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Darabi F, Ziapour A, Ahmadinia H. Motivations for suicide attempts and risk factors among youths in Western Iran: A cross-sectional study. Health Sci Rep 2024; 7:e2297. [PMID: 39118672 PMCID: PMC11306521 DOI: 10.1002/hsr2.2297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2023] [Revised: 07/26/2024] [Accepted: 07/30/2024] [Indexed: 08/10/2024] Open
Abstract
Background and Aims Suicide attempts are a fundamental problem in health care systems and are known for their complex and multifaceted nature. This study aimed to explore the reasons for suicide attempts and to identify associated factors in western Iran. Methods In Asadabad, western Iran, a cross-sectional study was carried out between April 2020 and March 2021. A nonrandom sampling method was used to select 110 participants, ages 15-35. Structured questionnaires such as the Beck Anxiety Inventory (BAI), the Beck Depression Inventory (BDI-II), and the Suicide Motivation Scale (IMSA) were used to gather the data. Multiple linear regression, one-way analysis of variance, Pearson's correlation coefficient, and independent t tests were all used in the data analysis. Results The majority of participants (59.1%) were female, with a mean age of 25.78 years. The most common reason for suicide attempts (43.6%) was family issues, and the most popular means (66.4%) were pills and medication. Eighty-nine percent of participants had symptoms of depression. The mean scores were calculated for motivation for suicide attempts (32.46 ± 16.11), depression (34.60 ± 20.50), and anxiety (34.14 ± 15.69). The analysis showed that the motivation for suicide attempts and anxiety was greater in single persons than in married and divorced persons (p < 0.05). Motivation for suicide attempts was also greater in low- to middle-income individuals with a history of divorce (p < 0.05). The multiple regression model showed that anxiety, sex, education, and medical history significantly influenced the motivation for suicide attempts (p < 0.001). Conclusion The results showed that a wide range of social, economic, and cultural factors and psychiatric disorders, including anxiety and depression, are involved in suicide attempts. This study aimed to design interventions and strategies to prioritize mental health, improve life skills to control stressful events, and focus on high-risk groups (women, married people, people with low education levels, and those with a history of physical and mental illnesses) for suicide prevention in health promotion programs.
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Affiliation(s)
- Fatemeh Darabi
- Department of Public HealthAsadabad School of Medical SciencesAsadabadIran
| | - Arash Ziapour
- Cardiovascular Research Center, Health Institute, Imam‐Ali HospitalKermanshah University of Medical SciencesKermanshahIran
| | - Hassan Ahmadinia
- Department of Epidemiology and Biostatistics, School of Health, Occupational Environment Research CenterRafsanjan University of Medical SciencesRafsanjanIran
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Fröding E, Vincent C, Andersson-Gäre B, Westrin Å, Ros A. Six Major Steps to Make Investigations of Suicide Valuable for Learning and Prevention. Arch Suicide Res 2024; 28:1-19. [PMID: 36259504 DOI: 10.1080/13811118.2022.2133652] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
OBJECTIVE The decline in suicide rates has leveled off in many countries during the last decade, suggesting that new interventions are needed in the work with suicide prevention. Learnings from investigations of suicide should contribute to the development of these new interventions. However, reviews of investigations have indicated that few new lessons have been learned. To be an effective tool, revisions of the current investigation methods are required. This review aimed to describe the problems with the current approaches to investigations of suicide as patient harm and to propose ways to move forward. METHODS Narrative literature review. RESULTS Several weaknesses in the current approaches to investigations were identified. These include failures in embracing patient and system perspectives, not addressing relevant factors, and insufficient competence of the investigation teams. Investigation methods need to encompass the progress of knowledge about suicidal behavior, suicide prevention, and patient safety. CONCLUSIONS There is a need for a paradigm shift in the approaches to investigations of suicide as potential patient harm to enable learning and insights valuable for healthcare improvement. Actions to support this paradigm shift include involvement of patients and families, education for investigators, multidisciplinary analysis teams with competence in and access to relevant parts across organizations, and triage of cases for extensive analyses. A new model for the investigation of suicide that support these actions should facilitate this paradigm shift.HIGHLIGHTSThere are weaknesses in the current approaches to investigations of suicide.A paradigm shift in investigations is needed to contribute to a better understanding of suicide.New knowledge of suicidal behavior, prevention, and patient safety must be applied.
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Moore F, Allott C, O'Connor R. Impulsivity, aggression, and impulsive aggression in suicidality. PERSONALITY AND INDIVIDUAL DIFFERENCES 2023. [DOI: 10.1016/j.paid.2022.111971] [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: 11/13/2022]
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Kukoyi O, Orok E, Oluwafemi F, Oni O, Oluwadare T, Ojo T, Bamitale T, Jaiyesimi B, Iyamu D. Factors influencing suicidal ideation and self-harm among undergraduate students in a Nigerian private university. MIDDLE EAST CURRENT PSYCHIATRY 2023. [DOI: 10.1186/s43045-022-00274-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Abstract
Background
Suicide and self-harm have been documented as the main cause of death among young adults. Nigeria as well as other low-income countries is reported to have a higher prevalence rate of suicidal ideation and self-harm as compared to high-income countries. The aim of this study was to evaluate the factors that influence self-harm and suicidal ideation among university undergraduates.
Results
Four hundred fifty students consented to participate in this study where 61.3% were female with mean age of 20.02 + 1.88 years. More than 46% (208) had moderate social support while 80.4% had a high self-esteem and 72.7% low environmental factor scores. There was an association between self-esteem (p=0.001), social support (p<0.001), and self-harm but no association between social support and suicide ideation (p=0.199) as well as between gender and self-harm (p=0.118).
Conclusions
There was some form of influence from self-esteem, social support, and environmental factors on self-harm and suicidal ideation. Interventions tailored towards these factors in order to improve mental health outcomes among undergraduates are needed.
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Clinical correlates and prognostic impact of binge-eating symptoms in major depressive disorder. Int Clin Psychopharmacol 2022; 37:247-254. [PMID: 35815954 PMCID: PMC9521583 DOI: 10.1097/yic.0000000000000422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Binge-eating (BE) symptoms are relatively common in major depressive disorder (MDD), but their prognostic role is not fully understood. This study compared two groups of patients with MDD experiencing or not BE symptoms to ascertain differences in terms of clinical manifestations, presence of bipolar features, and antidepressant treatment outcomes. The study involved 482 outpatients collected within the Combining Medications to Enhance Depression Outcomes (CO-MED) trial, who were assessed with scales for depressive and hypomanic symptomatology, suicidality, comorbid mental disorders, and childhood traumas. BE symptoms were reported in 95 patients (20%). Patients with MDD experiencing BE symptoms were characterized by higher scores of negative self-outlook ( P = 0.0018), negative outlook of future ( P = 0.0014), irritability ( P = 0.0043), comorbid anxiety disorders (generalized anxiety disorder: P = 0.0006; panic disorder: P < 0.0001; social phobia: P < 0.0001), obsessive-compulsive disorder ( P = 0.0053), hypomanic symptoms (increased talkativeness: P = 0.0029; reduced need for sleep: P = 0.0171), and suicidality (suicidal propensity: P = 0.0013; suicidal risk: P = 0.0148; lifetime suicidal behavior: P = 0.0052). BE symptoms (OR = 2.02; 95% CI = 1.06-3.84) and depression severity (OR = 1.04; 95% CI = 1.00-1.08) were independently associated with lifetime attempted suicide. The presence of BE symptoms might indicate higher severity of depressive disorder. Suicidal risk is a major issue in these patients, whereas the association between BE and bipolar features needs further research.
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Engda AS, Belete H, Wubetu AD, Engidaw NA, Amogne FK, Kitaw TM, Bete T, Kebede WM, Atinafu BT, Demeke SM. Magnitude and determinants of suicide among overweight reproductive-age women, Chacha and Debre Berhan Town, Ethiopia: community based cross-sectional study. Int J Ment Health Syst 2022; 16:41. [PMID: 35974397 PMCID: PMC9382839 DOI: 10.1186/s13033-022-00551-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 07/29/2022] [Indexed: 11/10/2022] Open
Abstract
Background The magnitude and impact of women's suicidal behaviors, like suicidal ideation and suicidal attempts, are an important public health problem in low and middle-income countries, including Ethiopia. Suicidal behavior and being overweight are typical complications of reproductive age with many undesired consequences. Despite both having a serious impact on women of reproductive age, they are neglected in Ethiopia. Accordingly, this study aimed to examine the magnitude and determinants of suicide among overweight reproductive-age women in Chacha and Debre Berhan towns, Ethiopia. Methods A community-based cross-sectional study design was once employed from April 1, 2020 to June 1, 2020. The Composite International Diagnostic Interview was used to measure suicidal attempts and ideation, and the data was collected by direct interview. All collected data were entered into Epi Data version 4.6 and analyzed with SPSS version 25. Bivariate and multivariable regression models were used to determine the factors associated with a suicidal attempt and ideation. A p-value of less than 0.05 was considered statistically significant. Result Of the total participants, 523 were included, with a response rate of 93.7%. The prevalence of suicidal ideation was 13.0% (95% CI 10.1–15.9), whereas suicidal attempt was 2.3% (95% CI 1.1–3.6). Based on multivariable regression analysis, the odds of suicidal ideation have been higher among overweight women with stressful life events, depression, and younger age groups. Conclusion Suicidal ideation was frequent in overweight reproductive-age women. Preventing, treating, and using coping mechanisms regarding identified factors is a good way to minimize the burden of suicide.
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Affiliation(s)
- Abayneh Shewangzaw Engda
- Department of Psychiatry, College of Health Sciences and Medicine, Debre Berhan University, Debre Berhan, Ethiopia.
| | - Habte Belete
- Department of Psychiatry, College of Health Sciences and Medicine, Bahir Dar University, Bahir Dar, Ethiopia
| | - Abate Dargie Wubetu
- Department of Psychiatry, College of Health Sciences and Medicine, Debre Berhan University, Debre Berhan, Ethiopia
| | - Nigus Alemnew Engidaw
- Department of Psychiatry, College of Health Sciences and Medicine, Debre Berhan University, Debre Berhan, Ethiopia
| | - Fetene Kasahun Amogne
- Department of Midwifery, College of Health Sciences and Medicine, Debre Berhan University, Debre Berhan, Ethiopia
| | - Tebabere Moltot Kitaw
- Department of Midwifery, College of Health Sciences and Medicine, Debre Berhan University, Debre Berhan, Ethiopia
| | - Tilahun Bete
- Department of Psychiatry, College of Health Sciences and Medicine, Haramaya University, Harar, Ethiopia
| | - Worku Misganaw Kebede
- Department of Nursing, College of Health Sciences and Medicine, Debre Berhan University, Debre Berhan, Ethiopia
| | - Bantalem Tilaye Atinafu
- Department of Nursing, College of Health Sciences and Medicine, Debre Berhan University, Debre Berhan, Ethiopia
| | - Solomon Moges Demeke
- Department of Psychiatry, College of Health Science Woldia University, Woldia, Ethiopia
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Costanza A, Vasileios C, Ambrosetti J, Shah S, Amerio A, Aguglia A, Serafini G, Piguet V, Luthy C, Cedraschi C, Bondolfi G, Berardelli I. Demoralization in suicide: A systematic review. J Psychosom Res 2022; 157:110788. [PMID: 35334350 DOI: 10.1016/j.jpsychores.2022.110788] [Citation(s) in RCA: 61] [Impact Index Per Article: 30.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Revised: 03/14/2022] [Accepted: 03/16/2022] [Indexed: 11/25/2022]
Abstract
OBJECTIVE In psychiatric literature, few original studies exist on the topic of demoralization in suicide. In this review, we aim to identify original studies on suicidal ideation (SI)/suicidal behavior (SB) and demoralization in populations of community-dwellers and patients with somatic or psychiatric disorders. METHODS We employed a systematic approach that followed PRISMA guidelines, searching through four major electronic databases (PubMed/MEDLINE, Scopus, Science Direct, and PsychINFO) for relevant titles/abstracts published from January 1980-June 2021. We included original studies that explicitly mentioned the investigation of a potential association between SI/SB and demoralization. RESULTS A total of 18 studies met our inclusion criteria. Their synthesis revealed that demoralization can be associated with SI/SB in a wide range of populations (community dwellers, patients with somatic or psychiatric disorders) and lead to significantly higher suicide risk (odds ratios of >6 were encountered in community dwellers experiencing financial hardship or isolation). Moreover, demoralization alone (about half the patients who were demoralized did not meet the criteria for an affective disorder nor were they clinically depressed) or together with depression has been identified as a major risk factor for SI/SB. Regarding the crucial issue of progression from SI to SA, in the context of the "ideation-to-action" frame, some authors found that the interaction of demoralization and over-arousal could be a useful predictor for this progression, while others found that depression alone was sufficient to differentiate attempters from non-attempters or the interaction with shutdown (helplessness and low positive emotions). CONCLUSION These results emphasize the possibility to identify demoralization as an independent risk factor for suicide. In patients with psychiatric disorders, the association between demoralization and SI/SB may be transnosographic. Overall, from the clinical implications perspective, our findings highlight that: i. Assessment of demoralization may contribute to a more comprehensive suicide risk detection. This appears particularly relevant in Emergency Departments (EDs) where heterogeneous population typologies are usually admitted and a clinical diagnosis of depression is often difficult to be defined. ii. Additionally, since meaninglessness is considered one of the demoralization subcomponents, meaning-centered psychotherapeutic approaches prove to be indicated and they can be initiated already at the EDs upon first contact with the patient. Further studies are necessary to confirm these findings.
