1
|
Lorente-Català R, Font-Furnieles P, Escriva-Sanchis R, Bertó-García C, Vera-Albero P, García-Palacios A. Telephone support vs. self-guidance in an Internet-based self-administered psychological program for the treatment of depression: Protocol for a hybrid type 1 effectiveness-implementation randomized controlled trial. Internet Interv 2024; 36:100742. [PMID: 38737981 PMCID: PMC11081795 DOI: 10.1016/j.invent.2024.100742] [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: 07/21/2023] [Revised: 03/12/2024] [Accepted: 04/17/2024] [Indexed: 05/14/2024] Open
Abstract
Background Depression is already the leading psychological disability around the world, impairing daily life, well-being, and social functioning and leading to personal and social costs. Despite the effectiveness of Evidence-Based Psychological Practices (EBPP), a significant percentage of depressive individuals remain untreated, especially in Primary Care (PC) settings in Spain. There are numerous barriers that limit access to EBPPs, including high costs, professional training, and adherence problems. Information and Communication Technologies (ICTs) offer a cost-effective way to disseminate and scale EBPPs to address these barriers. The iCBT program Smiling is Fun has been demonstrated to be a cost-effective treatment for depression in various Randomized Control Trials. However, adherence and implementation problems in real-world settings need to be addressed. Implementation research can help evaluate these challenges by identifying facilitators and barriers to the implementation process in PC. In this regard, including human support has been pointed out as a possible key factor in addressing the population's mental health needs and promoting treatment adherence. Objective The current study aims to examine the effectiveness, adherence rates, and implementation process of Smiling is Fun to address depression in a PC setting considering the influence of telephone support vs no support. Methods The proposed research is a Hybrid Effectiveness-Implementation Type I study, with a two-armed randomized controlled design, which will test a clinical intervention for major depressive disorder while gathering information on its implementation in a real-world setting. The study will include adult patients with mild to moderate symptoms of depression. Participants will be randomly assigned to one of two groups: self-applied psychotherapy or self-applied psychotherapy with psychotherapeutic telephone support. The trial will recruit 110 patient participants, with a loss-to-follow-up rate of 30 %. Discussion A study protocol for a hybrid effectiveness-implementation study is presented with the aim to assess the implementation of Smiling is Fun for the treatment of depression in PC. The study evaluates the influence of telephone support during a self-administered intervention compared to unguided self-administration. The main goal is to address the barriers and facilitators of the implementation process and to promote treatment adherence. Ultimately, the results of the study could help in the uptake of sustainable resources so that the population could gain better access to psychological interventions in mental health services. Registration ClinicalTrials.gov; NCT06230237.
Collapse
Affiliation(s)
- Rosa Lorente-Català
- Department of Basic and Clinical Psychology, and Psychobiology, Universitat Jaume I, Castellon, Spain
| | - Pablo Font-Furnieles
- Foundation for the Promotion of Health and Biomedical Research of the Valencian Community. (FISABIO), Valencia, Spain
| | | | | | | | - Azucena García-Palacios
- Department of Basic and Clinical Psychology, and Psychobiology, Universitat Jaume I, Castellon, Spain
- The Spanish Biomedical Research Centre in Physiopathology of Obesity and Nutrition (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain
| |
Collapse
|
2
|
Pan Y, Wang H, Geng Y, Lai J, Hu S. Latent Profile Analysis of Suicidal Ideation in Chinese Individuals with Bipolar Disorder. Behav Sci (Basel) 2024; 14:360. [PMID: 38785851 PMCID: PMC11117804 DOI: 10.3390/bs14050360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Revised: 04/02/2024] [Accepted: 04/22/2024] [Indexed: 05/25/2024] Open
Abstract
Individuals with bipolar disorder (BD) have a greater suicide risk than the general population. In this study, we employed latent profile analysis (LPA) to explore whether Chinese individuals with different phases of BD differed at the levels of suicidal ideation. We recruited 517 patients. Depressive symptoms were measured using the 24-item Hamilton Depression Rating Scale (HAMD-24), and manic symptoms were evaluated using the Young Mania Rating Scale (YMRS). The extent of suicidal thoughts was determined through the Beck Scale for Suicide Ideation (BSSI). The scores of HAMD and YMRS were used to perform LPA. LPA categorized participants into three classes: one exhibiting severe depressive and mild manic symptomatology, another showing severe depressive and severe manic symptomatology, and the third one displaying severe depressive and intermediate manic symptomatology. Suicidal ideation levels were found to be remarkably elevated across all three classes. Additionally, the three classes showed no significant differences in terms of suicidal ideation. Our research confirms the link between depressive symptoms and suicide, independent of the manic symptoms. These findings carry meaning as they provide insight into the suicide risk profiles within different phases of BD.
Collapse
Affiliation(s)
- Yanmeng Pan
- Department of Psychiatry, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China; (Y.P.); (H.W.); (Y.G.)
| | - Huaizhi Wang
- Department of Psychiatry, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China; (Y.P.); (H.W.); (Y.G.)
- School of Psychiatry, Wenzhou Medical University, Wenzhou 325035, China
| | - Yimeng Geng
- Department of Psychiatry, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China; (Y.P.); (H.W.); (Y.G.)
| | - Jianbo Lai
- Department of Psychiatry, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China; (Y.P.); (H.W.); (Y.G.)
| | - Shaohua Hu
- Department of Psychiatry, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China; (Y.P.); (H.W.); (Y.G.)
- Nanhu Brain-Computer Interface Institute, Hangzhou 310003, China
- Zhejiang Key Laboratory of Precision Psychiatry, Hangzhou 310003, China
- Brain Research Institute, Zhejiang University, Hangzhou 310003, China
- Zhejiang Engineering Center for Mathematical Mental Health, Hangzhou 310003, China
- MOE Frontier Science Center for Brain Science and Brain-machine Integration, Zhejiang University, Hangzhou 310003, China
- Department of Psychology and Behavioral Sciences, Zhejiang University, Hangzhou 310003, China
| |
Collapse
|
3
|
De Backer K, Pali A, Challacombe FL, Hildersley R, Newburn M, Silverio SA, Sandall J, Howard LM, Easter A. Women's experiences of attempted suicide in the perinatal period (ASPEN-study) - a qualitative study. BMC Psychiatry 2024; 24:255. [PMID: 38570802 PMCID: PMC10988966 DOI: 10.1186/s12888-024-05686-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Accepted: 03/14/2024] [Indexed: 04/05/2024] Open
Abstract
BACKGROUND Suicide is a leading cause of maternal death during pregnancy and the year after birth (the perinatal period). While maternal suicide is a relatively rare event with a prevalence of 3.84 per 100,000 live births in the UK [1], the impact of maternal suicide is profound and long-lasting. Many more women will attempt suicide during the perinatal period, with a worldwide estimated prevalence of 680 per 100,000 in pregnancy and 210 per 100,000 in the year after birth [2]. Qualitative research into perinatal suicide attempts is crucial to understand the experiences, motives and the circumstances surrounding these events, but this has largely been unexplored. AIM Our study aimed to explore the experiences of women and birthing people who had a perinatal suicide attempt and to understand the context and contributing factors surrounding their perinatal suicide attempt. METHODS Through iterative feedback from a group of women with lived experience of perinatal mental illness and relevant stakeholders, a qualitative study design was developed. We recruited women and birthing people (N = 11) in the UK who self-reported as having undertaken a suicide attempt. Interviews were conducted virtually, recorded and transcribed. Using NVivo software, a critical realist approach to Thematic Analysis was followed, and themes were developed. RESULTS Three key themes were identified that contributed to the perinatal suicide attempt. The first theme 'Trauma and Adversities' captures the traumatic events and life adversities with which participants started their pregnancy journeys. The second theme, 'Disillusionment with Motherhood' brings together a range of sub-themes highlighting various challenges related to pregnancy, birth and motherhood resulting in a decline in women's mental health. The third theme, 'Entrapment and Despair', presents a range of factors that leads to a significant deterioration of women's mental health, marked by feelings of failure, hopelessness and losing control. CONCLUSIONS Feelings of entrapment and despair in women who are struggling with motherhood, alongside a background of traumatic events and life adversities may indicate warning signs of a perinatal suicide. Meaningful enquiry around these factors could lead to timely detection, thus improving care and potentially prevent future maternal suicides.
