How does a suicide attempter eat differently from others? Comparison of macronutrient intakes

Frequency and correlates of lifetime suicidal ideation and suicide attempts among consecutively hospitalized youth with anorexia nervosa and bulimia nervosa: results from a retrospective chart review

BACKGROUND

Youth with eating disorders (EDs) face an increased risk of a premature suicide death. Precursors of completed suicide are suicidal ideation and suicide attempts, which need to be well understood to prevent suicide. However, epidemiological data on the lifetime prevalence and clinical correlates of suicidal ideation and suicide attempts (i.e., "suicidality") are lacking for the vulnerable group of inpatient ED youth.

METHODS

This retrospective chart review was conducted at a psychiatric child and adolescent inpatient department, covering a 25-year period. Consecutively hospitalized youth with an ICD-10 diagnosis of anorexia nervosa (AN), restricting type (AN-R), binge-purging type (AN-BP), and bulimia nervosa (BN) were included. Data extraction and coding were standardized with trained raters extracting information from patient records according to a procedural manual and using a piloted data extraction template. The lifetime prevalence of suicidal ideation and suicide attempts was calculated for each ED subgroup, and clinical correlates of suicidality were analyzed via multivariable regression analyses.

RESULTS

In the sample of 382 inpatients aged 9-18 years (median age = 15.6, females = 97.1%; AN-R: n = 242, BN: n = 84, AN-BP: n = 56), 30.6% of patients had lifetime suicidal ideation (BN:52.4% ≈ AN-BP:44.6% > AN-R:19.8%, χ²(2,382) = 37.2, p < 0.001, Φ = 0.31), and 3.4% of patients reported a history of suicide attempts (AN-BP:8.9% ≈ BN:4.8% > AN-R:1.7%, χ²(2,382) = 7.9, p = 0.019, Φ = 0.14). Independent clinical correlates of suicidality were i) for AN-R a higher number of psychiatric comorbidities (OR = 3.02 [1.90, 4.81], p < 0.001), and body weight < 1^st BMI percentile at hospital admission (OR = 1.25 [1.07,1.47], p = 0.005) (r² = 0.20); ii) for AN-BP patients a higher number of psychiatric comorbidities (OR = 3.68 [1.50, 9.04], p = 0.004) and history of childhood abuse (OR = 0.16 [0.03, 0.96], p = 0.045) (r² = 0.36), and iii) for BN patients a higher prevalence of non-suicidal self-injury (NSSI)(OR = 3.06 [1.37, 6.83], p = 0.006) (r² = 0.13).

CONCLUSIONS

About half of youth inpatients with AN-BP and BN had lifetime suicidal ideation, and one-tenth of patients with AN-BP had attempted suicide. Treatment programs need to address specific clinical correlates of suicidality, namely, low body weight, psychiatric comorbidities, history of childhood abuse, and NSSI.

TRIAL REGISTRATION

This study was not a clinical trial but a retrospective chart review based on routinely assessed clinical parameters. The study includes data from human participants; however: (1) no intervention and no prospective assignment to interventions were performed, and (2) no evaluation of intervention in participants was accomplished.

Frailty and Suicidality in Older Adults: A Mini-Review and Synthesis

The prevalence of frailty, which is significantly associated with late-life suicidality, increases with age in older adults. This review addresses the compiled evidence on the relationship between suicidality and frailty within older populations, explores the latest findings, weighs the effectiveness of various intervention strategies, and outlines potential future investigations in this area. Growing evidence suggests that identifying and addressing risk factors, including mood disorders, prior suicide attempts, poor physical health, and social isolation/problems can decrease the risk of late-in-life suicide. Various studies have shown that interventions such as diet improvements, cognitive training, psychosocial programs, and depression medication could reduce the severity of frailty and suicidality, with physical exercise being the most effective intervention. Combined programs with multiple interventions can have an even greater impact on combating depression, lowering risk of falls, and improving gait speed in older adults.

Changes in the association between the traditional Japanese diet score and suicide rates over 26 years: A global comparative study

BACKGROUND

This study examined the global association between the Traditional Japanese Diet Score and suicide rate.