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Affiliation(s)
- 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.
| | - Chytas Vasileios
- Division of Clinical Pharmacology & Toxicology, Multidisciplinary Pain Centre (MPC), University Hospitals of Geneva (HUG), Switzerland
| | - Julia Ambrosetti
- Department of Psychiatry and Department of Emergency, Emergency Psychiatric Unit (UAUP), Geneva University Hospitals (HUG), 1211 Geneva, Switzerland
| | - Sanam Shah
- Paris-Saclay University, UVSQ, Univ. Paris-Sud, Inserm U1018, Paris, France
| | - 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, Genoa, Italy
| | - 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, Genoa, Italy
| | - 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, Genoa, Italy
| | - Valérie Piguet
- Division of Clinical Pharmacology & Toxicology, Multidisciplinary Pain Centre (MPC), University Hospitals of Geneva (HUG), Switzerland
| | - Christophe Luthy
- Division of General Medical Rehabilitation, Geneva University Hospitals (HUG), Switzerland; Department of Geriatrics and Rehabilitation, Faculty of Medicine, University of Geneva (UNIGE), Geneva, Switzerland
| | - Christine Cedraschi
- Division of Clinical Pharmacology & Toxicology, Multidisciplinary Pain Centre (MPC), University Hospitals of Geneva (HUG), Switzerland; Division of General Medical Rehabilitation, Geneva University Hospitals (HUG), Switzerland; Department of Geriatrics and Rehabilitation, Faculty of Medicine, University of Geneva (UNIGE), Geneva, Switzerland
| | - Guido Bondolfi
- 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, Service of Liaison Psychiatry and Crisis Intervention (SPLIC), Geneva University Hospitals (HUG), Geneva, Switzerland
| | - Isabella Berardelli
- Department of Neurosciences, Mental Health and Sensory Organs, Suicide Prevention Center, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
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Effects of stress on endophenotypes of suicide across species: A role for ketamine in risk mitigation. Neurobiol Stress 2022; 18:100450. [PMID: 35685678 PMCID: PMC9170747 DOI: 10.1016/j.ynstr.2022.100450] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 04/05/2022] [Accepted: 04/15/2022] [Indexed: 12/28/2022] Open
Abstract
Suicide is a leading cause of death and morbidity worldwide, yet few interventions are available to mitigate its risk. Barriers to effective treatments involve a limited understanding of factors that predict the onset of suicidal thoughts and behaviors. In the context of suicide risk, stress is a precipitating factor that is largely overlooked in the literature. Indeed, the pathophysiology of stress and suicide are heavily interconnected, underscoring the need to target the stress system in suicide prevention. In this review, we integrate findings from the preclinical and clinical literature that links stress and suicide. We focus specifically on the effects of stress on underlying biological functions and processes associated with suicide, allowing for the review of research using animal models. Owing to the rapid anti-suicidal effects of (R,S)-ketamine, we discuss its ability to modulate various stress-related endophenotypes of suicide, as well as its potential role in preventing suicide in those with a history of chronic life stress (e.g., early life adversity). We highlight future research directions that could advance our understanding of stress-related effects on suicide risk, advocating a dimensional, endophenotype approach to suicide research. Suicide and chronic stress pathophysiology are interconnected. Chronic stress has profound impacts on several endophenotypes of suicide. Animal and human research points to stress as a precipitating factor in suicide. Ketamine modulates specific biological processes associated with stress and suicide. Suicide research into endophenotypes can help inform risk-mitigation strategies.
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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: 14] [Impact Index Per Article: 7.0] [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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Moore FR, Doughty H, Neumann T, McClelland H, Allott C, O'Connor RC. Impulsivity, aggression, and suicidality relationship in adults: A systematic review and meta-analysis. EClinicalMedicine 2022; 45:101307. [PMID: 35243273 PMCID: PMC8860929 DOI: 10.1016/j.eclinm.2022.101307] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 01/25/2022] [Accepted: 01/28/2022] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND The aim of the study was to crystallize the nature of relationships between impulsivity, aggression, and suicidality. We reviewed studies of adults with published, psychometric measures of impulsivity and aggression, and measures of suicidality. METHODS Our primary data source was Web of Science (from inception to 31st December 2021). Quality of articles was assessed using a Joanna Briggs Appraisal Tool and publication bias using Trim and Fill. We synthesised results using random effects meta-analyses and explored moderation by measure of impulsivity, aggression, and suicidality, and population. FINDINGS 77 studies were included in our analysis. We found weak positive relationships between impulsivity (r = 0·19 [95% CI: 0·15-0·22]), aggression (0·23 ([0·17, 0·29]), and impulsive aggression (0·16 [0·1, 0·22]) with suicidality. Heterogeneity was significant and only partially explained by moderators. Limitations included the lack of studies which assess impulsivity or aggression proximal to suicidality. INTERPRETATION Given small effect sizes and significant heterogeneity, the study suggests that additional studies are needed in the field to analyze the relation between impulsivity and aggression with suicidality. FUNDING None.
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Affiliation(s)
- Fhionna R. Moore
- NHS Highland's Child and Adolescent Mental Health Services, Phoenix Centre, Raigmore Hospital, Inverness, Scotland IV2 3UJ United Kingdom
- Suicidal Behavior Research Laboratory, Institute of Health and Wellbeing, College of Medicine, Veterinary, and Life Sciences, University of Glasgow, Glasgow, Northern Ireland G12 8QQ United Kingdom
| | - Heather Doughty
- School of Social and Health Science, University of Dundee, Dundee, Northern Ireland DD1 4HN United Kingdom
| | - Tabea Neumann
- School of Social and Health Science, University of Dundee, Dundee, Northern Ireland DD1 4HN United Kingdom
| | - Heather McClelland
- Suicidal Behavior Research Laboratory, Institute of Health and Wellbeing, College of Medicine, Veterinary, and Life Sciences, University of Glasgow, Glasgow, Northern Ireland G12 8QQ United Kingdom
| | - Claire Allott
- NHS Highland's Child and Adolescent Mental Health Services, Phoenix Centre, Raigmore Hospital, Inverness, Scotland IV2 3UJ United Kingdom
| | - Rory C. O'Connor
- Suicidal Behavior Research Laboratory, Institute of Health and Wellbeing, College of Medicine, Veterinary, and Life Sciences, University of Glasgow, Glasgow, Northern Ireland G12 8QQ United Kingdom
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11
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Stapel B, Xiao K, Gorinski N, Schmidt K, Pfanne A, Fiedler J, Richter I, Vollbrecht AL, Thum T, Kahl KG, Ponimaskin E. MicroRNAs as novel peripheral markers for suicidality in patients with major depressive disorder. Front Psychiatry 2022; 13:1020530. [PMID: 36506422 PMCID: PMC9729747 DOI: 10.3389/fpsyt.2022.1020530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Accepted: 11/02/2022] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE Major depressive disorder (MDD) constitutes a main risk factor for suicide. Suicide risk in psychiatric patients is primarily determined by often unreliable, self-reported information. We assessed serum levels of three microRNAs (miRNAs), previously demonstrated to be dysregulated in post-mortem brain samples of suicide victims, as potential peripheral biomarkers for suicidality. METHODS All study participants were diagnosed with MDD according to Diagnostic and Statistical Manual of Mental Disorders, 5th edition criteria. Suicidality, defined as acute suicide risk or suicide attempt within one week prior to study entry, was assessed by clinical interview. Relative serum levels of miR-30a, miR-30e, and miR-200a, normalized to U6, were measured by quantitative real-time PCR in MDD inpatients with (MDD/SI, N = 19) and without (MDD, N = 31) acute suicide risk. Median age and gender distribution were comparable in both groups. RESULTS Levels of miR-30a, miR-30e, and miR-200a were significantly elevated in MDD/SI compared to MDD. Subgroup analysis of the MDD/SI group showed that levels of miR-30e and miR-200a were significantly higher and miR-30a was increased by trend in patients admitted following a suicide attempt (N = 7) compared to patients with acute suicide risk but without recent suicide attempt (N = 12). Additionally, use of two databases for in silico transcription factor-miRNA interaction prediction indicated early growth response protein (EGR) 1 as potential transcriptional regulator for all three miRNAs. CONCLUSION This study demonstrates suicide risk in MDD patients to be associated with increased levels of miR-30a, miR-30e, and miR-200a. Thus, these miRNAs might constitute potential biomarkers to predict suicidal behavior in MDD patients.
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Affiliation(s)
- Britta Stapel
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hanover, Germany
| | - Ke Xiao
- Fraunhofer Institute for Toxicology and Experimental Medicine (ITEM), Hanover, Germany.,Fraunhofer Cluster of Excellence Immune-Mediated Diseases (CIMD), Hanover, Germany
| | | | - Kevin Schmidt
- Hannover Medical School, Institute of Molecular and Translational Therapeutic Strategies (IMTTS), Hanover, Germany
| | - Angelika Pfanne
- Hannover Medical School, Institute of Molecular and Translational Therapeutic Strategies (IMTTS), Hanover, Germany
| | - Jan Fiedler
- Fraunhofer Institute for Toxicology and Experimental Medicine (ITEM), Hanover, Germany.,Fraunhofer Cluster of Excellence Immune-Mediated Diseases (CIMD), Hanover, Germany
| | - Imke Richter
- Cellular Neurophysiology, Hannover Medical School, Hanover, Germany
| | | | - Thomas Thum
- Fraunhofer Institute for Toxicology and Experimental Medicine (ITEM), Hanover, Germany.,Fraunhofer Cluster of Excellence Immune-Mediated Diseases (CIMD), Hanover, Germany.,Hannover Medical School, Institute of Molecular and Translational Therapeutic Strategies (IMTTS), Hanover, Germany
| | - Kai G Kahl
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hanover, Germany
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12
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Serafini G, Trabucco A, Corsini G, Escelsior A, Amerio A, Aguglia A, Nasrallah H, Amore M. The potential of microRNAs as putative biomarkers in major depressive disorder and suicidal behavior. Biomark Neuropsychiatry 2021. [DOI: 10.1016/j.bionps.2021.100035] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
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13
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Ferreira LM, Lima KPD, Morais ARD, Safadi T, Ferreira JL. Suicide cases in developed and emerging countries: an analysis using wavelets. JORNAL BRASILEIRO DE PSIQUIATRIA 2021. [DOI: 10.1590/0047-2085000000341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
ABSTRACT Objective The aim of this study was to use a wavelet technique to determine whether the number of suicides is similar between developed and emerging countries. Methods Annual data were obtained from World Health Organization (WHO) reports from 1986 to 2015. Discrete nondecimated wavelet transform was used for the analysis, and the Daubechies wavelet function was applied with five-level decomposition. Regarding clustering, energy (variance) was used to analyze the clusters and visualize the clustering process. We constructed a dendrogram using the Mahalanobis distance. The number of groups was set using a specific function in the R program. Results The cluster analysis verified the formation of four groups as follows: Japan, the United States and Brazil were distinct and isolated groups, and other countries (Austria, Belgium, Chile, Israel, Mexico, Italy and the Netherlands) constituted a single group. Conclusion The methods utilized in this paper enabled a detailed verification of countries with similar behaviors despite very distinct socioeconomic, geographic and climate characteristics.
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14
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de Mendonça Lima CA, De Leo D, Ivbijaro G, Svab I. Suicide prevention in older adults. Asia Pac Psychiatry 2021; 13:e12473. [PMID: 34114355 DOI: 10.1111/appy.12473] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Accepted: 04/26/2021] [Indexed: 12/20/2022]
Abstract
BACKGROUND Suicide among older adults is a multifactorial problem with several interrelated factors involved that vary with age, gender and culture. The number of suicides is highest in those aged 70 years or older in almost all regions of the world. With the increase in life expectancy, and the decrease in mortality due to other causes of death, we could expect the absolute number of older adults' suicide continue increasing. METHODS Review of the literature on suicide protective factors of suicide among older adults. RESULTS Improvements on social determinants of health and the timely detection and early treatment of affective disorders are key interventions. Prevention based on community actions and training of gatekeepers may have positive impact. Community programs that promote a sense of usefulness, belonging and that contribute to preserve social integration should be encouraged. Governments should develop the improvement of retirement programs and the development of support systems. The access to general health and mental health services should be facilitated and Primary Care professionals should receive proper training to detect and manage older persons at risk. Actively promoting a culture of coping to different stages of life and to the changes imposed by the advancing of age should form the essential part of a process bringing to better successful aging avenues. CONCLUSIONS Suicide prevention in older adults should broaden its focus and pay attention to the many socio-environmental conditions that may be relevant in older age, especially social isolation, financial security and physical health.
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Affiliation(s)
| | - Diego De Leo
- Australian Institute for Suicide Research and Prevention, Griffith University, Brisbane, Australia.,Slovene Centre for Suicide Research, University of Primorska, Koper, Slovenia
| | - Gabriel Ivbijaro
- NOVA University, Lisbon, Portugal.,Faculty of Management, Law and Social Sciences, University of Bradford, Bradford, UK
| | - Igor Svab
- Department of Family Medicine, University of Ljubljana, Ljubljana, Slovenia
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15
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Hong JS, Zhang S, Burlaka V, Yoshihama M, Yan Y, Voisin DR. From Exposure to Violence between Mother and Her Intimate Partner to Suicidality Experienced by Urban Adolescents in Chicago's Southside. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18157870. [PMID: 34360163 PMCID: PMC8345526 DOI: 10.3390/ijerph18157870] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 07/11/2021] [Accepted: 07/22/2021] [Indexed: 11/16/2022]
Abstract
Although the relationship between exposure to intimate partner violence and youths’ psychological and other wellbeing has been widely studied, there is limited research about how youths’ exposure to violence between mother and her intimate partner may be related to youth psychological wellbeing. The study used a sample of urban adolescents in Chicago Southbound to examine whether youths’ exposure to verbal conflict between mother and her intimate partner is related to their suicidality and whether youth depression and aggression may be in between such a linkage. Our findings indicated that one-third of the youth had suicidal thoughts or suicidal/self-hurting attempts. Youths’ exposure to verbal conflict between mother and her intimate partner was associated with their depressive and aggressive symptoms, and depressive symptoms subsequently were linked to suicidality. The findings also showed that youth depressive symptoms and aggressive symptoms were positively correlated, which may influence their associations with suicidality. We concluded that youth exposure to parental intimate partner violence, even comparatively mild forms such as a verbal conflict between mother and her intimate partner, may increase their risk of suicidality by worsening psychological wellbeing. The findings highlight the importance of tackling youth suicidality risks while accounting for their exposure to intimate partner violence including verbal conflicts between parents.