Collapse
Affiliation(s)
- Kaat De Backer
- Department of Women & Children's Health, School of Life Course and Population Sciences, Faculty of Life Sciences & Medicine, King's College London, 10th Floor North Wing, St. Thomas' Hospital, Westminster Bridge Road, Lambeth, London, SE1 7EH, UK
| | - Alexandra Pali
- Department of Women & Children's Health, School of Life Course and Population Sciences, Faculty of Life Sciences & Medicine, King's College London, 10th Floor North Wing, St. Thomas' Hospital, Westminster Bridge Road, Lambeth, London, SE1 7EH, UK
- Department of Clinical Psychological Science, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Fiona L Challacombe
- Section of Women's Mental Health, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, Denmark Hill, 16 De Crespigny Park, London, SE5 8AF, England
| | - Rosanna Hildersley
- Section of Women's Mental Health, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, Denmark Hill, 16 De Crespigny Park, London, SE5 8AF, England
| | - Mary Newburn
- Patient and Public Involvement and Engagement Lead for ARC South London, Maternity and Perinatal Mental health theme, Department of Women & Children's Health, School of Life Sciences and Medicine, King's College London, 10th Floor North Wing, St. Thomas' Hospital, Westminster Bridge Road, Lambeth, London, SE1 7EH, UK
| | - Sergio A Silverio
- Department of Women & Children's Health, School of Life Course & Population Sciences, Faculty of Life Sciences & Medicine, King's College London, 6th Floor Addison House, Great Maze Pond, Southwark, London, SE1 1UK, UK
- School of Psychology, Faculty of Health, Liverpool John Moores University, Liverpool, Merseyside, L3 3AF, UK
| | - Jane Sandall
- Department of Women & Children's Health, School of Life Course and Population Sciences, Faculty of Life Sciences & Medicine, King's College London, 10th Floor North Wing, St. Thomas' Hospital, Westminster Bridge Road, Lambeth, London, SE1 7EH, UK
| | - Louise M Howard
- Section of Women's Mental Health, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, Denmark Hill, 16 De Crespigny Park, London, SE5 8AF, England
| | - Abigail Easter
- Department of Women & Children's Health, School of Life Course and Population Sciences, Faculty of Life Sciences & Medicine, King's College London, 10th Floor North Wing, St. Thomas' Hospital, Westminster Bridge Road, Lambeth, London, SE1 7EH, UK.
| |
Collapse
|
4
|
Picou P, Kemp EC, Ferreira R, Sharp C, Hill RM. Familism moderates the association between parent-child conflict, interpersonal needs, and suicidal ideation among adolescents. Clin Child Psychol Psychiatry 2024:13591045241235723. [PMID: 38466578 DOI: 10.1177/13591045241235723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/13/2024]
Abstract
Within the framework of the interpersonal theory of suicide, parent-child conflict in adolescence may be associated with suicidal ideation through increases in thwarted interpersonal needs (i.e., perceived burdensomeness and thwarted belongingness). Familism, a cultural value that emphasizes prioritizing familial interconnectedness and honor, may moderate the association between parent-child conflict and thwarted interpersonal needs. This study examined the relationship between parent-child conflict, familism, and suicidal ideation through the interpersonal theory of suicide. Participants were N = 250 psychiatrically hospitalized adolescents aged 12-17 years (Mage = 14.84, 60.8% female; 41.9% Hispanic, 21.5% African American/Black, 26.0% Caucasian). Participants completed survey and interview measures prior to discharge from psychiatric hospitalization. There was a significant conditional indirect effect of parent-child conflict on suicidal ideation through thwarted interpersonal needs [F (3, 246) = 54.41, p < .01], such that the strength of the indirect effects family conflict on suicidal ideation via thwarted interpersonal needs increased as familism increased. Findings indicate that the relationship between parent-child conflict and thwarted interpersonal needs may be exacerbated when levels of familism are also high. For youth who endorse high levels of familism, parent-child conflict may be particularly pernicious. Interventions targeting the family environment are needed to potentially improve adolescents' interpersonal functioning and protect against suicidal ideation.
Collapse
Affiliation(s)
- Paige Picou
- Department of Psychology, Louisiana State University, USA
| | - Emily C Kemp
- Department of Psychology, Louisiana State University, USA
| | | | - Carla Sharp
- Department of Psychology, University of Houston, USA
| | - Ryan M Hill
- Department of Psychology, Louisiana State University, USA
| |
Collapse
|
5
|
Mitchell SM, Brown SL, Moscardini EH, LeDuc M, Tucker R. A Psychometric Evaluation of the Interpersonal Hopelessness Scale Among Individuals With Elevated Suicide Risk. Assessment 2024; 31:304-320. [PMID: 36935566 PMCID: PMC10507143 DOI: 10.1177/10731911231161766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/21/2023]
Abstract
The interpersonal theory of suicide hypothesizes that suicide ideation (SI) emerges specifically in the context of hopelessness about the immutability of thwarted belongingness (TB) and perceived burdensomeness (PB; i.e., interpersonal hopelessness). The psychometrics of the Interpersonal Hopelessness Scale (IHS), which could be used to test this hypothesis directly, have not been rigorously evaluated. Participants (U.S. adults reporting past-year SI) completed online self-report assessments at Waves 1 (W1; N = 595) and 2 (W2; N = 215), 1 week apart. Confirmatory factor analyses supported a two-factor structure, IHS-TB and IHS-PB. Correlations indicated strong concurrent validity. Hurdle negative binomial regressions indicated that W1 IHS-TB and IHS-PB scores were associated with SI presence and severity at both waves, but this was inconsistent when adjusting for other W1 variables. IHS-TB and IHS-PB demonstrated excellent internal consistency and moderate to good test-retest reliability. The IHS could improve theory testing and suicide risk assessment and management.