METHODS

Average food supply and energy supply by country were obtained from the Food and Agriculture Organization of the United Nations Statistics Division database (FAOSTAT). Traditional Japanese Diet Score (TJDS) was calculated from food group classifications. Age-standardized suicide rates per 100,000 people by country were obtained from the Global Burden of Disease 2017 database. The 26-year associations between TJDS and suicide rates were examined controlling for covariates using a mixed-effects model in 138 countries with populations of 1 million or greater.

RESULTS

A significant negative association was found in the analysis of the relationship between TJDS and the prevalence of suicide [β (se) = -0.126 (0.031), p < 0.001]. The interaction term between TJDS and year was also significant [β (se) = -0.011 (0.003), p < 0.001]. The change in the effect of TJDS on suicide rates by year was examined. The effect of TJDS was not significant from 1991 to 1999 but became significant after 2000; the slope of the TJDS to suicide rate in 2017 was -0.270 (95% confidence interval -0.382, -0.169, p < 0.001).

LIMITATIONS

This was a national ecological study and did not consider individual differences in sex, age, and lifestyle.

CONCLUSIONS

TJDS may be is a protective factor for depression, which may prevent suicide. The association between TJDS and suicide rates became stronger over time and was inversely associated with suicide rates after 2000.

Relationship between psychological distress and the adherence to the Korean healthy eating index (KHEI): the Korea National Health and Nutrition Examination Survey (KNHANES) 2013 and 2015

BACKGROUND/OBJECTIVES

This study examined the association of depressive symptoms, stress perception, and suicidal ideation with overall dietary quality using the newly developed Korean healthy eating index (KHEI).

SUBJECTS/METHODS

This study included 9,607 adults (3,939 men and 5,668 women, ≥ 19 years) who participated in the 6th Korea National Health and Nutrition Examination Survey 2013 and 2015. The KHEI scores were calculated using the food frequency questionnaire data. Survey logistic regression analyses were performed to analyze the association between psychiatric distress and dietary quality.

RESULTS

The percentage of subjects with experience of depressive mood, higher stress perception, and suicidal ideation was 8.2%, 25.0%, and 3.7% in men and 15.4%, 27.3%, and 6.0% in women, respectively. The mean KHEI score was 61.5 ± 0.29 in men and 64.8 ± 0.24 in women (P < 0.001). The present study found a difference in the adherence to specific dietary components of the KHEI between sexes. Men experiencing depressive symptoms were less likely to eat meat, fish, eggs, and beans, while depressed women showed lower vegetable intake. Both men and women with suicidal ideation showed a lower intake of vegetables. The men with stress had a lower breakfast eating score than those without stress (7.21 vs. 6.77, P = 0.016). The multivariate-adjusted odds ratios for depressive symptoms, stress perception, and the suicidal idea in women with the highest quartile of KHEI scores compared to the lowest quartile was 0.69 (95% confidence interval, 0.51-0.92), 0.73 (0.58-0.82), and 0.52 (0.33-0.82), respectively and significant dose-response associations were observed (P for trends < 0.05 for all). On the other hand, these associations were not observed in men after adjusting for the confounding variables (P for trends > 0.05 for all).

CONCLUSIONS

Poor adherence to dietary recommendations is associated with psychological distress, especially in women.

Suizidalitäts-Barometer: Ursachen und Behandlung suizidalen Erlebens und Verhaltens aus Laienperspektive

