1
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Hu FH, Jia YJ, Zhao DY, Fu XL, Zhang WQ, Tang W, Hu SQ, Wu H, Ge MW, Du W, Shen WQ, Chen HL. Gender differences in suicide among patients with bipolar disorder: A systematic review and meta-analysis. J Affect Disord 2023; 339:601-614. [PMID: 37467799 DOI: 10.1016/j.jad.2023.07.060] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 07/10/2023] [Accepted: 07/11/2023] [Indexed: 07/21/2023]
Abstract
OBJECTIVE To examine gender differences in suicidal ideation, suicide attempts, and suicide deaths in patients with bipolar disorder. METHODS PubMed, Web of Science, and Embase were systematic searched from inception to March 7, 2023. Two reviewers extract data independently. Demographic data, the number of males and females with bipolar disorder, and the number of individuals with suicidal ideation, suicide attempts, and suicide deaths among participants were extracted. RESULTS The pooled prevalence of suicidal ideation in males and females was 48.0 % and 44.0 %, respectively, and the overall male-to-female ratios present a statistically insignificant result (OR = 0.95, 95%CI = 0.75-1.21) among patients with bipolar disorder. The pooled prevalence of suicide attempts in males and females was 6.7 % and 9.3 %, respectively, and there was a statistically significant lower prevalence among male patients with bipolar disorder (OR = 0.71, 95%CI = 0.67-0.75). However, the pooled prevalence of suicide deaths in males and females was 0.7 % and 0.3 % respectively, and there was a statistically significant higher prevalence among male patients with bipolar disorder (OR = 1.86, 95%CI = 1.63-2.13). LIMITATIONS The included studies were from mainly middle- and high-income countries and used inconsistent measurement tools. Thus, there is a potential for bias in our results. CONCLUSIONS Among patients with bipolar disorder, females were found to have a higher prevalence of suicide attempts, while males have a higher prevalence of suicide deaths. However, there is no significant gender difference in suicidal ideation. Efforts to optimize recognition, treatment, and administration in males and females may reduce gender differences.
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Affiliation(s)
- Fei-Hong Hu
- Medical School of Nantong University, Nantong, Jiangsu, PR China
| | - Yi-Jie Jia
- Medical School of Nantong University, Nantong, Jiangsu, PR China
| | - Dan-Yan Zhao
- Medical School of Nantong University, Nantong, Jiangsu, PR China
| | - Xue-Lei Fu
- Medical School of Nantong University, Nantong, Jiangsu, PR China
| | - Wan-Qing Zhang
- Medical School of Nantong University, Nantong, Jiangsu, PR China
| | - Wen Tang
- Medical School of Nantong University, Nantong, Jiangsu, PR China
| | - Shi-Qi Hu
- Medical School of Nantong University, Nantong, Jiangsu, PR China
| | - Hua Wu
- Medical School of Nantong University, Nantong, Jiangsu, PR China
| | - Meng-Wei Ge
- Medical School of Nantong University, Nantong, Jiangsu, PR China
| | - Wei Du
- Medical School of Nantong University, Nantong, Jiangsu, PR China
| | - Wang-Qin Shen
- Medical School of Nantong University, Nantong, Jiangsu, PR China
| | - Hong-Lin Chen
- School of Public Health, Nantong University, Nantong, Jiangsu, PR China.
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2
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Hong S, Jeon HJ, Ha JH. Differences in temperament and character inventory (TCI) profile between suicidal and nonsuicidal psychiatric outpatients. Medicine (Baltimore) 2022; 101:e30202. [PMID: 36107514 PMCID: PMC9439834 DOI: 10.1097/md.0000000000030202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
The purpose of this study was to identify personality traits associated with suicide attempt in a clinical sample. Temperament and character inventory (TCI) profiles of 759 patients who met the inclusion criteria among 1000 randomly selected hospital records collected. Of these 759 patients, 103 had a history of at least 1 actual suicide attempt (suicidal group) whereas 656 had no such history (nonsuicidal group). The suicidal group showed higher scores of novelty seeking (mean ± SD: 36.1 ± 1.2 vs 33.3 ± 0.5; P = .026) and harm avoidance (57.1 ± 1.5 vs 53.0 ± 0.6; P = .01) but lower scores of self-directedness (27.5 ± 1.5 vs 34.4 ± 0.6; P < .001) than the nonsuicidal group. Higher novelty seeking (OR [95% CI]: 1.031 [1.008-1.054]; P = .007) and lower self-directedness: 0.955 [0.927-0.983]; P = .002 were also associated with suicide attempts in the analysis of 7 personality scales. These findings suggest that patients who attempt suicide differ from nonattempters in terms of personality traits, especially in novelty seeking (NS), harm avoidance (HA), and self-directedness (SD). It is noteworthy that this study contains data from actual visits to the emergency room to evaluate suicide attempts. Abbreviations: CO = cooperativeness, Ha = harm avoidance, NS = novelty seeking, PS = persistence, RD = reward dependence, SD = self-directedness, ST = self-transcendence, TCI = temperament and character inventory.
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Affiliation(s)
- Sumin Hong
- Department of Psychiatry, Konkuk University Medical Center, Seoul, Korea
| | - Hong Jun Jeon
- Department of Psychiatry, Konkuk University Medical Center, Seoul, Korea
- Department of Psychiatry, School of Medicine, Konkuk University, Seoul, Korea
| | - Jee Hyun Ha
- Department of Psychiatry, Konkuk University Medical Center, Seoul, Korea
- Department of Psychiatry, School of Medicine, Konkuk University, Seoul, Korea
- *Correspondence: Jee Hyun Ha, Department of Psychiatry, Konkuk University Medical Center, 120-1 Neungdong-ro, Gwangjin-gu, Seoul 05030, Korea (e-mail: )
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3
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Subramanian K, Menon V, Sarkar S, Chandrasekaran V, Selvakumar N. Study of Risk Factors Associated with Suicide Attempt in Patients with Bipolar Disorder Type I. J Neurosci Rural Pract 2020; 11:291-298. [PMID: 32367986 PMCID: PMC7195972 DOI: 10.1055/s-0040-1709347] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
Background
Suicide is the leading contributor to mortality in bipolar disorder (BD). A history of suicidal attempt is a robust predictive marker for future suicide attempts. Personality profiles and coping strategies are the areas of contemporary research in bipolar suicides apart from clinical and demographic risk factors. However, similar research in developing countries is rarer.