Collapse
|
6
|
Law KC, Wee JY, O'Connell K, Moreira N, Preston O, Rogers ML, Anestis JC. The impact of different neurobehavioral symptoms on suicidal ideation and perceived likelihood of future suicidality. J Psychiatr Res 2024; 171:134-141. [PMID: 38280241 DOI: 10.1016/j.jpsychires.2024.01.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 12/01/2023] [Accepted: 01/05/2024] [Indexed: 01/29/2024]
Abstract
Existing literature suggests that psychological and functional impairment, independent of head injury severity, can increase suicide risk. This study explores the impacts of self-perceived dysfunction within four neurobehavioral symptom clusters-vestibular (e.g., dizziness, balance), somatosensory (e.g., headaches, nausea, vision), affective (e.g., anxious, irritable mood), and cognitive (e.g., concentration, memory, indecision)-on current suicidal ideation and the perceived likelihood of future suicidal ideation and attempts. Community participants (n = 309; Mage = 36.88; 51.6% female; 79.6% White) completed the Neurobehavioral Symptom Inventory (NSI) and the Self-Injurious Thoughts and Behaviors-Short Form (SITBI-SF). Quantile regression analysis was used to explore the effects of the four neurobehavioral symptom clusters at different levels of suicidal ideation intensity, perceived likelihood of future suicidal ideation, and self-perceived likelihood of future suicide attempt. Controlling for past head injuries and suicide attempts, affective symptoms were significantly associated with a moderate and high average intensity of current suicidal ideation. Somatosensory symptoms were significantly associated with a moderate perceived likelihood of future suicidal ideation. Finally, vestibular symptoms were significantly associated with a moderate perceived likelihood of a future suicide attempt. These findings highlight the critical need to consider a broader spectrum of symptoms, including chronic physical symptoms, when assessing suicide risk. Furthermore, they underscore the need to expand beyond affective symptoms as an explanation for increased suicidality and examine additional mechanisms through which chronic physical symptoms can increase suicide risk.
Collapse
Affiliation(s)
| | | | | | | | - Olivia Preston
- University of Florida College of Medicine - Jacksonvile, USA
| | | | | |
Collapse
|
7
|
Moreira-Neto A, Neves LM, Miliatto A, Juday V, Marquesini R, Lafer B, Cardoso EF, Ugrinowitsch C, Nucci MP, Silva-Batista C. Clinical and neuroimaging correlates in a pilot randomized trial of aerobic exercise for major depression. J Affect Disord 2024; 347:591-600. [PMID: 38092282 DOI: 10.1016/j.jad.2023.12.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 06/30/2023] [Accepted: 12/08/2023] [Indexed: 01/08/2024]
Abstract
BACKGROUND Aerobic exercise (AE) combined with pharmacotherapy is known to reduce depressive symptoms; however, studies have not focused on long-term AE for volumetric changes of brain regions (amygdala, thalamus, and nucleus accumbens [NAcc]) linked to the control of affective responses and hopelessness in individuals with major depression (MD). In addition, AE with motor complexity (AEMC) would be more effective than AE in causing brain plasticity. We compared the effects of 24 weeks of AE and AEMC combined with pharmacotherapy on clinical and volumetric outcomes in individuals with MD. METHODS Forty medicated individuals with MD were randomly assigned to nonexercising control (C), AE, and AEMC groups. The training groups exercised for 60 min, twice a week for 24 weeks. Clinical and volumetric outcomes were assessed before and after the 24 weeks. Effect size (ES) and confidence interval (CI) were calculated for within-group and between-groups changes. RESULTS AE and AEMC reduced hopelessness (ES = -0.73 and ES = -0.62, respectively) and increased affective responses (ES = 1.24 and ES = 1.56, respectively). Only AE increased amygdala (ES = 0.27 left and ES = 0.34 right), thalamus (ES = 0.33 left and ES = 0.26 right) and left NAcc (ES = 0.54) volumes. AE was more effective than the C group in reducing hopelessness and causing brain plasticity. The changes in the right amygdala volume showed a strong trend in explaining 72 % of the changes in affective responses following AE (p = 0.06). LIMITATION Lack of posttraining follow-up and small sample size. CONCLUSION These preliminary data indicate that AE combined with pharmacotherapy can cause clinical improvement and brain plasticity in individuals with MD.
Collapse
Affiliation(s)
- Acácio Moreira-Neto
- Laboratory of Magnetic Resonance in Neuroradiology - LIM- 44, University of São Paulo Faculty of Medicine Clinics Hospital, São Paulo, Brazil; Exercise Neuroscience Research Group, University of São Paulo, São Paulo, Brazil
| | - Lucas Melo Neves
- Laboratory of Neuromuscular Adaptations to Strength Training, School of Physical Education and Sport, University of São Paulo, São Paulo, Brazil; Bipolar Disorder Program (PROMAN), Department of Psychiatry, University of São Paulo Medical School, São Paulo, Brazil; Post-Graduate Program in Health Sciences, Santo Amaro University, São Paulo, Brazil
| | - Angelo Miliatto
- Exercise Neuroscience Research Group, University of São Paulo, São Paulo, Brazil
| | | | - Raquel Marquesini
- Laboratory of Neuromuscular Adaptations to Strength Training, School of Physical Education and Sport, University of São Paulo, São Paulo, Brazil
| | - Beny Lafer
- Bipolar Disorder Program (PROMAN), Department of Psychiatry, University of São Paulo Medical School, São Paulo, Brazil
| | - Ellison Fernando Cardoso
- Laboratory of Magnetic Resonance in Neuroradiology - LIM- 44, University of São Paulo Faculty of Medicine Clinics Hospital, São Paulo, Brazil
| | - Carlos Ugrinowitsch
- Laboratory of Neuromuscular Adaptations to Strength Training, School of Physical Education and Sport, University of São Paulo, São Paulo, Brazil
| | - Mariana Penteado Nucci
- Laboratory of Magnetic Resonance in Neuroradiology - LIM- 44, University of São Paulo Faculty of Medicine Clinics Hospital, São Paulo, Brazil
| | - Carla Silva-Batista
- Exercise Neuroscience Research Group, University of São Paulo, São Paulo, Brazil; Department of Neurology, Oregon Health & Science University, Portland, OR, United States of America
| |
Collapse
|
8
|
Chen D, Ejlskov L, Laustsen LM, Weye N, Sørensen CLB, Momen NC, Dreier JW, Zheng Y, Damgaard AJ, McGrath JJ, Sørensen HT, Plana-Ripoll O. The Role of Socioeconomic Position in the Association Between Mental Disorders and Mortality: A Systematic Review and Meta-Analysis. JAMA Psychiatry 2024; 81:125-134. [PMID: 37966825 PMCID: PMC10652216 DOI: 10.1001/jamapsychiatry.2023.4316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 09/14/2023] [Indexed: 11/16/2023]
Abstract
Importance Studies are lacking summarizing how the association between mental disorders and mortality varies by socioeconomic position (SEP), particularly considering different aspects of SEP, specific types of mental disorders, and causes of death. Objective To investigate the role of SEP in the association between mental disorders and mortality and the association between SEP and mortality among people with mental disorders. Data Sources MEDLINE, Embase, PsycINFO, and Web of Science were searched from January 1, 1980, through April 3, 2023, and a snowball search of reference and citation lists was conducted. Study Selection Inclusion criteria were observational studies estimating the associations between different types of mental disorders and mortality, stratified by SEP and between SEP and mortality in people with mental disorders. Data Extraction and Synthesis Pairs of reviewers independently extracted data using a predefined data extraction form and assessed the risk of bias using the adapted Newcastle-Ottawa scale. Graphical analyses of the dose-response associations and random-effects meta-analyses were performed. Heterogeneity was explored through meta-regressions and sensitivity analyses. Main Outcomes and Measures All-cause and cause-specific mortality. Results Of 28 274 articles screened, 71 including more than 4 million people with mental disorders met the inclusion criteria (most of which were conducted in high-income countries). The relative associations between mental disorders and mortality were similar across SEP levels. Among people with mental disorders, belonging to the highest rather than the lowest SEP group was associated with lower all-cause mortality (pooled relative risk [RR], 0.79; 95% CI, 0.73-0.86) and mortality from natural causes (RR, 0.73; 95% CI, 0.62-0.85) and higher mortality from external causes (RR, 1.18; 95% CI, 0.99-1.41). Heterogeneity was high (I2 = 83% to 99%). Results from subgroup, sensitivity, and meta-regression analyses were consistent with those from the main analyses. Evidence on absolute scales, specific diagnoses, and specific causes of death was scarce. Conclusion and Relevance This study did not find a sufficient body of evidence that SEP moderated the relative association between mental disorders and mortality, but the underlying mortality rates may differ by SEP group, despite having scarcely been reported. This information gap, together with our findings related to SEP and a possible differential risk between natural and external causes of death in individuals with specific types of mental disorders, warrants further research.