<b><i>Hintergrund:</i></b> Ziel der vorliegenden Untersuchung war es, ein Meinungsbild über Ursachen und Behandlungsmöglichkeiten suizidalen Erlebens und Verhaltens aus Laiensicht zu erstellen. <b><i>Probanden:</i></b> Insgesamt nahmen 879 Personen (58,2% weiblich; Alter (Jahre): Mittelwert = 32,28, SD = 8,41) an einer internetbasierten Fragebogenstudie teil. <b><i>Ergebnisse:</i></b> Mehr als 90% der Befragten messen psychischen Erkrankungen, schwerwiegenden Lebensereignissen sowie den Wahrnehmungen keine Hoffnung zu haben, eine Last für andere und sozial isoliert zu sein, ursächliche Bedeutung für das Verständnis von Suiziden bei. Nahezu 100% halten eine Psychotherapie für eine angemessene Behandlung suizidalen Erlebens und Verhaltens. Die Zustimmungsraten zu verschiedenen Mythen über Suizidalität sind vergleichsweise niedrig (&#x3c;20%). <b><i>Diskussion und Schlussfolgerung:</i></b> Die Gesamtbefundlage stellt sich als positiv heraus: Sowohl bedeutsame Risikofaktoren für suizidales Erleben und Verhalten als auch zentrale Behandlungsmöglichkeiten sind den Befragten weitgehend bekannt.

Effectiveness of Complementary and Integrative Approaches in Promoting Engagement and Overall Wellness Toward Suicide Prevention in Veterans

Objective: Suicide is a major public health problem, specifically among U.S. veterans, who do not consistently engage in mental health services, often citing stigma as a barrier. Complementary and Integrative Health (CIH) interventions are promising alternatives in promoting patient engagement and further, they may play a critical role in transitioning people into mental health care. Toward this goal, the Resilience and Wellness Center (RWC) was developed to break through the stigma barrier by addressing risk factors of suicide through multimodal CIH interventions via cohort design, promoting social connectedness and accountability among participants. Design: This is a program evaluation study at a large urban VA medical center, where assessments were evaluated from pre- to post-program completion to determine the effectiveness of an intensive multimodal CIH 4-week group outpatient intervention for suicide prevention. Outcome measures: Primary outcomes measured included group connectedness, severity of depression and hopelessness symptoms, suicidal ideation, sleep quality, and diet. Secondary outcomes included measures of post-traumatic stress disorder (PTSD), generalized anxiety severity stress/coping skills, pain, and fatigue. Results: The RWC showed high participant engagement, with an 84%-95% attendance engagement rate depending on suicide risk history. Data from 15 cohorts (N = 126) demonstrate favorable outcomes associated with participation in this comprehensive program, as evidenced by a reduction in suicidal ideation, depression, and hopelessness, but not sleep quality and diet. In addition, in a subset of veterans with a history of suicidal ideation or attempt, significant improvements were noted in pain, PTSD/anxiety symptoms, and stress coping measures. Conclusions: The RWC shows that an intensive complement of CIH interventions is associated with a significant improvement with high veteran engagement. Findings from this program evaluation study can be used to aid health care systems and their providers in determining whether or not to utilize such multimodal CIH integrated interventions as an effective treatment for at-risk populations as a part of suicide prevention efforts.

Association between serum lipid concentrations and attempted suicide in patients with major depressive disorder: A meta-analysis

Background

There is growing evidence that serum lipid concentrations may be associated with attempted suicide in patients with major depressive disorder (MDD), but these findings remain controversial. Thus, we performed a comprehensive meta-analysis to quantitatively assess the associations between serum lipid concentrations and attempted suicide in MDD patients.

Materials and methods

Electronic databases (PubMed, Embase, the Cochrane Library and the China National Knowledge Library) were searched for relevant literature up to 10 February 2020. We used a random-effects model based on heterogeneity amongst studies and generated pooled standardised mean differences (SMDs).

Results

Thirty-two studies comprising 7,068 subjects met the inclusion criteria. A pooled analysis showed that compared with non-attempters, MDD patients who had attempted suicide had significantly lower serum concentrations of total cholesterol (TC) (SMD: -0.63, 95% CI: -0.83 to -0.44) and low-density lipoprotein cholesterol (LDL-C) (SMD: -0.69, 95% CI: -1.04 to -0.34), but the serum concentrations of high-density lipoprotein cholesterol (HDL-C) (SMD: -0.12, 95% CI: -0.33 to 0.10) and triglycerides (TGs) (SMD: 0.00, 95% CI: -0.20 to 0.20) were not significantly different between the two groups. Subgroup and meta-regression analysis indicated that heterogeneity with respect to TC concentrations may be due to different ages (p = 0.041) and sample sizes (p = 0.016) of studies, and that heterogeneity with respect to HDL-C concentrations may be partly due to different settings of studies (p = 0.017).