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Affiliation(s)
- Jun Sung Hong
- School of Social Work, Wayne State University, Detroit, MI 48202, USA;
- Correspondence: ; Tel.: +1-313-577-9367
| | - Saijun Zhang
- Department of Social Work, University of Mississippi, Oxford, MS 38677, USA;
| | - Viktor Burlaka
- School of Social Work, Wayne State University, Detroit, MI 48202, USA;
| | - Mieko Yoshihama
- School of Social Work, University of Michigan, Ann Arbor, MI 48109, USA;
| | - Yueqi Yan
- Biostatistics and Data Support, University of California Merced, Merced, CA 95344, USA;
| | - Dexter R. Voisin
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON M5S 1V4, Canada;
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16
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Cornelius SL, Berry T, Goodrich AJ, Shiner B, Riblet NB. The Effect of Meteorological, Pollution, and Geographic Exposures on Death by Suicide: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18157809. [PMID: 34360101 PMCID: PMC8345465 DOI: 10.3390/ijerph18157809] [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: 06/10/2021] [Revised: 07/07/2021] [Accepted: 07/20/2021] [Indexed: 12/07/2022]
Abstract
Suicide is a significant public health concern worldwide and in the United States. Despite the far-reaching impact of suicide, risk factors are still not well understood and efforts to accurately assess risk have fallen short. Current research has highlighted how potentially modifiable environmental exposures (i.e., meteorological, pollution, and geographic exposures) can affect suicide risk. A scoping review was conducted to evaluate the strength of the historical and current literature on the environment’s effect on suicide and suicide risk. Three databases (i.e., Medline, Embase, and PsychInfo) were reviewed to identify relevant studies and two authors independently reviewed studies considering pre-determined inclusion criteria. A total of 46 meteorological studies were included as well as 23 pollution studies and 12 geographic studies. Descriptive statistics, including counts, percentages, review of studies’ sample size (minimum, maximum, median, and interquartile range), were calculated using Excel and SAS 9.4. Overall, strong evidence supports that exposure to sunlight, temperature, air pollution, pesticides, and high altitude increases suicide risk, although effect sizes range from very small to small.
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Affiliation(s)
- Sarah L. Cornelius
- VA Medical Center, White River Junction, VT 05009, USA; (T.B.); (B.S.); (N.B.R.)
- Correspondence: ; Tel.: +1-(802)-295-9363
| | - Tara Berry
- VA Medical Center, White River Junction, VT 05009, USA; (T.B.); (B.S.); (N.B.R.)
| | - Amanda J. Goodrich
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA 90033, USA;
| | - Brian Shiner
- VA Medical Center, White River Junction, VT 05009, USA; (T.B.); (B.S.); (N.B.R.)
- Geisel School of Medicine, Dartmouth College, Hanover, NH 03755, USA
| | - Natalie B. Riblet
- VA Medical Center, White River Junction, VT 05009, USA; (T.B.); (B.S.); (N.B.R.)
- Geisel School of Medicine, Dartmouth College, Hanover, NH 03755, USA
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17
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Suicide and Associations with Air Pollution and Ambient Temperature: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18147699. [PMID: 34300149 PMCID: PMC8303705 DOI: 10.3390/ijerph18147699] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 07/17/2021] [Accepted: 07/19/2021] [Indexed: 12/22/2022]
Abstract
Given health threats of climate change, a comprehensive review of the impacts of ambient temperature and ar pollution on suicide is needed. We performed systematic literature review and meta-analysis of suicide risks associated with short-term exposure to ambient temperature and air pollution. Pubmed, Scopus, and Web of Science were searched for English-language publications using relevant keywords. Observational studies assessing risks of daily suicide and suicide attempts associated with temperature, particulate matter with aerodynamic diameter ≤10 μm (PM10) and ≤2.5 mm (PM2.5), ozone (O3), sulfur dioxide (SO2), nitrogen dioxide (NO2), and carbon monoxide (CO) were included. Data extraction was independently performed in duplicate. Random-effect meta-analysis was applied to pool risk ratios (RRs) for increases in daily suicide per interquartile range (IQR) increase in exposure. Meta-regression analysis was applied to examine effect modification by income level based on gross national income (GNI) per capita, national suicide rates, and average level of exposure factors. In total 2274 articles were screened, with 18 studies meeting inclusion criteria for air pollution and 32 studies for temperature. RRs of suicide per 7.1 °C temperature was 1.09 (95% CI: 1.06, 1.13). RRs of suicide per IQR increase in PM2.5, PM10, and NO2 were 1.02 (95% CI: 1.00, 1.05), 1.01 (95% CI: 1.00, 1.03), and 1.03 (95% CI: 1.00, 1.07). O3, SO2, and CO were not associated with suicide. RR of suicide was significantly higher in higher-income than lower-income countries (1.09, 95% CI: 1.07, 1.11 and 1.20, 95% CI: 1.14, 1.26 per 7.1 °C increased temperature, respectively). Suicide risks associated with air pollution did not significantly differ by income level, national suicide rates, or average exposure levels. Research gaps were found for interactions between air pollution and temperature on suicide risks.
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18
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Lopez-Morinigo JD, Boldrini M, Ricca V, Oquendo MA, Baca-García E. Aggression, Impulsivity and Suicidal Behavior in Depressive Disorders: A Comparison Study between New York City (US), Madrid (Spain) and Florence (Italy). J Clin Med 2021; 10:jcm10143057. [PMID: 34300222 PMCID: PMC8303717 DOI: 10.3390/jcm10143057] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 06/07/2021] [Accepted: 06/26/2021] [Indexed: 12/13/2022] Open
Abstract
The association of aggression and impulsivity with suicidal behavior (SB) in depression may vary across countries. This study aimed (i) to compare aggression and impulsivity levels, measured with the Brown-Goodwin Scale (BGS) and the Barratt Impulsivity Scale (BIS), respectively, between New York City (NYC) (US), Madrid (Spain) and Florence (Italy) (ANOVA); and (ii) to investigate between-site differences in the association of aggression and impulsivity with previous SB (binary logistic regression). Aggression scores were higher in NYC, followed by Florence and Madrid. Impulsivity levels were higher in Florence than in Madrid or NYC. Aggression and impulsivity scores were higher in suicide attempters than in non-attempters in NYC and in Madrid. SB was associated with aggression in NYC (OR 1.12, 95% CI 1.07–1.16; p < 0.001) and in Florence (OR 1.11, 95% CI 1.01–1.22; p = 0.032). Impulsivity was linked with SB in NYC (OR 1.01, 95% CI 1.00–1.02; p < 0.001) and in Madrid (OR 1.03, 95% CI 1.02–1.05; p < 0.001). The higher suicide rates in NYC, compared to Madrid or Florence, may be, in part, explained by these cross-cultural differences in the contribution of aggression-impulsivity to SB, which should be considered by future research on SB prevention.
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Affiliation(s)
- Javier-David Lopez-Morinigo
- Department of Psychiatry, Universidad Autónoma de Madrid, 28049 Madrid, Spain;
- Department of Psychiatry, IIS-Fundación Jiménez Díaz, 28040 Madrid, Spain
- Centro de Investigación Biomédica en Red Salud Mental (CIBERSAM), 28029 Madrid, Spain
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, IiSGM, CIBERSAM, School of Medicine, Universidad Complutense, 28009 Madrid, Spain
- Correspondence: ; Tel.: +34-627-277-126
| | - Maura Boldrini
- Department of Psychiatry, New York State Psychiatric Institute, Columbia University Irvin Medical Center, New York, NY 10032, USA;
| | - Valdo Ricca
- Department of Health Sciences, University of Florence, 50121 Florence, Italy;
| | - Maria A. Oquendo
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA;
| | - Enrique Baca-García
- Department of Psychiatry, Universidad Autónoma de Madrid, 28049 Madrid, Spain;
- Department of Psychiatry, IIS-Fundación Jiménez Díaz, 28040 Madrid, Spain
- Centro de Investigación Biomédica en Red Salud Mental (CIBERSAM), 28029 Madrid, Spain
- Department of Psychiatry, University Hospital Rey Juan Carlos, 28933 Mostoles, Spain
- Department of Psychiatry, General Hospital of Villalba, 28400 Madrid, Spain
- Department of Psychiatry, University Hospital Infanta Elena, 28342 Valdemoro, Spain
- Universidad Católica del Maule, Talca 3466706, Chile
- Department of Psychiatry, Centre Hospitalier Universitaire de Nîmes, 30900 Nîmes, France
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Hippocampal Subfield Volumes in Major Depressive Disorder Adolescents with a History of Suicide Attempt. BIOMED RESEARCH INTERNATIONAL 2021; 2021:5524846. [PMID: 33954172 PMCID: PMC8057893 DOI: 10.1155/2021/5524846] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Revised: 03/23/2021] [Accepted: 04/05/2021] [Indexed: 12/03/2022]
Abstract
Suicidal behavior is a leading cause of death and often commences during adolescence/young adulthood (15~29 years old). The hippocampus, which consists of multiple functionally specialized subfields, may contribute to the pathophysiology of depression and suicidal behavior. We aimed to investigate the differences of hippocampal subfield volume between major depressive disorder (MDD) patients with and without suicide attempts and healthy controls in adolescents and young adults. A total of 40 MDD suicide attempters (MDD+SA), 27 MDD patients without suicide attempt (MDD-SA), and 37 healthy controls (HC) were recruited. High-resolution T1 MRI images were analyzed with the automated hippocampal substructure module in FreeSurfer 6.0. Volume differences among the groups were analyzed by a generalized linear model controlling for intracranial cavity volume (ICV). The relationship between hippocampal subfield volumes and clinical characteristics (HAM-D and SSI scores) was assessed using two-tailed partial correlation controlling for ICV in MDD+SA and MDD-SA. We found that MDD-SA had significantly smaller bilateral hippocampal fissure volume than HC and MDD+SA. No significant correlation was observed between hippocampal subfield volume and clinical characteristics (HAM-D and SSI scores) in MDD+SA and MDD-SA. Adolescent/young adult suicide attempters with MDD suicide attempters have larger bilateral hippocampal fissures than depressed patients without suicide attempts, independently from clinical characteristics. Within the heterogeneous syndrome of major depressive disorder that holds a risk for suicidality for subgroups, hippocampal morphology may help to explain or possibly predict such risk, yet longitudinal and functional studies are needed for understanding the biological mechanisms underlying.
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Fröding E, Gäre BA, Westrin Å, Ros A. Suicide as an incident of severe patient harm: a retrospective cohort study of investigations after suicide in Swedish healthcare in a 13-year perspective. BMJ Open 2021; 11:e044068. [PMID: 33687954 PMCID: PMC7944973 DOI: 10.1136/bmjopen-2020-044068] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES To explore how mandatory reporting to the supervisory authority of suicides among recipients of healthcare services has influenced associated investigations conducted by the healthcare services, the lessons obtained and whether any suicide-prevention-related improvements in terms of patient safety had followed. DESIGN AND SETTINGS Retrospective study of reports from Swedish primary and secondary healthcare to the supervisory authority after suicide. PARTICIPANTS Cohort 1: the cases reported to the supervisory authority in 2006, from the time the reporting of suicides became mandatory, to 2007 (n=279). Cohort 2: the cases reported in 2015, a period of well-established reporting (n=436). Cohort 3: the cases reported from September 2017, which was the time the law regarding reporting was removed, to November 2019 (n=316). PRIMARY AND SECONDARY OUTCOME MEASURES Demographic data and received treatment in the months preceding suicide were registered. Reported deficiencies in healthcare and actions were categorised by using a coding scheme, analysed per individual and aggregated per cohort. Separate notes were made when a deficiency or action was related to a healthcare-service routine. RESULTS The investigations largely adopted a microsystem perspective, focusing on final patient contact, throughout the overall study period. Updating existing or developing new routines as well as educational actions were increasingly proposed over time, while sharing conclusions across departments rarely was recommended. CONCLUSIONS The mandatory reporting of suicides as potential cases of patient harm was shown to be restricted to information transfer between healthcare providers and the supervisory authority, rather than fostering participative improvement of patient safety for suicidal patients.The similarity in outcomes across the cohorts, regardless of changes in legislation, suggests that the investigations were adapted to suit the structure of the authority's reports rather than the specific incident type, and that no new service improvements or lessons are being identified.
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Affiliation(s)
- Elin Fröding
- Jönköping University, Jönköping, Sweden
- Region Jönköpings län, Jönköping, Sweden
| | - Boel Andersson Gäre
- Jönköping University, Jönköping, Sweden
- Futurum, Region Jönköpings län, Jönköping, Sweden
| | - Åsa Westrin
- Division of Psychiatry, Department of Clinical Sciences, Lund University, Lund, Sweden
- Region Skåne, Psychiatry Research Skåne, Office for Psychiatry and Habilitation, Lund, Sweden
| | - Axel Ros
- Jönköping University, Jönköping, Sweden
- Region Jönköpings län, Jönköping, Sweden
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Can AT, Hermens DF, Dutton M, Gallay CC, Jensen E, Jones M, Scherman J, Beaudequin DA, Yang C, Schwenn PE, Lagopoulos J. Low dose oral ketamine treatment in chronic suicidality: An open-label pilot study. Transl Psychiatry 2021; 11:101. [PMID: 33542187 PMCID: PMC7862447 DOI: 10.1038/s41398-021-01230-z] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 01/12/2021] [Accepted: 01/18/2021] [Indexed: 01/07/2023] Open
Abstract
Recently, low-dose ketamine has been proposed as a rapid-acting treatment option for suicidality. The majority of studies to date have utilised intravenous (IV) ketamine, however, this route of administration has limitations. On the other hand, oral ketamine can be administered in a range of settings, which is important in treating suicidality, although studies as to safety and feasibility are lacking. n = 32 adults (aged 22-72 years; 53% female) with chronic suicidal thoughts participated in the Oral Ketamine Trial on Suicidality (OKTOS), an open-label trial of sub-anaesthetic doses of oral ketamine over 6 weeks. Participants commenced with 0.5 mg/kg of ketamine, which was titrated to a maximum 3.0 mg/kg. Follow-up assessments occurred at 4 weeks after the final dose. The primary outcome measure was the Beck Scale for Suicide Ideation (BSS) and secondary measures included scales for suicidality and depressive symptoms, and measures of functioning and well-being. Mean BSS scores significantly reduced from a high level of suicidal ideation at the pre-ketamine (week 0) timepoint to below the clinical threshold at the post-ketamine (week 6) timepoint. The proportion of participants that achieved clinical improvement within the first 6 weeks was 69%, whereas 50% achieved a significant improvement by the follow-up (week 10) timepoint. Six weeks of oral ketamine treatment in participants with chronic suicidality led to significant reduction in suicidal ideation. The response observed in this study is consistent with IV ketamine trials, suggesting that oral administration is a feasible and tolerable alternative treatment for chronic suicidality.
