino, Largo Rosanna Benzi 10, Genoa 16132, Italy
| | - Leo Sher
- James J. Peters VA Medical Center, Bronx, NY, USA; Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Department of Psychiatry, New York, NY, USA
| | - Mario Amore
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health DINOGMI, Section of Psychiatry, University of Genoa, Genoa, Italy; IRCCS Ospedale Policlinico San Martino, Largo Rosanna Benzi 10, Genoa 16132, Italy
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Barua PD, Vicnesh J, Lih OS, Palmer EE, Yamakawa T, Kobayashi M, Acharya UR. Artificial intelligence assisted tools for the detection of anxiety and depression leading to suicidal ideation in adolescents: a review. Cogn Neurodyn 2022:1-22. [PMID: 36467993 PMCID: PMC9684805 DOI: 10.1007/s11571-022-09904-0] [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: 05/09/2022] [Revised: 09/26/2022] [Accepted: 10/17/2022] [Indexed: 11/24/2022] Open
Abstract
Epidemiological studies report high levels of anxiety and depression amongst adolescents. These psychiatric conditions and complex interplays of biological, social and environmental factors are important risk factors for suicidal behaviours and suicide, which show a peak in late adolescence and early adulthood. Although deaths by suicide have fallen globally in recent years, suicide deaths are increasing in some countries, such as the US. Suicide prevention is a challenging global public health problem. Currently, there aren't any validated clinical biomarkers for suicidal diagnosis, and traditional methods exhibit limitations. Artificial intelligence (AI) is budding in many fields, including in the diagnosis of medical conditions. This review paper summarizes recent studies (past 8 years) that employed AI tools for the automated detection of depression and/or anxiety disorder and discusses the limitations and effects of some modalities. The studies assert that AI tools produce promising results and could overcome the limitations of traditional diagnostic methods. Although using AI tools for suicidal ideation exhibits limitations, these are outweighed by the advantages. Thus, this review article also proposes extracting a fusion of features such as facial images, speech signals, and visual and clinical history features from deep models for the automated detection of depression and/or anxiety disorder in individuals, for future work. This may pave the way for the identification of individuals with suicidal thoughts.
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Affiliation(s)
- Prabal Datta Barua
- School of Management and Enterprise, University of Southern Queensland, Springfield, Australia
| | - Jahmunah Vicnesh
- Department of Electronics and Computer Engineering, Ngee Ann Polytechnic, Singapore, Singapore
| | - Oh Shu Lih
- Department of Electronics and Computer Engineering, Ngee Ann Polytechnic, Singapore, Singapore
| | - Elizabeth Emma Palmer
- Discipline of Pediatric and Child Health, School of Clinical Medicine, University of New South Wales, Kensington, Australia
- Sydney Children’s Hospitals Network, Sydney, Australia
| | - Toshitaka Yamakawa
- Department of Computer Science and Electrical Engineering, Kumamoto University, Kumamoto, Japan
| | - Makiko Kobayashi
- Department of Computer Science and Electrical Engineering, Kumamoto University, Kumamoto, Japan
| | - Udyavara Rajendra Acharya
- Department of Electronics and Computer Engineering, Ngee Ann Polytechnic, Singapore, Singapore
- School of Science and Technology, Singapore University of Social Sciences, Singapore, Singapore
- Department of Bioinformatics and Medical Engineering, Asia University, Taizhong, Taiwan
- International Research Organization for Advanced Science and Technology (IROAST), Kumamoto University, Kumamoto, Japan
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Aly H, Bafarat AY, Alzamil AM, Bagabas IS, Labban SA. Suicide Attempt by Cement Ingestion: A Case Report. Cureus 2022; 14:e31650. [DOI: 10.7759/cureus.31650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/18/2022] [Indexed: 11/19/2022] Open
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Aguglia A, Natale A, Fusar-Poli L, Gnecco GB, Lechiara A, Marino M, Meinero M, Pastorino F, Costanza A, Spedicato GA, Amerio A, Serafini G, Aguglia E, Amore M. C-Reactive Protein as a Potential Peripheral Biomarker for High-Lethality Suicide Attempts. Life (Basel) 2022; 12:life12101557. [PMID: 36294992 PMCID: PMC9605506 DOI: 10.3390/life12101557] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2022] [Revised: 09/14/2022] [Accepted: 10/05/2022] [Indexed: 06/01/2023] Open
Abstract
The aim of the present study was to identify a cut-off of c-reactive protein (c-RP) potentially predictive of high-lethality suicide attempts (SA) in an inpatient psychiatric sample. After attempting suicide, subjects were admitted to the emergency ward of the IRCCS Ospedale Policlinico San Martino and later to the section of Psychiatry from 1 August 2013 to 31 July 2018. C-reactive protein was measured. The Area Under the Receiver Operating Characteristic (ROC_AUC) was used to assess the discriminative capacity of c-RP for high- vs. low-lethality SA, and a logistic regression was performed to detect the odds ratio, adjusted for age and sex. High-lethality suicide attempters were 133 (30.8%), while low-lethality suicide attempters were 299 (69.2%). The optimal cut-off threshold (and corresponding sensitivity and specificity values) for c-RP was 4.65 mg/L (68/71%). This cut-off corresponds to an AUC of 73.5%. An odds ratio of 4.70 was generated for current high-lethality SA after a logistic regression, adjusted for age and sex. Research on social and biological factors underlying the lethality of SA is crucial for a better understanding of this complex phenomenon. Identifying potential predictors of SA, especially those at high lethality, is essential to implement personalized preventive strategies.
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Affiliation(s)
- Andrea Aguglia
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, 16132 Genoa, Italy
- Istituto di Ricovero e Cura a Carattere Scientifico Ospedale Policlinico San Martino, 16132 Genoa, Italy
| | - Antimo Natale
- Department of Clinical and Experimental Medicine, University of Catania, 95123 Catania, Italy
| | - Laura Fusar-Poli
- Department of Clinical and Experimental Medicine, University of Catania, 95123 Catania, Italy
| | - Giovanni Battista Gnecco
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, 16132 Genoa, Italy
| | - Alessio Lechiara
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, 16132 Genoa, Italy
| | - Margherita Marino
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, 16132 Genoa, Italy
| | - Matteo Meinero
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, 16132 Genoa, Italy
| | - Fabrizio Pastorino
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, 16132 Genoa, Italy
| | - Alessandra Costanza
- Department of Psychiatry, Faculty of Medicine, University of Geneva (UNIGE), 1211 Geneva, Switzerland
- Department of Psychiatry, Faculty of Biomedical Sciences, University of Italian Switzerland (USI), 6912 Lugano, Switzerland
| | | | - Andrea Amerio
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, 16132 Genoa, Italy
- Istituto di Ricovero e Cura a Carattere Scientifico Ospedale Policlinico San Martino, 16132 Genoa, Italy
| | - Gianluca Serafini
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, 16132 Genoa, Italy
- Istituto di Ricovero e Cura a Carattere Scientifico Ospedale Policlinico San Martino, 16132 Genoa, Italy
| | - Eugenio Aguglia
- Department of Clinical and Experimental Medicine, University of Catania, 95123 Catania, Italy
| | - Mario Amore
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, 16132 Genoa, Italy
- Istituto di Ricovero e Cura a Carattere Scientifico Ospedale Policlinico San Martino, 16132 Genoa, Italy
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Costanza A, Amerio A, Aguglia A, Serafini G, Amore M, Hasler R, Ambrosetti J, Bondolfi G, Sampogna G, Berardelli I, Fiorillo A, Pompili M, Nguyen KD. Hyper/neuroinflammation in COVID-19 and suicide etiopathogenesis: Hypothesis for a nefarious collision? Neurosci Biobehav Rev 2022; 136:104606. [PMID: 35289272 PMCID: PMC8916836 DOI: 10.1016/j.neubiorev.2022.104606] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 02/23/2022] [Accepted: 03/06/2022] [Indexed: 11/24/2022]
Abstract
Accumulating scientific and clinical evidence highlighted pathological hyperinflammation as a cardinal feature of SARS-CoV-2 infection and acute COVID-19 disease. With the emergence of long COVID-19 syndrome, several chronic health consequences, including neuropsychiatric sequelae, have gained attention from the public and medical communities. Since inflammatory mediators have also been accredited as putative biomarkers of suicidal ideations and behaviors, hyper- and neuroinflammation might share some colliding points, overlapping and being interconnected in the context of COVID-19. This review aims to provide a summary of current knowledge on the molecular and cellular mechanisms of COVID-19-associated hyper/neuroinflammation with focus on their relevance to the inflammatory hypothesis of suicide development. Subsequently, strategies to alleviate COVID-19 hyper/neuroinflammation by immunomodulatory agents (many of which at experimental stages) as well as psychopharmacologic/psychotherapeutic approaches are also mentioned. While suicide risk in COVID-19 survivors - until now little known - needs further analysis through longitudinal studies, current observations and mechanistic postulates warrant additional attention to this possibly emerging mental health concern.
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Affiliation(s)
- A Costanza
- Departement of Psychiatry, Faculty of Medicine, University of Geneva (UNIGE), Geneva, Switzerland; Faculty of Biomedical Sciences, Università della Svizzera Italiana (USI), Lugano, Switzerland.
| | - A Amerio
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Section of Psychiatry, University of Genoa, Genoa, Italy; IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - A Aguglia
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Section of Psychiatry, University of Genoa, Genoa, Italy; IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - G Serafini
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Section of Psychiatry, University of Genoa, Genoa, Italy; IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - M Amore
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Section of Psychiatry, University of Genoa, Genoa, Italy; IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - R Hasler
- Departement of Psychiatry, Faculty of Medicine, University of Geneva (UNIGE), Geneva, Switzerland; Department of Psychiatry, Service of Psychiatric Specialties, University Hospitals of Geneva (HUG), Geneva, Switzerland
| | - J Ambrosetti
- Department of Psychiatry and Department of Emergency, Emergency Psychiatric Unit (UAUP), Geneva University Hospitals (HUG), Geneva, Switzerland
| | - G Bondolfi
- Departement of Psychiatry, Faculty of Medicine, University of Geneva (UNIGE), Geneva, Switzerland; Faculty of Biomedical Sciences, Università della Svizzera Italiana (USI), Lugano, Switzerland; Department of Psychiatry, Service of Liaison Psychiatry and Crisis Intervention (SPLIC), University Hospitals (HUG), Geneva, Switzerland
| | - G Sampogna
- Department of Psychiatry, University of Campania "L. Vanvitelli", Naples, Italy
| | - I Berardelli
- Sant'Andrea Hospital, "Sapienza" University of Rome, Rome, Italy
| | - A Fiorillo
- Department of Psychiatry, University of Campania "L. Vanvitelli", Naples, Italy
| | - M Pompili
- Sant'Andrea Hospital, "Sapienza" University of Rome, Rome, Italy
| | - K D Nguyen
- Tranquis Therapeutics, Palo Alto, CA, USA; Department of Microbiology and Immunology, Stanford University, Palo Alto, CA, USA
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10
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Johnston JN, Campbell D, Caruncho HJ, Henter ID, Ballard ED, Zarate CA. Suicide Biomarkers to Predict Risk, Classify Diagnostic Subtypes, and Identify Novel Therapeutic Targets: 5 Years of Promising Research. Int J Neuropsychopharmacol 2022; 25:197-214. [PMID: 34865007 PMCID: PMC8929755 DOI: 10.1093/ijnp/pyab083] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 11/02/2021] [Accepted: 11/30/2021] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Suicide is a global health crisis. However, no objective biomarkers of suicide risk currently exist, and self-reported data can be unreliable, which limits prediction, diagnostic, and treatment efforts. Reliable biomarkers that can differentiate between diagnostic subgroups, predict worsening symptoms, or suggest novel therapeutic targets would be extremely valuable for patients, researchers, and clinicians. METHODS MEDLINE was searched for reports published between 2016 and 2021 using search terms (suicid*) AND (biomarker*) OR (indicat*). Reports that compared biomarkers between suicidal ideation, suicide attempt, death from suicide, or any suicide subgroup against other neuropsychiatric disorders were included. Studies exclusively comparing suicidal behavior or death from suicide with healthy controls were not included to ensure that biomarkers were specific to suicide and not other psychopathology. RESULTS This review summarizes the last 5 years of research into suicide-associated biomarkers and provides a comprehensive guide for promising and novel biomarkers that encompass varying presentations of suicidal ideation, suicide attempt, and death by suicide. The serotonergic system, inflammation, hypothalamic-pituitary-adrenal axis, lipids, and endocannabinoids emerged as the most promising diagnostic, predictive, and therapeutic indicators. CONCLUSIONS The utility of diagnostic and predictive biomarkers is evident, particularly for suicide prevention. While larger-scale studies and further in-depth research are required, the last 5 years of research has uncovered essential biomarkers that could ultimately improve predictive strategies, aid diagnostics, and help develop future therapeutic targets.