Conclusions

This meta-analysis demonstrated that lower concentrations of TC and LDL-C, but not of HDL-C and TGs, were associated with attempted suicide in MDD patients. This indicates that TC and LDL-C may be useful as biological markers for predicting whether MDD patients may attempt to commit suicide.

Nitrated meat products are associated with suicide behavior in psychiatric patients

There has been little previous study of the association between dietary factors and suicide. The association between food exposures and suicide attempt history was investigated in a sample of 270 individuals with schizophrenia, bipolar disorder, or major depressive disorder. Individuals who had a suicide attempt history were almost 3 times as likely to report eating cured meat, typically prepared with added nitrates, compared to patients without a suicide attempt history, adjusting for demographic and clinical variables. A suicide attempt history was 6 times greater in those who in addition were cigarette smokers and had a history of substance abuse compared to those who did not have any of these risk factors. If dietary factors were shown to affect suicide risk, an additional method of risk reduction would be available which could be widely disseminated to address this major public health problem.

Association Between Suicidal Behavior and Clinical Features of Premenstrual Syndrome and Menstrual History: A Cross Sectional Study

BACKGROUND

The link between suicidal behavior and premenstrual syndrome has been poorly studied. This study aimed to determine the association of suicide attempts, and suicidal ideation and signs and symptoms of premenstrual syndrome and menstrual history in women in Durango City, Mexico.

METHODS

Using a cross-sectional study design, 437 women were interviewed to obtain clinical data about their premenstrual period, menstrual history and suicidal behavior. Logistic regression was used to assess the association between suicide behavior and clinical features of women. Odds ratio (OR) adjusted by age, presence of mental illness, and residence area, and 95% confidence interval (CI) were obtained.

RESULTS

Of these women, 29 (6.6%) had a history of suicidal ideation, and 15 (3.4%) had a history of suicide attempts. Logistic regression showed that suicidal ideation was associated with the variables: presence of irregular periods (OR = 2.89; 95% CI: 1.10 - 7.55; P = 0.03), low back pain (OR = 4.57; 95% CI: 1.31 - 15.92; P = 0.01), desire to eat certain food or eat a lot (OR = 2.47; 95% CI: 1.10 - 5.57; P = 0.02), guilty feeling (OR = 2.43; 95% CI: 1.06 - 5.59; P = 0.03), and aggressiveness (OR = 3.19; 95% CI: 1.42 - 7.13; P = 0.005). Whereas logistic regression showed that a history of suicide attempts was associated with the variables: presence of irregular periods (OR = 9.57; 95% CI: 1.23 - 74.44; P = 0.03), and desire to eat certain food or eat a lot (OR = 3.08; 95% CI: 1.04 - 9.15; P =0.04).

CONCLUSIONS

In this first study on the link of suicide behavior and clinical features of premenstrual syndrome, results suggest that suicidal ideation and suicide attempts are associated to specific signs or symptoms of premenstrual syndrome. Further research to confirm the findings of this study is needed. Results might help for an optimal planning of preventive measures against suicide.

Exploring metabolic factors and health behaviors in relation to suicide attempts: A case-control study

BACKGROUND

Suicide attempts are a serious public health concern with devastating global impact, thereby necessitating the development of an adequate prevention strategy. Few known risk factors of suicide attempts are directly modifiable. This study sought to investigate potential associations between health behaviors and suicide attempts, identifying novel opportunities for clinicians to help prevent suicidal behavior.

METHODS

A case-control study was conducted to compare body weight, serum total cholesterol, physical activity, tobacco use, and dietary food groups among adults who had made a suicide attempt (n = 84) to psychiatric inpatients (n = 104) and community controls (n = 93) without history of suicide attempt. Multivariable binary logistic regression analyses were used to investigate the association between metabolic risk factors and attempted suicide.