Collapse
Affiliation(s)
- Danni Chen
- Department of Clinical Epidemiology, Aarhus University and Aarhus University Hospital, Aarhus, Denmark
| | - Linda Ejlskov
- Department of Clinical Epidemiology, Aarhus University and Aarhus University Hospital, Aarhus, Denmark
| | - Lisbeth Mølgaard Laustsen
- Department of Clinical Epidemiology, Aarhus University and Aarhus University Hospital, Aarhus, Denmark
| | - Nanna Weye
- Department of Clinical Epidemiology, Aarhus University and Aarhus University Hospital, Aarhus, Denmark
- Department of Disease Burden, Norwegian Institute of Public Health, Bergen, Norway
| | | | - Natalie C. Momen
- Department of Clinical Epidemiology, Aarhus University and Aarhus University Hospital, Aarhus, Denmark
| | | | - Yan Zheng
- Department of Clinical Epidemiology, Aarhus University and Aarhus University Hospital, Aarhus, Denmark
| | - Astrid Jensen Damgaard
- Master Program in Health Science, Rehabilitation and Prevention, Aarhus University, Aarhus, Denmark
| | - John J. McGrath
- National Centre for Register-Based Research, Aarhus University, Aarhus, Denmark
- Queensland Centre for Mental Health Research, University of Queensland, Wacol, Queensland, Australia
- Queensland Brain Institute, University of Queensland, St Lucia, Queensland, Australia
| | - Henrik Toft Sørensen
- Department of Clinical Epidemiology, Aarhus University and Aarhus University Hospital, Aarhus, Denmark
| | - Oleguer Plana-Ripoll
- Department of Clinical Epidemiology, Aarhus University and Aarhus University Hospital, Aarhus, Denmark
- National Centre for Register-Based Research, Aarhus University, Aarhus, Denmark
| |
Collapse
|
9
|
Ross JM, Barone JC, Tauseef H, Schmalenberger KM, Nagpal A, Crane NA, Eisenlohr-Moul TA. Predicting Acute Changes in Suicidal Ideation and Planning: A Longitudinal Study of Symptom Mediators and the Role of the Menstrual Cycle in Female Psychiatric Outpatients With Suicidality. Am J Psychiatry 2024; 181:57-67. [PMID: 38093647 PMCID: PMC11031249 DOI: 10.1176/appi.ajp.20230303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2024]
Abstract
OBJECTIVE Cross-sectional and preliminary longitudinal findings suggest that cyclical ovarian hormone fluctuations influence acute suicide risk. The authors provide the first analyses in females with suicidality to investigate which daily symptoms covary with suicidal ideation and planning thoughts, the role of the menstrual cycle in daily symptom variation, how daily fluctuations in symptoms mediate the menstrual cycle-suicidality relationship, and how these associations vary across individuals. METHODS Naturally cycling psychiatric outpatients (N=119) with past-month suicidal ideation provided daily ratings of psychiatric symptoms (depression, hopelessness, anxiety, feeling overwhelmed, agitation, anhedonia, worthlessness, rejection sensitivity, anger, perceived burdensomeness, and interpersonal conflict), suicidal ideation, and suicidal planning across at least one menstrual cycle. Symptom ratings were decomposed into trait (person-centered mean) and state (daily person-centered mean deviation) components. Five cycle phases were identified in relation to menses onset and ovulation (surge in urine luteinizing hormone level). Hypotheses were tested in multilevel structural equation models. RESULTS Nearly all psychiatric symptoms covaried with fluctuations in daily suicidal ideation, and a limited set of symptoms (depression, hopelessness, rejection sensitivity, and perceived burdensomeness) predicted within-person increases in suicidal planning. Many patients demonstrated perimenstrual worsening of psychiatric symptoms, suicidal ideation, and suicidal planning. Depressive symptoms (depression, hopelessness, perceived burdensomeness, and anhedonia) were the most robust statistical mediators predicting perimenstrual exacerbation of suicidality. CONCLUSIONS Research on the menstrual cycle and suicide has been limited historically by small, cross-sectional samples. This study provides the first evidence that measuring day-to-day correlates of suicidality in a large transdiagnostic sample of females with suicidal ideation can contribute to understanding the pathways by which the menstrual cycle influences acute suicide risk.
Collapse
Affiliation(s)
- Jaclyn M Ross
- Department of Psychiatry, College of Medicine, University of Illinois at Chicago
| | - Jordan C Barone
- Department of Psychiatry, College of Medicine, University of Illinois at Chicago
| | - Hafsah Tauseef
- Department of Psychiatry, College of Medicine, University of Illinois at Chicago
| | | | - Anisha Nagpal
- Department of Psychiatry, College of Medicine, University of Illinois at Chicago
| | - Natania A Crane
- Department of Psychiatry, College of Medicine, University of Illinois at Chicago
| | | |
Collapse
|
10
|
Kim HJ, Kim J, Yook KH, Choi TK, Lee SH. Early Trauma Subtypes are Differentially Related to Anxiety Symptomatology and Suicidal Ideation in Panic Disorder. Psychiatry Investig 2023; 20:1211-1220. [PMID: 38163660 PMCID: PMC10758330 DOI: 10.30773/pi.2023.0371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2023] [Revised: 11/09/2023] [Accepted: 11/12/2023] [Indexed: 01/03/2024] Open
Abstract
OBJECTIVE Early trauma significantly affects the severity of panic disorder (PD) symptoms and suicidal ideation. However, few studies have explored the specific effects of different early trauma subtypes on PD. This study analyzed how childhood trauma subtypes, including general, physical, emotional, and sexual, influence panic and phobia levels and suicidal ideation in adults with PD and healthy controls (HCs). METHODS In total, 455 adults with PD and 149 HCs participated in this study. The independent variables were sociodemographic and clinical variables such as coping strategies and early trauma subtypes from the Early Trauma Inventory Self Report-Short Form. The dependent variables were the Albany Panic and Phobia Questionnaire (APPQ), the Panic Disorder Severity Scale, and the Scale for Suicide Ideation (SSI). RESULTS Early emotional trauma significantly influenced the APPQ scores, whereas early physical trauma significantly influenced the SSI scores in patients with PD. However, in HCs, only early emotional trauma was significantly associated with the APPQ and SSI scores. CONCLUSION These findings highlight the influence of early trauma subtypes on the phobic symptom severity of PD and suicidal ideation among patients with PD. Early emotional trauma is associated with the severity of phobic symptoms, whereas early physical trauma is associated with suicidal ideation, suggesting distinct clinical outcomes based on the type of trauma in patients with PD.