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Affiliation(s)
- Jenessa N Johnston
- Division of Medical Sciences, University of Victoria, Victoria, British Columbia, Canada
- Experimental Therapeutics and Pathophysiology Branch, Division of Intramural Research Programs, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland,USA
| | - Darcy Campbell
- Experimental Therapeutics and Pathophysiology Branch, Division of Intramural Research Programs, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland,USA
| | - Hector J Caruncho
- Division of Medical Sciences, University of Victoria, Victoria, British Columbia, Canada
- Experimental Therapeutics and Pathophysiology Branch, Division of Intramural Research Programs, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland,USA
| | - Ioline D Henter
- Experimental Therapeutics and Pathophysiology Branch, Division of Intramural Research Programs, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland,USA
| | - Elizabeth D Ballard
- Experimental Therapeutics and Pathophysiology Branch, Division of Intramural Research Programs, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland,USA
| | - Carlos A Zarate
- Experimental Therapeutics and Pathophysiology Branch, Division of Intramural Research Programs, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland,USA
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11
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Fusar-Poli L, Aguglia A, Amerio A, Orsolini L, Salvi V, Serafini G, Volpe U, Amore M, Aguglia E. Peripheral BDNF levels in psychiatric patients with and without a history of suicide attempt: A systematic review and meta-analysis. Prog Neuropsychopharmacol Biol Psychiatry 2021; 111:110342. [PMID: 33961965 DOI: 10.1016/j.pnpbp.2021.110342] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 04/20/2021] [Accepted: 05/02/2021] [Indexed: 12/14/2022]
Abstract
OBJECTIVE Psychiatric patients are at increased risk of attempting suicide. Several potential biomarkers of suicide risk have been proposed with inconsistent findings. The present paper aimed to evaluate differences in peripheral BDNF levels between psychiatric patients with and without a history of suicide attempts. METHODS We conducted a systematic review and meta-analysis following the PRISMA guidelines. Relevant papers published up to January 5, 2021 were identified searching the electronic databases Web of KnowledgeSM and PsycINFO. A random-effect meta-analysis was conducted using Stata 16. RESULTS Thirteen studies met inclusion criteria. Overall, no significant differences in BDNF levels between the two groups were found (13 studies, n = 1340, Hedge's g = -0.21, 95% CI -0.44 to 0.02). Heterogeneity was substantial (I2 = 72.91%). Subgroup analyses revealed that BDNF levels were significantly reduced in plasma with medium effect size (5 studies, n = 363, Hedge's g = -0.44, 95% CI -0.86 to -0.02), but not in serum (8 studies, n = 977, Hedge's g = -0.09, 95% CI -0.33 to 0.15). No significant differences were found according to the type of diagnosis (major depressive disorder vs. other diagnoses) or the period of suicide attempt (lifetime vs. recent). CONCLUSION The utility of BDNF as a biomarker of suicide attempts in psychiatric patients appears limited to its plasma concentration. Although caution interpretation is needed, our findings may represent a starting point for the design of rigorous case-control studies exploring the association between neurotrophins and suicidal behaviors.
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Affiliation(s)
- Laura Fusar-Poli
- Department of Clinical and Experimental Medicine, Psychiatry Unit, University of Catania, Catania, Italy.
| | - Andrea Aguglia
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, Genoa, Italy; IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Andrea Amerio
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, Genoa, Italy; IRCCS Ospedale Policlinico San Martino, Genoa, Italy; Department of Psychiatry, Tufts University, Boston, MA, USA
| | - Laura Orsolini
- Unit of Clinical Psychiatry, Department of Clinical Neurosciences/DIMSC, School of Medicine, Polytechnic University of Marche, Ancona, Italy; Drug Misuse and Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, United Kingdom
| | - Virginio Salvi
- Unit of Clinical Psychiatry, Department of Clinical Neurosciences/DIMSC, School of Medicine, Polytechnic University of Marche, Ancona, Italy
| | - Gianluca Serafini
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, Genoa, Italy; IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Umberto Volpe
- Unit of Clinical Psychiatry, Department of Clinical Neurosciences/DIMSC, School of Medicine, Polytechnic University of Marche, Ancona, Italy
| | - Mario Amore
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, Genoa, Italy; IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Eugenio Aguglia
- Department of Clinical and Experimental Medicine, Psychiatry Unit, University of Catania, Catania, Italy
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12
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Arafat SMY, Khan MM, Menon V, Ali SA, Rezaeian M, Shoib S. Psychological autopsy study and risk factors for suicide in Muslim countries. Health Sci Rep 2021; 4:e414. [PMID: 34622034 PMCID: PMC8485607 DOI: 10.1002/hsr2.414] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2021] [Revised: 09/07/2021] [Accepted: 09/12/2021] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND Suicide and risk factors have been poorly studied in the Muslim-majority countries that hinder the formulation of prevention strategies and affect suicide prevention eventually. OBJECTIVES We aimed at identifying and analyzing the psychological autopsy studies assessing the risk factors for suicide conducted in Muslim-majority countries. METHODS We did a search to trace all the available psychological autopsy studies in the Muslim countries with the search term "psychological autopsy study in Muslim countries." We also checked the available bibliographies to identify the psychological autopsy studies in the Muslim countries so that all the possible studies could be included. RESULTS Out of the Muslim countries, only eight psychological autopsy studies were identified in five countries (Bangladesh [1], Indonesia [1], Iran [1], Pakistan [2], and Turkey [3]). Six studies adopted a case-control study design, and all were carried out in urban settings. The prevalence of psychiatric disorders among case-control studies varied from 52.8% in Turkey to 96% in Pakistan. Psychiatric illness, self-harm, and stressful life events were the commonly replicated risk factors for suicide across studies. CONCLUSIONS Psychological autopsy studies have been conducted only in five Muslim countries revealing that the risk factor for suicide is certainly under-researched in the incumbent countries. This review identified a similar list of risk factors for suicide, namely, psychiatric disorder, past non-fatal attempts, and adverse life events compared to the Western countries even though the rate varies.
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Affiliation(s)
- S. M. Yasir Arafat
- Department of PsychiatryEnam Medical College and HospitalDhakaBangladesh
| | - Murad M. Khan
- Department of PsychiatryAga Khan UniversityKarachiPakistan
| | - Vikas Menon
- Department of PsychiatryJawaharlal Institute of Postgraduate Medical Education and Research (JIPMER)PuducherryIndia
| | | | - Mohsen Rezaeian
- Epidemiology and Biostatistics DepartmentRafsanjan Medical School, Occupational Environmental Research Center, Rafsanjan University of Medical SciencesRafsanjanIran
| | - Sheikh Shoib
- Department of PsychiatryJawahar Lal Nehru Memorial Hospital (JLNMH)SrinagarIndia
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13
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Costanza A, Amerio A, Aguglia A, Escelsior A, Serafini G, Berardelli I, Pompili M, Amore M. When Sick Brain and Hopelessness Meet: Some Aspects of Suicidality in the Neurological Patient. CNS & NEUROLOGICAL DISORDERS-DRUG TARGETS 2021; 19:257-263. [PMID: 32525785 PMCID: PMC7569280 DOI: 10.2174/1871527319666200611130804] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/03/2020] [Revised: 06/13/2020] [Accepted: 08/18/2020] [Indexed: 12/11/2022]
Abstract
Neurological diseases expose individuals to a higher risk of suicidal ideation and suicidal behavior, including completed suicides and suicide attempts. They also represent a paradigmatic arena to study the etiopathogenic mechanisms underlying suicidality because they are emblematic of the heterogeneity and complexity of mutual interrelationships characterizing this issue. On the one hand, neurological diseases imply strictly biological impairments that are postulated to be the basis of vulnerability to suicide or result in the need for treatments for which a suicidal risk has been hypothesized. On the other hand, they question some subjective experiences of neurological patients, up to near existential positions. Often, in fact, they are accompanied by severe hopelessness. The latter may originate in, particularly for the most severe neurological diseases, the absence of curative treatments, unpredictable disease progression that leads to acute relapses or chronicity, a decrease in autonomy or selfidentity, progressive social isolation, a sense of becoming useless, and perception of feeling stigmatized. This may ultimately cause a slip into experiencing an absurd condition. At the confluence of neurobiology and hopelessness, frequent psychiatric comorbidities may play a primary role. To conclude, neurological patients require special attention from clinicians in form of openly verbalizing and exploring the suicidal thematic, inquiring about protective and risk factors, and promptly initiating both a psychopharmacological treatment and, where possible, psychological support.
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Affiliation(s)
- Alessandra Costanza
- Department of Psychiatry, Faculty of Medicine, University of Geneva (UNIGE), Geneva, Switzerland.,Department of Psychiatry, ASO Santi Antonio e Biagio e Cesare Arrigo Hospital, Alessandria, Italy
| | - Andrea Amerio
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, Genoa, Italy.,IRCCS Ospedale Policlinico San Martino, Genoa, Italy.,Mood Disorders Program, Tufts Medical Center, Boston, MA, USA
| | - Andrea Aguglia
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, Genoa, Italy.,IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Andrea Escelsior
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, Genoa, Italy.,IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Gianluca Serafini
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, Genoa, Italy.,IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Isabella Berardelli
- Department of Neurosciences, Mental Health and Sensory Organs, Suicide Prevention Center, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | - Maurizio Pompili
- Department of Neurosciences, Mental Health and Sensory Organs, Suicide Prevention Center, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | - Mario Amore
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, Genoa, Italy.,IRCCS Ospedale Policlinico San Martino, Genoa, Italy
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14
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Amerio A, Giacomini C, Fusar-Poli L, Aguglia A, Costanza A, Serafini G, Aguglia E, Amore M. Efficacy and safety of lurasidone in children and adolescents: Recommendations for clinical management and future research. Curr Pharm Des 2021; 27:4062-4069. [PMID: 34348620 DOI: 10.2174/1381612827666210804110853] [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: 03/15/2021] [Accepted: 06/24/2021] [Indexed: 11/22/2022]
Abstract
Lurasidone is a novel azapirone derivative, and atypical antipsychotic agent with a high binding affinity for dopaminergic (D2), serotoninergic (5-HT2A), and 5-HT7 receptors (antagonist), a moderate affinity for 5-HT1A receptors (partial agonist), and no appreciable affinity for histaminergic (H1) and muscarinic (M1) receptors. It was recently included by the European Medication Agency among the in-label pharmacological treatments for children and adolescents affected by early onset schizophrenia. As a dopamine and serotonin antagonist, lurasidone acts on a variety of receptors and showed its efficacy both as an antipsychotic and an activating compound. Administered with food or within 30 minutes from a meal, it presents sufficient bioavailability and does not interact ith most of the other drugs during metabolism. With little effects on hormones and weight gain, potential procognitive profile due to its 5-HT7 antagonism, and reduced extrapyramidal side effects, lurasidone could be a good choice in terms of both effectiveness and tolerability, particularly for patients headed towards a long-term treatment. This article aims to summarize the available scientific evidence from the literature on the use of lurasidone in children and adolescents and to provide recommendations for clinical management and future research.
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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, Genoa. Italy
| | - Costanza Giacomini
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Section of Psychiatry, University of Genoa, Genoa. Italy
| | - Laura Fusar-Poli
- Department of Clinical and Experimental Medicine, Psychiatry Unit, University of Catania, Catania. Italy
| | - Andrea Aguglia
- 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
| | - Gianluca Serafini
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Section of Psychiatry, University of Genoa, Genoa. Italy
| | - Eugenio Aguglia
- Department of Clinical and Experimental Medicine, Psychiatry Unit, University of Catania, Catania. Italy
| | - Mario Amore
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Section of Psychiatry, University of Genoa, Genoa. Italy
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15
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Zuriaga A, Kaplan MS, Choi NG, Hodkinson A, Storman D, Brudasca NI, Hirani SP, Brini S. Association of mental disorders with firearm suicides: A systematic review with meta-analyses of observational studies in the United States. J Affect Disord 2021; 291:384-399. [PMID: 34098496 DOI: 10.1016/j.jad.2021.05.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Revised: 04/26/2021] [Accepted: 05/05/2021] [Indexed: 11/30/2022]
Abstract
In the United States (US), 61% of all suicide cases may involve firearms, and some evidence suggests that mental disorders may play a role in suicide by firearm. We performed the first systematic review and meta-analyses to investigate: (i) whether mental disorders are associated with suicide by firearm, and (ii) whether the risk of using a firearm compared with alternative means is associated with higher levels of suicide in individuals with a mental disorder METHODS AND FINDINGS: We searched twelve databases from inception to the 24th of May 2020. We retrieved 22 observational studies conducted in the US. Random-effects meta-analyses showed individuals who had a diagnosis of a mental disorder had lower odds (odds ratios (OR)= 0.50, 95% CI: 0.36 to 0.69; I2=100 (95% CI: 87 to 100%), of dying by suicide with a firearm than those who did not have a diagnosis of a mental disorder. Secondary analysis showed that decedents who had a mental health diagnosis resulted in lower odds of dying by suicide by using firearms than using other means LIMITATIONS: Risk of bias revealed a heterogeneous and poor definition of mental disorders as well as lack of control for potential demographic confounding factors. In the meta-analyses, studies were combined in the same analytic sample as 77% of these studies did not specify the type of mental disorder CONCLUSION: While our results seem to suggest that having a mental disorder may not be consistently associated with the odds of dying by suicide using a firearm, the presence of substantial heterogeneity and high risk of bias precludes any firm conclusions.