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Affiliation(s)
- Adem T. Can
- grid.1034.60000 0001 1555 3415Thompson Institute, University of the Sunshine Coast, Birtinya, Queensland Australia
| | - Daniel F. Hermens
- grid.1034.60000 0001 1555 3415Thompson Institute, University of the Sunshine Coast, Birtinya, Queensland Australia
| | - Megan Dutton
- grid.1034.60000 0001 1555 3415Thompson Institute, University of the Sunshine Coast, Birtinya, Queensland Australia
| | - Cyrana C. Gallay
- grid.1034.60000 0001 1555 3415Thompson Institute, University of the Sunshine Coast, Birtinya, Queensland Australia
| | - Emma Jensen
- grid.1034.60000 0001 1555 3415Thompson Institute, University of the Sunshine Coast, Birtinya, Queensland Australia
| | - Monique Jones
- grid.1034.60000 0001 1555 3415Thompson Institute, University of the Sunshine Coast, Birtinya, Queensland Australia
| | - Jennifer Scherman
- grid.1034.60000 0001 1555 3415Thompson Institute, University of the Sunshine Coast, Birtinya, Queensland Australia
| | - Denise A. Beaudequin
- grid.1034.60000 0001 1555 3415Thompson Institute, University of the Sunshine Coast, Birtinya, Queensland Australia
| | - Cian Yang
- grid.1034.60000 0001 1555 3415Thompson Institute, University of the Sunshine Coast, Birtinya, Queensland Australia
| | - Paul E. Schwenn
- grid.1034.60000 0001 1555 3415Thompson Institute, University of the Sunshine Coast, Birtinya, Queensland Australia
| | - Jim Lagopoulos
- grid.1034.60000 0001 1555 3415Thompson Institute, University of the Sunshine Coast, Birtinya, Queensland Australia
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Kang HJ, Kim JW, Lee JY, Kim SW, Shin IS, Hong YJ, Ahn Y, Jeong MH, Kim JM. Time-Specific Associations of Tumor Necrosis Factor-α Levels and Polymorphisms (-850 C/T or -308 G/A) With Suicidal Ideation in Acute Coronary Syndrome Patients. Front Psychiatry 2021; 12:739823. [PMID: 34630187 PMCID: PMC8496737 DOI: 10.3389/fpsyt.2021.739823] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Accepted: 08/17/2021] [Indexed: 01/02/2023] Open
Abstract
Background: Considering the association of inflammation with suicide and acute coronary syndrome (ACS), we investigated the individual and interactive effects of serum tumor necrosis factor-alpha (sTNFα) levels and two polymorphisms (-850 C/T and -308 G/A) on suicidal ideation (SI) after ACS. Methods: The SI status using items on the Montgomery-Åsberg Depression Rating Scale (MADRS), related covariates including sociodemographic and clinical characteristics, sTNFα levels, and tumor necrosis factor-alpha (TNF-α) polymorphisms were evaluated in 969 patients within 2 weeks after ACS. Of the patients, 711 were evaluated 1 year later for SI. Multivariate logistic regression models were used to calculate individual and interactive associations after adjusting for the covariates. Results: Higher (vs. lower) sTNFα levels and the -850 C/T or T/T (vs. C/C) polymorphism were significantly associated with SI 2 weeks after ACS, while only higher sTNFα levels were significantly associated with SI after 1 year. Significant interactive effects were detected between sTNFα (higher) levels and the -850 C/T (C/C or C/T) polymorphism on SI 2 weeks after ACS and between the two (-850 CC or CT and -308 G/A or AA) polymorphisms on SI 1 year after ACS. Conclusions: The sTNFα level and two polymorphisms (-850C/T and -308 G/A), separately or in combination, could be time-specific biomarkers for SI in ACS. Focused interventions for ACS patients at risk of SI might reduce the suicidal burden in patients with ACS.
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Affiliation(s)
- Hee-Ju Kang
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, South Korea
| | - Ju-Wan Kim
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, South Korea
| | - Ju-Yeon Lee
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, South Korea
| | - Sung-Wan Kim
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, South Korea
| | - Il-Seon Shin
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, South Korea
| | - Young Joon Hong
- Department of Cardiology, Chonnam National University Medical School, Gwangju, South Korea
| | - Youngkeun Ahn
- Department of Cardiology, Chonnam National University Medical School, Gwangju, South Korea
| | - Myung-Ho Jeong
- Department of Cardiology, Chonnam National University Medical School, Gwangju, South Korea
| | - Jae-Min Kim
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, South Korea
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23
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Dhrisya C, Prasathkumar M, Becky R, Anisha S, Sadhasivam S, Essa MM, Chidambaram SB, Al-Balushi B, Guillemin GJ, Qoronfleh MW. Social and Biological Parameters Involved in Suicide Ideation During the COVID-19 Pandemic: A Narrative Review. Int J Tryptophan Res 2020; 13:1178646920978243. [PMID: 35185341 PMCID: PMC8851148 DOI: 10.1177/1178646920978243] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Accepted: 11/08/2020] [Indexed: 12/24/2022] Open
Abstract
Fear is an indispensable characteristic of any infectious disease, and the alarm will be further amplified when the infection spreads uncontrollable, unpredictable, and global. The novel corona virus (SARS CoV-2) lead Covid-19, has been declared as a global emergency by WHO as it has affected millions of people with a high mortality rate. The non-availability of medicine for Covid-19 and the various control measures such as social distancing, self-isolation, house quarantine, and the new normal implementation by different nations across the world to control the spread of Covid-19 made people vulnerable to fear and anxiety. As a result, considerable number of Covid-19-related suicidal deaths has been reported across the world during this pandemic. There have been several studies which describe the psychosocial aspects of suicidal ideation. However, the research on the biological aspects of suicidal ideation/suicidal risk factors that are related to pandemic are unreported. Hence this review article is intended to provide a comprehensive analysis of suicidal deaths during Covid-19 and also aimed to addresses the possible link between suicidal ideation and different factors, including psycho-social, behavioral, neurobiological factors (proximal, distal, and inflammatory) and immunity. The alterations in glutamatergic and GABAergic neurotransmitters had upregulated the GABARB3, GABARA4, GABARA3, GABARR1, GABARG2, and GAD2 gene expressions in suicidal victims. The changes in the Kynurenine (KYN) pathway, Hypothalamus-Pituitary-Adrenal axis (HPA axis) hyperactivation, and dysregulation of serotonin biosynthesis would significantly alter the brain chemistry in people with suicide ideation.
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Affiliation(s)
- Chenthamara Dhrisya
- Bioprocess and Biomaterials Laboratory, Department of Microbial Biotechnology, Bharathiar University, Coimbatore, India
| | - Murugan Prasathkumar
- Bioprocess and Biomaterials Laboratory, Department of Microbial Biotechnology, Bharathiar University, Coimbatore, India
| | - Robert Becky
- Bioprocess and Biomaterials Laboratory, Department of Microbial Biotechnology, Bharathiar University, Coimbatore, India
| | - Salim Anisha
- Bioprocess and Biomaterials Laboratory, Department of Microbial Biotechnology, Bharathiar University, Coimbatore, India
| | - Subramaniam Sadhasivam
- Bioprocess and Biomaterials Laboratory, Department of Microbial Biotechnology, Bharathiar University, Coimbatore, India
- Department of Extension and Career Guidance, Bharathiar University, Coimbatore, India
| | - Musthafa Mohamed Essa
- Department of Food Science and Nutrition, CAMS, Sultan Qaboos University, Muscat, Oman
- Ageing and Dementia Research Group, Sultan Qaboos University, Muscat, Oman
| | - Saravana Babu Chidambaram
- Centre for Experimental Pharmacology & Toxicology (CPT), JSS Academy of Higher Education & Research, Mysuru, India
| | - Buthainah Al-Balushi
- Department of Food Science and Nutrition, CAMS, Sultan Qaboos University, Muscat, Oman
| | - Gilles J Guillemin
- Neuroinflammation Group, Faculty of Medicine and Health Sciences, Macquarie University, NSW, Australia
| | - M Walid Qoronfleh
- Research & Policy Department, World Innovation Summit for Health (WISH), Qatar Foundation, Doha, Qatar
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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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Cheung S, Woo J, Maes MS, Zai CC. Suicide epigenetics, a review of recent progress. J Affect Disord 2020; 265:423-438. [PMID: 32090769 DOI: 10.1016/j.jad.2020.01.040] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Revised: 11/17/2019] [Accepted: 01/11/2020] [Indexed: 02/08/2023]
Abstract
BACKGROUND Suicide results in over 800,000 deaths every year, making it a major public health concern worldwide. It is highly complex, with genetic and environmental influences. Epigenetic mechanisms, including DNA methylation, miRNA, and histone modifications, could explain the complex interplay of environmental risk factors with genetic risk factors in the emergence of suicidal behavior. METHODS Here, we review the literature on suicide epigenetics over the past 10 years. RESULTS There has been significant progress in the field of suicide epigenetics, with emerging findings in the brain-derived neurotrophic factor and hypothalamic-pituitary-adrenal axis genes. LIMITATIONS Studying patient subgroups is needed in order to extract more comparable and reproducible epigenetic findings in suicide. CONCLUSIONS It is crucial to consider suicidal patients or suicide victims' distal and proximal past history e.g., early-life adversity and psychiatric disorder in epigenetic studies of suicidality.
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Affiliation(s)
- Serina Cheung
- Neurogenetics Section, Tanenbaum Centre for Pharmacogenetics, Molecular Brain Science, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Canada
| | - Julia Woo
- Neurogenetics Section, Tanenbaum Centre for Pharmacogenetics, Molecular Brain Science, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Canada; Faculty of Medicine, University of Toronto, Canada
| | - Miriam S Maes
- Neurogenetics Section, Tanenbaum Centre for Pharmacogenetics, Molecular Brain Science, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Canada
| | - Clement C Zai
- Neurogenetics Section, Tanenbaum Centre for Pharmacogenetics, Molecular Brain Science, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Canada; Division of Brain and Therapeutics, Department of Psychiatry, University of Toronto, Canada; Institute of Medical Science, University of Toronto, Canada; Laboratory Medicine and Pathobiology, University of Toronto, Canada; Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA.
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26
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Cabello-Arreola A, Ho AMC, Ozerdem A, Cuellar-Barboza AB, Kucuker MU, Heppelmann CJ, Charlesworth MC, Ceylan D, Stockmeier CA, Rajkowska G, Frye MA, Choi DS, Veldic M. Differential Dorsolateral Prefrontal Cortex Proteomic Profiles of Suicide Victims with Mood Disorders. Genes (Basel) 2020; 11:E256. [PMID: 32120974 PMCID: PMC7140872 DOI: 10.3390/genes11030256] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Revised: 02/23/2020] [Accepted: 02/24/2020] [Indexed: 12/29/2022] Open
Abstract
Suicide is a major public health concern; nevertheless, its neurobiology remains unknown. An area of interest in suicide research is the dorsolateral prefrontal cortex (DLPFC). We aimed to identify altered proteins and potential biological pathways in the DLPFC of individuals who died by suicide employing mass spectrometry-based untargeted proteomics. Postmortem DLPFC from age-matched male suicide mood disorder cases (n = 5) and non-suicide mood disorder cases (n = 5) were compared. The proteins that differed between groups at false discovery rate (FDR) adjusted p-values (Benjamini-Hochberg-Yekutieli) <0.3 and Log2 fold change (FC) >|0.4| were considered statistically significant and were subjected to pathway analysis by Qiagen Ingenuity software. Thirty-three of the 5162 detected proteins showed significantly altered expression levels in the suicide cases and two of them after adjustment for body mass index. The top differentially expressed protein was potassium voltage-gated channel subfamily Q member 3 (KCNQ3) (Log2FC = -0.481, p = 2.10 × 10-09, FDR = 5.93 × 10-06), which also showed a trend to downregulation in Western blot (p = 0.045, Bonferroni adjusted p = 0.090). The most notably enriched pathway was the GABA receptor signaling pathway (p < 0.001). Here, we report a reduction trend of KCNQ3 levels in the DLPFC of male suicide victims with mood disorders. Further studies with a larger sample size and equal sex representation are needed.
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Affiliation(s)
| | - Ada Man-Choi Ho
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN 55905, USA
| | - Aysegul Ozerdem
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN 55905, USA
- Department of Neurosciences, Dokuz Eylul University, Health Sciences Institute, Izmir 35340, Turkey
- Department of Psychiatry, Dokuz Eylul University, School of Medicine, Izmir 35220, Turkey
| | - Alfredo B. Cuellar-Barboza
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN 55905, USA
- Department of Psychiatry, Universidad Autonoma de Nuevo Leon, Monterrey 64460, Mexico
| | - Mehmet U. Kucuker
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN 55905, USA
| | | | | | - Deniz Ceylan
- Izmir University of Economics, Faculty of Medicine, Department of Psychiatry, Izmir 35330, Turkey
| | - Craig A. Stockmeier
- Department of Psychiatry, Case Western Reserve University, Cleveland, OH 44106, USA
- Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, Jackson, MS 39216, USA
| | - Grazyna Rajkowska
- Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, Jackson, MS 39216, USA
| | - Mark A. Frye
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN 55905, USA
| | - Doo-Sup Choi
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN 55905, USA
- Department of Molecular Pharmacology and Experimental Therapeutics, Mayo Clinic College of Medicine and Science, Rochester, MN 55905, USA
- Neuroscience Program, Mayo Clinic College of Medicine, Rochester, MN 55905, USA
| | - Marin Veldic
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN 55905, USA
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Behavioral Epigenetics: Perspectives Based on Experience-Dependent Epigenetic Inheritance. EPIGENOMES 2019; 3:epigenomes3030018. [PMID: 34968228 PMCID: PMC8594690 DOI: 10.3390/epigenomes3030018] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Revised: 08/15/2019] [Accepted: 08/20/2019] [Indexed: 11/16/2022] Open
Abstract
Epigenetic regulation plays an important role in gene regulation, and epigenetic markers such as DNA methylation and histone modifications are generally described as switches that regulate gene expression. Behavioral epigenetics is defined as the study of how epigenetic alterations induced by experience and environmental stress may affect animal behavior. It studies epigenetic alterations due to environmental enrichment. Generally, molecular processes underlying epigenetic regulation in behavioral epigenetics include DNA methylation, post-translational histone modifications, noncoding RNA activity, and other unknown molecular processes. Whether the inheritance of epigenetic features will occur is a crucial question. In general, the mechanism underlying inheritance can be explained by two main phenomena: Germline-mediated epigenetic inheritance and interact epigenetic inheritance of somatic cells through germline. In this review, we focus on examining behavioral epigenetics based on its possible modes of inheritance and discuss the considerations in the research of epigenetic transgenerational inheritance.