Objectives
The present study aimed to identify the risk factors associated with suicidal attempts in BD type I (BD-I).
Materials and Methods
Patients with BD-I currently in clinical remission (
N
= 102) were recruited. Sociodemographic details and the clinical data were collected using a semistructured pro forma. The psychiatric diagnoses were confirmed using the Mini-International Neuropsychiatric Interview 5.0. The National Institute of Mental Health–Life Chart Methodology Clinician Retrospective Chart was used to chart the illness course. Presumptive Stressful Life Events Scale, Coping Strategies Inventory Short Form, Buss–Perry aggression questionnaire, Past Feelings and Acts of Violence, and Barratt Impulsivity scale were used to assess the patient’s stress scores, coping skills, aggression, violence, and impulsivity, respectively.
Statistical Analysis
Descriptive statistics were used for demographic details and characteristics of the illness course. Binary logistic regression analyses were performed to identify the predictors for lifetime suicide attempt in BD-I.
Results
A total of 102 patients (males = 49 and females = 53) with BD-I were included. Thirty-seven subjects (36.3%) had a history of suicide attempt. The illness course in suicide attempters more frequently had an index episode of depression, was encumbered with frequent mood episodes, especially in depression, and had a higher propensity for psychiatric comorbidities. On binary logistic regression analysis, the odds ratios (ORs) for predicting a suicide attempt were highest for positive family history of suicide (OR: 13.65, 95% confidence interval [CI]: 1.28–145.38,
p
= 0.030), followed by the presence of an index depressive episode (OR: 6.88, 95% CI: 1.70–27.91,
p
= 0.007), and lower scores on problem-focused disengagement (OR: 0.72, 95% CI: 0.56–0.92,
p
= 0.009).
Conclusion
BD-I patients with lifetime suicide attempt differ from non-attempters on various course-related and temperamental factors. However, an index episode depression, family history of suicide, and lower problem-focused engagement can predict lifetime suicide attempt in patients with BD-I.
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Affiliation(s)
- Karthick Subramanian
- Department of Psychiatry, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidyapeeth (Deemed-to-be University), Puducherry, India
| | - Vikas Menon
- Department of Psychiatry, JIPMER, Puducherry, India
| | - Siddharth Sarkar
- Department of Psychiatry and NDDTC, All India Institute of Medical Sciences, New Delhi, India
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4
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Monteiro C, Tavares E, Câmara A, Nobre J. Regulação molecular do ritmo circadiano e transtornos psiquiátricos: uma revisão sistemática. JORNAL BRASILEIRO DE PSIQUIATRIA 2020. [DOI: 10.1590/0047-2085000000258] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
RESUMO Objetivo O artigo possui como objetivo investigar os genes relógio que estão mais associados com os transtornos psiquiátricos, as funções e localizações desses genes, assim como investigar o principal transtorno, método e modelo considerados nas análises. O trabalho busca resumir os achados e discutir o impacto dessas pesquisas no conhecimento científico. Métodos Esta revisão utilizou-se de uma metodologia sistemática (Prospero; ID 152031) e seguiu as diretrizes PRISMA. A busca dos estudos foi realizada nas bases de dados PubMed/MEDLINE e Scientific Eletronic Library Online e foram utilizados os termos do Medical Subject Headings Terms . Foram selecionados estudos quantitativos com resultados conclusivos referentes à associação de transtornos psiquiátricos com a regulação molecular do ritmo circadiano. As informações úteis foram extraídas e utilizadas para a elaboração de gráficos e tabelas. Resultados Foram incluídos 24 artigos em nosso estudo. Observou-se que o transtorno bipolar consistiu no transtorno psiquiátrico mais abordado (40% dos estudos); a nacionalidade polonesa dos participantes também se destacou em 39% dos trabalhos. Adicionalmente, o gene PER foi o mais estudado (25%) e o córtex cerebral foi a principal região em que os genes relógio avaliados se expressam (34%). A PCR comum mostrou ser o método mais utilizado (38%) e o metabolismo da serotonina mostrou ser a principal função desempenhada pelos produtos gênicos (16%). Conclusões Em conjunto, os resultados sugerem que o transtorno bipolar consiste no distúrbio psiquiátrico mais prevalente entre as pesquisas relacionadas aos genes circadianos, expressos principalmente no córtex cerebral de humanos, em especial o gene PER .
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Affiliation(s)
| | | | - Alice Câmara
- Universidade Federal do Rio Grande do Norte, Brasil
| | - Jonas Nobre
- Universidade Federal do Rio Grande do Norte, Brasil
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5
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Prevalence of suicide attempts in bipolar disorder: a systematic review and meta-analysis of observational studies. Epidemiol Psychiatr Sci 2019; 29:e63. [PMID: 31648654 PMCID: PMC8061290 DOI: 10.1017/s2045796019000593] [Citation(s) in RCA: 60] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
AIMS Bipolar disorder (BD) is a severe psychiatric disorder associated with a high risk of suicide. This meta-analysis examined the prevalence of suicide attempts (SA) in patients with BD and its associated factors. METHODS A systematic literature search was conducted in the PubMed, PsycINFO, EMBASE and Web of Science databases from their inception to 11 June 2018. The prevalence of SA in BD was synthesised using the random-effects model. RESULTS The search identified 3451 articles of which 79 studies with 33 719 subjects met the study entry criteria. The lifetime prevalence of SA was 33.9% (95% CI 31.3-36.6%; I2 = 96.4%). Subgroup and meta-regression analyses revealed that the lifetime prevalence of SA was positively associated with female gender, BD-I, BD Not Otherwise Specified and rapid cycling BD subtypes, income level and geographic region. CONCLUSION This meta-analysis confirmed that SA is common in BD and identified a number of factors related to SA. Further efforts are necessary to facilitate the identification and prevention of SA in BD. Long-term use of mood stabilisers coupled with psycho-social interventions should be available to BD patients to reduce the risk of suicidal behaviour.