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Affiliation(s)
- Ana Zuriaga
- Division of Health Services Research and Management, School of Health Sciences, City, University of London, London, United Kingdom.
| | - Mark S Kaplan
- Luskin School of Public Affairs, University of California, Los Angeles, United States
| | - Namkee G Choi
- Steve Hicks School of Social Work, University of Texas at Austin, United States
| | - Alexander Hodkinson
- National Institute for Health Research, School for Primary Care Research, Manchester Academic Health Science Centre, University of Manchester, United Kingdom
| | - Dawid Storman
- Chair of Epidemiology and Preventive Medicine, Department of Hygiene and Dietetics, Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland; Systematic Reviews Unit, Jagiellonian University Medical College, Krakow, Poland
| | - Nicoleta I Brudasca
- Division of Health Services Research and Management, School of Health Sciences, City, University of London, London, United Kingdom
| | - Shashivadan P Hirani
- Division of Health Services Research and Management, School of Health Sciences, City, University of London, London, United Kingdom
| | - Stefano Brini
- Division of Health Services Research and Management, School of Health Sciences, City, University of London, London, United Kingdom
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16
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Ftanou M, Reavley N, Robinson J, Spittal MJ, Pirkis J. Developing Public Service Announcements to Help Prevent Suicide among Young People. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18084158. [PMID: 33920012 PMCID: PMC8070985 DOI: 10.3390/ijerph18084158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Revised: 04/10/2021] [Accepted: 04/12/2021] [Indexed: 11/24/2022]
Abstract
Background: Suicide is the leading cause of death among young people in Australia. Media campaigns have the potential to reach a broad audience, change attitudes and behaviours, and, ultimately, help prevent suicide. Little is known about the type of content or format suicide prevention media message should take to help prevent suicide among young people. Objective: the objective of this study was to involve young people aged 18 to 24 years in developing three suicide prevention public service announcement (PSAs) targeting young people at risk of suicide appropriate for testing in a randomised controlled trial (RCT). Method: fifteen young people attended at least one of four workshops in Melbourne, Australia. The workshops focused on exploring the appropriateness of three key suicide prevention media PSAs: “Talk to someone”, “Find what works for you”, and “Life can get better”. Young people also provided input into message content, format, and design. Results: participants perceived that all three suicide prevention PSAs were useful and helpful. Participants were concerned that the PSAs may not be suitable for nonwestern cultural groups, could trivialise psychological suffering, and that the actions they promoted could seem distant or unattainable to young people at risk. The featuring of young people, especially young people with hopeful narratives of how they overcame a suicidal crisis, was considered to be an important characteristic of suicide prevention PSAs targeting young people. Conclusions: Developing suicide prevention PSAs with young people is rare but essential to better understand young people’s needs and improve the quality of suicide prevention media PSAs. Further research is needed to evaluate the impact of suicide prevention PSAs developed by young people, for young people.
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Affiliation(s)
- Maria Ftanou
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC 3053, Australia; (N.R.); (M.J.S.); (J.P.)
- Correspondence: ; Tel.: +61-3-8344-0655; Fax: +61-3-9348-1174
| | - Nicola Reavley
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC 3053, Australia; (N.R.); (M.J.S.); (J.P.)
| | - Jo Robinson
- Orygen, Parkville, VIC 3052, Australia;
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC 3052, Australia
| | - Matthew J. Spittal
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC 3053, Australia; (N.R.); (M.J.S.); (J.P.)
| | - Jane Pirkis
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC 3053, Australia; (N.R.); (M.J.S.); (J.P.)
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17
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Costanza A, Radomska M, Bondolfi G, Zenga F, Amerio A, Aguglia A, Serafini G, Amore M, Berardelli I, Pompili M, Nguyen KD. Suicidality Associated With Deep Brain Stimulation in Extrapyramidal Diseases: A Critical Review and Hypotheses on Neuroanatomical and Neuroimmune Mechanisms. Front Integr Neurosci 2021; 15:632249. [PMID: 33897384 PMCID: PMC8060445 DOI: 10.3389/fnint.2021.632249] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2020] [Accepted: 03/15/2021] [Indexed: 12/13/2022] Open
Abstract
Deep brain stimulation (DBS) is a very well-established and effective treatment for patients with extrapyramidal diseases. Despite its generally favorable clinical efficacy, some undesirable outcomes associated with DBS have been reported. Among such complications are incidences of suicidal ideation (SI) and behavior (SB) in patients undergoing this neurosurgical procedure. However, causal associations between DBS and increased suicide risk are not demonstrated and they constitute a debated issue. In light of these observations, the main objective of this work is to provide a comprehensive and unbiased overview of the literature on suicide risk in patients who received subthalamic nucleus (STN) and internal part of globus pallidum (GPi) DBS treatment. Additionally, putative mechanisms that might be involved in the development of SI and SB in these patients as well as caveats associated with these hypotheses are introduced. Finally, we briefly propose some clinical implications, including therapeutic strategies addressing these potential disease mechanisms. While a mechanistic connection between DBS and suicidality remains a controversial topic that requires further investigation, it is of critical importance to consider suicide risk as an integral component of candidate selection and post-operative care in DBS.
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Affiliation(s)
- Alessandra Costanza
- Department of Psychiatry, Faculty of Medicine, University of Geneva (UNIGE), Geneva, Switzerland.,Department of Psychiatry, ASO Santi Antonio e Biagio e Cesare Arrigo Hospital, Alessandria, Italy
| | - Michalina Radomska
- Faculty of Psychology, University of Geneva (UNIGE), Geneva, Switzerland
| | - Guido Bondolfi
- Department of Psychiatry, Faculty of Medicine, University of Geneva (UNIGE), Geneva, Switzerland.,Department of Psychiatry, Service of Liaison Psychiatry and Crisis Intervention (SPLIC), Geneva University Hospitals (HUG), Geneva, Switzerland
| | - Francesco Zenga
- Department of Neurosurgery, University and City of Health and Science Hospital, Turin, Italy
| | - Andrea Amerio
- Section of Psychiatry, Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genova, Genova, Italy.,Department of Psychiatry, IRCCS Ospedale Policlinico San Martino, Genoa, Italy.,Mood Disorders Program, Tufts Medical Center, Boston, MA, United States
| | - Andrea Aguglia
- Section of Psychiatry, Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genova, Genova, Italy.,Department of Psychiatry, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Gianluca Serafini
- Section of Psychiatry, Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genova, Genova, Italy.,Department of Psychiatry, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Mario Amore
- Section of Psychiatry, Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genova, Genova, Italy.,Department of Psychiatry, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Isabella Berardelli
- Department of Neurosciences, Mental Health and Sensory Organs, Suicide Prevention Center, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | - Maurizio Pompili
- Department of Neurosciences, Mental Health and Sensory Organs, Suicide Prevention Center, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | - Khoa D Nguyen
- Department of Microbiology and Immunology, Stanford University, Palo Alto, CA, United States.,Tranquis Therapeutics, Palo Alto, CA, United States.,Hong Kong University of Science and Technology, Hong Kong, China
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18
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Kim JS, Kim S, Lee HS, Kwon YJ, Lee HY, Shim SH. Auditory evoked potentials and suicidal behaviors in patients with major depressive disorders. Sci Rep 2021; 11:7255. [PMID: 33790320 PMCID: PMC8012352 DOI: 10.1038/s41598-021-86602-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Accepted: 03/15/2021] [Indexed: 11/09/2022] Open
Abstract
Loudness dependence of auditory evoked potentials (LDAEP) has been proposed as a biological marker of central serotonergic activity related to suicides. This study’s objective was to analyze the difference in LDAEP between depressed patients with suicide attempts (SA) and suicidal ideation (SI). It included 130 participants (45 depressed patients with SA, 49 depressed patients with SI, and 36 healthy controls) aged > 18 years who exhibited LDAEP during electroencephalography. Psychological characteristics and event-related potentials of the three groups were compared. There was no significant difference in LDAEP between major depressive disorder (MDD) patients with SA and SI (p = 0.59). MDD patients with SI, who attempted suicide had significantly lower LDAEP than healthy controls (p = 0.01 and p = 0.01, respectively). However, the significance disappeared when psychological characteristics were controlled. Our results suggest that LDAEP might not be possible biomarkers for suicidal behaviors in patients with MDD. Further studies to assess the biological basis of suicide and identify the underlying dimensions that mediate the relationship between the biological basis and suicidal behaviors will be needed.
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Affiliation(s)
- Ji Sun Kim
- Department of Psychiatry, College of Medicine, Soonchunhyang University Cheonan Hospital, 31 Suncheonhyang 6-gil, Dongnam-gu, Cheonan, 31151, Republic of Korea
| | - Sungkean Kim
- Department of Human-Computer Interaction, Hanyang University, Ansan-si, 15588, South Korea
| | - Ho-Sung Lee
- Department of Pulmonology and Allergy, Cheonan Hospital, Soonchunhyang University, Cheonan, Republic of Korea
| | - Young Joon Kwon
- Department of Psychiatry, College of Medicine, Soonchunhyang University Cheonan Hospital, 31 Suncheonhyang 6-gil, Dongnam-gu, Cheonan, 31151, Republic of Korea
| | - Hwa Young Lee
- Department of Psychiatry, College of Medicine, Soonchunhyang University Cheonan Hospital, 31 Suncheonhyang 6-gil, Dongnam-gu, Cheonan, 31151, Republic of Korea
| | - Se-Hoon Shim
- Department of Psychiatry, College of Medicine, Soonchunhyang University Cheonan Hospital, 31 Suncheonhyang 6-gil, Dongnam-gu, Cheonan, 31151, Republic of Korea.
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Costanza A, Radomska M, Zenga F, Amerio A, Aguglia A, Serafini G, Amore M, Berardelli I, Ojio Y, Nguyen KD. Severe Suicidality in Athletes with Chronic Traumatic Encephalopathy: A Case Series and Overview on Putative Ethiopathogenetic Mechanisms. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18030876. [PMID: 33498520 PMCID: PMC7908343 DOI: 10.3390/ijerph18030876] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Revised: 01/13/2021] [Accepted: 01/15/2021] [Indexed: 12/14/2022]
Abstract
Chronic traumatic encephalopathy (CTE) results from repetitive brain injuries and is a common neurotraumatic sequela in contact sports. CTE is often accompanied by neuropsychiatric symptoms, which could escalate to suicidal ideation (SI) and suicidal behaviour (SB). Nevertheless, fairly limited emphasis about the association between suicidality and CTE exists in medical literature. Here, we report two cases of retired professional athletes in high contact sports (boxing and ice hockey) who have developed similar clinical trajectories characterized by progressive neuropsychiatric symptoms compatible with a CTE diagnosis and subsequent SB in its severe forms (medical serious suicide attempt (SA) and completed suicide). In addition to the description of outlining clinical, neuropsychological, neuroimaging, and differential diagnosis elements related to these cases, we also hypothesized some mechanisms that might augment the suicide risk in CTE. They include those related to neurobiological (neuroanatomic/neuroinflammatory) dysfunctions as well as those pertaining to psychiatry and psychosocial maladaptation to neurotraumas and retirement from professional competitive activity. Findings described here can provide clinical pictures to improve the identification of patients with CTE and also potential mechanistic insights to refine the knowledge of eventual severe SB development, which might enable its earlier prevention.
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Affiliation(s)
- Alessandra Costanza
- Department of Psychiatry, Faculty of Medicine, University of Geneva (UNIGE), 1211 Geneva, Switzerland
- Department of Psychiatry, ASO Santi Antonio e Biagio e Cesare Arrigo Hospital, 15121 Alessandria, Italy
- Correspondence:
| | - Michalina Radomska
- Faculty of Psychology, University of Geneva (UNIGE), 1206 Geneva, Switzerland;
| | - Francesco Zenga
- Department of Neurosurgery, City of Health and Science Hospital, 10126 Torino, Italy;
| | - Andrea Amerio
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, 16132 Genoa, Italy; (A.A.); (A.A.); (G.S.); (M.A.)
- IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy
- Department of Psychiatry, Tufts University, Boston, MA 02111, USA
| | - Andrea Aguglia
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, 16132 Genoa, Italy; (A.A.); (A.A.); (G.S.); (M.A.)
- IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy
| | - Gianluca Serafini
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, 16132 Genoa, Italy; (A.A.); (A.A.); (G.S.); (M.A.)
- IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy
| | - Mario Amore
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, 16132 Genoa, Italy; (A.A.); (A.A.); (G.S.); (M.A.)
- IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy
| | - Isabella Berardelli
- Suicide Prevention Center, Department of Neurosciences, Mental Health and Sensory Organs, Sant’Andrea Hospital, Sapienza University of Rome, 00189 Rome, Italy;
| | - Yasutaka Ojio
- National Center of Neurology and Psychiatry, Department of Community Mental Health Law, National Institute of Mental Health, Tokyo 187-8553, Japan;
| | - Khoa D. Nguyen
- Department of Microbiology and Immunology, Stanford University, Palo Alto, CA 94304, USA;
- Tranquis Therapeutics, Palo Alto, CA 94304, USA
- Hong Kong University of Science and Technology, Hong Kong, China
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Costanza A, Zenga F, Rudà R, Amerio A, Aguglia A, Serafini G, Amore M, Bondolfi G, Berardelli I, Nguyen KD. Suicidality in Patients with Brain Tumors: A Brief Literature Review with Clinical Exemplar. MEDICINA (KAUNAS, LITHUANIA) 2020; 56:725. [PMID: 33371470 PMCID: PMC7767493 DOI: 10.3390/medicina56120725] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/03/2020] [Revised: 12/11/2020] [Accepted: 12/19/2020] [Indexed: 12/11/2022]
Abstract
Background: Suicidality and brain tumors are two life-threatening conditions and, somewhat unexpectedly, the associations between them have scarcely been reported. Objective: In this study, we aimed to provide a brief literature review of epidemiological studies on suicidal ideation (SI) and suicidal behavior (SB) in patients with brain tumors. To illustrate various aspects of brain tumors that potentially underlie the emergence of suicidality, the review is supplemented with a clinical exemplar of a long-term survivor of brain tumor (glioblastoma) who experienced persistent SI. Furthermore, we discuss putative both neurobiological (including anatomical and immunological) and psychosocial mechanisms that might be accountable for the development of SI and SB in patients with brain tumors. Conclusions: While the etiology of this phenomenon appears to be multifactorial and still remains a subject of much debate, it is of critical importance to identify patients for which a psychiatric evaluation could recognize, in a timely manner, a possible suicide risk and alleviate the deep related suffering, by appropriate psychopharmacological and supportive and psychotherapeutic interventions.
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Affiliation(s)
- Alessandra Costanza
- Department of Psychiatry, Faculty of Medicine, University of Geneva (UNIGE), 1211 Geneva, Switzerland;
- Department of Psychiatry, ASO Santi Antonio e Biagio e Cesare Arrigo Hospital, 15121 Alessandria, Italy
| | - Francesco Zenga
- Department of Neurosurgery, University and City of Health and Science Hospital, 10126 Torino, Italy;
| | - Roberta Rudà
- Department of Neuro-Oncology, University and City of Health and Science Hospital, 10126 Torino, Italy;
| | - Andrea Amerio
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, 16133 Genoa, Italy; (A.A.); (A.A.); (G.S.); (M.A.)
- IRCCS Ospedale Policlinico San Martino, 16133 Genoa, Italy
- Department of Psychiatry, Tufts University, Boston, MA 02111, USA
| | - Andrea Aguglia
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, 16133 Genoa, Italy; (A.A.); (A.A.); (G.S.); (M.A.)
- IRCCS Ospedale Policlinico San Martino, 16133 Genoa, Italy
| | - Gianluca Serafini
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, 16133 Genoa, Italy; (A.A.); (A.A.); (G.S.); (M.A.)
- IRCCS Ospedale Policlinico San Martino, 16133 Genoa, Italy
| | - Mario Amore
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, 16133 Genoa, Italy; (A.A.); (A.A.); (G.S.); (M.A.)
- IRCCS Ospedale Policlinico San Martino, 16133 Genoa, Italy
| | - Guido Bondolfi
- Department of Psychiatry, Faculty of Medicine, University of Geneva (UNIGE), 1211 Geneva, Switzerland;
- Department of Psychiatry, Service of Liaison Psychiatry and Crisis Intervention, Geneva University Hospitals, 1211 Geneva, Switzerland
| | - Isabella Berardelli
- Department of Neuroscience, Mental Health and Sensory Organs, Suicide Prevention Center, Sant’Andrea Hospital, Sapienza University of Rome, 00185 Rome, Italy;
| | - Khoa Dinh Nguyen
- Department of Microbiology and Immunology, Stanford University, Palo Alto, CA 94305, USA;
- Tranquis Therapeutics, Palo Alto, CA 94305, USA
- Hong Kong University of Science and Technology, Hong Kong, China
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Du L, Shi HY, Qian Y, Jin XH, Li Y, Yu HR, Liu XM, Fu XL, Chen HL. Association between social support and suicidal ideation in patients with cancer: A systematic review and meta-analysis. Eur J Cancer Care (Engl) 2020; 30:e13382. [PMID: 33277772 DOI: 10.1111/ecc.13382] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 10/27/2020] [Accepted: 11/18/2020] [Indexed: 12/24/2022]
Abstract
OBJECTIVE To quantitatively examine the relationship between social support and suicidal ideation (SI) among patients with cancer and identify the moderators that influence the magnitude of this association. METHODS Publications were searched in PubMed, PsycINFO, EMBASE, Cochrane Library and Chinese National Knowledge Infrastructure from database inception to May, 2020. Correlation coefficients (r) were chosen as the effect size with a random model to evaluate the overall effect size between social support and SI in patients with cancer. To assess statistical heterogeneity, we examined potential moderator variables on the social support and SI. RESULTS A total of 881 studies were identified in initial search, and twelve studies were eligible. A negative, small but significant correlation (r = -0.22, 95% CIs: -0.30,-0.14, p < 0.001) was observed between social support and SI in patients with cancer, with a significant heterogeneity (I2 = 95.24%, Q = 231.27, p < 0.001). Moderator analyses indicated that race/ethnicity (Q(1) = 8.4, p < 0.05) and measurements of social support (Q(3) = 9.78, p < 0.05) and SI (Q(3) = 9.69, p < 0.05) significantly moderate the effect size between social support and SI. CONCLUSION Taken together, we found a negative yet significant association between social support and SI in patients with cancer, which supported the importance of social support for the prevention of SI in patients with cancer.
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Affiliation(s)
- Lin Du
- School of Medicine, Nantong University, Nantong, China
| | - Hai-Yan Shi
- Department of Thoracic Oncology, Rugao People's Hospital, Nantong, China
| | - Yan Qian
- Department of Oncology, Affiliated Hospital of Nantong University, Nantong, China
| | - Xiao-Hong Jin
- Department of Oncology, Affiliated Hospital of Nantong University, Nantong, China
| | - Yang Li
- School of Public Health, Nantong University, Nantong, China
| | - Hai-Rong Yu
- Department of Thoracic Oncology, Affiliated Hospital of Nantong University, Nantong, China
| | - Xiao-Man Liu
- Department of Ophthalmology, Affiliated Hospital of Nantong University, Nantong, Jiangsu, China
| | - Xue-Lei Fu
- School of Medicine, Nantong University, Nantong, China
| | - Hong-Lin Chen
- School of Public Health, Nantong University, Nantong, China
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Costanza A, Chytas V, Mazzola V, Piguet V, Desmeules J, Bondolfi G, Cedraschi C. The Role of Demoralization and Meaning in Life (DEMIL) in Influencing Suicidal Ideation Among Patients Affected by Chronic Pain: Protocol of a Single-Center, Observational, Case-Control Study. JMIR Res Protoc 2020; 9:e24882. [PMID: 33144275 PMCID: PMC7728536 DOI: 10.2196/24882] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 11/03/2020] [Accepted: 11/03/2020] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Chronic pain is a significant risk factor for suicidal ideation (SI) and suicidal behavior (SB), including a 20%-40% prevalence rate of SI, a prevalence between 5% and 14% of suicide attempts, and a doubled risk of death by suicide in patients with chronic pain compared to controls. In most studies, associations between chronic pain and suicidality are robust, even after adjusting for the effect of sociodemographics and psychiatric comorbidity, and particularly for depressive conditions. A number of specific conditions that can modulate suicidality risk in patients with chronic pain have been investigated, but there is a need for their more specific characterization. Numerous recent studies have shown that demoralization and meaning in life (MiL) constructs affect suicidality as risk and protective factors, respectively. These constructs have been mainly investigated in patients with somatic illness and in community-dwelling individuals who may present with SI or SB independently of a psychiatric diagnosis of depression. However, a paucity of studies investigated them in suicidal patients affected by chronic pain. OBJECTIVE The primary objective of this project is to investigate the relationship between demoralization and MiL on SI risk in patients with chronic pain. The secondary objectives are (1) to test whether demoralization can occur independently of depression in patients with chronic pain and SI, (2) to examine whether the expected association between demoralization and SI may be explained by a sole dimension of demoralization: hopelessness, (3) to examine whether the presence of MiL, but not the search for MiL, is associated with less SI, and (4) to explore whether previously described MiL profiles (ie, high presence-high search, high presence-low search, moderate presence-moderate search, low presence-low search, and low presence-high search) emerge in our cohort. METHODS This project is a single-center, observational, case-control study-the Demoralization and Meaning in Life (DEMiL) study-conducted by the Division of Clinical Pharmacology and Toxicology, the Multidisciplinary Pain Centre, and the Service of Liaison Psychiatry and Crisis Intervention at the Geneva University Hospitals. Self- and hetero-administered questionnaires were conducted among patients and controls, matched by age and gender. The Ethics Committee of the Canton of Geneva approved the scientific utilization of collected data (project No. 2017-02138; decision dated January 25, 2018). Data have been analyzed with SPSS, version 23.0, software (IBM Corp). RESULTS From March 1, 2018, to November 30, 2019, 70 patients and 70 controls were enrolled. Statistical analyses are still in progress and are expected to be finalized in November 2020. To date, we did not observe any unfavorable event for which a causal relationship with the collection of health-related personal data could be ruled out. Results of this study are expected to form the basis for possible prevention and psychotherapeutic interventions oriented toward demoralization and MiL constructs for suicidal patients with chronic pain. CONCLUSIONS The interest in exploring demoralization and MiL in chronic pain patients with SI arises from the common clinical observation that experiencing chronic pain often requires a revision of one's life goals and expectations. Hence, the impact of chronic pain is not limited to patients' biopsychosocial functioning, but it affects the existential domain as well. The major clinical implications in suicidal patients with chronic pain consist in trying to (1) delineate a more precise and individualized suicide risk profile, (2) improve detection and prevention strategies by investigating SI also in individuals who do not present with a clinically diagnosed depression, and (3) enhance the panel of interventions by broadening supportive or psychotherapeutic actions, taking into consideration the existential condition of a person who suffers and strives to deal with his or her suffering. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/24882.
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Affiliation(s)
- Alessandra Costanza
- Department of Psychiatry, Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Department of Psychiatry, Santi Antonio e Biagio e Cesare Arrigo Hospital, Alessandria, Italy
| | - Vasileios Chytas
- Division of Clinical Pharmacology and Toxicology, Multidisciplinary Pain Center, Geneva University Hospitals, Geneva, Switzerland
| | - Viridiana Mazzola
- Department of Psychiatry, Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Department of Psychiatry, Service of Liaison Psychiatry and Crisis Intervention, Geneva University Hospitals, Geneva, Switzerland
| | - Valérie Piguet
- Division of Clinical Pharmacology and Toxicology, Multidisciplinary Pain Center, Geneva University Hospitals, Geneva, Switzerland
| | - Jules Desmeules
- Department of Psychiatry, Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Division of Clinical Pharmacology and Toxicology, Multidisciplinary Pain Center, Geneva University Hospitals, Geneva, Switzerland
| | - Guido Bondolfi
- Department of Psychiatry, Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Department of Psychiatry, Service of Liaison Psychiatry and Crisis Intervention, Geneva University Hospitals, Geneva, Switzerland
| | - Christine Cedraschi
- Department of Psychiatry, Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Division of Clinical Pharmacology and Toxicology, Multidisciplinary Pain Center, Geneva University Hospitals, Geneva, Switzerland
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Costanza A, Di Marco S, Burroni M, Corasaniti F, Santinon P, Prelati M, Chytas V, Cedraschi C, Ambrosetti J. Meaning in life and demoralization: a mental-health reading perspective of suicidality in the time of COVID-19. ACTA BIO-MEDICA : ATENEI PARMENSIS 2020; 91:e2020163. [PMID: 33525223 PMCID: PMC7927501 DOI: 10.23750/abm.v91i4.10515] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/23/2020] [Accepted: 09/02/2020] [Indexed: 12/19/2022]
Abstract
Consequences on mental health have been reported in general population, vulnerable individuals, psychiatric patients, and healthcare professionals. It is urgently necessary to study mental health issues in order to set priorities for public health policies and implement effective interventions. Suicidality is one of the most extreme outcomes of a mental health crisis. It is currently too early to know what the effect of COVID-19 will be on suicidality. However, authoritative commentary papers alert that most of the factors precipitating suicide are, and probably will be for a long time, present at several individual existence levels. A number of prevention measures and research considerations have been drawn up. A point of the latter, recommended by the International COVID-10 Suicide Prevention Research Collaboration, states that “the COVID-19 suicide research response should be truly multidisciplinary. This will foster research that addresses the different aspects and layers of risk and resilience […]. It will also foster research that informs prevention efforts by taking a range of perspectives” (Niederkrotenthaler et al., 2020). In this light, we would like to propose a reading perspective of suicidality that takes into account Meaning in Life (MiL) and demoralization. Both of the constructs were studied in heterogeneous populations with extreme life situations having led to a fracture between a “before” and an “after”, and play a role in affecting suicidality, respectively as resilience and risk factors. In clinical practice, during these unprecedent times, we wish that this more inclusive approach could: 1) contribute to prevention, by delineating more individualized suicidal risk profiles in persons conventionally non-considered at risk but here exposed to an extremely uncommon experience, 2) enrich supportive/psychotherapeutic interventions, by broadening the panel of means to some aspects constitutive of the existential condition of a person who is brutally confronted with something unexpected, incomprehensible and, in some ways, still unpredictable. (www.actabiomedica.it)
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Affiliation(s)
- Alessandra Costanza
- Departement of Psychiatry, Faculty of Medicine, University of Geneva (UNIGE), Geneva, Switzerland; Department of Psychiatry, ASO Santi Antonio e Biagio e Cesare Arrigo Hospital, Alessandria, Italy.