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Goldberg X, Serra-Blasco M, Vicent-Gil M, Aguilar E, Ros L, Arias B, Courtet P, Palao D, Cardoner N. Childhood maltreatment and risk for suicide attempts in major depression: a sex-specific approach. Eur J Psychotraumatol 2019; 10:1603557. [PMID: 31105902 PMCID: PMC6507860 DOI: 10.1080/20008198.2019.1603557] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Revised: 03/21/2019] [Accepted: 03/26/2019] [Indexed: 01/14/2023] Open
Abstract
Background: Childhood maltreatment increases the risk of suicide attempts in the general population, possibly having similar effects among patients with major depressive disorder (MDD). The few studies that have addressed this association have been restricted to specific populations (e.g. treatment-resistant depression, personality disorders) and have rarely taken sex into account. Objective: To examine the impact of childhood maltreatment on suicide attempts among MDD patients above and beyond other risk factors and potential confounders, while considering potential sex-specific effects. Methods: The study assessed 165 patients with a principal diagnosis of MDD. Neurological alterations, psychiatric comorbidities, and drug abuse were reasons for exclusion. Logistic regressions using the whole sample, and divided by sex, were run to test the association between childhood maltreatment and history of suicide attempts, controlling for symptom severity, comorbidities, and treatment-resistant depression. Results: There was a significant and clinically relevant association between childhood maltreatment and history of suicide attempts in the total sample. Patients with childhood maltreatment were 3.01 times more likely to present a history of suicide attempts than patients without childhood maltreatment. A family history of psychiatric disorders also contributed to the variance of attempted suicide, but its interaction with childhood maltreatment was not statistically significant. When testing the model separately, the effect of childhood maltreatment on suicide attempts remained for females, whereas for males, age of MDD onset and Childhood Trauma Questionnaire minimization-denial scale were predictive variables. Conclusions: Childhood maltreatment is a clear predictor of suicidal behaviour among MDD patients, and this effect remains significant after controlling for potential confounders. Also, the sex of patients emerges as a relevant factor that may model the mechanisms underlying the prediction of suicide attempts. Since suicide is the main cause of premature death among MDD patients, interventions targeting childhood maltreatment should be included in preventive and clinical strategies.
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Affiliation(s)
- Ximena Goldberg
- Mental Health Department, Neuroscience and Mental Health Research Area, Parc Taulí Hospital Universitari, Institut d’Investigació i Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, CIBERSAM, Sabadell, Spain
| | - Maria Serra-Blasco
- Mental Health Department, Neuroscience and Mental Health Research Area, Parc Taulí Hospital Universitari, Institut d’Investigació i Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, CIBERSAM, Sabadell, Spain
| | - Muriel Vicent-Gil
- Mental Health Department, Neuroscience and Mental Health Research Area, Parc Taulí Hospital Universitari, Institut d’Investigació i Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, CIBERSAM, Sabadell, Spain
- Department de Psiquiatria, Institut d’Investigació Biomèdica Sant-Pau (IIB-Sant Pau), CIBERSAM, Barcelona, Spain
| | - Eva Aguilar
- Mental Health Department, Neuroscience and Mental Health Research Area, Parc Taulí Hospital Universitari, Institut d’Investigació i Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, CIBERSAM, Sabadell, Spain
| | - Laura Ros
- Mental Health Department, Neuroscience and Mental Health Research Area, Parc Taulí Hospital Universitari, Institut d’Investigació i Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, CIBERSAM, Sabadell, Spain
| | - Barbara Arias
- Departament Biologia Evolutiva, Ecologia i Ciències Ambientals, Facultat de Biologia, Institut de Biomedicina de la Universitat de Barcelona (IBUB), Universitat de Barcelona, CIBERSAM, Barcelona, Spain
| | - Philippe Courtet
- Department of Emergency Psychiatry and Acute Care, CHU Montpellier, Hopital Lapeyronie, INSERM Unit 1061, University of Montpellier, Montpellier, France
| | - Diego Palao
- Mental Health Department, Neuroscience and Mental Health Research Area, Parc Taulí Hospital Universitari, Institut d’Investigació i Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, CIBERSAM, Sabadell, Spain
| | - Narcís Cardoner
- Mental Health Department, Neuroscience and Mental Health Research Area, Parc Taulí Hospital Universitari, Institut d’Investigació i Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, CIBERSAM, Sabadell, Spain
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29
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Brick LA, Marraccini ME, Micalizzi L, Benca-Bachman CE, Knopik VS, Palmer RHC. Overlapping genetic effects between suicidal ideation and neurocognitive functioning. J Affect Disord 2019; 249:104-111. [PMID: 30769295 PMCID: PMC6937431 DOI: 10.1016/j.jad.2019.02.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2018] [Revised: 01/18/2019] [Accepted: 02/05/2019] [Indexed: 02/08/2023]
Abstract
BACKGROUND Suicide is the second leading cause of death among adolescents and young adults. Several studies have indicated significant genetic influences on suicide-related phenotypes and mounting evidence from neurobiological research has linked deficits in neurocognitive abilities to suicide phenotypes. The goal of the present study was to estimate the heritability of suicidal ideation (SI) in a large sample of adolescents and determine if SI is genetically correlated with neurocognitive functioning. METHODS Genome-wide data (N = 3564 unrelated individuals of European Ancestry) were drawn from the Philadelphia Neurodevelopment Cohort. Adolescents completed a psychiatric assessment, as well as a computerized neurocognitive battery to assess performance across four domains: memory, executive function, social cognition, and complex cognition. Genomic-relatedness-matrix restricted maximum likelihood (GREML) estimation was used to determine SNP-heritability (h2SNP) of SI and the genetic correlation (rG) between SI and neurocognitive domains. RESULTS Nearly 17% of adolescents reported SI. The SNP-heritability estimate for SI was marginally significant (h2SNP = 11%, SE = 8%, p = 0.086). Bivariate analyses indicated a significant rG between SI and emotion identification (rG = 0.79, SE = 0.45, p = 0.006; phenotypic correlation r = 0.04, p = 0.017). LIMITATIONS It is possible that SI may represent a related, but differentially heritable construct from suicide attempts/completion and other comorbid psychopathology. Additionally, though genetic correlations point to shared genetic factors across traits, direct causal mechanisms cannot be deduced. CONCLUSIONS Common heritable factors contribute to variation in SI and neurocognitive functioning. Genetic factors influencing emotion identification have significant genetic overlap with SI.
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Affiliation(s)
- Leslie A Brick
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA.
| | - Marisa E Marraccini
- School of Education, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Lauren Micalizzi
- Center for Alcohol and Addiction Studies, Department of Behavioral and Social Sciences, School of Public Health, Brown University, Providence, RI, USA
| | - Chelsie E Benca-Bachman
- Behavioral Genetics of Addiction Laboratory, Department of Psychology, Emory University, Atlanta, GA, USA
| | - Valerie S Knopik
- Department of Human Development and Family Studies, Purdue University, West Lafayette, IN, USA
| | - Rohan H C Palmer
- Behavioral Genetics of Addiction Laboratory, Department of Psychology, Emory University, Atlanta, GA, USA
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Stewart SL, Poss JW, Thornley E, Hirdes JP. Resource Intensity for Children and Youth: The Development of an Algorithm to Identify High Service Users in Children's Mental Health. Health Serv Insights 2019; 12:1178632919827930. [PMID: 30828248 PMCID: PMC6390227 DOI: 10.1177/1178632919827930] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2018] [Accepted: 12/27/2018] [Indexed: 11/25/2022] Open
Abstract
Children’s mental health care plays a vital role in many social, health care, and
education systems, but there is evidence that appropriate targeting strategies
are needed to allocate limited mental health care resources effectively. The aim
of this study was to develop and validate a methodology for identifying children
who require access to more intense facility-based or community resources.
Ontario data based on the interRAI Child and Youth Mental Health instruments
were analysed to identify predictors of service complexity in children’s mental
health. The Resource Intensity for Children and Youth (RIChY) algorithm was a
good predictor of service complexity in the derivation sample. The algorithm was
validated with additional data from 61 agencies. The RIChY algorithm provides a
psychometrically sound decision-support tool that may be used to inform the
choices related to allocation of children’s mental health resources and
prioritisation of clients needing community- and facility-based resources.
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Affiliation(s)
| | - Jeff W Poss
- University of Waterloo, Faculty of Applied Health Sciences, Waterloo, ON, Canada
| | | | - John P Hirdes
- University of Waterloo, Faculty of Applied Health Sciences, Waterloo, ON, Canada
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From the microscope to the magnet: Disconnection in schizophrenia and bipolar disorder. Neurosci Biobehav Rev 2019; 98:47-57. [PMID: 30629976 DOI: 10.1016/j.neubiorev.2019.01.005] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2018] [Revised: 12/22/2018] [Accepted: 01/06/2019] [Indexed: 12/15/2022]
Abstract
White matter (WM) abnormalities have implicated schizophrenia (SZ) and bipolar disorder (BD) as disconnection syndromes, yet the extent to which these abnormalities are shared versus distinct remains unclear. Diffusion tensor imaging (DTI) studies yield a putative measure of WM integrity while neuropathological studies provide more specific microstructural information. We therefore systematically reviewed all neuropathological (n = 12) and DTI (n = 11) studies directly comparing patients with SZ and BD. Most studies (18/23) reported no difference between patient groups. Changes in oligodendrocyte density, myelin staining and gene, protein and mRNA expression were found in SZ and/or BD patients as compared to healthy individuals, while DTI studies showed common alterations in thalamic radiations, uncinate fasciculus, corpus callosum, longitudinal fasciculus and corona radiata. Altogether, findings suggest shared disconnectivity in SZ and BD, which are likely related to their considerable overlap. Above all, neuroimaging findings corroborated neuropathological findings in the prefrontal cortex, demonstrating the utility of integrating multiple methodologies. Focusing on clinical dimensions over disease entities will advance our understanding of disconnectivity and help inform preventive medicine.
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Fan Y, Chen P, Raza MU, Szebeni A, Szebeni K, Ordway GA, Stockmeier CA, Zhu MY. Altered Expression of Phox2 Transcription Factors in the Locus Coeruleus in Major Depressive Disorder Mimicked by Chronic Stress and Corticosterone Treatment In Vivo and In Vitro. Neuroscience 2018; 393:123-137. [PMID: 30315878 DOI: 10.1016/j.neuroscience.2018.09.038] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Revised: 09/21/2018] [Accepted: 09/26/2018] [Indexed: 12/16/2022]
Abstract
Phox2a and Phox2b are two homeodomain transcription factors playing a pivotal role in the development of noradrenergic neurons during the embryonic period. However, their expression and function in adulthood remain to be elucidated. Using human postmortem brain tissues, rat stress models and cultured cells, this study aimed to examine the alteration of Phox2a and Phox2b expression. The results show that Phox2a and Phox2b are normally expressed in the human locus coeruleus (LC) in adulthood. Furthermore, the levels of Phox2a protein and mRNA and protein levels of Phox2b were significantly elevated in the LC of brain donors that suffered from the major depressive disorder, as compared to age-matched and psychiatrically normal control donors. Fischer 344 rats subjected to chronic social defeat showed higher mRNA and protein levels of Phox2a and Phox2b in the LC, as compared to non-stressed control rats. In rats chronically administered oral corticosterone, mRNA and protein levels of Phox2b, but not Phox2a, in the LC were significantly increased. In addition, the corticosterone-induced increase in Phox2b protein was reversed by simultaneous treatment with either mifepristone or spironolactone. Exposing SH-SY5Y cells to corticosterone significantly increased expression of Phox2a and Phox2b, which was blocked by corticosteroid receptor antagonists. Taken together, these experiments reveal that Phox2 genes are expressed throughout the lifetime in the LC of humans and Fischer 344 rats. Alterations in their expression may play a role in major depressive disorder and possibly other stress-related disorders through their modulatory effects on the noradrenergic phenotype.
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Affiliation(s)
- Yan Fan
- Department of Biochemistry, Nantong University College of Medicine, Nantong, China
| | - Ping Chen
- School of Life Science and Technology, Tongji University, Shanghai, China
| | - Muhammad U Raza
- Department of Biomedical Sciences, Quillen College of Medicine, East Tennessee State University, Johnson City, TN, USA
| | - Attila Szebeni
- Department of Biomedical Sciences, Quillen College of Medicine, East Tennessee State University, Johnson City, TN, USA
| | - Katalin Szebeni
- Department of Biomedical Sciences, Quillen College of Medicine, East Tennessee State University, Johnson City, TN, USA
| | - Gregory A Ordway
- Department of Biomedical Sciences, Quillen College of Medicine, East Tennessee State University, Johnson City, TN, USA
| | - Craig A Stockmeier
- Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, Jackson, MS, USA
| | - Meng-Yang Zhu
- Department of Biomedical Sciences, Quillen College of Medicine, East Tennessee State University, Johnson City, TN, USA.