Collapse
Affiliation(s)
- Hyun-Ju Kim
- Department of Psychiatry, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Republic of Korea
| | - Jieun Kim
- Department of Family Environment and Welfare, Chonnam National University, Gwangju, Republic of Korea
| | - Ki-Hwan Yook
- Department of Psychiatry, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Republic of Korea
| | - Tai Kiu Choi
- Department of Psychiatry, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Republic of Korea
| | - Sang-Hyuk Lee
- Department of Psychiatry, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Republic of Korea
| |
Collapse
|
11
|
Matuza T, Shikh A, Sullivan SR, Wheeler A, Miranda R. Induced optimism to lessen hopelessness-related cognitions among young adults at risk for suicidal thoughts and behavior. JOURNAL OF AFFECTIVE DISORDERS REPORTS 2023; 14:100670. [PMID: 38125966 PMCID: PMC10732345 DOI: 10.1016/j.jadr.2023.100670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2023] Open
Abstract
Background Hopelessness is one of the best-studied cognitive predictors of depression and suicide. Previous research suggests that hopelessness may develop through repetitive thinking about the occurrence of positive and negative future outcomes. The present study sought to investigate whether mental rehearsal in making optimistic future-event predictions, or induced optimism, would lead to reductions in hopelessness, particularly among individuals with a history of suicide ideation or suicide attempts. Methods Participants with (n = 58) and without (n = 76) a history of suicide ideation or attempts were randomly assigned to either practice making optimistic future-event predictions or to a control condition in which they practiced making a lexical decision (using the same stimuli) over three study sessions, each separated by one week. Results Findings offered modest support for the hypothesis that induced optimism would decrease hopelessness but not improve mood; this was regardless of history of suicide ideation or attempts. Limitations The sample was predominantly female, and assessment of suicide ideation and attempt history was not confirmed by clinical interview, which may limit generalizability. Conclusion Practice in making optimistic future-event predictions over time may be one way to reduce the hopelessness-related cognitions that confer vulnerability to suicide ideation and behavior.
Collapse
Affiliation(s)
| | - Allan Shikh
- Hunter College, City University of New York, USA
- University of Rochester Medical Center, USA
| | - Sarah R. Sullivan
- Hunter College, City University of New York, USA
- The Graduate Center, City University of New York, USA
| | | | - Regina Miranda
- Hunter College, City University of New York, USA
- The Graduate Center, City University of New York, USA
| |
Collapse
|
12
|
Jamieson C, Canuso CM, Ionescu DF, Lane R, Qiu X, Rozjabek H, Molero P, Fu DJ. Effects of esketamine on patient-reported outcomes in major depressive disorder with active suicidal ideation and intent: a pooled analysis of two randomized phase 3 trials (ASPIRE I and ASPIRE II). Qual Life Res 2023; 32:3053-3061. [PMID: 37439961 PMCID: PMC10522733 DOI: 10.1007/s11136-023-03451-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/24/2023] [Indexed: 07/14/2023]
Abstract
PURPOSE To assess the effect of esketamine nasal spray on patient-reported outcomes (PROs) in patients with major depressive disorder having active suicidal ideation with intent (MDSI). METHODS Patient-level data from two phase 3 studies (ASPIRE I; ASPIRE II) of esketamine + standard of care (SOC) in patients (aged 18-64 years) with MDSI, were pooled. PROs were evaluated from baseline through end of the double-blind treatment phase (day 25). Outcome assessments included: Beck Hopelessness Scale (BHS), Quality of Life (QoL) in Depression Scale (QLDS), European QoL Group-5-Dimension-5-Level (EQ-5D-5L), and 9-item Treatment Satisfaction Questionnaire for Medication (TSQM-9). Changes in BHS and QLDS scores (baseline to day 25) were analyzed using a mixed-effects model for repeated measures (MMRM). RESULTS Pooled data for esketamine + SOC (n = 226; mean age: 40.5 years, 59.3% females) and placebo + SOC (n = 225; mean age: 39.6 years, 62.2% females) were analyzed. Mean ± SD change from baseline to day 25, esketamine + SOC vs placebo + SOC (least-square mean difference [95% CI] based on MMRM): BHS total score, - 7.4 ± 6.7 vs - 6.8 ± 6.5 [- 1.0 (- 2.23, 0.21)]; QLDS score, - 14.4 ± 11.5 vs - 12.2 ± 10.8 [- 3.1 (- 5.21, - 1.02)]. Relative risk (95% CI) of reporting perceived problems (slight to extreme) in EQ-5D-5L dimensions (day 25) in esketamine + SOC vs placebo + SOC: mobility [0.78 (0.50, 1.20)], self-care [0.83 (0.55, 1.27)], usual activities [0.87 (0.72, 1.05)], pain/discomfort [0.85 (0.69, 1.04)], and anxiety/depression [0.90 (0.80, 1.00)]. Mean ± SD changes from baseline in esketamine + SOC vs placebo + SOC for health status index: 0.23 ± 0.21 vs 0.19 ± 0.22; and for EQ-Visual Analogue Scale: 24.0 ± 27.2 vs 19.3 ± 24.4. At day 25, mean ± SD in domains of TSQM-9 scores in esketamine + SOC vs placebo + SOC were: effectiveness, 67.2 ± 25.3 vs 56.2 ± 26.8; global satisfaction, 69.9 ± 25.2 vs 56.3 ± 27.8; and convenience, 74.0 ± 19.4 vs 75.4 ± 18.7. CONCLUSION These PRO data support the patient perspective of the effect associated with esketamine + SOC in improving health-related QoL in patients with MDSI. TRIAL REGISTRATION ClinicalTrials.gov Identifier: ASPIRE I, NCT03039192 (Registration date: February 1, 2017); ASPIRE II, NCT03097133 (Registration date: March 31, 2017).