| | - Sarah Di Marco
- Department of Psychiatry, ASO Santi Antonio e Biagio e Cesare Arrigo Hospital, Alessandria, Italy.
| | - Marta Burroni
- Department of Psychiatry, ASO Santi Antonio e Biagio e Cesare Arrigo Hospital, Alessandria, Italy.
| | - Francesco Corasaniti
- Department of Psychiatry, ASO Santi Antonio e Biagio e Cesare Arrigo Hospital, Alessandria, Italy.
| | - Patrizia Santinon
- Department of Psychiatry, ASO Santi Antonio e Biagio e Cesare Arrigo Hospital, Alessandria, Italy.
| | - Massimo Prelati
- Department of Psychiatry, ASO Santi Antonio e Biagio e Cesare Arrigo Hospital, Alessandria, Italy.
| | - Vasileios Chytas
- Division of Clinical Pharmacology and Toxicology, Multidisciplinary Pain Centre, University of Geneva and University Hospitals of Geneva, Switzerland.
| | - Christine Cedraschi
- Departement of Psychiatry, Faculty of Medicine, University of Geneva (UNIGE), Geneva, Switzerland; Division of Clinical Pharmacology & Toxicology, Multidisciplinary Pain Centre (MPC), University of Geneva (UNIGE) and University Hospitals of Geneva (HUG), Switzerland; Division of General Medical Rehabilitation, Faculty of Medicine, University of Geneva (UNIGE) and University Hospitals of Geneva (HUG), Switzerland.
| | - Julia Ambrosetti
- Department of Psychiatry and Emergency Department, Emergency Psychiatric Unit (UAUP), Geneva University Hospitals, 1211 Geneva (HUG), Switzerland.
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Costanza A, Amerio A, Aguglia A, Serafini G, Amore M. Meaning in Life and Demoralization Constructs in Light of the Interpersonal Theory of Suicide: A Trans-Theoretical Hypothesis for a Cross-Sectional Study. Psychol Res Behav Manag 2020; 13:855-858. [PMID: 33154680 PMCID: PMC7605968 DOI: 10.2147/prbm.s279829] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Accepted: 10/15/2020] [Indexed: 12/13/2022] Open
Abstract
Following V. Frankl's (in the 1950s) and J. Frank's (in the 1970s) historical definitions of the constructs Meaning in Life (MiL) and demoralization, there have been a multitude of studies which have described them from different theoretical perspectives. These constructs are closely linked, with the lack of MiL as one of the subconstructs underlying the definition of demoralization. Numerous studies have shown that MiL and demoralization affect suicidality, as protective and risk factors, respectively. The Interpersonal Theory of Suicide (IPTS) is a more recent framework conceptualized by T. Joiner (in the 2000s) to provide an additional possible reading key in the effort to better understand suicidality. By analogy to a previous study by E. Kleiman & J. Beaver (2013), examining MiL and demoralization in suicidality through a perspective of the IPTS framework can be of considerable interest. This study showed, in a cohort of undergraduate students, that MiL mediated the relationship between two variables associated with IPTS (perceived burdensomeness and thwarted belongingness) and suicidal ideation (SI). Taking into consideration future studies that these latter authors advocated, our aim is to verify this finding using a cross-sectional study. Differences in our approach would include a) studying a clinical population (suicidal patients attending an emergency department), b) analyzing relationships not only with SI but also with suicidal attempts (SA), and c) in consideration of the interconnection between MiL and demoralization, exploring also the possible role of demoralization as a mediator. The clinical implication lies in identifying multi-faceted targets that may be useful to mitigate suicidality risk in individuals, both in prevention and therapy intervention.
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Affiliation(s)
- Alessandra Costanza
- Department of Psychiatry, Faculty of Medicine, University of Geneva (UNIGE), Geneva, Switzerland
- Department of Psychiatry, ASO Santi Antonio e Biagio e Cesare Arrigo Hospital, Alessandria, Italy
| | - Andrea Amerio
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, Genoa, Italy
- Department of Psychiatry, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
- Mood Disorders Program, Tufts Medical Center, Boston, MA, USA
| | - Andrea Aguglia
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, Genoa, Italy
- Department of Psychiatry, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Gianluca Serafini
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, Genoa, Italy
- Department of Psychiatry, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Mario Amore
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, Genoa, Italy
- Department of Psychiatry, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
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Biological Targets Underlying the Antisuicidal Effects of Lithium. Curr Behav Neurosci Rep 2020. [DOI: 10.1007/s40473-020-00208-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/07/2022]
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Impulsivity and Impulsivity-Related Endophenotypes in Suicidal Patients with Substance Use Disorders: an Exploratory Study. Int J Ment Health Addict 2020. [DOI: 10.1007/s11469-020-00259-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
AbstractSuicidal behavior (SB) is a major problem in patients with substance use disorders (SUDs). However, little is known about specific SB risk factors in this population, and pathogenetic hypotheses are difficult to disentangle. This study investigated some SB and SUD-related endophenotypes, such as impulsivity, aggression, trait anger, and risk-taking behaviors (RTBs), in forty-eight patients with SUDs in relation to lifetime history of suicide attempts (SAs). Disorders related to alcohol, cannabis, cocaine, opiates, and hallucinogenic drugs were included. Lifetime SAs was significantly associated with both higher impulsivity and higher aggression, but not with trait anger. A higher number of RTBs were associated with lifetime SAs and higher impulsivity, but not with aggression and trait anger. Assessing these endophenotypes could refine clinical SB risk evaluation in SUDs patients by detecting higher-risk subgroups. An important limitation of this study is exiguity of its sample size. Its primary contribution is inclusion of all SUD types.
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Fehling KB, Selby EA. Suicide in DSM-5: Current Evidence for the Proposed Suicide Behavior Disorder and Other Possible Improvements. Front Psychiatry 2020; 11:499980. [PMID: 33613330 PMCID: PMC7891495 DOI: 10.3389/fpsyt.2020.499980] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Accepted: 12/29/2020] [Indexed: 02/06/2023] Open
Abstract
Suicide continues to be one of the greatest challenges faced by mental health clinicians and researchers, an issue made worse by increasing trends in the global suicide rate. Suicide behavior disorder (SBD) was introduced in DSM-5 as a disorder for further consideration and potential acceptance into the diagnostic system. There are numerous positive developments that would arise from the addition of a suicide-related diagnosis. Utilizing the 2009 guidelines established by Kendler and colleagues, the present review examines the evidence for SBD's validity and discusses the diagnosis' potential clinical benefits and limitations. Altogether, growing evidence indicates that SBD has preliminary validity and benefit. SBD presents with several significant limitations, however, and possible alternative additions to future DSMs are highlighted.
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Affiliation(s)
| | - Edward A Selby
- Department of Psychology, Rutgers, The State University of New Jersey, New Brunswick, NJ, United States
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Nugent AC, Ballard ED, Park LT, Zarate CA. Research on the pathophysiology, treatment, and prevention of suicide: practical and ethical issues. BMC Psychiatry 2019; 19:332. [PMID: 31675949 PMCID: PMC6824024 DOI: 10.1186/s12888-019-2301-6] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Accepted: 09/20/2019] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Despite decades of research, the rate of death from suicide is rising in the United States. Suicide is a complex and multifactorial phenomenon and, to date, no validated biomarkers that predict suicidal behavior have been identified. Only one FDA-approved drug to prevent suicide exists, and it is approved only for patients with schizophrenia. Although anti-suicide psychotherapeutic techniques exist, treatment takes time, and only preliminary data exist for rapid-acting therapies. DISCUSSION While more research into suicidal ideation and acute suicidal behavior is clearly needed, this research is fraught with both practical and ethical concerns. As a result, many investigators and bioethicists have called for restrictions on the types of research that individuals with suicidal behavior can participate in, despite the fact that the available empirical evidence suggests that this research can be done safely. This manuscript presents background information on the phenomenology of suicide, discusses the current state of treatment and prevention strategies, and reviews the practical and ethical issues surrounding suicide research in the context of available empirical data. Currently, the causes of suicide are poorly understood, in part due to the fact that very few studies have investigated the acute suicidal crisis. Although some biomarkers for predicting risk have been developed, none have been sufficiently validated. The most successful current interventions involve means restriction. However, while numerous hurdles face researchers, these are not insurmountable. The available evidence suggests that research into suicide can be conducted both safely and ethically.
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Affiliation(s)
- Allison C. Nugent
- 0000 0004 0464 0574grid.416868.5Section on the Neurobiology and Treatment of Mood Disorders, National Institute of Mental Health, National Institutes of Health, Bethesda, MD USA ,0000 0004 0464 0574grid.416868.5Magnetoencephalography Core Facility, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
| | - Elizabeth D. Ballard
- 0000 0004 0464 0574grid.416868.5Section on the Neurobiology and Treatment of Mood Disorders, National Institute of Mental Health, National Institutes of Health, Bethesda, MD USA
| | - Lawrence T. Park
- 0000 0004 0464 0574grid.416868.5Section on the Neurobiology and Treatment of Mood Disorders, National Institute of Mental Health, National Institutes of Health, Bethesda, MD USA
| | - Carlos A. Zarate
- 0000 0004 0464 0574grid.416868.5Section on the Neurobiology and Treatment of Mood Disorders, National Institute of Mental Health, National Institutes of Health, Bethesda, MD USA
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Knowles EEM, Curran JE, Göring HHH, Mathias SR, Mollon J, Rodrigue A, Olvera RL, Leandro A, Duggirala R, Almasy L, Blangero J, Glahn DC. Family-based analyses reveal novel genetic overlap between cytokine interleukin-8 and risk for suicide attempt. Brain Behav Immun 2019; 80:292-299. [PMID: 30953777 PMCID: PMC7168352 DOI: 10.1016/j.bbi.2019.04.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Revised: 02/25/2019] [Accepted: 04/02/2019] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Suicide is major public health concern. It is imperative to find robust biomarkers so that at-risk individuals can be identified in a timely and reliable manner. Previous work suggests mechanistic links between increased cytokines and risk for suicide, but questions remain regarding the etiology of this association, as well as the roles of sex and BMI. METHODS Analyses were conducted using a randomly-ascertained extended-pedigree sample of 1882 Mexican-American individuals (60% female, mean age = 42.04, range = 18-97). Genetic correlations were calculated using a variance components approach between the cytokines TNF-α, IL-6 and IL-8, and Lifetime Suicide Attempt and Current Suicidal Ideation. The potentially confounding effects of sex and BMI were considered. RESULTS 159 individuals endorse a Lifetime Suicide Attempt. IL-8 and IL-6 shared significant genetic overlap with risk for suicide attempt (ρg = 0.49, pFDR = 7.67 × 10-03; ρg = 0.53, pFDR = 0.01), but for IL-6 this was attenuated when BMI was included as a covariate (ρg = 0.37, se = 0.23, pFDR = 0.12). Suicide attempts were significantly more common in females (pFDR = 0.01) and the genetic overlap between IL-8 and risk for suicide attempt was significant in females (ρg = 0.56, pFDR = 0.01), but not in males (ρg = 0.44, pFDR = 0.30). DISCUSSION These results demonstrate that: IL-8 shares genetic influences with risk for suicide attempt; females drove this effect; and BMI should be considered when assessing the association between IL-6 and suicide. This finding represents a significant advancement in knowledge by demonstrating that cytokine alterations are not simply a secondary manifestation of suicidal behavior, but rather, the pathophysiology of suicide attempts is, at least partly, underpinned by the same biological mechanisms responsible for regulating inflammatory response.