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Lewitzka U, Bauer M, Ripke B, Bronisch T, Günther L. Impulsivity and Saliva Cortisol in Patients with Suicide Attempt and Controls. Neuropsychobiology 2018; 75:162-168. [PMID: 29346785 DOI: 10.1159/000484664] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Accepted: 10/24/2017] [Indexed: 11/19/2022]
Abstract
OBJECTIVES The objective of this study was to prove concepts in the characterization of suicidal patients and the possible usefulness of those markers to potentially identify patients with a higher risk for suicidality. METHODS Patients with a recent suicide attempt were compared with patients suffering from depression, adjustment disorder, anxiety, or eating disorders without suicidality, healthy controls and remitted patients with a history of at least 1 suicide attempt (≥1 year). We analyzed impulsivity (Barratt Impulsivity Scale, BIS) and saliva cortisol concentrations. RESULTS Independently of suicidality and disease state patients display higher BIS scores than healthy controls. Saliva cortisol levels tend to be higher in patients in the acute disease state than in remitted patients and healthy controls. CONCLUSIONS Saliva cortisol may be a useful marker that reveals alterations in nonsuicidal patients suffering from depression, adjustment disorder, anxiety, or eating disorders who might be at risk.
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Affiliation(s)
- Ute Lewitzka
- Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Michael Bauer
- Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | | | | | - Lydia Günther
- Division of Medical Biology, Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
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Khalsa HMK, Baldessarini RJ, Tohen M, Salvatore P. Aggression among 216 patients with a first-psychotic episode of bipolar I disorder. Int J Bipolar Disord 2018; 6:18. [PMID: 30097737 PMCID: PMC6161985 DOI: 10.1186/s40345-018-0126-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Accepted: 07/05/2018] [Indexed: 12/03/2022] Open
Abstract
Background Aggression by patients with bipolar I disorder (BD-I) is not uncommon. Identifying potential risk factors early in the illness-course should inform clinical management and reduce risk. Methods In a study sample of 216 initially hospitalized, first-psychotic episode subjects diagnosed with DSM-IV-TR BD-I, we identified recent (within 1 month before hospitalization) aggression by ratings on the Brief Psychiatric Rating Scale-Expanded and review of detailed clinical research records. We compared subjects with versus without aggressive behavior for associations with selected demographic and clinical factors. Results Aggression was identified in 23/216 subjects (10.6%). It was associated significantly with recent suicide attempt (OR = 4.86), alcohol abuse (OR = 3.63), learning disability (OR = 3.14), and initial manic episode (OR = 2.59), but not with age, sex, onset-type, personality disorder, time to recovery, or functional status. Conclusions Among first-major episode BD-I patients with psychotic features, recent serious aggression towards others was identified in 10.6%. The odds of aggression increased by 4.9-times in association with a recent suicide attempt, more than 3-times with alcohol-abuse or learning disability, and by 2.6-times if the episode polarity was manic. The findings encourage closer management of alcohol misuse, suicide risk, and manic symptoms, and early detection of learning problems in BD-I patients.
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Affiliation(s)
- Hari-Mandir K Khalsa
- International Consortium for Bipolar & Psychotic Disorders Research, Psychotic Disorders Division, McLean Hospital, Belmont, MA, 02478, USA. .,Division of Mental Health and Wellbeing, Warwick Medical School, Coventry, UK. .,Department of Psychiatry, Harvard Medical School, Boston, MA, 02215, USA.
| | - Ross J Baldessarini
- International Consortium for Bipolar & Psychotic Disorders Research, Psychotic Disorders Division, McLean Hospital, Belmont, MA, 02478, USA.,Department of Psychiatry, Harvard Medical School, Boston, MA, 02215, USA
| | - Mauricio Tohen
- International Consortium for Bipolar & Psychotic Disorders Research, Psychotic Disorders Division, McLean Hospital, Belmont, MA, 02478, USA.,Department of Psychiatry, Harvard Medical School, Boston, MA, 02215, USA.,Department of Psychiatry & Behavioral Sciences, University of New Mexico, Health Sciences Center, Albuquerque, NM, 87131, USA
| | - Paola Salvatore
- International Consortium for Bipolar & Psychotic Disorders Research, Psychotic Disorders Division, McLean Hospital, Belmont, MA, 02478, USA.,Department of Psychiatry, Harvard Medical School, Boston, MA, 02215, USA.,Psychiatry Section, Department of Medicine & Surgery, University of Parma, Parma, Italy
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35
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Sher L, Flory J, Bierer L, Makotkine I, Yehuda R. Dehydroepiandrosterone and dehydroepiandrosterone sulfate levels in combat veterans with or without a history of suicide attempt. Acta Psychiatr Scand 2018; 138:55-61. [PMID: 29790155 DOI: 10.1111/acps.12897] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/16/2018] [Indexed: 01/12/2023]
Abstract
OBJECTIVE The goal of this study was to determine whether combat veterans who have made a suicide attempt postdeployment can be distinguished from combat veterans who have never made a suicide attempt based on differences in psychological and biological variables. METHODS Demographic and clinical parameters of suicide attempters and non-attempters were assessed. Blood samples were assayed for dehydroepiandrosterone (DHEA) and dehydroepiandrosterone sulfate (DHEAS). RESULTS Suicide attempters had higher Scale for Suicidal Ideation and Montgomery-Åsberg Depression Rating Scale (MADRS)-suicidal thoughts item scores in comparison with non-attempters. There was a trend toward higher MADRS scores in the suicide attempter group compared with non-attempters. Suicide attempters had significantly lower levels of DHEA and DHEAS compared with non-attempters. Scale for Suicidal Ideation scores in all study participants combined negatively correlate with DHEA and DHEAS levels. DHEAS levels negatively correlate with Scale for Suicidal Ideation scores in suicide non-attempters but not in suicide attempters. DHEA/DHEAS ratios positively correlate with total adolescence aggression scores, total adulthood aggression scores, and total aggression scale scores in suicide attempters but not in suicide non-attempters. CONCLUSION There are psychobiological differences between combat veterans with or without a history of suicidal behaviour.
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Affiliation(s)
- L Sher
- James J. Peters Veterans' Administration Medical Center, Bronx, NY, USA.,Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - J Flory
- James J. Peters Veterans' Administration Medical Center, Bronx, NY, USA.,Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - L Bierer
- James J. Peters Veterans' Administration Medical Center, Bronx, NY, USA.,Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - I Makotkine
- James J. Peters Veterans' Administration Medical Center, Bronx, NY, USA.,Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - R Yehuda
- James J. Peters Veterans' Administration Medical Center, Bronx, NY, USA.,Icahn School of Medicine at Mount Sinai, New York, NY, USA
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Baek JH, Kim K, Hong JP, Cho MJ, Fava M, Mischoulon D, Chang SM, Kim JY, Cho H, Jeon HJ. Binge eating, trauma, and suicide attempt in community adults with major depressive disorder. PLoS One 2018; 13:e0198192. [PMID: 29927937 PMCID: PMC6013207 DOI: 10.1371/journal.pone.0198192] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2017] [Accepted: 05/15/2018] [Indexed: 01/16/2023] Open
Abstract
Eating disorders comorbid with depression are an established risk factor for suicide. In this study, we aimed to determine the effects of binge eating (BE) symptoms on suicidality and related clinical characteristics in major depressive disorder (MDD). A total of 817 community participants with MDD were included. We compared two groups (with and without lifetime BE symptoms). The MDD with BE group was subdivided into a frequent BE (FBE) subgroup (BE symptoms greater than twice weekly) and any BE (ABE) subgroup (BE symptoms greater than twice weekly). The MDD with BE group comprised 142 (17.38%) patients. The FBE and ABE subgroups comprised 75 (9.18%) and 67 (8.20%) patients, respectively. Comorbid alcohol use disorder, anxiety disorder, post-traumatic stress disorder (PTSD) and history of suicide attempt were significantly more frequent in the MDD with BE group than MDD without BE group. Sexual trauma was also reported more frequently in MDD with BE group. No significant differences were observed between the ABE and FBE subgroups. Multivariate logistic regression revealed an association of suicide attempt with BE symptoms and sexual trauma. Structural equation modeling showed that sexual trauma increased BE (β = 0.337, P <0.001) together with alcohol use (β = 0.185, P <0.001) and anxiety (β = 0.299, p<0.001), which in turn increased suicide attempt (β = 0.087, p = 0.011). BE symptoms were associated with suicide attempt in MDD after adjusting for other factors associated with suicidality. BE symptoms also moderated an association between suicide attempt and sexual trauma.
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Affiliation(s)
- Ji Hyun Baek
- Department of Psychiatry, Depression Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Kiwon Kim
- Department of Psychiatry, Depression Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Jin Pyo Hong
- Department of Psychiatry, Depression Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Maeng Je Cho
- Department of Psychiatry & Behavioral Science, Seoul National University College of Medicine, Seoul, South Korea
| | - Maurizio Fava
- Depression Clinical and Research Program, Massachusetts General Hospital, Harvard Medical School, Boston, United States of America
| | - David Mischoulon
- Depression Clinical and Research Program, Massachusetts General Hospital, Harvard Medical School, Boston, United States of America
| | - Sung Man Chang
- Department of Psychiatry, School of Medicine, Kyungpook National University, Daegu, South Korea
| | - Ji Yeon Kim
- Department of Psychiatry, Depression Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Hana Cho
- Department of Physiology, Sungkyunkwan University School of Medicine, Samsung Biomedical Research Institute, Suwon, Korea
| | - Hong Jin Jeon
- Department of Psychiatry, Depression Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
- Department of Health Sciences & Technology, Department of Medical Device Management & Research, and Department of Clinical Research Design & Evaluation, Samsung Advanced Institute for Health Sciences & Technology (SAIHST), Sungkyunkwan University, Seoul, Korea
- * E-mail:
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Lenz B, Röther M, Bouna-Pyrrou P, Mühle C, Tektas OY, Kornhuber J. The androgen model of suicide completion. Prog Neurobiol 2018; 172:84-103. [PMID: 29886148 DOI: 10.1016/j.pneurobio.2018.06.003] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2017] [Revised: 09/02/2017] [Accepted: 06/05/2018] [Indexed: 10/14/2022]
Abstract
Suicide is a devastating public health issue that imposes severe psychological, social, and economic burdens not only for the individuals but also for their relatives, friends, clinicians, and the general public. Among the different suicidal behaviors, suicide completion is the worst and the most relevant outcome. The knowledge of biological etiopathological mechanisms involved in suicide completion is limited. Hitherto, no objective markers, either alone or in combination, can reliably predict who will complete a suicide. However, such parameters are strongly needed to establish and optimize prediction and prevention. We introduce here a novel ideation-to-completion framework in suicide research and discuss the problems of studies aiming at identifying and validating clinically useful markers. The male gender is a specific risk factor for suicide, which suggests that androgen effects are implicated in the transition from suicidal ideation to suicide completion. We present multiple lines of direct and indirect evidence showing that both an increased prenatal androgen load (with subsequent permanent neuroadaptations) and increased adult androgen activity are involved in suicide completion. We also review data arguing that modifiable maternal behavioral traits during pregnancy contribute to the offspring's prenatal androgen load and increase the risk for suicide completion later in life. We conclude that in utero androgen exposure and adult androgen levels facilitate suicide completion in an synergistic manner. The androgen model of suicide completion provides the basis for the development of novel predictive and preventive strategies in the future.
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Affiliation(s)
- Bernd Lenz
- Department of Psychiatry and Psychotherapy, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Germany.
| | - Mareike Röther
- Department of Psychiatry and Psychotherapy, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Germany
| | - Polyxeni Bouna-Pyrrou
- Department of Psychiatry and Psychotherapy, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Germany
| | - Christiane Mühle
- Department of Psychiatry and Psychotherapy, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Germany
| | - Ozan Y Tektas
- Department of Psychiatry and Psychotherapy, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Germany
| | - Johannes Kornhuber
- Department of Psychiatry and Psychotherapy, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Germany
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Kim H, Jeon HJ, Bae JN, Cho MJ, Cho SJ, Lee H, Hong JP. Association of Body Mass Index with Suicide Behaviors, Perceived Stress, and Life Dissatisfaction in the Korean General Population. Psychiatry Investig 2018; 15:272-278. [PMID: 29486542 PMCID: PMC5900366 DOI: 10.30773/pi.2017.06.28] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2017] [Revised: 04/25/2017] [Accepted: 06/28/2017] [Indexed: 01/31/2023] Open
Abstract
OBJECTIVE The purpose of the present study was to investigate the association between Body Mass Index, suicide, perceived stress, and life dissatisfaction in a general population sample of Korean adults. METHODS A total of 6,022 nationally representative adults aged 18 to 74 were selected using a multistage cross-sectional cluster sampling method. Questionnaires regarding suicide behaviors, perceived stress, and life satisfaction were completed by the participants. They also reported their heights and weights, which were used to calculate BMI. Psychiatric disorders were diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, using the Korean version of the Composite International Diagnostic Interview. RESULTS The results showed that being underweight was associated with higher risk for suicide ideation [odds ratio (OR), 1.6; 95% confidence interval (Cl), 1.18-2.05] and suicide attempt (OR, 2.0, 95% Cl, 1.23-3.31). Likewise, obesity also increased the risk of suicide ideation (OR, 1.3; 95% Cl, 1.11-1.56) although not suicide attempt. Furthermore, underweight individuals were more likely to report severe level of perceived stress (OR, 1.7; 95% Cl, 1.26-2.17) and life dissatisfaction (OR, 1.3; 95% Cl, 1.07-1.68). All of the results remained significant after adjusting for age, gender, education, and psychiatric illnesses. CONCLUSION This study found that being underweight is a significant risk factor for suicide and poor subjective wellbeing in Korea. It suggests that BMI status may be an important modifiable factor for improving mental health in Korea.