RESULTS

Psychiatric inpatients who had attempted suicide were less likely to be physically active [moderate/strenuous (OR 0.42, 95% CI 0.19-0.95) and mild (OR 0.35, 95% CI 0.16-0.76)] compared to controls. Psychiatric inpatients who attempted suicide were more likely to use tobacco (OR 2.25, 95% CI 1.07-4.73) compared to controls. Contrary to prior research, obesity, serum total cholesterol, and diet were not significantly associated with risk of attempted suicide.

LIMITATIONS

Our study was limited by its cross-sectional design, which precludes the identification of causal or temporal relationships between the risk of attempted suicide and factors such as physical activity and tobacco use.

CONCLUSIONS

Study results suggest that a history of attempted suicide is associated with a decreased likelihood of being physically active and an increased risk of tobacco use. Further investigation is warranted to understand the role of exercise and tobacco use in suicide intervention and prevention strategies.

Predicting Suicide Risk in Trauma Exposed Veterans: The Role of Health Promoting Behaviors

INTRODUCTION

Returning veterans of the wars in Iraq and Afghanistan experience high rates of post-traumatic stress disorder (PTSD) and suicidal behavior. Suicidal ideation is among the strongest risk factors for completed suicide. Some research suggests an association between PTSD and suicidal ideation, and that health-promoting behaviors-behaviors that sustain or increase well-being-play a role in this association. The current study examined whether health-promoting behaviors moderate the association between PTSD severity and suicidal ideation.

METHODS

Veterans of Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF; N = 108) completed measures of PTSD symptoms, trauma exposure, suicidal ideation, and health-promoting behaviors.

RESULTS

Moderated regression was used to test the hypothesis. Results indicated that health promoting behaviors, β = -.06, p = .001, and PTSD symptoms, β = .36, p < .001, were significantly related to suicidal ideation. Consistent with our main hypothesis, the health promoting behaviors x PTSD interaction term was significantly associated with suicidal ideation, β = -.09, p = .001. The overall model accounted for 13% of the variance in suicidal ideation. Among individuals with high PTSD symptom severity, those who engaged in more health promoting behaviors reported less suicidal ideation than those who engaged in fewer health promoting behaviors.

CONCLUSIONS

Health-promoting behaviors could be important for reducing suicidal ideation among veterans with high levels of PTSD symptoms. It is recommended that future research examine health promotion interventions as a means of reducing suicidal ideation.

Omega-3 fatty acids and depression: scientific evidence and biological mechanisms

The changing of omega-6/omega-3 polyunsaturated fatty acids (PUFA) in the food supply of Western societies occurred over the last 150 years is thought to promote the pathogenesis of many inflammatory-related diseases, including depressive disorders. Several epidemiological studies reported a significant inverse correlation between intake of oily fish and depression or bipolar disorders. Studies conducted specifically on the association between omega-3 intake and depression reported contrasting results, suggesting that the preventive role of omega-3 PUFA may depend also on other factors, such as overall diet quality and the social environment. Accordingly, tertiary prevention with omega-3 PUFA supplement in depressed patients has reached greater effectiveness during the last recent years, although definitive statements on their use in depression therapy cannot be yet freely asserted. Among the biological properties of omega-3 PUFA, their anti-inflammatory effects and their important role on the structural changing of the brain should be taken into account to better understand the possible pathway through which they can be effective both in preventing or treating depression. However, the problem of how to correct the inadequate supply of omega-3 PUFA in the Westernized countries' diet is a priority in order to set food and health policies and also dietary recommendations for individuals and population groups.