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Affiliation(s)
- E E M Knowles
- Department of Psychiatry, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA 02115, USA; Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, USA.
| | - Joanne E Curran
- South Texas Diabetes and Obesity Institute and Department of Human Genetics, University of Texas Rio Grande Valley School of Medicine, Brownsville, TX, USA
| | - Harald H H Göring
- South Texas Diabetes and Obesity Institute and Department of Human Genetics, University of Texas Rio Grande Valley School of Medicine, Brownsville, TX, USA
| | - Samuel R Mathias
- Department of Psychiatry, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA 02115, USA; Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, USA
| | - Josephine Mollon
- Department of Psychiatry, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA 02115, USA; Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, USA
| | - Amanda Rodrigue
- Department of Psychiatry, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA 02115, USA; Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, USA
| | - Rene L Olvera
- Department of Psychiatry, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Ana Leandro
- South Texas Diabetes and Obesity Institute and Department of Human Genetics, University of Texas Rio Grande Valley School of Medicine, Brownsville, TX, USA
| | - Ravi Duggirala
- South Texas Diabetes and Obesity Institute and Department of Human Genetics, University of Texas Rio Grande Valley School of Medicine, Brownsville, TX, USA
| | - Laura Almasy
- Department of Genetics at University of Pennsylvania and Department of Biomedical and Health Informatics at Children's Hospital of Philadelphia, PA, USA
| | - John Blangero
- South Texas Diabetes and Obesity Institute and Department of Human Genetics, University of Texas Rio Grande Valley School of Medicine, Brownsville, TX, USA
| | - David C Glahn
- Department of Psychiatry, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA 02115, USA; Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, USA; Olin Neuropsychiatric Research Center, Institute of Living, Hartford Hospital, Hartford, CT, USA
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Zhang L, Hu XZ, Benedek DM, Fullerton CS, Forsten RD, Naifeh JA, Li X. Genetic predictor of current suicidal ideation in US service members deployed to Iraq and Afghanistan. J Psychiatr Res 2019; 113:65-71. [PMID: 30904785 DOI: 10.1016/j.jpsychires.2019.03.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Revised: 03/05/2019] [Accepted: 03/07/2019] [Indexed: 10/27/2022]
Abstract
OBJECTIVE Suicide is one of the ten leading causes of death in United States and the suicide rate in the military population has increased since the start of the Iraq and Afghanistan wars. However, few biomarkers for current suicidal ideation (CSI) have been identified. The current study examined the association of four candidate genes with CSI in active duty US Army Special Operations Command and National Guard units (n = 3,889) who served in Iraq and Afghanistan between November 2009 and July 2014. METHODS Current PTSD symptoms and CSI were assessed using the PTSD Checklist (PCL) and PHQ-9, respectively. Traumatic events were assessed using items from the Life Events Checklist (LEC) that met the DSM-IV PTSD criteria of a traumatic stressor. All genotypes of saliva DNA were discriminated using the TaqMan 5'-exonuclease assay. RESULTS The associations between CSI and brain-derived neurotrophic factor (BDNF), FK506 binding protein (FKBP5), catechol-O-methyltransferase (COMT), or S100A10 (p11) were examined. We found CSI was associated with BDNF (OR = 1.5, 95% CI = 1.5-1.8, P = 0.0002), but not FKBP5, COMT and p11. Female soldiers reported CSI more often than males (χ2 = 7.403, p = 0.0065), although gender did not affect CSI severity. In addition, associations were found between CSI and depression, PTSD, and BDNF, but not traumatic events. The BDNF Val66Met contributed to the severity of CSI even after adjusting to PTSD, depression and LEC. CONCLUSIONS The associations of BDNF with CSI and its severity suggest that BDNF may be a predictor of suicidal risk and present an opportunity to develop laboratory tools with clinical implications in suicide prevention and treatment.
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Affiliation(s)
- Lei Zhang
- Center for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University of the Health Sciences, USA.
| | - Xian-Zhang Hu
- Center for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University of the Health Sciences, USA
| | - David M Benedek
- Center for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University of the Health Sciences, USA
| | - Carol S Fullerton
- Center for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University of the Health Sciences, USA
| | - Robert D Forsten
- Center for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University of the Health Sciences, USA
| | - James A Naifeh
- Center for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University of the Health Sciences, USA
| | - Xiaoxia Li
- Center for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University of the Health Sciences, USA
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- Center for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University of the Health Sciences, USA
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Deflesselle E, Colle R, Rigal L, David DJ, Vievard A, Martin S, Becquemont L, Verstuyft C, Corruble E. The TRKB rs2289656 genetic polymorphism is associated with acute suicide attempts in depressed patients: A transversal case control study. PLoS One 2018; 13:e0205648. [PMID: 30308049 PMCID: PMC6181406 DOI: 10.1371/journal.pone.0205648] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Accepted: 09/29/2018] [Indexed: 12/19/2022] Open
Abstract
INTRODUCTION Suicide Attempts (SA) are the main complications of Major Depressive Episodes (MDE) and are difficult to predict. Suicide is associated with the expression of Receptor Tyrosin-Kinase B (TRKB), the receptor of the Brain Derived Neurotrophic Factor (BDNF) involved in MDE. However, the impact of its genetic polymorphisms as predictive factors of SA should be clarified. Our main aim is to assess the association of 8 TRKB genetic polymorphisms and SA in depressed patients. MATERIAL AND METHODS In 624 patients currently experiencing an MDE in the context of Major Depressive Disorder (MDD) (METADAP study), we assessed the association between 8 TRKB genetic polymorphisms (rs1778933, rs1187352, rs2289658, rs2289657, rs2289656, rs3824519, rs56142442 and rs1439050) and acute (previous month) or past (older than one month) SA. Bonferroni corrections and multivariate analysis adjusted for age, sex, level of education, marital status, Hamilton Depression Rating Scale score and previous MDE were used. RESULTS The rs2289656 was associated with acute SA (CC = 28.5%, CT = 15.0% and TT = 11.5%, p = 0.0008). However, the other SNPs were not. Patients with the CC genotype had a higher rate of acute SA (28.5%) as compared to T carriers (14.6%) (adjusted OR = 2.2, CI95% [1.4; 3.5], p<0.0001). CONCLUSION The TRKB rs2289656 CC genotype is associated with a 2.2 fold higher risk of acute SA in depressed patients. If this result could be confirmed, this TRKB SNP may be assessed to contribute to the prediction of SA in depressed patients.
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Affiliation(s)
- Eric Deflesselle
- INSERM UMR_S1178, Equipe “Dépression et Antidépresseurs”, Faculté de Médecine, CESP, Université Paris-Sud, Le Kremlin Bicêtre, France
- Département de Médecine Générale, Université Paris-Sud, Faculté de Médecine, Le Kremlin Bicêtre, France
| | - Romain Colle
- INSERM UMR_S1178, Equipe “Dépression et Antidépresseurs”, Faculté de Médecine, CESP, Université Paris-Sud, Le Kremlin Bicêtre, France
- Service Hospitalo-Universitaire de Psychiatrie, Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris-Sud, Hôpital de Bicêtre, Le Kremlin Bicêtre, France
| | - Laurent Rigal
- Département de Médecine Générale, Université Paris-Sud, Faculté de Médecine, Le Kremlin Bicêtre, France
| | - Denis J. David
- INSERM UMR-S1178, Université Paris-Sud, Faculté de Pharmacie, CESP, Université Paris-Saclay, Chatenay-Malabry, France
| | - Albane Vievard
- INSERM UMR_S1178, Equipe “Dépression et Antidépresseurs”, Faculté de Médecine, CESP, Université Paris-Sud, Le Kremlin Bicêtre, France
- Service Hospitalo-Universitaire de Psychiatrie, Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris-Sud, Hôpital de Bicêtre, Le Kremlin Bicêtre, France
| | - Séverine Martin
- INSERM UMR_S1178, Equipe “Dépression et Antidépresseurs”, Faculté de Médecine, CESP, Université Paris-Sud, Le Kremlin Bicêtre, France
- Service Hospitalo-Universitaire de Psychiatrie, Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris-Sud, Hôpital de Bicêtre, Le Kremlin Bicêtre, France
| | - Laurent Becquemont
- INSERM UMR_S1178, Equipe “Dépression et Antidépresseurs”, Faculté de Médecine, CESP, Université Paris-Sud, Le Kremlin Bicêtre, France
- Service de Génétique Moléculaire, Pharmacogénétique et Hormonologie, Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris-Sud, Hôpital de Bicêtre, Le Kremlin Bicêtre, France
| | - Céline Verstuyft
- INSERM UMR_S1178, Equipe “Dépression et Antidépresseurs”, Faculté de Médecine, CESP, Université Paris-Sud, Le Kremlin Bicêtre, France
- Service de Génétique Moléculaire, Pharmacogénétique et Hormonologie, Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris-Sud, Hôpital de Bicêtre, Le Kremlin Bicêtre, France
- Centre de Ressources Biologiques Paris Sud, Hôpital Bicêtre, Assistance Publique-Hôpitaux de Paris, Le Kremlin Bicêtre, France
| | - Emmanuelle Corruble
- INSERM UMR_S1178, Equipe “Dépression et Antidépresseurs”, Faculté de Médecine, CESP, Université Paris-Sud, Le Kremlin Bicêtre, France
- Service Hospitalo-Universitaire de Psychiatrie, Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris-Sud, Hôpital de Bicêtre, Le Kremlin Bicêtre, France
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Jahangard L, Solgy R, Salehi I, Taheri SK, Holsboer-Trachsler E, Haghighi M, Brand S. Cholecystokinin (CCK) level is higher among first time suicide attempters than healthy controls, but is not associated with higher depression scores. Psychiatry Res 2018; 266:40-46. [PMID: 29803785 DOI: 10.1016/j.psychres.2018.05.031] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2018] [Revised: 04/26/2018] [Accepted: 05/11/2018] [Indexed: 11/19/2022]
Abstract
Suicide and suicide attempts are dramatic events for both the individuals concerned and for their social environments. Efforts have been made to identify reliable biological predictors of suicide and suicide attempts. In the present study, we focused on one potential marker, cholecystokinin (CCK), among first time suicide attempters. A total of 25 suicide attempters (mean age: 30 years; 80% females) and 23 healthy controls were enrolled in the present cross-sectional study. Experts rated participants' symptoms of depression (Hamilton Depression Rating Scale; HDRS). Blood levels of CCK levels were assessed. Suicide attempters had CCK levels 22.67 times higher and HDRS scores 14.33 higher than healthy controls. CCK levels were only weakly associated with HDRS scores. CCK appears to be a fairly reliable biomarker for suicide attempts. However, CCK levels were not associated with depression scores, making it difficult to match biological markers to depressive behaviour.
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Affiliation(s)
- Leila Jahangard
- Research Center for Behavioral Disorders and Substance Abuse, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Rahmat Solgy
- Research Center for Behavioral Disorders and Substance Abuse, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Iraj Salehi
- Research Center for Behavioral Disorders and Substance Abuse, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Seyed Kazem Taheri
- Research Center for Behavioral Disorders and Substance Abuse, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Edith Holsboer-Trachsler
- University of Basel, Psychiatric Clinics (UPK), Center for Affective, Stress and Sleep Disorders (ZASS), Basel, Switzerland
| | - Mohammad Haghighi
- Research Center for Behavioral Disorders and Substance Abuse, Hamadan University of Medical Sciences, Hamadan, Iran.
| | - Serge Brand
- University of Basel, Psychiatric Clinics (UPK), Center for Affective, Stress and Sleep Disorders (ZASS), Basel, Switzerland; University of Basel, Department of Sport, Exercise, and Health, Division of Sport and Psychosocial Health, Basel, Switzerland; Kermanshah University of Medical Sciences (KUMS), Psychiatry Department, Substance Abuse Prevention Research Center and Sleep Disorders Research Center, Kermanshah, Iran.
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Sonal A, Raghavan V. Brain derived neurotrophic factor (BDNF) and suicidal behavior: A review of studies from Asian countries. Asian J Psychiatr 2018. [PMID: 29525506 DOI: 10.1016/j.ajp.2018.03.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
The biological basis of suicide and suicidal behavior is actively researched. Recently, the role of Brain Derived Neurotropic Factor (BDNF) in suicidal behavior has gained attention and significant results are observed. In this review, we aimed to focus on the studies from Asian countries that have explored the role of BDNF and suicidal behavior. The review highlights the findings from these studies and discusses the possible avenues that should be explored in future studies from Asian countries to understand more on suicidal behavior and possible prevention.
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Affiliation(s)
- Akanksha Sonal
- Department of Geriatric Psychiatry, King George Medical University, Lucknow, Uttar Pradesh, India
| | - Vijaya Raghavan
- Schizophrenia Research Foundation, R/7A, North Main Road, Anna Nagar West Extension, Chennai, Tamil Nadu, 600101, India.