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6
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Su MH, Chen HC, Lu ML, Feng J, Chen IM, Wu CS, Chang SW, Kuo PH. Risk profiles of personality traits for suicidality among mood disorder patients and community controls. Acta Psychiatr Scand 2018; 137:30-38. [PMID: 29141103 DOI: 10.1111/acps.12834] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/23/2017] [Indexed: 01/02/2023]
Abstract
OBJECTIVE To examine the associations between personality traits and suicidal ideation (SI) and attempt (SA) in mood disorder patients and community controls. METHOD We recruited 365 bipolar, 296 major depressive disorder patients, and 315 community controls to assess their lifetime suicidality. Participants filled out self-reported personality questionnaires to collect data of personality traits, including novelty seeking (NS), harm avoidance (HA), extraversion (E), and neuroticism (N). We used logistic regression models adjusted for diagnoses to analyze combinational effects of personality traits on the risk of suicide. Additionally, radar charts display personality profiles for suicidal behaviours by groups. RESULTS All personality traits were associated with the risk of suicidality with various effect size, except for E that showed protective effect. High N or HA had prominent and independent risk effects on SI and SA. Combinations of high N and low E, or high HA and NS were the risk personality profiles for suicidality. Higher N scores further distinguished SA from SI in mood disorder patients. CONCLUSION Introvert personality traits showed independent risk effects on suicidality regardless of diagnosis status. Among high-risk individuals with suicidal thoughts, higher neuroticism tendency is further associated with increased risk of suicide attempt.
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Affiliation(s)
- M-H Su
- Department of Public Health, Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - H-C Chen
- Department of Psychiatry, Center of Sleep Disorders, National Taiwan University Hospital, Taipei, Taiwan
| | - M-L Lu
- Department of Psychiatry, Wan-Fang Hospital, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - J Feng
- Department of Psychiatry, Far Eastern Memorial Hospital, New Taipei City, Taiwan
| | - I-M Chen
- Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan.,Institute of Health Policy and Management, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - C-S Wu
- Department of Psychiatry, Far Eastern Memorial Hospital, New Taipei City, Taiwan
| | - S-W Chang
- Department of Psychiatry, Shin Kong Wu Ho Su Memorial Hospital, Taipei, Taiwan
| | - P-H Kuo
- Department of Public Health, Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan.,Research Center for Genes, Environment and Human Health, National Taiwan University, Taipei, Taiwan
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7
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Pawlak J, Szczepankiewicz A, Kapelski P, Rajewska-Rager A, Slopien A, Skibinska M, Czerski P, Hauser J, Dmitrzak-Weglarz M. Suicidal behavior in the context of disrupted rhythmicity in bipolar disorder-Complementary research of clock genes with suicide risks factors and course of disease. Psychiatry Res 2017; 257:446-449. [PMID: 28837935 DOI: 10.1016/j.psychres.2017.07.057] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2016] [Revised: 06/06/2017] [Accepted: 07/29/2017] [Indexed: 11/15/2022]
Abstract
Former findings indicate that suicidal behavior in bipolar disorder is associated with clock genes. Additionally, numerous non-genetic risk factors are potentially associated with suicidal behavior. Therefore, we conducted an analysis of the relationship between clock genes (as distal risk factors) with clinical characteristics and the course of bipolar disorder. We also tried to obtain a predictive model for suicide attempts based on clinical and genetic data. We found associations between selected polymorphisms and.
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Affiliation(s)
- Joanna Pawlak
- Department of Psychiatric Genetics, Department of Psychiatry, Poznan University of Medical Sciences, Poland
| | - Aleksandra Szczepankiewicz
- Department of Psychiatric Genetics, Department of Psychiatry, Poznan University of Medical Sciences, Poland; Laboratory of Molecular and Cell Biology, Department of Pulmonology, Pediatric Allergy and Clinical Immunology, Poznan University of Medical Sciences, Poland
| | - Pawel Kapelski
- Department of Psychiatric Genetics, Department of Psychiatry, Poznan University of Medical Sciences, Poland; Department of Adult Psychiatry, Poznan University of Medical Sciences, Poland
| | | | - Agnieszka Slopien
- Department of Children and Adolescents' Psychiatry, Poznan University of Medical Sciences, Poland
| | - Maria Skibinska
- Department of Psychiatric Genetics, Department of Psychiatry, Poznan University of Medical Sciences, Poland
| | - Piotr Czerski
- Department of Psychiatric Genetics, Department of Psychiatry, Poznan University of Medical Sciences, Poland
| | - Joanna Hauser
- Department of Psychiatric Genetics, Department of Psychiatry, Poznan University of Medical Sciences, Poland
| | - Monika Dmitrzak-Weglarz
- Department of Psychiatric Genetics, Department of Psychiatry, Poznan University of Medical Sciences, Poland.
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8
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Abreu LN, Oquendo MA, Galfavy H, Burke A, Grunebaum MF, Sher L, Sullivan GM, Sublette ME, Mann J, Lafer B. Are comorbid anxiety disorders a risk factor for suicide attempts in patients with mood disorders? A two-year prospective study. Eur Psychiatry 2017; 47:19-24. [PMID: 29096128 DOI: 10.1016/j.eurpsy.2017.09.005] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2017] [Revised: 09/05/2017] [Accepted: 09/10/2017] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Comorbid anxiety disorders have been considered a risk factor for suicidal behavior in patients with mood disorders, although results are controversial. The aim of this two-year prospective study was to determine if lifetime and current comorbid anxiety disorders at baseline were risk factors for suicide attempts during the two-year follow-up. METHODS We evaluated 667 patients with mood disorders (504 with major depression and 167 with bipolar disorder) divided in two groups: those with lifetime comorbid anxiety disorders (n=229) and those without (n=438). Assessments were performed at baseline and at 3, 12, and 24 months. Kaplan-Meier survival analysis and log-rank test were used to evaluate the relationship between anxiety disorders and suicide attempts. Cox proportional hazard regression was performed to investigate clinical and demographic variables that were associated with suicide attempts during follow-up. RESULTS Of the initial sample of 667 patients, 480 had all three follow-up interviews. During the follow-up, 63 patients (13.1%) attempted suicide at least once. There was no significant difference in survival curves for patients with and without comorbid anxiety disorders (log-rank test=0.269; P=0.604). Female gender (HR=3.66, P=0.001), previous suicide attempts (HR=3.27, P=0.001) and higher scores in the Buss-Durkee Hostility Inventory (HR=1.05, P≤0.001) were associated with future suicide attempts. CONCLUSIONS Our results suggest that comorbid anxiety disorders were not risk factors for suicide attempts. Further studies were needed to determine the role of anxiety disorders as risk factors for suicide attempts.