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Affiliation(s)
- Haesoo Kim
- Department of Psychiatry, Samsung Medical Center, Seoul, Republic of Korea
| | - Hong Jin Jeon
- Department of Psychiatry, Samsung Medical Center, Sungkyunkwan University School of Medicine, Samsung Social Mental Health Institute, Seoul, Republic of Korea
| | - Jae Nam Bae
- Department of Psychiatry, Inha University College of Medicine, Incheon, Republic of Korea
| | - Maeng Je Cho
- Department of Psychiatry & Behavioral Science, Institute of Human Behavioral Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Seong Jin Cho
- Department of Psychiatry, Gachon Medical School, Incheon, Republic of Korea
| | - Hyochul Lee
- Department of Psychiatry, Samsung Medical Center, Seoul, Republic of Korea
| | - Jin Pyo Hong
- Department of Psychiatry, Samsung Medical Center, Sungkyunkwan University School of Medicine, Samsung Social Mental Health Institute, Seoul, Republic of Korea
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Consoloni JL, Ibrahim EC, Lefebvre MN, Zendjidjian X, Olié E, Mazzola-Pomietto P, Desmidt T, Samalin L, Llorca PM, Abbar M, Lopez-Castroman J, Haffen E, Baumstarck K, Naudin J, Azorin JM, El-Hage W, Courtet P, Belzeaux R. Serotonin transporter gene expression predicts the worsening of suicidal ideation and suicide attempts along a long-term follow-up of a Major Depressive Episode. Eur Neuropsychopharmacol 2018; 28:401-414. [PMID: 29287766 DOI: 10.1016/j.euroneuro.2017.12.015] [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] [Received: 06/16/2017] [Revised: 12/05/2017] [Accepted: 12/08/2017] [Indexed: 12/27/2022]
Abstract
The quest for biomarkers in suicidal behaviors has been elusive so far, despite their potential utility in clinical practice. One of the most robust biological findings in suicidal behaviors is the alteration of the serotonin transporter function in suicidal individuals. Our main objective was to investigate the predictive value of the serotonin transporter gene expression (SLC6A4) for suicidal ideation and as secondary, for suicide attempts in individuals with a major depressive episode (MDE). A 30-week prospective study was conducted on 148 patients with a MDE and 100 healthy controls including 4 evaluation times (0, 2, 8 and 30 weeks). Blood samples and clinical data were collected and SLC6A4 mRNA levels were measured from peripheral blood mononuclear cells using RT-qPCR. We first demonstrated the stability and reproducibility of SLC6A4 mRNA expression measures over time in healthy controls (F=0.658; p=0.579; η2=0.008; ICC=0.91, 95% CI [0.87-0.94]). Baseline SLC6A4 expression level (OR=0.563 [0.340-0.932], p=0.026) as well as early changes in SLC6A4 expression between baseline and the 2nd week (β=0.200, p=0.042) predicted the worsening of suicidal ideation (WSI) in the following 8 weeks. Moreover, changes in SLC6A4 expression between the 2nd and 8th weeks predicted the occurrence of a suicide attempt within 30 weeks (OR=10.976 [1.438-83.768], p=0.021). Altogether, the baseline level and the changes in SLC6A4 mRNA expression during a MDE might predict the WSI and the occurrence of suicidal attempts and could be a useful biomarker in clinical practice.
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Affiliation(s)
- Julia-Lou Consoloni
- APHM, Department of psychiatry, Marseille, France; Aix Marseille Univ, CNRS, CRN2M, UMR 7286, Marseille, France; Fondation FondaMental, Fondation de Recherche et de Soins en Santé Mentale, Créteil, France
| | - El Chérif Ibrahim
- Aix Marseille Univ, CNRS, CRN2M, UMR 7286, Marseille, France; Fondation FondaMental, Fondation de Recherche et de Soins en Santé Mentale, Créteil, France; Aix Marseille Univ, CNRS, INT, Inst Neurosci Timone, Marseille, France
| | | | - Xavier Zendjidjian
- APHM, Department of psychiatry, Marseille, France; Aix Marseille Univ, SPMC, EA 3279, Public Health, Chronic Diseases and Quality of Life - Research Unit, Marseille, France
| | - Emilie Olié
- Fondation FondaMental, Fondation de Recherche et de Soins en Santé Mentale, Créteil, France; Department of Emergency Psychiatry and Acute Care, CHU Montpellier, France; Inserm, U1061, University of Montpellier, Montpellier, France
| | | | - Thomas Desmidt
- CHRU de Tours, Clinique Psychiatrique Universitaire, Tours, France; Inserm U1253 Imaging & Brain, Université de Tours, Tours, France
| | - Ludovic Samalin
- Fondation FondaMental, Fondation de Recherche et de Soins en Santé Mentale, Créteil, France; CHU Clermont-Ferrand, Department of Psychiatry, EA 7280, University of Clermont Auvergne, Clermont-Ferrand, France
| | - Pierre-Michel Llorca
- Fondation FondaMental, Fondation de Recherche et de Soins en Santé Mentale, Créteil, France; CHU Clermont-Ferrand, Department of Psychiatry, EA 7280, University of Clermont Auvergne, Clermont-Ferrand, France
| | - Mocrane Abbar
- Department of Adult Psychiatry, CHRU Nimes, Nimes, France
| | - Jorge Lopez-Castroman
- Inserm, U1061, University of Montpellier, Montpellier, France; Department of Adult Psychiatry, CHRU Nimes, Nimes, France
| | - Emmanuel Haffen
- Fondation FondaMental, Fondation de Recherche et de Soins en Santé Mentale, Créteil, France; Department of Clinical Psychiatry, University Hospital, Besançon, France; EA 481, Laboratory of Neurosciences, University of Franche-Comté, Besançon, France; CIC-1431 Inserm, University Hospital, Besançon, France
| | - Karine Baumstarck
- Aix Marseille Univ, SPMC, EA 3279, Public Health, Chronic Diseases and Quality of Life - Research Unit, Marseille, France
| | - Jean Naudin
- APHM, Department of psychiatry, Marseille, France
| | - Jean-Michel Azorin
- APHM, Department of psychiatry, Marseille, France; Fondation FondaMental, Fondation de Recherche et de Soins en Santé Mentale, Créteil, France; Aix Marseille Univ, CNRS, INT, Inst Neurosci Timone, Marseille, France
| | - Wissam El-Hage
- CHRU de Tours, Clinique Psychiatrique Universitaire, Tours, France; Inserm U1253 Imaging & Brain, Université de Tours, Tours, France; Inserm CIC 1415, Centre d'Investigation Clinique, CHRU de Tours, Tours, France
| | - Philippe Courtet
- Fondation FondaMental, Fondation de Recherche et de Soins en Santé Mentale, Créteil, France; Department of Emergency Psychiatry and Acute Care, CHU Montpellier, France; Inserm, U1061, University of Montpellier, Montpellier, France
| | - Raoul Belzeaux
- APHM, Department of psychiatry, Marseille, France; Aix Marseille Univ, CNRS, CRN2M, UMR 7286, Marseille, France; Fondation FondaMental, Fondation de Recherche et de Soins en Santé Mentale, Créteil, France; McGill Group for Suicide Studies, Department of Psychiatry, McGill University, Douglas Mental Health University Institute, Montreal, QC, Canada.
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Hartzell JW, Geary R, Gyure K, Chivukula VR, Haut MW. Completed suicide in an autopsy-confirmed case of early onset Alzheimer's disease. Neurodegener Dis Manag 2018; 8:81-88. [PMID: 29319406 PMCID: PMC6367712 DOI: 10.2217/nmt-2017-0045] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
We report a case of a 57-year-old male with clinically diagnosed and autopsy-confirmed early onset Alzheimer's disease who completed suicide by gunshot wound to the chest. This case has several unique aspects that have not been discussed in previous case reports of completed suicide in Alzheimer's disease. In particular, our patient's death was highly planned with successful compensation for his cognitive deficits. After all firearms had been removed from the home as a safety precaution, he obtained a new weapon, hid it and left himself cues to find and use it. The case is discussed in the context of literature differentiating the neural circuitry propagating impulsive versus planned suicidal acts.
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Affiliation(s)
- Jennifer Wiener Hartzell
- Department of Supportive Oncology, Levine Cancer Institute, Carolinas HealthCare System, NC 28202, USA.,Department of Neuropsychology & Psychology, Carolinas Rehabilitation, Carolinas HealthCare System, NC 28203, USA
| | - Richard Geary
- Department of Psychiatry, Overlake Medical Center, WA 98004, USA
| | - Kymberly Gyure
- Department of Pathology, West Virginia University School of Medicine, WV 26506, USA.,Department of Neurology, West Virginia University School of Medicine, WV 26506, USA.,Department of Neurosurgery, West Virginia University School of Medicine, WV 26506, USA
| | - Venkata Ravi Chivukula
- Department of Behavioral Medicine & Psychiatry, West Virginia University School of Medicine, WV 26505, USA
| | - Marc W Haut
- Department of Neurology, West Virginia University School of Medicine, WV 26506, USA.,Department of Behavioral Medicine & Psychiatry, West Virginia University School of Medicine, WV 26505, USA.,Department of Radiology, West Virginia University School of Medicine, WV 26506, USA
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Icick R, Karsinti E, Lépine JP, Bloch V, Brousse G, Bellivier F, Vorspan F. Serious suicide attempts in outpatients with multiple substance use disorders. Drug Alcohol Depend 2017; 181:63-70. [PMID: 29035706 DOI: 10.1016/j.drugalcdep.2017.08.037] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2017] [Revised: 08/29/2017] [Accepted: 08/30/2017] [Indexed: 12/17/2022]
Abstract
BACKGROUND Suicide is a major public health concern and suicide attempts (SA) are frequent and burdensome in people suffering from substance use disorders (SUDs). In particular, serious SAs are a preoccupying form of attempt, which remain largely overlooked in these populations, especially regarding basic risk factors such as gender, addictive comorbidity and substance use patterns. Thus, we undertook a gender-specific approach to identify the risk factors for serious SAs in outpatients with multiple SUDs. MATERIAL AND METHODS 433 Treatment-seeking outpatients were consecutively recruited in specialized care centers and reliably classified as serious, non-serious and non-suicide attempters. We also characterized lifetime exposure to SUDs, including tobacco smoking, with standardized instruments. Current medication, including psychotropic treatments were collected, which informed psychiatric diagnoses. Multinomial regression identified independent factors specifically associated with serious SAs in each gender, separately. RESULTS 32% Participants (N=139, 47% Women and 27% Men) reported lifetime SA. There were 82 serious attempters (59% of attempters), without significant gender difference. Sedative dependence was an independent risk factor for serious SA compared to non-SA in Women and compared to non-serious SA in Men, respectively. Other risk factors included later onset of daily tobacco smoking in Men and history of psychiatric hospitalizations in Women, whose serious SA risk was conversely lower when reporting opiate use disorder or mood disorder, probably because of treatment issues. CONCLUSIONS Despite several study limitations, we identified subgroups for a better-tailored prevention of serious SAs among individuals with SUDs, notably highlighting the need to better prevent and treat sedative dependence.
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Affiliation(s)
- R Icick
- Assistance Publique - Hôpitaux de Paris (AP-HP), Department of Psychiatry and Addiction Medicine, Groupe Hospitalier Saint-Louis - Lariboisière - Fernand Widal, Paris F-75010, France; INSERM U1144, Paris, F-75006, France; Paris Descartes University, Inserm UMR-S1144, Paris, F-75006, France; Paris Diderot University, Sorbonne Paris Cité, Inserm UMR-S1144, Paris, F-75013, France; FondaMental Foundation, Créteil, F-94000, France.
| | - E Karsinti
- Assistance Publique - Hôpitaux de Paris (AP-HP), Department of Psychiatry and Addiction Medicine, Groupe Hospitalier Saint-Louis - Lariboisière - Fernand Widal, Paris F-75010, France; INSERM U1144, Paris, F-75006, France; Paris Descartes University, Inserm UMR-S1144, Paris, F-75006, France; Paris Diderot University, Sorbonne Paris Cité, Inserm UMR-S1144, Paris, F-75013, France
| | - J-P Lépine
- Assistance Publique - Hôpitaux de Paris (AP-HP), Department of Psychiatry and Addiction Medicine, Groupe Hospitalier Saint-Louis - Lariboisière - Fernand Widal, Paris F-75010, France; INSERM U1144, Paris, F-75006, France; Paris Descartes University, Inserm UMR-S1144, Paris, F-75006, France; Paris Diderot University, Sorbonne Paris Cité, Inserm UMR-S1144, Paris, F-75013, France
| | - V Bloch
- INSERM U1144, Paris, F-75006, France; Paris Descartes University, Inserm UMR-S1144, Paris, F-75006, France; Paris Diderot University, Sorbonne Paris Cité, Inserm UMR-S1144, Paris, F-75013, France; Hospital Pharmacy, Groupe Hospitalier Saint-Louis - Lariboisière - Fernand Widal, Paris F-75010, France
| | - G Brousse
- Psychiatry B-Department of Addiction Psychiatry, Université Clermont 1, UFR Médecine, EA7280, Clermont-Ferrand, France; CHU Clermont-Ferrand, Clermont-Ferrand, F-63003, France
| | - F Bellivier
- Assistance Publique - Hôpitaux de Paris (AP-HP), Department of Psychiatry and Addiction Medicine, Groupe Hospitalier Saint-Louis - Lariboisière - Fernand Widal, Paris F-75010, France; INSERM U1144, Paris, F-75006, France; Paris Descartes University, Inserm UMR-S1144, Paris, F-75006, France; Paris Diderot University, Sorbonne Paris Cité, Inserm UMR-S1144, Paris, F-75013, France; FondaMental Foundation, Créteil, F-94000, France
| | - F Vorspan
- Assistance Publique - Hôpitaux de Paris (AP-HP), Department of Psychiatry and Addiction Medicine, Groupe Hospitalier Saint-Louis - Lariboisière - Fernand Widal, Paris F-75010, France; INSERM U1144, Paris, F-75006, France; Paris Descartes University, Inserm UMR-S1144, Paris, F-75006, France; Paris Diderot University, Sorbonne Paris Cité, Inserm UMR-S1144, Paris, F-75013, France
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Abstract
OBJECTIVE The main aim of the current study was to investigate epigenetic alterations in serotonin 2A receptor (HTR2A) exon I CpG sites as possible risk factors for suicidal behavior. We also aimed to analyze the epigenetic alterations in two different tissues as epigenetic mechanisms are tissue specific. These epigenetic changes may lead to a better prediction of suicidal behavior. METHODS Direct CpG methylation analysis was carried out on genomic DNA from the saliva of 20 schizophrenia suicide attempters and 27 non-attempters, and from post-mortem brain tissues of nine suicide victims and 11 controls. We used bisulfite pyrosequencing to assess the contributions of six CpG sites including the rs6313 (C102T) site in the first exon of HTR2A in suicide attempters and suicide victims. RESULTS DNA methylation analysis did not find a significant difference in CpG methylation between suicide attempters and non-attempters (P=0.759) or between suicide victims and controls (P=0.189). We found a strong positive correlation between CpG methylation levels in blood and saliva (r=0.547, P<0.001). DISCUSSION DNA methylation analysis confirmed that the overall methylation level of HTR2A exon I was around 80% for DNA extracted from saliva and almost 30% in the frontal cortex DNA. The results of this investigation do not support the evidence that methylation analysis of the HTR2A may be useful for investigating the epigenetic factors involved in suicidal behavior.