Collapse
Affiliation(s)
| | - Carla M Canuso
- Janssen Research & Development, LLC, Titusville, NJ, USA
| | | | - Rosanne Lane
- Janssen Research & Development, LLC, Titusville, NJ, USA
| | - Xin Qiu
- Janssen Research & Development, LLC, Raritan, NJ, USA
| | | | - Patricio Molero
- Department of Psychiatry, Clinica Universidad de Navarra, Pamplona, Spain
| | - Dong-Jing Fu
- Janssen Research & Development, LLC, Titusville, NJ, USA
| |
Collapse
|
13
|
Abascal-Peiró S, Alacreu-Crespo A, Peñuelas-Calvo I, López-Castromán J, Porras-Segovia A. Characteristics of Single vs. Multiple Suicide Attempters Among Adult Population: A Systematic Review and Meta-Analysis. Curr Psychiatry Rep 2023; 25:769-791. [PMID: 37740850 DOI: 10.1007/s11920-023-01461-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/13/2023] [Indexed: 09/25/2023]
Abstract
PURPOSE OF REVIEW We aimed to examine the factors that differentiate single and multiple suicide attempters in adult population. We followed the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines to conduct this review and meta-analysis. The review protocol was registered in PROSPERO. We carried out a systematic literature search in three databases to identify original studies that explored the differences between single and multiple suicide attempters among adult population. RECENT FINDINGS There might be meaningful differences between those individuals that attempt suicide once in their lifespan and those who make multiple attempts in terms of sociodemographic and clinical characteristics. There are no previous meta-analysis addressing this topic in the adult population. A total of 75 studies were included in the review and 69 were included in the meta-analysis. Multiple attempters were more likely to present certain disorders such as mood and psychotic disorders, as well as personality or substance use disorders. Higher suicide ideation and suicide intent scores also characterized this group. Childhood trauma experiences, stressful life events, and higher rates of hopelessness were statistically significant in multiple attempters. Identifying the factors predicting multiple suicide attempts helps to delineate a high-risk suicidal profile that should be taken into account in the clinical and suicide prevention scenario.
Collapse
Affiliation(s)
- Sofía Abascal-Peiró
- Department of Psychiatry, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain.
| | - Adrián Alacreu-Crespo
- Department of Psychology and Sociology, Area of Personality, Assessment and Psychological Treatment, Universidad of Zaragoza, Teruel, Spain
| | - Inmaculada Peñuelas-Calvo
- Department of Child and Adolescent Psychiatry, Hospital 12 de Octubre, Madrid, Spain
- Department of Legal Medicine, Psychiatry and Pathology, Universidad Complutense de Madrid, Madrid, Spain
| | - Jorge López-Castromán
- Department of Psychiatry, CNRS-INSERM, University of Montpellier, CHU Nîmes & IGF, Montpellier, France
| | - Alejandro Porras-Segovia
- Instituto de Investigación Sanitaria Fundación Jiménez Díaz, Madrid, Spain
- Division of Psychiatry, Imperial College, London, UK
| |
Collapse
|
14
|
Pearlman AT, Murphy MA, Raiciulescu S, Johnson N, Klein DA, Gray JC, Schvey NA. Longitudinal Associations Between Perceived Discrimination and Suicidality in Youth. J Pediatr 2023; 262:113642. [PMID: 37517645 DOI: 10.1016/j.jpeds.2023.113642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 07/14/2023] [Accepted: 07/25/2023] [Indexed: 08/01/2023]
Abstract
Research among adults reveals robust associations between discrimination and suicidality. However, the relationship between discrimination and suicidality is understudied in youth. Participants in the Adolescent Brain Cognitive Development study (n = 10 312) completed a measure of discrimination based on multiple attributes. The Kiddie Schedule for Affective Disorders and Schizophrenia was administered 1 year later to assess depressive disorders and suicidality (ideation and behavior). Logistic regressions, adjusting for age, sex, race/ethnicity, family income, lifetime depressive disorders, and body composition were conducted. Adjusting for covariates, discrimination based on weight (OR: 2.19), race/ethnicity/color (OR: 3.21), and sexual orientation (OR: 3.83) were associated with greater odds of reporting suicidality 1 year later (ps < 0.025). Nationality-based discrimination was not significantly associated with suicidality. Compared with those reporting no discrimination, youths reporting discrimination based on 2 or more attributes had nearly 5 times greater odds of recent suicidality (OR: 4.72; P < .001). The current study highlights the deleterious impacts of discrimination on mental health among youths reporting multiple forms of discrimination.
Collapse
Affiliation(s)
- Arielle T Pearlman
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USU), Bethesda, MD
| | - Mikela A Murphy
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USU), Bethesda, MD; The Henry M. Jackson Foundation for the Advancement of Military Medicine (HJF), Bethesda, MD
| | - Sorana Raiciulescu
- Department of Preventitive Medicine and Biostatistics, USU, Bethesda, MD
| | - Nia Johnson
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USU), Bethesda, MD; The Henry M. Jackson Foundation for the Advancement of Military Medicine (HJF), Bethesda, MD
| | - David A Klein
- Department of Pediatrics, USU, Bethesda, MD; Department of Family Medicine, USU, Bethesda, MD
| | - Joshua C Gray
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USU), Bethesda, MD
| | - Natasha A Schvey
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USU), Bethesda, MD.
| |
Collapse
|
15
|
Fowler K, Dooley KE. Positive mental health in adults with bipolar disorder: exploring social support subtypes, negative social interactions and potential to flourish. BMC Psychiatry 2023; 23:759. [PMID: 37848851 PMCID: PMC10580554 DOI: 10.1186/s12888-023-05244-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 10/01/2023] [Indexed: 10/19/2023] Open
Abstract
BACKGROUND Bipolar disorder (BD) (i.e., BD-I or BD-II) is a serious mental illness (SMI) that can cause significant life challenges, but its impact and management may be mediated by psychosocial factors. This study's primary objectives were to investigate whether adults with BD differ from those without in terms of social support, negative social interactions (NSIs), and positive mental health (PMH). Secondly, examine whether gender differences exist in terms of these variables, as well as whether specific social support subscales and NSI predict PMH for those with BD. METHODS Using data extracted from a national Canadian survey, 563 adults reporting a lifetime BD diagnosis were compared to a matched, non-BD sample using the Social Provisions Scale 10 Items (SPS-10), the NSI Scale, and the Mental Health Continuum - Short Form (MHC-SF) Scale. For the BD sample, males and females were compared based on study variables, and hierarchical regressions were subsequently performed to assess whether SPS-10 subscales and NSIs predicted PMH. RESULTS Respondents with BD reported significantly lower SPS-10 and PMH scores, and significantly higher NSI scores. Within the BD sample, females reported significantly higher SPS-10 and NSIs scores, and 'social integration' and 'reassurance of worth' positively predicted PMH, while NSI uniquely predicted lower PMH levels for both males and females. CONCLUSIONS The results implicate specific psychosocial factors and gender in the degree to which adults with BD might flourish, particularly in terms negative relationships. The implications of social erosion and the bi-directionality of social support are also considered.