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Affiliation(s)
- L N Abreu
- Bipolar Disorder Research Program (PROMAN), Institute of Psychiatry, University of Sao Paulo Medical School, Sao Paulo, Brazil.
| | - M A Oquendo
- New York State Psychiatry Institute and Molecular Imaging and Neuropathology Division (MIND), Columbia University, New York, USA
| | - H Galfavy
- New York State Psychiatry Institute and Molecular Imaging and Neuropathology Division (MIND), Columbia University, New York, USA
| | - A Burke
- New York State Psychiatry Institute and Molecular Imaging and Neuropathology Division (MIND), Columbia University, New York, USA
| | - M F Grunebaum
- New York State Psychiatry Institute and Molecular Imaging and Neuropathology Division (MIND), Columbia University, New York, USA
| | - L Sher
- James J. Peters Veterans' Administration Medical Center and Icahn School of Medicine at Mount Sinai, New York, USA
| | - G M Sullivan
- New York State Psychiatry Institute and Molecular Imaging and Neuropathology Division (MIND), Columbia University, New York, USA
| | - M E Sublette
- New York State Psychiatry Institute and Molecular Imaging and Neuropathology Division (MIND), Columbia University, New York, USA
| | - J Mann
- New York State Psychiatry Institute and Molecular Imaging and Neuropathology Division (MIND), Columbia University, New York, USA
| | - B Lafer
- Bipolar Disorder Research Program (PROMAN), Institute of Psychiatry, University of Sao Paulo Medical School, Sao Paulo, Brazil
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9
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Liu SI, Huang YH, Wu YH, Huang KY, Huang HC, Sun FJ, Huang CR, Sung MR, Huang YP. Temperament traits in suicidal and non-suicidal mood disorder patients in Taiwan. Psychiatry Res 2017; 253:260-266. [PMID: 28407557 DOI: 10.1016/j.psychres.2017.04.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2016] [Revised: 02/27/2017] [Accepted: 04/02/2017] [Indexed: 12/13/2022]
Abstract
Suicide is a major social and clinical problem in Asia. Although studies have suggested that personality traits are possible risk factors for suicide, no study has been conducted among Chinese to compare the temperament traits of suicidal and non-suicidal mood disorder patients with those of healthy controls. This study compared temperament traits of two patient groups, those with a mood disorder who have attempted suicide (n=204), and those with a mood disorder who have not attempted suicide (n=160), and compared the traits of these patients to those of healthy controls (n=178), assessed by Cloninger's Tridimensional Personality Questionnaire and the Brown-Goodwin Aggression Inventory. Patients with suicidal attempts had significantly higher novelty seeking and aggression scores than healthy controls and patients without suicidal attempts. Two groups of patients with mood disorder had significantly higher harm avoidance scores than the healthy controls. However, patients with suicidal attempts did not have higher harm avoidance scores than patients without suicidal attempts. This study confirms findings that harm avoidance and mood disorder are related, and extends them by suggesting that those with a mood disorder and suicide attempts have higher novelty seeking and lifetime aggression scores than those without suicidal attempt, either patients or healthy controls.
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Affiliation(s)
- Shen-Ing Liu
- Department of Psychiatry, Mackay Memorial Hospital, Taipei, Taiwan; Department of Medicine, Mackay Medical College, Taipei, Taiwan; Department of Medical Research, Mackay Memorial Hospital, Taipei, Taiwan; Mackay Junior College of Medicine, Nursing and Management, Taipei, Taiwan.
| | - Yu-Hsin Huang
- Department of Psychiatry, Mackay Memorial Hospital, Taipei, Taiwan; Department of Medicine, Mackay Medical College, Taipei, Taiwan; Mackay Junior College of Medicine, Nursing and Management, Taipei, Taiwan
| | - Ying-Hui Wu
- Department of Psychiatry, Mackay Memorial Hospital, Taipei, Taiwan
| | - Kuo-Yang Huang
- Department of Psychiatry, Taiwan Adventist Hospital, Taipei, Taiwan
| | - Hui-Chun Huang
- Department of Medical Research, Mackay Memorial Hospital, Taipei, Taiwan; Mackay Junior College of Medicine, Nursing and Management, Taipei, Taiwan
| | - Fang-Ju Sun
- Department of Medical Research, Mackay Memorial Hospital, Taipei, Taiwan; Mackay Junior College of Medicine, Nursing and Management, Taipei, Taiwan
| | - Chiu-Ron Huang
- Department of Medical Research, Mackay Memorial Hospital, Taipei, Taiwan
| | - Ming-Ru Sung
- Department of Medical Research, Mackay Memorial Hospital, Taipei, Taiwan
| | - Yo-Ping Huang
- Department of Electrical Engineering, National Taipei University of Technology, Taipei, Taiwan
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10
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Berk L, Hallam KT, Venugopal K, Lewis AJ, Austin DW, Kulkarni J, Dodd S, de Castella A, Fitzgerald PB, Berk M. Impact of irritability: a 2-year observational study of outpatients with bipolar I or schizoaffective disorder. Bipolar Disord 2017; 19:184-197. [PMID: 28470892 DOI: 10.1111/bdi.12486] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2014] [Accepted: 03/12/2017] [Indexed: 01/09/2023]
Abstract
OBJECTIVES Many people experience irritability when manic, hypomanic, or depressed, yet its impact on illness severity and quality of life in bipolar and schizoaffective disorders is poorly understood. This study aimed to examine the relationship between irritability and symptom burden, functioning, quality of life, social support, suicidality, and overall illness severity in a naturalistic cohort of people with bipolar I or schizoaffective disorder. METHODS We used data from 239 adult outpatients with bipolar I or schizoaffective disorder in the Bipolar Comprehensive Outcomes Study (BCOS) - a non-interventional observational study with a 2-year follow-up period. Baseline demographic and clinical characteristics of participants with and without irritability were compared. A mixed-model repeated measures analysis was conducted to examine the longitudinal effect of irritability on clinical and quality-of-life variables over follow-up using significant baseline variables. RESULTS At baseline, 54% of participants were irritable. Baseline irritability was associated with illness severity, mania, depression, psychotic symptoms, suicidality, poor functioning, and quality of life, but not diagnosis (schizoaffective/bipolar disorder). Participants with irritability were less likely to have a partner and perceived less adequate social support. On average, over follow-up, those with irritability reported more symptoms, functional impairment, and suicidality. Furthermore, the effects of irritability could not be fully explained by illness severity. CONCLUSIONS Irritability was associated with more negative symptomatic, functional, and quality-of-life outcomes and suicidality. The identification, monitoring, and targeted treatment of irritability may be worth considering, to enhance health and wellbeing outcomes for adults with bipolar and schizoaffective disorders.