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Muñoz-Sánchez JL, Delgado C, Parra-Vidales E, Franco-Martín M. Facilitating Factors and Barriers to the Use of Emerging Technologies for Suicide Prevention in Europe: Multicountry Exploratory Study. JMIR Ment Health 2018; 5:e7. [PMID: 29367183 PMCID: PMC5803527 DOI: 10.2196/mental.7784] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2017] [Revised: 10/05/2017] [Accepted: 10/29/2017] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND This study provides an analysis on the use of emerging technologies for the prevention of suicide in 8 different European countries. OBJECTIVE The objective of this study was to analyze the potentiality of using emerging technologies in the area of suicide prevention based on the opinion of different professionals involved in suicide prevention. METHODS Opinions of 3 groups of stakeholders (ie, relevant professionals in suicide field) were gathered using a specifically designed questionnaire to explore dimensions underlying perceptions of facilitating factors and barriers in relation to the use of emerging technologies for suicide prevention. RESULTS Goal 1 involved facilitating factors for the use of emerging technologies in suicide prevention. Northern European countries, except for Belgium, attach greater relevance to those that optimize implementation and benefits. On the other hand, Southern European countries attach greater importance to professionally oriented and user-centered facilitating factors. According to different stakeholders, the analysis of these facilitating factors suggest that professionals in the field of social work attach greater relevance to those that optimize implementation and benefits. However, professionals involved in the area of mental health, policy makers, and political decision makers give greater importance to professionally oriented and user-centered facilitating factors. Goal 2 was related to barriers to the usability of emerging technologies for suicide prevention. Both countries and stakeholders attach greater importance to barriers associated with resource constraints than to those centered on personal limitations. There are no differences between countries or between stakeholders. Nevertheless, there is a certain stakeholders-countries interaction that indicates that the opinions on resource constraints expressed by different stakeholders do not follow a uniform pattern in different countries, but they differ depending on the country. CONCLUSIONS Although all countries and stakeholders agree in identifying resource constraints as the main barrier to the use of emerging technologies, factors facilitating their use in suicide prevention differ among countries and among stakeholders.
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Affiliation(s)
| | - Carmen Delgado
- Faculty of Psychology, Universidad Pontificia de Salamanca, Salamanca, Spain
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Prokofieva M, Karadima G, Koukia E, Michou V, Kyprianidou C, Papageorgiou CV, Alexiadis E, Constantoulakis P, Dikeos D. Association of 5-HTTLPR Polymorphism with the Nursing Diagnoses and the Achievement of Nursing Outcomes in Patients with Major Depression. Issues Ment Health Nurs 2017; 38:798-804. [PMID: 29016262 DOI: 10.1080/01612840.2017.1364811] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
The aim of this study is to investigate whether a 44-base-pair insertion/deletion polymorphism in the upstream regulatory region of the serotonin transporter gene (5-HTTLPR) is associated with the nursing diagnoses and the achievement of the desired nursing outcomes in inpatients with major depression. Thirty five patients were evaluated. The nursing diagnoses of risk for suicide and imbalanced nutrition are reported less often in homozygotes of the high-expressing gene (LA). Carriers of the low-expressing genes (LG or S) have a worse response to interventions which aim to increase low self-esteem, indicating that they may need more intensive care in order to achieve the desired outcome. Genetics in psychiatric nursing could help refine personalized care, however further studies with large sample sizes and multiple gene evaluations are needed.
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Affiliation(s)
- Margarita Prokofieva
- a Psychiatric Hospital of Attica , Fourth Department of Psychiatry , Athens , Greece
| | - Georgia Karadima
- b National and Kapodistrian University of Athens , Medical School, Eginition Hospital , First Department of Neurology, Neurogenetics Unit, Athens , Greece
| | - Evmorfia Koukia
- c National and Kapodistrian University of Athens , School of Health Sciences, Faculty of Nursing , Athens , Greece
| | - Vassiliki Michou
- d Locus Medicus SA , Department of Molecular Pathology and Genetics , Athens , Greece
| | - Chrysoula Kyprianidou
- d Locus Medicus SA , Department of Molecular Pathology and Genetics , Athens , Greece
| | | | - Evangelos Alexiadis
- e BioAnalytica Genotype SA , Department of Molecular Biology and Genetics , Athens , Greece
| | | | - Dimitris Dikeos
- f National and Kapodistrian University of Athens , Medical School, Eginition Hospital, First Department of Psychiatry , Athens , Greece
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Naveed S, Qadir T, Afzaal T, Waqas A. Suicide and Its Legal Implications in Pakistan: A Literature Review. Cureus 2017; 9:e1665. [PMID: 29152422 PMCID: PMC5677340 DOI: 10.7759/cureus.1665] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
In recent decades, great strides have been made in understanding the science of suicide. Thus, it is imperative that Pakistani legal systems bridge the gap between Pakistani law and science. For instance, recent discoveries in public health, psychology, and neurobiology have shaped the etiological model of suicidal behavior and highlighted the high preponderance of certain psychiatric patients towards suicide. We present here a brief overview of psychiatric evidence implicated in suicides to better inform the Pakistani legal system of advances in the psychiatric literature.
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Affiliation(s)
| | - Tooba Qadir
- Dow University of Health Sciences, Dow University of Health Sciences, Karachi, Pakistan
| | - Tayyaba Afzaal
- Psychology, Government College University, Lahore, Pakistan
| | - Ahmed Waqas
- Department of Psychiatry, CMH Lahore Medical College and Institute of Dentistry
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Pestian JP, Sorter M, Connolly B, Bretonnel Cohen K, McCullumsmith C, Gee JT, Morency LP, Scherer S, Rohlfs L. A Machine Learning Approach to Identifying the Thought Markers of Suicidal Subjects: A Prospective Multicenter Trial. Suicide Life Threat Behav 2017; 47:112-121. [PMID: 27813129 DOI: 10.1111/sltb.12312] [Citation(s) in RCA: 59] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2016] [Accepted: 06/28/2016] [Indexed: 12/14/2022]
Abstract
Death by suicide demonstrates profound personal suffering and societal failure. While basic sciences provide the opportunity to understand biological markers related to suicide, computer science provides opportunities to understand suicide thought markers. In this novel prospective, multimodal, multicenter, mixed demographic study, we used machine learning to measure and fuse two classes of suicidal thought markers: verbal and nonverbal. Machine learning algorithms were used with the subjects' words and vocal characteristics to classify 379 subjects recruited from two academic medical centers and a rural community hospital into one of three groups: suicidal, mentally ill but not suicidal, or controls. By combining linguistic and acoustic characteristics, subjects could be classified into one of the three groups with up to 85% accuracy. The results provide insight into how advanced technology can be used for suicide assessment and prevention.
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Affiliation(s)
- John P Pestian
- Division of Biomedical Informatics, Cincinnati Children's Hospital Medical Center, University of Cincinnati, Cincinnati, OH, USA
| | - Michael Sorter
- Division of Psychiatry, Cincinnati Children's Hospital Medical Center, University of Cincinnati, Cincinnati, OH, USA
| | - Brian Connolly
- Division of Biomedical Informatics, Cincinnati Children's Hospital Medical Center, University of Cincinnati, Cincinnati, OH, USA
| | - Kevin Bretonnel Cohen
- Computational Bioscience Program, University of Colorado School of Medicine, Denver, CO, USA
| | - Cheryl McCullumsmith
- Department of Psychiatry, College of Medicine, University of Cincinnati, Cincinnati, OH, USA
| | - Jeffry T Gee
- Princeton Community Hospital, Princeton, WV, USA
| | | | - Stefan Scherer
- Institute for Creative Technologies, University of Southern California, Los Angeles, CA, USA
| | - Lesley Rohlfs
- Institute for Creative Technologies, University of Southern California, Los Angeles, CA, USA
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Resting-state functional MRI of abnormal baseline brain activity in young depressed patients with and without suicidal behavior. J Affect Disord 2016; 205:252-263. [PMID: 27467529 DOI: 10.1016/j.jad.2016.07.002] [Citation(s) in RCA: 78] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2015] [Revised: 05/23/2016] [Accepted: 07/03/2016] [Indexed: 12/11/2022]
Abstract
BACKGROUND Suicide among youth is a major public health challenge, attracting increasing attention. However, the neurobiological mechanisms and the pathophysiology underlying suicidal behavior in depressed youths are still unclear. The fMRI enables a better understanding of functional changes in the brains of young suicide attempters with depressive disorder through detecting spontaneous neural activity. The purpose of this study was to identify the relationship between abnormalities involving local brain function and suicidal attempts in depressed youths using resting-state fMRI (RS-fMRI). METHOD Thirty-five depressed youths aged between 15 and 29 years with a history of suicidal attempts (SU group), 18 patients without suicidal attempts (NSU group) and 47 gender-, age- and education-matched healthy controls (HC) underwent psychological assessment and R-fMRI. The differences in fractional amplitude of low-frequency fluctuation (ALFF) among the three groups were compared. The clinical factors correlated with z-score ALFF in the regions displaying significant group differences were investigated. The ROC method was used to evaluate these clusters as markers to screen patients with suicidal behavior. RESULTS Compared with the NSU and HC groups, the SU group showed increased zALFF in the right superior temporal gyrus (r-STG), left middle temporal gyrus (L-MTG) and left middle occipital gyrus (L-MOG). Additionally, significantly decreased zALFF values in the L-SFG and L-MFG were found in the SU group compared with the NSU group, which were negatively correlated with BIS scores in the SU group. Further ROC analysis revealed that the mean zALFF values in these two regions (sensitivity=83.3% and specificity=71.4%) served as markers to differentiate the two patient subtypes. CONCLUSION The SU group had abnormal spontaneous neural activity during the resting state, and decreased activity in L-SFG and L-MFG was associated with increased impulsivity in SU group. Our results suggested that abnormal neural activity in these brain regions may represent a potential neurobiological diathesis or predisposition to suicidal behavior in youth depression.
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Liu P, Jing Y, Collie ND, Dean B, Bilkey DK, Zhang H. Altered brain arginine metabolism in schizophrenia. Transl Psychiatry 2016; 6:e871. [PMID: 27529679 PMCID: PMC5022089 DOI: 10.1038/tp.2016.144] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2016] [Revised: 06/07/2016] [Accepted: 06/15/2016] [Indexed: 12/24/2022] Open
Abstract
Previous research implicates altered metabolism of l-arginine, a versatile amino acid with a number of bioactive metabolites, in the pathogenesis of schizophrenia. The present study, for we believe the first time, systematically compared the metabolic profile of l-arginine in the frontal cortex (Brodmann's area 8) obtained post-mortem from schizophrenic individuals and age- and gender-matched non-psychiatric controls (n=20 per group). The enzyme assays revealed no change in total nitric oxide synthase (NOS) activity, but significantly increased arginase activity in the schizophrenia group. Western blot showed reduced endothelial NOS protein expression and increased arginase II protein level in the disease group. High-performance liquid chromatography and liquid chromatography/mass spectrometric assays confirmed significantly reduced levels of γ-aminobutyric acid (GABA), but increased agmatine concentration and glutamate/GABA ratio in the schizophrenia cases. Regression analysis indicated positive correlations between arginase activity and the age of disease onset and between l-ornithine level and the duration of illness. Moreover, cluster analyses revealed that l-arginine and its main metabolites l-citrulline, l-ornithine and agmatine formed distinct groups, which were altered in the schizophrenia group. The present study provides further evidence of altered brain arginine metabolism in schizophrenia, which enhances our understanding of the pathogenesis of schizophrenia and may lead to the future development of novel preventions and/or therapeutics for the disease.
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Affiliation(s)
- P Liu
- Department of Anatomy, University of Otago, Dunedin, New Zealand,Brain Health Research Centre, University of Otago, Dunedin, New Zealand,Department of Anatomy, University of Otago, Lindo Ferguson Building, 270 Great King Street, Dunedin 9016, New Zealand. E-mail:
| | - Y Jing
- Department of Anatomy, University of Otago, Dunedin, New Zealand,Brain Health Research Centre, University of Otago, Dunedin, New Zealand
| | - N D Collie
- Department of Anatomy, University of Otago, Dunedin, New Zealand,Brain Health Research Centre, University of Otago, Dunedin, New Zealand
| | - B Dean
- The Molecular Psychiatry Laboratory, The Florey Institute for Neuroscience and Mental Health, Parkville, VIC, Australia
| | - D K Bilkey
- Brain Health Research Centre, University of Otago, Dunedin, New Zealand,Department of Psychology, University of Otago, Dunedin, New Zealand
| | - H Zhang
- Brain Health Research Centre, University of Otago, Dunedin, New Zealand,School of Pharmacy, University of Otago, Dunedin, New Zealand
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Sachs-Ericsson NJ, Rushing NC, Stanley IH, Sheffler J. In my end is my beginning: developmental trajectories of adverse childhood experiences to late-life suicide. Aging Ment Health 2016; 20:139-65. [PMID: 26264208 DOI: 10.1080/13607863.2015.1063107] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
OBJECTIVES Converging evidence suggests that the sequelae of adverse childhood experiences (ACEs) including childhood abuse (e.g., sexual, physical, emotional/verbal abuse, neglect) and other ACE (e.g., family dysfunction, parental loss, parental psychopathology, substance abuse, incarceration, and domestic violence) have pronounced effects on suicidal behaviors (suicidal ideation, attempts, and death by suicide) in older age. There are fundamental changes in the developmental trajectory of biological, psychological and behavioral processes that result from ACE and that exert influence throughout the life span. Different moderators and mediators may affect the extent and nature of the relationship. However, the literature on the specific mechanisms whereby ACE affects suicidality in later life has not been well identified. METHOD We review and draw from extant multidisciplinary evidence to develop a heuristic framework through which to understand how ACE may lead to suicide in later life. RESULTS Proposed mechanisms span biological factors (neurological, gene-environment), psychiatric and health functioning, and psychosocial development (cognitive biases, coping resources, interpersonal deficits). Evidence suggests that ACEs affect each of these constructs, and it is likely in the interaction of these constructs with late-life stressors that suicidality in older adulthood emerges. CONCLUSION ACEs have persistent and multifaceted effects on suicidality in late life. This association is due to multi-varied pathways. It is believed that the explanatory framework developed herein--in which biological, psychological and behavioral factors are organized, and the role of late-life stressors is highlighted--will spark further scientific inquiry into this important area.