Collapse
Affiliation(s)
- Ken Fowler
- Student Wellness and Counselling Centre, Memorial University of Newfoundland, St. John's, NL, Canada.
| | - Kaya E Dooley
- Department of Psychology, Faculty of Science, Memorial University of Newfoundland, St. John's, NL, Canada
| |
Collapse
|
16
|
Livingston WS, Tannahill HS, Meter DJ, Fargo JD, Blais RK. The Association of Military Sexual Harassment/Assault With Suicide Ideation, Plans, Attempts, and Mortality Among US Service Members/Veterans: A Meta-Analysis. TRAUMA, VIOLENCE & ABUSE 2023; 24:2616-2629. [PMID: 35763372 DOI: 10.1177/15248380221109790] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Suicide rates continue to increase among service members/veterans. Military sexual harassment/assault (MSH/A) may increase risk of suicide, but little is known about the collective magnitude of associations between MSH/A and suicide outcomes, including ideation, plan, attempt, and mortality. The current meta-analysis addressed this literature gap while testing potential moderators of gender, marital status, discharge status, and military branch. PsycINFO, PubMed, Dissertations/Theses, relevant citation lists, and conference brochures were reviewed for papers that included quantitative analyses in English, U.S. military samples, and measures of MSH/A and suicide ideation/plan/attempt/mortality. The search resulted in 22 studies (N = 10,898,875) measuring the association of MSH/A with suicide ideation (k = 15), plans (k = 1), attempts (k = 14), and mortality (k = 2), with papers published from 2007-2021. MSH/A was associated with suicide ideation (r ¯ = .14) and attempts (r ¯ = .11, ps < .05). The association of MSH/A and suicide ideation and attempts was higher among women relative to men, those identifying as married versus not married, those actively serving compared to discharged, and those reporting service in the Air Force relative to all other branches. The association of MSH/A with suicide plans and mortality was not calculated due to the small number of studies reporting those effect sizes (ks = 1-2). The effect sizes observed suggest MSH/A is part of a larger network of risk factors for suicide. Moderators indicate that suicide risk is higher among specific groups, and prevention strategies would be most effective if they targeted these individuals. This research area would be strengthened by additional studies of plans and mortality.
Collapse
Affiliation(s)
| | | | - Diana J Meter
- Department of Psychology, Utah State University, Logan, UT, USA
| | - Jamison D Fargo
- Department of Psychology, Utah State University, Logan, UT, USA
| | - Rebecca K Blais
- Department of Psychology, Utah State University, Logan, UT, USA
- Psychology Department, Arizona State University,Tempe, AZ, USA
| |
Collapse
|
17
|
Wu Q, Zhang J, Walsh L, Slesnick N. Heterogeneous trajectories of suicidal ideation among homeless youth: predictors and suicide-related outcomes. Dev Psychopathol 2023; 35:1671-1683. [PMID: 35440358 PMCID: PMC9582044 DOI: 10.1017/s0954579422000372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
The current study examined heterogeneous trajectories of suicidal ideation among homeless youth experiencing suicidal ideation over 9 months in a randomized controlled intervention study. Suicidal homeless youth (N = 150) were randomly assigned to Cognitive Therapy for Suicide Prevention (CTSP) + Treatment as Usual (TAU) or TAU alone. Youth reported their suicidal ideation four times during a 9-month period. We also assessed pretreatment mental health, demographic information and session attendance as predictors of the subgroups, as well as suicide-related factors as outcomes at the 9-month follow-up. Growth mixture models suggested three distinct trajectory groups among youth: Fast Declining (74.7%), Chronic (19.3%), and Steadily Declining (6.0%). Youth in the Chronic group used more substances at baseline than the Steadily Declining group, were more likely to be White, non-Hispanic than the Fast Declining group, and attended more CTSP sessions than other groups. Contrastingly, youth in the Steadily Declining group all experienced childhood abuse. Finally, youth in the Chronic group showed significant higher risk for future suicide compared to those in the Fast Declining group at 9 months. Findings support the heterogeneity of treatment responses in suicide intervention among homeless youth, with implications to improve treatment efforts in this very high-risk population.
Collapse
Affiliation(s)
- Qiong Wu
- Department of Human Development & Family Science, College of Health and Human Sciences, Florida State University
| | - Jing Zhang
- Department of Human Development and Family Studies, School of Lifespan Development and Educational Sciences, Kent State University
| | - Laura Walsh
- Department of Human Sciences, College of Education and Human Ecology, The Ohio State University
| | - Natasha Slesnick
- Department of Human Sciences, College of Education and Human Ecology, The Ohio State University
| |
Collapse
|
18
|
Ihme H, Courtet P, Risch N, Dubois J, Belzeaux R, Olié E. Mediation effect of anxious attachment on relationship between childhood trauma and suicidal ideation sensitive to psychological pain levels. Eur Psychiatry 2023; 66:e79. [PMID: 37737057 PMCID: PMC10594339 DOI: 10.1192/j.eurpsy.2023.2452] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 09/06/2023] [Accepted: 09/06/2023] [Indexed: 09/23/2023] Open
Abstract
BACKGROUND Childhood trauma (CT), depression, and psychological pain are known predictors of suicidal ideation. Recent literature additionally highlights the importance of the attachment system. METHODS We aimed to predict suicidal ideation through CT, attachment, and psychological and social pain by using mediation models aiming to predict suicidal ideation through CT (predictor) and attachment (mediator). In the same models, we introduced psychological or social pain as a moderator of the relationship between attachment, CT, and suicidal ideation. We included 161 depressed patients and assessed depression, attachment, CT, suicidal ideation, psychological pain, and social pain. RESULTS We found (1) a complete mediating effect of anxious attachment (a2b2 = 0.0035, CI95% = [0.0010; 0.0069]) on the relationship between CT on suicidal ideation, and (2) a significant complete conditional mediating effect of anxious attachment and psychological pain (index of moderated mediation VAS: 0.0014; CI95% = [0.0002; 0.0032]) but not social pain on the relationship between CT and suicidal ideation. Both models were controlled for history of suicidal attempt, depression severity, and sex. CONCLUSIONS Our results suggest a developmental profile of suicidal ideation in mood disorder that is characterized by the presence of CT and insecure attachment, especially anxious attachment, that is sensitive to experiences of psychological pain. Nevertheless, we cannot conclude that avoidantly attached individuals do not present the same mechanism, as they may not disclose those ideas.