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Affiliation(s)
- Lesley Berk
- Deakin University, IMPACT Strategic Research Centre, School of Medicine, Barwon Health, Geelong, Vic., Australia.,Department of Psychiatry, University of Melbourne, Parkville, Vic., Australia.,Melbourne School of Global and Population Health, University of Melbourne, Parkville, Vic., Australia
| | - Karen T Hallam
- Department of Psychology, The University of Melbourne, Parkville, Vic., Australia.,Department of Psychology, Victoria University, Melbourne, Vic., Australia
| | - Kamalesh Venugopal
- South Australian Department for Health and Ageing, Adelaide, SA, Australia
| | - Andrew James Lewis
- School of Psychology & Exercise Science, Murdoch University, Murdoch, WA, Australia.,Harry Perkins Institute of Medical Research, Fiona Stanley Hospital, Murdoch, WA, Australia
| | - David W Austin
- School of Psychology, Faculty of Health, Deakin University, Burwood, Vic., Australia
| | - Jayashri Kulkarni
- Monash Alfred Psychiatry Research Centre (MAPrc), Monash University Central Clinical School and The Alfred, Melbourne, Vic., Australia
| | - Seetal Dodd
- Deakin University, IMPACT Strategic Research Centre, School of Medicine, Barwon Health, Geelong, Vic., Australia.,Department of Psychiatry, University of Melbourne, Parkville, Vic., Australia.,Centre for Youth Mental Health, University of Melbourne, Parkville, Vic., Australia
| | - Anthony de Castella
- Monash Alfred Psychiatry Research Centre (MAPrc), Monash University Central Clinical School and The Alfred, Melbourne, Vic., Australia
| | - Paul B Fitzgerald
- Monash Alfred Psychiatry Research Centre (MAPrc), Monash University Central Clinical School and The Alfred, Melbourne, Vic., Australia
| | - Michael Berk
- Deakin University, IMPACT Strategic Research Centre, School of Medicine, Barwon Health, Geelong, Vic., Australia.,Department of Psychiatry, University of Melbourne, Parkville, Vic., Australia.,Centre for Youth Mental Health, University of Melbourne, Parkville, Vic., Australia.,Florey Institute for Neuroscience and Mental Health, Parkville, Vic., Australia
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11
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Abstract
UNLABELLED Introduction The influence of personality traits on suicidal behaviour risk has been well documented. Personality traits and suicidal behaviour are partially genetically determined and personality has been described as an endophenotype of suicidal behaviour. The aim of this study was to investigate a possible association between personality traits with suicidal behaviour and selected serotonergic gene polymorphisms. METHODS In the study we included 156 patients meeting DSM-IV criteria for bipolar disorder (BP) and 93 healthy controls. The personality dimensions were assessed using the Temperament and Character Inventory (TCI). We genotyped two selected polymorphisms of the tryptophan hydroxylase 1 (TPH1) gene (rs1800532 218A>C and rs1799913 779A>C) and polymorphism in the promoter region of serotonin transporter gene (5-HTTLPR, rs25531) related to serotoninergic neurotransmission. Multiple poisson regression, logistic regression and Kruskal-Wallis tests were applied. RESULTS We found numerous differences between the BP patients and the control group in terms of their TCI dimensions/subdimensions. Significant differences were found between patients with, and without, suicidal attempts in fatigability and asthenia (Ha4), as well as in harm avoidance (Ha). We also found that the interactions between TCI subdimensions (the interaction of disordiness (Ns4) and spiritual acceptance (St3), disordiness (Ns4) and integrated conscience (C5), extravagance (Ns3) and resourcefulness (Sd3)) were significantly contributing for suicidal behaviour risk. We found association between all studied genetic polymorphisms and several TCI dimensions and subdimensions. CONCLUSION Our results confirm that personality traits are partially determined by genes. Both personality traits and the interactions between temperament and character traits, may be helpful in predicting suicidal behaviour.
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Pawlak J, Dmitrzak-Weglarz M, Wilkosc M, Szczepankiewicz A, Leszczynska-Rodziewicz A, Zaremba D, Kapelski P, Rajewska-Rager A, Hauser J. Suicide behavior as a quantitative trait and its genetic background. J Affect Disord 2016; 206:241-250. [PMID: 27479537 DOI: 10.1016/j.jad.2016.07.029] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2015] [Revised: 07/06/2016] [Accepted: 07/16/2016] [Indexed: 01/14/2023]
Abstract
INTRODUCTION Studies have not given yet a clear answer what is the genetic background of suicidal predisposition. The associations between polymorphisms of the TPH1 and 5-HTTLPR genes and violent suicidal behavior was revealed with the least inconsistencies. METHOD We selected 10 "strong candidate genes" and 35 SNPs, SLC6A4 and ACP1 for replication study. We searched associations between precisely described suicidal phenotype in 825 affective patients and polymorphisms of selected neurobiological pathways genes as well as their interactions that constitute suicidal risk. RESULTS The results confirm the role of TPH1, TPH2, 5HT2A, CRHR1 and ACP1 variants in the risk of suicidal behavior. LIMITATIONS In our study we analyzed limited number of candidate genes and only one of them is linked to lithium mechanism of action. We had no data on pharmacological treatment of investigated patients and its relation to the time of suicide attempt. CONCLUSION Our results indicate that polymorphisms of various signaling pathways are involved in the pathogenesis of suicidal behavior. Non-genetic factors are also involved in the risk of suicidal attempts.