Nutrition status of primary care patients with depression and anxiety

The objective of this study was to evaluate the nutrition status of people referred to a nutrition and physical activity program for the management of mental health in general practice. Patients currently being treated for depression and/or anxiety were referred by their GPs to a lifestyle intervention program. The nutrition status was assessed during a comprehensive assessment at the commencement of the program. The lifestyle intervention program, including all assessments, was offered at multiple sites including GP clinics in the Illawarra, and in clinic rooms at the University of Wollongong. Thirty-two men and seventy-seven women completed the assessment. Patients were referred with depression (52%), anxiety (19%) or both (28%). Eighty percent of participants were overweight or obese. All participants completed an assessment that included a diet history, anthropometric measurements and the completion of several questionnaires including the Depression, Anxiety and Stress Scale (DASS). Nutrition status was assessed using mean nutrient intakes and Australian modified Healthy Eating Index scores evaluated against the National Nutrition Survey intakes and DASS scores. Participants met the estimated average requirements for all nutrients except folate (17%), magnesium (78%) and calcium (57%). Intakes were similar to those reported in the National Nutrition Survey. Only magnesium intakes were significantly related to depression (r = –0.26). Australian modified Healthy Eating Index scores were significantly negatively correlated with DASS scores (P < 0.01). The associations presented here support the existing body of literature. Nutrition recommendations for patients with depression and anxiety should be based on the Australian Guide to Healthy Eating with particular attention to fruit, vegetables and wholegrains.

Fish consumption and severely depressed mood, findings from the first national nutrition follow-up study

The evidence obtained from prospective studies to support the hypothesis that fish consumption may improve mental status remains limited. The current study prospectively assessed a low frequency of fish consumption as a risk factor for depressed mood. Included were 5068 adults aged 25-74 years examined in 1971-1975 as the baseline of the First National Health and Nutrition Examination Survey Follow-up Study. Frequency of eating fish at baseline was obtained using a 3-month food frequency questionnaire. Severely depressed mood (SDM) was defined as the Center for Epidemiologic Studies Depression Scale scores ≥22 or taking anti-depressants. After an average of 10.6 years of follow-up, among men (n=2039), the percentage of individuals with SDM was 11.7%. Compared with frequent consumers (more than once a week), the odds ratios (ORs) were 1.43 (95%CI=0.66-3.11) and 2.08 (1.08-4.09) respectively for the men eating fish once a week and less than once a week (p for trend=0.03). Among women (n=3029), the percentage of individuals with SDM was 17.89%. The ORs were 1 (reference), 0.91 (0.68-1.22) and 1.15 (0.83-1.59) respectively for the women eating fish more than once, once, and less than once a week. These estimates were obtained after adjustment for indicators of social deprivation and major physical diseases. The study concluded that independently from social deprivation and physical diseases, low fish consumption was a risk factor for SDM among men. Further studies are needed to confirm these findings and elucidate mechanisms for the difference between men and women.

Long chain n-3 fatty acids intake, fish consumption and suicide in a cohort of Japanese men and women--the Japan Public Health Center-based (JPHC) prospective study

OBJECTIVE

Eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) have been implicated as protective against suicide. However, it is uncertain whether a higher intake of EPA and DHA or of fish, a major source of these nutrients, lowers suicidal risk among Japanese, whose fish consumption and suicide rate are both high. This study prospectively examined the relation between fish, EPA, or DHA intake and suicide among Japanese men and women.

METHOD

Subjects were 47,351 men and 54,156 women aged 40-69 years who participated in the JPHC Study, completed a food frequency questionnaire in 1995-1999, and were followed for death through December 2005. We used the Cox proportional hazards regression model to estimate the hazard ratio (HR) and 95% confidence interval (CI) for suicide by quintile of intake.

RESULTS

A total of 213 and 85 deaths from suicide were recorded during 403,019 and 473,351 person-years of follow-up for men and women, respectively. Higher intakes of fish, EPA, or DHA were not associated with a lower risk of suicide. Multivariate HRs (95% CI) of suicide death for the highest versus lowest quintile of fish consumption were 0.95 (0.60-1.49) and 1.20 (0.58-2.47) for men and women, respectively. A significantly increased risk of suicidal death was observed among women with very low intake of fish, with HRs (95% CI) for those in 0-5th percentile versus middle quintile of 3.41 (1.36-8.51).

CONCLUSIONS

Our overall result does not support a protective role of higher intake of fish, EPA, or DHA against suicide in Japanese men and women.

Legume consumption and severe depressed mood, the modifying roles of gender and menopausal status

OBJECTIVE

Legumes have been recommended as staple foods in the anticipation of disease prevention. However, the scientific evidence of their benefits, particularly on mental well-being, remains preliminary. We longitudinally assessed the association between legume consumption and the risk of severe depressed mood (SDM) among a national cohort.