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Chen L, Miao Z, Xu X. β-hydroxybutyrate alleviates depressive behaviors in mice possibly by increasing the histone3-lysine9-β-hydroxybutyrylation. Biochem Biophys Res Commun 2017; 490:117-122. [DOI: 10.1016/j.bbrc.2017.05.184] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2017] [Accepted: 05/24/2017] [Indexed: 01/09/2023]
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Tayyab M, Shahi MH, Farheen S, Mariyath MPM, Khanam N, Castresana JS, Hossain MM. Sonic hedgehog, Wnt, and brain-derived neurotrophic factor cell signaling pathway crosstalk: potential therapy for depression. J Neurosci Res 2017. [PMID: 28631844 DOI: 10.1002/jnr.24104] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
There are various theories to explain the pathophysiology of depression and support its diagnosis and treatment. The roles of monoamines, brain-derived neurotrophic factor (BDNF), and Wnt signaling are well researched, but sonic hedgehog (Shh) signaling and its downstream transcription factor Gli1 are not well studied in depression. Shh signaling plays a fundamental role in embryonic development and adult hippocampal neurogenesis and also involved in the growth of cancer. In this article, we summarize the evidence for the Shh signaling pathway in depression and the potential crosstalk of Shh with Wnt and BDNF. Antidepressants are known to upregulate the adult hippocampal neurogenesis to treat depression. Shh plays an important role in adult hippocampal neurogenesis, and its downstream signaling components regulate the synthesis of Wnt proteins. Moreover, the expression of Gli1 and Smo is downregulated in depression. BDNF and Wnt signaling are also regulated by various available antidepressants, so there is the possibility that Shh may be involved in the pathophysiology of depression. Therefore, the crosstalk between the Shh, Wnt, and BDNF signaling pathways is being discussed to identify the potential targets. Specifically, the potential role of the Shh signaling pathway in depression is explored as a new target for better therapies for depression.
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Affiliation(s)
- Mohd Tayyab
- Interdisciplinary Brain Research Centre, Faculty of Medicine, Aligarh Muslim University, Aligarh, India
| | - Mehdi H Shahi
- Interdisciplinary Brain Research Centre, Faculty of Medicine, Aligarh Muslim University, Aligarh, India
| | - Shirin Farheen
- Interdisciplinary Brain Research Centre, Faculty of Medicine, Aligarh Muslim University, Aligarh, India
| | - Mubeena P M Mariyath
- Interdisciplinary Brain Research Centre, Faculty of Medicine, Aligarh Muslim University, Aligarh, India
| | - Nabeela Khanam
- Interdisciplinary Brain Research Centre, Faculty of Medicine, Aligarh Muslim University, Aligarh, India
| | - Javier S Castresana
- Department of Biochemistry and Genetics, University of Navarra, Faculty of Sciences, Pamplona, Spain
| | - M Mobarak Hossain
- Interdisciplinary Brain Research Centre, Faculty of Medicine, Aligarh Muslim University, Aligarh, India.,Department of Physiology, JNMC, Faculty of Medicine, Aligarh Muslim University, Aligarh, India
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Cui X, Niu W, Kong L, He M, Jiang K, Chen S, Zhong A, Li W, Lu J, Zhang L. Long noncoding RNA expression in peripheral blood mononuclear cells and suicide risk in Chinese patients with major depressive disorder. Brain Behav 2017; 7:e00711. [PMID: 28638716 PMCID: PMC5474714 DOI: 10.1002/brb3.711] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND WHO stated that nearly one million people commit suicide every year worldly, and 40% of the suicide completer suffered from depression. The primary aim of this study was to explore the association between long noncoding RNAs (lncRNAs) expression in peripheral blood mononuclear cells (PBMCs) and suicide risk of patients with major depressive disorder (MDD). METHODS Using Human LncRNA 3.0 microarray profiling which includes 30,586 human lncRNAs and RT-PCR, six down-regulated lncRNAs were identified differentially expressed in MDD patients. According to suicidal ideation and suicidal attempt, the suicide risk of MDD patients was classified into suicidal ideation versus no suicidal ideation groups, and past attempt versus no past attempt groups, respectively. The expression of six lncRNAs in MDD patients and controls were examined by RT-PCR. RESULTS The expression of six lncRNAs had significant differences between no suicidal ideation, suicidal ideation, and controls; corresponding lncRNAs associated with suicidal attempt had remarkable differences between no past attempt, past attempt, and controls. Additionally, only the expression of lncRNAs in suicidal ideation group and past attempt group markedly declined compared with controls. CONCLUSIONS This study indicated that the expression of six down-regulated lncRNAs had a negative association with suicide risk in MDD patients, and the expression of lncRNAs in PBMCs could have the potential to help clinician judge the suicide risk of MDD patients to provide timely treatment and prevent suicide.
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Affiliation(s)
- Xuelian Cui
- Health Care Department Changzhou Maternity and Child Health Care Hospital Affiliated with Nanjing Medical University Changzhou China
| | - Wei Niu
- Department of Rehabilitation No. 102 Hospital of Chinese People's Liberation Army Changzhou China
| | - Lingming Kong
- Prevention and Treatment Center for Psychological Diseases No.102 Hospital of Chinese People's Liberation Army Changzhou China
| | - Mingjun He
- Prevention and Treatment Center for Psychological Diseases No.102 Hospital of Chinese People's Liberation Army Changzhou China
| | - Kunhong Jiang
- Prevention and Treatment Center for Psychological Diseases No.102 Hospital of Chinese People's Liberation Army Changzhou China
| | - Shengdong Chen
- Department of Neurology No.102 Hospital of Chinese People's Liberation Army Changzhou China
| | - Aifang Zhong
- Department of Laboratory No.102 Hospital of Chinese People's Liberation Army Changzhou China
| | - Wanshuai Li
- Gopath Diagnostic Laboratory Co. Ltd Changzhou China
| | - Jim Lu
- Gopath Diagnostic Laboratory Co. Ltd Changzhou China.,Gopath Laboratories LLC Buffalo Grove IL USA
| | - Liyi Zhang
- Prevention and Treatment Center for Psychological Diseases No.102 Hospital of Chinese People's Liberation Army Changzhou China
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Fudalej S, Klimkiewicz A, Mach A, Jakubczyk A, Fudalej M, Wasilewska K, Podgórska A, Krajewski P, Płoski R, Wojnar M. An association between genetic variation in the glutamatergic system and suicide attempts in alcohol-dependent individuals. Am J Addict 2017; 26:595-601. [DOI: 10.1111/ajad.12571] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2016] [Revised: 03/19/2017] [Accepted: 05/11/2017] [Indexed: 12/21/2022] Open
Affiliation(s)
- Sylwia Fudalej
- Department of Psychiatry; Medical University of Warsaw; Warsaw Poland
| | - Anna Klimkiewicz
- Department of Psychiatry; Medical University of Warsaw; Warsaw Poland
| | - Anna Mach
- Department of Psychiatry; Medical University of Warsaw; Warsaw Poland
| | - Andrzej Jakubczyk
- Department of Psychiatry; Medical University of Warsaw; Warsaw Poland
| | - Marcin Fudalej
- Department of Forensic Medicine; Medical University of Warsaw; Warsaw Poland
| | | | - Anna Podgórska
- The Institute of Physiology and Pathology of Hearing; Kajetany Poland
| | - Paweł Krajewski
- Department of Forensic Medicine; Medical University of Warsaw; Warsaw Poland
| | - Rafał Płoski
- Department of Medical Genetics; Medical University of Warsaw; Warsaw Poland
| | - Marcin Wojnar
- Department of Psychiatry; Medical University of Warsaw; Warsaw Poland
- Department of Psychiatry; University of Michigan; Ann Arbor Michigan
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Ludwig B, Roy B, Wang Q, Birur B, Dwivedi Y. The Life Span Model of Suicide and Its Neurobiological Foundation. Front Neurosci 2017; 11:74. [PMID: 28261051 PMCID: PMC5306400 DOI: 10.3389/fnins.2017.00074] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2016] [Accepted: 01/31/2017] [Indexed: 01/19/2023] Open
Abstract
The very incomprehensibility of the suicidal act has been occupying the minds of researchers and health professionals for a long time. Several theories of suicide have been proposed since the beginning of the past century, and a myriad of neurobiological studies have been conducted over the past two decades in order to elucidate its pathophysiology. Both neurobiology and psychological theories tend to work in parallel lines that need behavioral and empirical data respectively, to confirm their hypotheses. In this review, we are proposing a "Life Span Model of Suicide" with an attempt to integrate the "Stress-Diathesis Model" and the "Interpersonal Model of Suicide" into a neurobiological narrative and support it by providing a thorough compilation of related genetic, epigenetic, and gene expression findings. This proposed model comprises three layers, forming the capability of suicide: genetic factors as the predisposing Diathesis on one side and Stress, characterized by epigenetic marks on the other side, and in between gene expression and gene function which are thought to be influenced by Diathesis and Stress components. The empirical evidence of this model is yet to be confirmed and further research, specifically epigenetic studies in particular, are needed to support the presence of a life-long, evolving capability of suicide and identify its neurobiological correlates.
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Affiliation(s)
| | | | | | | | - Yogesh Dwivedi
- UAB Mood Disorder Program, Department of Psychiatry and Behavioral Neurobiology, University of Alabama at BirminghamBirmingham, AL, USA
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Abstract
High levels of stress are common among young adults, particularly those enrolled in college. These degrees of stress have shown numerous deleterious effects across both academic and health variables. Findings regarding the role of stress in the presentation of impulse control disorders, particular among college students, are limited. This study examined potential associations between perceived stress, academic achievement, physical/mental health, and impulse control disorders in young adults. A total of 1805 students completed an online survey and were included in the analysis. Responders were grouped by their overall score on the Perceived Stress Scale into mild, moderate, or severe. Severe perceived stress was associated with worse academic achievement and worse physical health, as well as higher rates of psychiatric and impulsive disorders. These findings may suggest associations between stress and numerous aspects of mental/physical health in young adults, which could be an important consideration for individuals working with college students.
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Prefrontal changes in the glutamate-glutamine cycle and neuronal/glial glutamate transporters in depression with and without suicide. J Psychiatr Res 2016; 82:8-15. [PMID: 27450072 DOI: 10.1016/j.jpsychires.2016.06.017] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2015] [Revised: 06/24/2016] [Accepted: 06/24/2016] [Indexed: 12/13/2022]
Abstract
There are indications for changes in glutamate metabolism in relation to depression or suicide. The glutamate-glutamine cycle and neuronal/glial glutamate transporters mediate the uptake of the glutamate and glutamine. The expression of various components of the glutamate-glutamine cycle and the neuronal/glial glutamate transporters was determined by qPCR in postmortem prefrontal cortex. The anterior cingulate cortex (ACC) and the dorsolateral prefrontal cortex (DLPFC) were selected from young MDD patients who had committed suicide (MDD-S; n = 17), from MDD patients who died of non-suicide related causes (MDD-NS; n = 7) and from matched control subjects (n = 12). We also compared elderly depressed patients who had not committed suicide (n = 14) with matched control subjects (n = 22). We found that neuronal located components (EAAT3, EAAT4, ASCT1, SNAT1, SNAT2) of the glutamate-glutamine cycle were increased in the ACC while the astroglia located components (EAAT1, EAAT2, GLUL) were decreased in the DLPFC of MDD-S patients. In contrast, most of the components in the cycle were increased in the DLPFC of MDD-NS patients. In conclusion, the glutamate-glutamine cycle - and thus glutamine transmission - is differentially affected in depressed suicide patients and depressed non-suicide patients in an area specific way.
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De la Cruz-Cano E. Association between FKBP5 and CRHR1 genes with suicidal behavior: A systematic review. Behav Brain Res 2016; 317:46-61. [PMID: 27638035 DOI: 10.1016/j.bbr.2016.09.032] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2016] [Revised: 09/08/2016] [Accepted: 09/12/2016] [Indexed: 12/26/2022]
Abstract
Suicide is one of the leading causes of death around the world with approximately one million suicides per year. An increasing number of neurobiological studies implicate HPA system dysfunction in suicide behavior, stimulating genetic research to focus on genes related to this system. This systematic review was focused on searching a correlation between FKBP5 and CRHR1 genes with suicidal behavior. Therefore, an electronic search strategy, using PubMed, EBSCO and Cochrane Library databases, was conducted from the inception of the studies into the databases to July 2016. The inclusion criteria were: use of at least one analysis investigating the relation between either the genetic variants in FKBP5 and/or CRHR1 genes with suicidal behavior. 2) use of a case-control design; 3) investigation about suicidal behavior in the form of suicide completion or history of at least one suicide attempt, as defined by each individual study; 4) inclusion of samples comprising control subjects; and 6) inclusion of reports written only in English language. The PRISMA guidelines were followed and the search strategy ensured that all possible studies were identified to compile the review. Using the keyword combinations, the search strategy provided 3334 articles, of which only 15 case-control studies were included in this systematic review. The included studies comprised 2526 subjects with suicidal behavior. A quantitative synthesis of results from the included studies was not undertaken due to marked methodological heterogeneity. This review showed a significant genetic association in most studies in FKBP5 and CRHR1 genes with a high rate of attempted suicide, pointing out that the expression of these genes and its polymorphisms could be a key predictor of suicide risk. In conclusion, this systematic review supports an association between suicidal behavior and genetic variants in FKBP5 and CRHR1 genes.
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Affiliation(s)
- Eduardo De la Cruz-Cano
- División Académica de Ciencias de la Salud, Universidad Juárez Autónoma de Tabasco, Villahermosa, Tabasco, C.P. 86100, Mexico; Secretaría de Salud, Hospital General de Comalcalco, Departamento de Laboratorio de Análisis Clínicos, Comalcalco, Tabasco C.P. 86300, Mexico.
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