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Affiliation(s)
- Joanna Pawlak
- Psychiatric Genetics Unit, Department of Psychiatry, Poznan University of Medical Sciences, Poland.
| | - Monika Dmitrzak-Weglarz
- Psychiatric Genetics Unit, Department of Psychiatry, Poznan University of Medical Sciences, Poland
| | - Monika Wilkosc
- Department of Individual Differences, Institute of Psychology, University of Bydgoszcz, Poland
| | - Aleksandra Szczepankiewicz
- Psychiatric Genetics Unit, Department of Psychiatry, Poznan University of Medical Sciences, Poland; Department of Pediatrics, Laboratory of Molecular and Cell Biology, Poznan University of Medical Sciences, Poland
| | | | - Dorota Zaremba
- Psychiatric Genetics Unit, Department of Psychiatry, Poznan University of Medical Sciences, Poland
| | - Pawel Kapelski
- Psychiatric Genetics Unit, Department of Psychiatry, Poznan University of Medical Sciences, Poland
| | | | - Joanna Hauser
- Psychiatric Genetics Unit, Department of Psychiatry, Poznan University of Medical Sciences, Poland
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Tomita T, Yasui-Furukori N, Kaneda A, Ishioka M, Sugawara N, Nakagami T, Nakamura K. An attempt to construct a 7-item short version of the temperament and character inventory to predict the treatment response of patients with depression; a validation study. BMC Psychiatry 2016; 16:290. [PMID: 27520460 PMCID: PMC4983023 DOI: 10.1186/s12888-016-0997-0] [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: 09/16/2015] [Accepted: 08/04/2016] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND The Temperament and Character Inventory (TCI) is a psychological test that is frequently used to assess personality traits. Many studies have shown the potential of the inventory to predict the treatment response of patients with major depressive disorder (MDD). Previously, we showed the association between 10 items of the TCI and the treatment response. In the present study, we reanalyzed the 10 items and aimed to provide cut-off values. METHODS This work is a secondary analysis of previously published work. Seventy-three patients were enrolled in the previously done study. Participants were treated with 10-40 mg/day of paroxetine for six weeks, and then the participants completed the TCI. The Montgomery-Asberg Depression Rating Scale (MADRS) was used to evaluate depression. The participants were divided into two groups (responders and non-responders). Using chi-squared tests, we reanalyzed the 10 items that had the strongest association with the treatment response in the previous study. We rated the answers to each item associated with the treatment response as a "1", and the answers associated with a non-response were rated as a "0". We calculated predictive scores using 10 models. Each model consisted of 1-10 scores of the best 1-10 items. We defined cut-off values for predicting treatment responses using a receiver operating characteristic (ROC) curve analysis. RESULTS Ranked by the strength of the association with the treatment response, items 174, 137, 70, 237, 106, 191, 34, 232, 161, and 215 of the TCI significantly predicted treatment responses. All predictive scores from models 1 to 10 significantly predicted treatment responses. The predictive score threshold of model 7 was 3/4, with an area under the curve of 0.825, and this model showed the highest odds and likelihood ratios (19.3 and 8.86, respectively). CONCLUSIONS We might predict the treatment response of patients with MDD using TCI predictive scoring, including items 174, 137, 70, 237, 106, 191, and 34 and a cut-off value of 3/4.
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Affiliation(s)
- Tetsu Tomita
- Department of Neuropsychiatry, Graduate School of Medicine, Hirosaki University, Hirosaki, 036-8562, Japan.
| | - Norio Yasui-Furukori
- Department of Neuropsychiatry, Graduate School of Medicine, Hirosaki University, Hirosaki, 036-8562 Japan
| | - Ayako Kaneda
- Department of Neuropsychiatry, Graduate School of Medicine, Hirosaki University, Hirosaki, 036-8562 Japan
| | - Masamichi Ishioka
- Department of Neuropsychiatry, Graduate School of Medicine, Hirosaki University, Hirosaki, 036-8562 Japan ,Department of Neuropsychiatry, Hirosaki-Aiseikai Hospital, Hirosaki, Japan
| | - Norio Sugawara
- Department of Neuropsychiatry, Graduate School of Medicine, Hirosaki University, Hirosaki, 036-8562 Japan ,Aomori Prefectural Center for Mental Health and Welfare, Aomori, Japan
| | - Taku Nakagami
- Department of Neuropsychiatry, Odate Municipal General Hospital, Odate, Japan
| | - Kazuhiko Nakamura
- Department of Neuropsychiatry, Graduate School of Medicine, Hirosaki University, Hirosaki, 036-8562 Japan
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Chavez SB, Alvarado LA, Gonzalez R. Relationship Between Temperament and Character Traits, Mood, and Medications in Bipolar I Disorder. Prim Care Companion CNS Disord 2016; 18:15br01908. [PMID: 27733949 DOI: 10.4088/pcc.15br01908] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2015] [Accepted: 02/15/2016] [Indexed: 10/21/2022] Open
Abstract
INTRODUCTION Bipolar I disorder is an illness causing mood shifts that can result in personality and character trait alterations. The relationship between mood and personality and character traits in bipolar I disorder is unclear at this time. METHODS We conducted a study from February 2009 to March 2010 that included 42 subjects with bipolar I disorder, which was confirmed using the Structured Clinical Interview for DSM-IV Axis I Disorders. Mood was assessed via the Young Mania Rating Scale (YMRS) and the 30-item Clinician-rated Inventory of Depressive Symptomatology (IDS-C). Temperament and character traits were assessed via the Temperament and Character Inventory (TCI). Multivariate analysis was used to test relationships between mood and temperament and character traits with the effects of possible cofactors taken into account (eg, age, gender, medications). RESULTS We noted a positive correlation between YMRS scores and persistence (P = .046) and a trend toward positive correlation with novelty seeking (P = .054). There was a positive correlation between higher IDS-C scores and harm avoidance (P < .001) and a negative correlation with self-directedness scores (P < .001). Antipsychotic use was positively correlated with the character trait self-directedness (P = .008), with a trend toward a positive correlation with reward dependence (P = .056). Lithium was negatively correlated with reward dependence (P = .047) and self-transcendence (P = .028), with a trend toward a negative correlation with novelty seeking (P = .053). CONCLUSIONS The findings of our study suggest that some personality and character traits may vary according to mood state and medications in patients with bipolar I disorder. Prospective and longitudinal studies are required to fully characterize the relationships between personality and character traits and mood state in bipolar I disorder.