DESIGN

The study included adults aged 25-74 years who were examined in 1971-1975 as a part of the National Health and Nutrition Examination Survey. Legume consumption at baseline was obtained from a 3-month FFQ and categorised as infrequent (<1 time/week), moderate (1-2 times/week) and frequent (> or = 3 times/week). SDM was defined as Center for Epidemiologic Studies Depression Scale score > or = 22 or taking anti-depression medication after an average of 10.6 years of follow-up (from 8.0 to 12.5 years).

RESULTS

Among women, the proportion of individuals with SDM was 17.75 %. For premenopausal women (n 1778), a significant linear trend of deleterious effect from legume consumption was observed (P for trend = 0.0148). The relative risks (RR) for infrequent, moderate and frequent consumptions were 1 (reference), 1.24 (95 % CI = 0.91, 1.70) and 1.75 (1.12, 2.75), respectively. However, moderate consumption showed a significant protective effect (RR = 0.52 (0.27, 1.00)) among women undergoing the menopausal transition (n 454). No association was obtained from either postmenopausal women (n 601) or men (n 2036).

CONCLUSIONS

These findings suggest that gender and menopausal status were effect modifiers of the association between legume consumption and SDM. Detrimental effects of frequent consumption of legumes may exist among premenopausal women; moderate consumption, however, may protect perimenopausal women against SDM.

Cross-sectional assessment of diet quality in individuals with a lifetime history of attempted suicide

Increased evidence indicates an association between psychiatric disorders and dietary pattern. The objective of this study is to describe the differences in food consumption between suicide attempters and non-attempters. We analyzed the dietary information retrospectively collected from 6803 adults, aged 17 to 39 years, who also completed a mental disorder diagnostic interview as a part of the Third National Health and Nutrition Examination Survey, 1988-1994. The Healthy Eating Index score was used to measure the degree of compliance with the national diet guidelines. In men, attempters (n=92) had a high odds of low consumption of vegetables (OR=2.47, 95%CI=1.19, 5.15). In women, attempters (n=275) had a high odds of insufficient fruit consumption (OR=2.36, 95%CI=1.15, 4.85). For both men and women, the component scores for meat were lower in non-attempters compared with attempters. On a scale of zero (no serving) to 10 (meeting the serving recommendations), the scores were 6.74 (SE: 0.39) and 7.76 (0.10), respectively, for attempters and non-attempters among men, and 5.81 (0.33) and 6.43 (0.07), respectively, for attempters and non-attempters among women. It was further observed that female attempters ate significantly less fish and seafood. These results were obtained after adjustment for various factors, including the history of medical and psychiatric illnesses. The data suggest that fruits, vegetables and meat were significantly under-consumed in adults who had ever attempted suicide. The deleterious contribution of insufficient consumption of these foods to physical and psychiatric status in attempters merits investigation. In clinical practice, psychiatrists should pay more attention to what patients eat.

Low plasma cholesterol levels in suicidal males: a gender- and body mass index-matched case-control study of suicide attempters and nonattempters

Findings from animal and human studies suggest an association between low cholesterol levels and suicidal behaviors. The purpose of this case-control study was to test whether cholesterol levels in suicide attempters are lower than in controls without suicide attempt history matched by gender, age, and body mass index (BMI). Suicide attempters (n=177: 68 men and 109 women) and controls (177 blood donors) were assessed. Serum cholesterol levels were significantly lower in suicide attempters than in controls. After gender stratification, the difference remained significant in men, but not in women.

Essential fatty acids and their role in conditions characterised by impulsivity

There is a biological basis for anticipating a role for the essential fatty acids (EFAs) in the therapeutics of the large number of conditions characterized by impulsivity, hostility and aggression. Abnormalities in these constructs have been linked to dysfunction of several monoaminergic systems, 5-hydroxytryptamine (5-HT) in particular. The EFAs ameliorate the function of these systems and also act through a number of other mechanisms. While limited in volume, a number of EFA supplementation studies support their role in the treatment of such conditions. This paper summarises the literature in terms of epidemiology, clinical science and therapeutics in clinical and non-clinical populations.