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Affiliation(s)
| | - Nicole C Rushing
- b Department of Psychology , Coastal Carolina University , SC , USA
| | - Ian H Stanley
- c Department of Psychology , Florida State University , FL , USA
| | - Julia Sheffler
- c Department of Psychology , Florida State University , FL , USA
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Dogan KH, Unaldi M, Demirci S. Evaluation of Postmortem Cerebrospinal Fluid S100B Protein and Serotonin Levels: Comparison of Suicidal Versus Nonsuicidal Deaths in Konya, Turkey. J Forensic Sci 2016; 61:1285-91. [DOI: 10.1111/1556-4029.13124] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2015] [Revised: 11/16/2015] [Accepted: 11/27/2015] [Indexed: 12/15/2022]
Affiliation(s)
- Kamil Hakan Dogan
- Department of Forensic Medicine; Faculty of Medicine; Selcuk University; 42075 Konya Turkey
| | - Mustafa Unaldi
- Department of Biochemistry; Private Ticaret Borsasi Hospital; Sukran Mh. Taskapu Medrese Sk. 42040 Konya Turkey
| | - Serafettin Demirci
- Department of Forensic Medicine; Meram Medical School; Necmettin Erbakan University; Akyokus 42080 Konya Turkey
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Cho SE, Na KS, Cho SJ, Im JS, Kang SG. Geographical and temporal variations in the prevalence of mental disorders in suicide: Systematic review and meta-analysis. J Affect Disord 2016; 190:704-713. [PMID: 26600412 DOI: 10.1016/j.jad.2015.11.008] [Citation(s) in RCA: 69] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2015] [Revised: 11/01/2015] [Accepted: 11/09/2015] [Indexed: 01/04/2023]
Abstract
BACKGROUND In contrast to the previous studies reporting that most suicides occur among people with mental disorders, recent studies have reported various rates of mental disorders in suicide in different geographical regions. We aimed to comprehensively investigate the factors influencing the variation in the prevalence of mental disorders reported among suicide victims. METHOD The authors searched Embase, Medline, Web of Science, and the Cochrane Library to identify psychological autopsy studies reporting the prevalence of any mental disorders among suicide victims. A meta-regression analysis was conducted to identify the potential effects of geographical regions, the year of publication, measurements of personality disorder, measurements of comorbidity, and the ratio of females on the prevalence of mental disorders in addition to examining the heterogeneity across studies. RESULTS From 4475 potentially relevant studies, 48 studies met eligibility criteria, with 6626 suicide victims. The studies from East Asia had a significantly lower mean prevalence (69.6% [95% CI=56.8 to 80.0]) than those in North America (88.2% [95% CI=79.7-93.5]) and South Asia (90.4% [95% CI=71.8-97.2]). The prevalence of any mental disorder decreased according to the year of publication (coefficients=-0.0715, p<0.001). LIMITATIONS Substantial heterogeneities were identified within all subgroup analyses. CONCLUSIONS The prevalence of mental disorders among suicide cases seemed relatively low in the East Asia region, and recently published studies tended to report a lower prevalence of mental disorders. The link between the risk factors and suicide in the absence of a mental disorder should be examined in different geographical and sociocultural contexts.
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Affiliation(s)
- Seo-Eun Cho
- Department of Psychiatry, Gachon University Gil Medical Center, Incheon, Republic of Korea
| | - Kyoung-Sae Na
- Department of Psychiatry, Gachon University Gil Medical Center, Incheon, Republic of Korea.
| | - Seong-Jin Cho
- Department of Psychiatry, Gachon University Gil Medical Center, Incheon, Republic of Korea
| | - Jeong-Soo Im
- Department of Preventive Medicine, Gachon University Gil Medical Center, Incheon, Republic of Korea
| | - Seung-Gul Kang
- Department of Psychiatry, Gachon University Gil Medical Center, Incheon, Republic of Korea
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Thomas CR. Epigenetics and Child Psychiatry: Ethical and Legal Issues. BEHAVIORAL SCIENCES & THE LAW 2015; 33:644-652. [PMID: 26358684 DOI: 10.1002/bsl.2207] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Epigenetics has the potential to revolutionize diagnosis and treatment in psychiatry, especially child psychiatry, as it may offer the opportunity for early detection and prevention, as well as development of new treatments. As with the previous introduction of genetic research in psychiatry, there is also the problem of unrealistic expectations and new legal and ethical problems. This article reviews the potential contributions and problems of epigenetic research in child psychiatry. Previous legal and ethical issues in genetic research serve as a guide to those in epigenetic research. Recommendations for safeguards and guidelines on the use of epigenetics with children and adolescents are outlined based on the identified issues.
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Association of Body Mass Index with Depression, Anxiety and Suicide-An Instrumental Variable Analysis of the HUNT Study. PLoS One 2015; 10:e0131708. [PMID: 26167892 PMCID: PMC4500562 DOI: 10.1371/journal.pone.0131708] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2015] [Accepted: 06/04/2015] [Indexed: 11/19/2022] Open
Abstract
Objective While high body mass index is associated with an increased risk of depression and anxiety, cumulative evidence indicates that it is a protective factor for suicide. The associations from conventional observational studies of body mass index with mental health outcomes are likely to be influenced by reverse causality or confounding by ill-health. In the present study, we investigated the associations between offspring body mass index and parental anxiety, depression and suicide in order to avoid problems with reverse causality and confounding by ill-health. Methods We used data from 32,457 mother-offspring and 27,753 father-offspring pairs from the Norwegian HUNT-study. Anxiety and depression were assessed using the Hospital Anxiety and Depression Scale and suicide death from national registers. Associations between offspring and own body mass index and symptoms of anxiety and depression and suicide mortality were estimated using logistic and Cox regression. Causal effect estimates were estimated with a two sample instrument variable approach using offspring body mass index as an instrument for parental body mass index. Results Both own and offspring body mass index were positively associated with depression, while the results did not indicate any substantial association between body mass index and anxiety. Although precision was low, suicide mortality was inversely associated with own body mass index and the results from the analysis using offspring body mass index supported these results. Adjusted odds ratios per standard deviation body mass index from the instrumental variable analysis were 1.22 (95% CI: 1.05, 1.43) for depression, 1.10 (95% CI: 0.95, 1.27) for anxiety, and the instrumental variable estimated hazard ratios for suicide was 0.69 (95% CI: 0.30, 1.63). Conclusion The present study’s results indicate that suicide mortality is inversely associated with body mass index. We also found support for a positive association between body mass index and depression, but not for anxiety.
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Hubers AAM, van der Mast RC, Pereira AM, Roos RAC, Veen LJ, Cobbaert CM, van Duijn E, Giltay EJ. Hypothalamic-pituitary-adrenal axis functioning in Huntington's disease and its association with depressive symptoms and suicidality. J Neuroendocrinol 2015; 27:234-44. [PMID: 25565388 DOI: 10.1111/jne.12255] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2014] [Revised: 12/10/2014] [Accepted: 01/04/2015] [Indexed: 12/27/2022]
Abstract
Hyperactivity of the hypothalamic-pituitary-adrenal (HPA) axis has been reported in Huntington's disease (HD). In non-HD populations, alterations in HPA axis activity have been associated with depression and suicidality. The present study aims to compare HPA axis activity between HD mutation carriers and controls, and examine its association with depressive symptoms and suicidality. To this end, salivary cortisol concentrations at seven time points, as well as depressive symptoms and suicidality, were assessed in 49 pre-motor, 102 motor symptomatic mutation carriers and 55 controls, at baseline and follow-up combined. Differences in parameters of HPA axis activity between these three groups, and their associations with depressive symptoms and suicidality in HD mutation carriers, were analysed using multilevel regression analyses. There were no differences in parameters of HPA axis activity between mutation carriers and controls, whereas pre-motor symptomatic mutation carriers had a significantly higher area under the curve to the increase (AUCi ) compared to motor symptomatic mutation carriers. In the entire HD cohort, HPA axis activity was not associated with depressive symptoms or suicidality. After stratifying mutation carriers into pre-motor, early and advanced disease stages, β values differed between these groups. Remarkably, a higher AUCi was significantly associated with depressive symptoms in pre-motor and early disease stage mutation carriers, with a reverse nonsignificant association in advanced disease stage mutation carriers. The lower AUCi in motor symptomatic mutation carriers and the varying associations with depressive symptoms and suicidality in pre-motor, early and advanced disease stages could possibly be explained by exhaustion of the HPA axis after prolonged stress-induced HPA axis hyperactivity and deserves further longitudinal study.
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Affiliation(s)
- A A M Hubers
- Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands
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Quan C, Wang M, Ren F. An unsupervised text mining method for relation extraction from biomedical literature. PLoS One 2014; 9:e102039. [PMID: 25036529 PMCID: PMC4103846 DOI: 10.1371/journal.pone.0102039] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2014] [Accepted: 06/15/2014] [Indexed: 12/31/2022] Open
Abstract
The wealth of interaction information provided in biomedical articles motivated the implementation of text mining approaches to automatically extract biomedical relations. This paper presents an unsupervised method based on pattern clustering and sentence parsing to deal with biomedical relation extraction. Pattern clustering algorithm is based on Polynomial Kernel method, which identifies interaction words from unlabeled data; these interaction words are then used in relation extraction between entity pairs. Dependency parsing and phrase structure parsing are combined for relation extraction. Based on the semi-supervised KNN algorithm, we extend the proposed unsupervised approach to a semi-supervised approach by combining pattern clustering, dependency parsing and phrase structure parsing rules. We evaluated the approaches on two different tasks: (1) Protein-protein interactions extraction, and (2) Gene-suicide association extraction. The evaluation of task (1) on the benchmark dataset (AImed corpus) showed that our proposed unsupervised approach outperformed three supervised methods. The three supervised methods are rule based, SVM based, and Kernel based separately. The proposed semi-supervised approach is superior to the existing semi-supervised methods. The evaluation on gene-suicide association extraction on a smaller dataset from Genetic Association Database and a larger dataset from publicly available PubMed showed that the proposed unsupervised and semi-supervised methods achieved much higher F-scores than co-occurrence based method.
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Affiliation(s)
- Changqin Quan
- AnHui Province Key Laboratory of Affective Computing and Advanced Intelligent Machine, School of Computer and Information, Hefei University of Technology, Hefei, China
| | - Meng Wang
- AnHui Province Key Laboratory of Affective Computing and Advanced Intelligent Machine, School of Computer and Information, Hefei University of Technology, Hefei, China
| | - Fuji Ren
- AnHui Province Key Laboratory of Affective Computing and Advanced Intelligent Machine, School of Computer and Information, Hefei University of Technology, Hefei, China
- Faculty of Engineering, University of Tokushima, 2–1 MinamiJosanjima, Tokushima, Japan
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Suicidal ligature strangulation using gymnastics bands. Int J Legal Med 2014; 128:313-6. [PMID: 24429766 DOI: 10.1007/s00414-013-0959-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2013] [Accepted: 12/16/2013] [Indexed: 10/25/2022]
Abstract
Suicidal ligature strangulation is a rare event. The most important issue to solve in the investigation is whether it is a case of homicide or suicide. The characteristics of suicidal ligature strangulation are summarized by Koops and Brinkmann with the emphasis on the nature of the ligature instrument(s). In this article, we present two cases of self-strangulation with an almost identical modus operandi using gymnastics bands. The autopsy findings and the nature of the ligature in these cases are depicted and in good accordance with the described typical observations in suicidal cases. The importance of a broad medico-legal investigation is demonstrated.
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Serotonergic modulation of suicidal behaviour: integrating preclinical data with clinical practice and psychotherapy. Exp Brain Res 2013; 230:605-24. [DOI: 10.1007/s00221-013-3669-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2013] [Accepted: 07/30/2013] [Indexed: 11/25/2022]
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