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Affiliation(s)
- Sergio B Chavez
- Department of Health Services, Arizona State Hospital, Phoenix
| | | | - Robert Gonzalez
- Department of Psychiatry and Center for Excellence in Neuroscience , Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center, El Paso
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A meta-analysis of temperament and character dimensions in patients with mood disorders: Comparison to healthy controls and unaffected siblings. J Affect Disord 2016; 194:84-97. [PMID: 26803780 DOI: 10.1016/j.jad.2015.12.077] [Citation(s) in RCA: 60] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2015] [Accepted: 12/30/2015] [Indexed: 12/30/2022]
Abstract
BACKGROUND Cloninger's psychobiological model of personality has been extensively applied to subjects affected by mood disorders (MOOD). However, most studies are widely heterogeneous in terms of sample size, methods of assessment, and selection of participants. METHODS We conducted a systematic review of literature and a random effects meta-analysis of studies comparing at least two of the following groups: (a) adults with a primary MOOD diagnosis (Bipolar Disorder (BP) or major depressive disorder (MDD)), (b) their unaffected siblings (SIB) or (c) healthy subjects (HS), and reporting quantitative results from the Tridimensional Personality Questionnaire (TPQ) or the Temperament and Character Inventory (TCI). Subgroup, sensitivity and meta-regression analyses were also conducted. RESULTS High Harm Avoidance and low Self-Directedness were consistently associated with MOOD and SIB samples. BP was characterized by higher scores in Novelty Seeking and Self-Transcendence than HS, SIB and MDD. Age seemed to have a negative effect on Novelty Seeking and a positive effect on Harm Avoidance, Cooperativeness and Self-Transcendence. An euthymic mood state was associated with reduced Harm Avoidance, but increased Reward Dependence, Self-Directedness and Cooperativeness. LIMITATIONS The quality of the included studies varied and was relatively low. Moreover, publication bias and heterogeneity in the distribution of effect sizes may also have limited our results. CONCLUSION High Harm Avoidance and Low Self-Directedness may be trait markers for MOOD in general, while high Novelty Seeking and high Self-Transcendence may be specific to BP. Future studies are needed to disentangle the state-trait effect of each personality dimension.
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Abstract
Involvement of personality traits in susceptibility to suicidal behaviour has attracted considerable research interest over the past decades. This study was motivated by reports that emotionality may play a potentially confounding role in the association between the personality profile and suicidal behaviour. We assessed the association between personality traits, as measured using the Temperament and Character Inventory (TCI), and suicidal behaviour, while controlling for the effects of Affective Temperaments, measured using the Temperament Evaluation of the Memphis, Pisa, Paris and San Diego auto-questionnaire (TEMPS-A) in a sample of 140 consecutive self-poisoning nonlethal suicide (SNS) attempters admitted to the Emergency Toxicology Clinic, comparing them with a sample of 140 age and sex matched healthy controls. After controlling for Affective Temperaments, the temperament dimension of Novelty Seeking (NS) and the character dimensions of Self-directedness and Self-transcendence remained significantly associated with SNS attempts. NS, in particular, was most consistently and uniquely associated with suicidal behaviour. The present study conveys the difficulty in disentangling the personality profile of SNS attempters from their emotionality. We conclude that the risk associated with certain personality traits is often entirely mediated by Affective Temperaments and few dimensions independently contribute to the risk of self-poisoning nonlethal suicidal behaviour.
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Suicidal behavior in the context of disrupted rhythmicity in bipolar disorder--data from an association study of suicide attempts with clock genes. Psychiatry Res 2015; 226:517-20. [PMID: 25724486 DOI: 10.1016/j.psychres.2015.01.010] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2014] [Revised: 12/28/2014] [Accepted: 01/12/2015] [Indexed: 11/22/2022]
Abstract
Suicidal behavior exhibits both circadian and annual rhythms. We were seeking an association between selected candidate clock genes and suicidal behavior in bipolar patients. The study included 441 bipolar patients and 422 controls and we genotyped 41 SNPs of the CLOCK, ARNTL, TIMELESS, PER3 genes. The main positive findings built up associations between selected polymorphisms and.
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Tomita T, Yasui-Furukori N, Tsuchimine S, Kaneda A, Kaneko S. Relationships between vascular endothelial growth factor levels and temperament and character inventory traits in healthy Japanese subjects. Neuropsychobiology 2015; 69:1-5. [PMID: 24401189 DOI: 10.1159/000356233] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2013] [Accepted: 10/08/2013] [Indexed: 11/19/2022]
Abstract
BACKGROUND AND AIM Personality traits and vascular endothelial growth factor (VEGF) levels are both independently correlated with major depressive disorder and depressive mood. However, no studies have reported associations between personality traits and VEGF levels. Thus, we hypothesized that there is a correlation between the results of the Temperament and Character Inventory (TCI) and VEGF levels. METHODS We investigated 179 healthy participants who completed the TCI. We collected a serum sample from each subject and measured each participant's VEGF level by an enzyme-linked immunosorbent assay (ELISA). Simple and multiple regression analyses were performed to examine the correlations between the scores on the seven TCI dimensions and several other factors, including gender, age and VEGF level. RESULTS A total of 150 subjects completed the examination. Among the dimensions of the TCI, the harm avoidance (HA) scores were negatively correlated with VEGF levels, but there were no significant correlations between the scores for any other dimensions and VEGF levels. The HA score was significantly correlated with sex, age and VEGF level, and single and multiple regression analyses yielded the same results. CONCLUSION VEGF may be associated with certain personality factors. This study is the first to demonstrate a direct association between VEGF levels and a dimension of the TCI in healthy subjects.
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Affiliation(s)
- Tetsu Tomita
- Department of Neuropsychiatry, Graduate School of Medicine, Hirosaki University, Hirosaki, Japan
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Costa LDS, Alencar ÁP, Nascimento Neto PJ, dos Santos MDSV, da Silva CGL, Pinheiro SDFL, Silveira RT, Bianco BAV, Pinheiro RFF, de Lima MAP, Reis AOA, Rolim Neto ML. Risk factors for suicide in bipolar disorder: a systematic review. J Affect Disord 2015; 170:237-54. [PMID: 25261630 DOI: 10.1016/j.jad.2014.09.003] [Citation(s) in RCA: 81] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2014] [Revised: 08/18/2014] [Accepted: 09/02/2014] [Indexed: 01/27/2023]
Abstract
BACKGROUND Bipolar disorder confers the highest risk of suicide among major psychological disorders. The risk factors associated with bipolar disorder and suicide exist and are relevant to clinicians and researchers. OBJECTIVE The aim of the present study was to conduct a systematic review of articles regarding the suicide risk factors in bipolar disorder. METHODS A systematic review of articles on suicide risk factors in bipolar disorder, published from January 1, 2010 to April 05, 2014, on SCOPUS and PUBMED databases was carried out. Search terms were "Suicide" (medical subject headings [MeSH]), "Risk factors" (MeSH), and "Bipolar" (keyword). Of the 220 retrieved studies, 42 met the eligibility criteria. RESULTS Bipolar disorder is associated with an increased rate death by suicide which contributes to overall mortality rates. Studies covered a wide range of aspects regarding suicide risk factors in bipolar disorder, such as risk factors associated to Sociodemographic conditions, Biological characteristics, Drugs Relationships, Psychological Factors, Genetic Compound, Religious and Spirituals conditions. Recent scientific literature regarding the suicide risk factors in bipolar disorder converge to, directly or indirectly, highlight the negative impacts of risk factors to the affected population quality of life. CONCLUSION This review demonstrated that Bipolar disorders commonly leads to other psychiatric disorders and co-morbidities involving risk of suicide. Thus the risk factors are relevant to have a better diagnosis and prognosis of BD cases involving risk of suicide.
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Affiliation(s)
- Lucas da Silva Costa
- Laboratório de Escrita Científica, Faculdade de Medicina, Universidade Federal do Cariri, UFCA, Barbalha, Ceará, Brazil.
| | - Átila Pereira Alencar
- Laboratório de Escrita Científica, Faculdade de Medicina, Universidade Federal do Cariri, UFCA, Barbalha, Ceará, Brazil
| | | | | | | | | | - Regiane Teixeira Silveira
- Programa de Pós-Graduação em Ciências da Saúde, Faculdade de Medicina do ABC, Santo André, São Paulo, Brazil
| | - Bianca Alves Vieira Bianco
- Programa de Pós-Graduação em Ciências da Saúde, Faculdade de Medicina do ABC, Santo André, São Paulo, Brazil
| | | | | | - Alberto Olavo Advincula Reis
- Programa de Pós-Graduação em Saúde Pública, Faculdade de Saúde Pública, Universidade de São Paulo, USP, São Paulo, São Paulo, Brazil
| | - Modesto Leite Rolim Neto
- Líder de Grupo de Pesquisa em Suicidologia, Universidade Federal do Ceará, UFC/Conselho Nacional de Desenvolvimento Científico e Tecnológico, CNPq, Faculdade de Medicina, Universidade Federal do Cariri, UFCA, Barbalha, Ceará, Brazil
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Tomita T, Ishioka M, Kaneda A, Sugawara N, Nakagami T, Nakamura K, Yasui-Furukori N. An investigation of temperament and character inventory items for predicting the response to paroxetine treatment in patients with major depressive disorder. J Affect Disord 2014; 165:109-13. [PMID: 24882186 DOI: 10.1016/j.jad.2014.04.076] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2014] [Accepted: 04/25/2014] [Indexed: 10/25/2022]
Abstract
BACKGROUND Previous studies have reported associations between Temperament and Character Inventory (TCI) dimension scores and the response to treatment in patients with major depressive disorder (MDD). We aimed to determine which TCI items could predict the response to treatment with paroxetine in patients with MDD. METHODS Seventy-three patients were enrolled in this study. The participants were treated with 10-40mg/day of paroxetine for six weeks; they then completed the TCI. The Montgomery-Asberg Depression Rating Scale (MADRS) was used to evaluate the patients. The participants were divided into two groups (responders and non-responders). We used a chi-squared test to identify the 10 items with the strongest association with treatment response from among all 240 items on the TCI, and we used a multiple logistic regression analysis to confirm the validity of these 10 items. RESULTS Among the TCI dimension scores, only the C score differed significantly between the two groups. We analyzed 10 models using each of the 10 best items. All the models significantly predicted treatment response. The TCI dimensions model also significantly predicted treatment response, but its predictive value was lower than those of the other 10 models. LIMITATIONS The responders included the early responders. The results lacked information about responders whose responses were not predicted by the logistic regression models and TCI items. CONCLUSIONS Some TCI items showed significant associations with the response to paroxetine treatment in the patients with MDD. Treatment response in patients with MDD may be predicted using only 10 items from the TCI.
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Affiliation(s)
- Tetsu Tomita
- Department of Neuropsychiatry, Graduate School of Medicine, Hirosaki University, Hirosaki 036-8562, Japan
| | - Masamichi Ishioka
- Department of Neuropsychiatry, Graduate School of Medicine, Hirosaki University, Hirosaki 036-8562, Japan
| | - Ayako Kaneda
- Department of Neuropsychiatry, Graduate School of Medicine, Hirosaki University, Hirosaki 036-8562, Japan
| | - Norio Sugawara
- Department of Neuropsychiatry, Graduate School of Medicine, Hirosaki University, Hirosaki 036-8562, Japan
| | - Taku Nakagami
- Department of Neuropsychiatry, Graduate School of Medicine, Hirosaki University, Hirosaki 036-8562, Japan
| | - Kazuhiko Nakamura
- Department of Neuropsychiatry, Graduate School of Medicine, Hirosaki University, Hirosaki 036-8562, Japan
| | - Norio Yasui-Furukori
- Department of Neuropsychiatry, Graduate School of Medicine, Hirosaki University, Hirosaki 036-8562, Japan.
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Exploring personality features in patients with affective disorders and history of suicide attempts: a comparative study with their parents and control subjects. DEPRESSION RESEARCH AND TREATMENT 2014; 2014:291802. [PMID: 24724019 PMCID: PMC3958670 DOI: 10.1155/2014/291802] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/02/2013] [Revised: 12/18/2013] [Accepted: 01/29/2014] [Indexed: 11/17/2022]
Abstract
Personality traits are important candidate predictors of suicidal behavior. Several studies have reported an association between personality/temperament traits and suicidal behavior, suggesting personality traits as intermediary phenotypes related to suicidal behavior. Thus, it is possible that suicide attempts can be accounted for by increased familial rates of risk personality traits. The aim of this work was to evaluate personality traits in affective disorder patients with attempted suicide and to compare them with the personality trait scores of their parents. In addition, ITC scores in the two groups were compared with a healthy control sample. The patients evaluated met the DSM-IV criteria for major depression disorder or dysthymia and had a documented history of suicide attempts. Psychiatric diagnoses of patients and parents were done according to the SCID-I and the personality was assessed using the Temperament and Character Inventory. We analyzed 49 suicide attempt subjects and their parents (n = 95) and 89 control subjects. We observed that temperament and character dimensions were similar between patients and their parents (P > 0.05). In particular, we observed that high HA and low P, SD, and CO were shared among families. Our study is the first to report that the personality traits of affective disorder patients with a history of attempted suicide are shared between patients and their parents.
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