Collapse
Affiliation(s)
- Hannah Ihme
- Institut de Neurosciences de la Timone, UMR 7289, Aix Marseille Université, CNRS, Marseille, France
| | - Philippe Courtet
- IGF,Univ. Montpellier, CNRS, INSERM, Montpellier, France
- Department of Emergency Psychiatry and Acute Care, Lapeyronie Hospital, CHU Montpellier, Montpellier, France
| | - Nathan Risch
- IGF,Univ. Montpellier, CNRS, INSERM, Montpellier, France
| | - Jonathan Dubois
- IGF,Univ. Montpellier, CNRS, INSERM, Montpellier, France
- Department of Emergency Psychiatry and Acute Care, Lapeyronie Hospital, CHU Montpellier, Montpellier, France
| | - Raoul Belzeaux
- Institut de Neurosciences de la Timone, UMR 7289, Aix Marseille Université, CNRS, Marseille, France
- Pôle Universitaire de Psychiatrie, CHU de Montpellier, Montpellier, France
| | - Emilie Olié
- IGF,Univ. Montpellier, CNRS, INSERM, Montpellier, France
- Department of Emergency Psychiatry and Acute Care, Lapeyronie Hospital, CHU Montpellier, Montpellier, France
| |
Collapse
|
19
|
Silva C, Smith PN, Rogers M, Joiner TE, Foote B, Van Orden KA. Clinically Significant Scores for Thwarted Belonging and Perceived Burden from the Interpersonal Needs Questionnaire (INQ-15). CRISIS 2023; 44:406-414. [PMID: 36762737 PMCID: PMC10412729 DOI: 10.1027/0227-5910/a000898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Abstract
Background: Social disconnection is associated with all-cause mortality and suicide. Measures of social disconnection with reliable cut-off scores are needed to aid in the assessment of clinically significant change. Aims: The current study sought to identify reliable clinical cut-off scores for the 15-item Interpersonal Needs Questionnaire (INQ-15), which assesses two indices of social disconnection associated with suicide ideation - thwarted belonging (TB) and perceived burden (PB) on others. Methods: The INQ-15 and measures of suicide ideation were administered to psychiatric outpatients (Nsample1 = 493; Nsample2 = 213) and psychiatric inpatients (Nsample3 = 79; Nsample4 = 87). Results: Reliable cut-off scores discriminating between the presence and absence of suicide ideation were identified across samples (TB ≥ 36 for psychiatric outpatients and ≥ 32 for inpatients; PB ≥ 12 for both psychiatric outpatients and inpatients). Limitations: Data are cross-sectional; thus, conclusions cannot be made about the predictive utility of INQ scores for future suicide ideation, attempts, or death. Conclusions: The INQ-15 yields scores with reliable cut-off scores for both TB and PB that represent clinically significant levels of social disconnection. These cut-off scores can be used in treatment trials and clinical practice to assess clinical improvement (or decline) in belonging and perceived burden.
Collapse
Affiliation(s)
- Caroline Silva
- Department of Psychiatry, University of Rochester School of Medicine, Rochester, NY, USA
| | - Phillip N. Smith
- Department of Psychology, University of South Alabama, Mobile, AL, USA
| | - Megan Rogers
- Department of Psychology, Texas State University, San Marcos, TX, USA
| | - Thomas E. Joiner
- Department of Psychology, Florida State University, Tallahassee, FL, USA
| | - Brad Foote
- Department of Psychiatry and Behavioral Sciences, Montefiore Medical Center, Bronx, NY, USA
| | - Kimberly A. Van Orden
- Department of Psychiatry, University of Rochester School of Medicine, Rochester, NY, USA
| |
Collapse
|
20
|
Jagger-Rickels A, Stumps A, Rothlein D, Evans T, Lee D, McGlinchey R, DeGutis J, Esterman M. Aberrant connectivity in the right amygdala and right middle temporal gyrus before and after a suicide attempt: Examining markers of suicide risk. J Affect Disord 2023; 335:24-35. [PMID: 37086805 PMCID: PMC10330566 DOI: 10.1016/j.jad.2023.04.061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 04/05/2023] [Accepted: 04/16/2023] [Indexed: 04/24/2023]
Abstract
Functional neuroimaging has the potential to help identify those at risk for self-injurious thoughts and behaviors, as well as inform neurobiological mechanisms that contribute to suicide. Based on whole-brain patterns of functional connectivity, our previous work identified right amygdala and right middle temporal gyrus (MTG) connectivity patterns that differentiated Veterans with a history of a suicide attempt (SA) from a Veteran control group. In this study, we aimed to replicate and extend our previous findings by examining whether this aberrant connectivity was present prior to and after a SA. In a trauma-exposed Veteran sample (92 % male, mean age = 34), we characterized if the right amygdala and right MTG connectivity differed between a psychiatric control sample (n = 56) and an independent sample of Veterans with a history of SA (n = 17), using fMRI data before and after the SA. Right MTG and amygdala connectivity differed between Veterans with and without a history of SA (replication), while MTG connectivity also distinguished Veterans prior to engaging in a SA (extension). In a second study, neither MTG or amygdala connectivity differed between those with current suicidal ideation (n = 27) relative to matched psychiatric controls (n = 27). These results indicate a potential stable marker of suicide risk (right MTG connectivity) as well as a potential marker of acute risk of or recent SA (right amygdala connectivity) that are independent of current ideation.
Collapse
Affiliation(s)
- Audreyana Jagger-Rickels
- National Center for PTSD, VA Boston Healthcare System, United States of America; Boston University Chobanian and Avedisian School of Medicine, Department of Psychiatry, United States of America; Boston Attention and Learning Lab, VA Boston Healthcare System, United States of America.
| | - Anna Stumps
- Department of Psychological and Brain Sciences, University of Delaware, United States of America
| | - David Rothlein
- National Center for PTSD, VA Boston Healthcare System, United States of America; Boston Attention and Learning Lab, VA Boston Healthcare System, United States of America
| | - Travis Evans
- Boston University Chobanian and Avedisian School of Medicine, Department of Psychiatry, United States of America; Boston Attention and Learning Lab, VA Boston Healthcare System, United States of America
| | - Daniel Lee
- National Center for PTSD, VA Boston Healthcare System, United States of America; Boston University Chobanian and Avedisian School of Medicine, Department of Psychiatry, United States of America
| | - Regina McGlinchey
- Translational Research Center for TBI and Stress Disorders (TRACTS), VA Boston Healthcare System, United States of America; Department of Psychiatry, Harvard Medical School, United States of America; Geriatric Research, Education and Clinical Center (GRECC), VA Boston Healthcare System, United States of America
| | - Joseph DeGutis
- Boston Attention and Learning Lab, VA Boston Healthcare System, United States of America; Translational Research Center for TBI and Stress Disorders (TRACTS), VA Boston Healthcare System, United States of America; Department of Psychiatry, Harvard Medical School, United States of America
| | - Michael Esterman
- National Center for PTSD, VA Boston Healthcare System, United States of America; Boston University Chobanian and Avedisian School of Medicine, Department of Psychiatry, United States of America; Boston Attention and Learning Lab, VA Boston Healthcare System, United States of America; Neuroimaging Research for Veterans (NeRVe) Center, VA Boston Healthcare System, United States of America
| |
Collapse
|
21
|
Mohamad Farok NH, Mahmud N. A Bibliometric Analysis of Global Research Trends on Suicidal Ideation. Malays J Med Sci 2023; 30:48-60. [PMID: 37655154 PMCID: PMC10467595 DOI: 10.21315/mjms2023.30.4.5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Accepted: 03/03/2022] [Indexed: 09/02/2023] Open
Abstract
Suicide cases have increased drastically over the years, while the upsurge has inevitably spiked society's concerns. Suicidal behaviours such as suicidal ideation have received special attention from professionals due to the harmful and irreversible consequences of possible suicide attempts. There is increasing concern that a more complete understanding of suicidal ideation trends is necessary to achieve scientific insights into suicidal behaviours through future integrated advanced research efforts. Thus, this paper aims to observe research patterns through publication outputs and co-authorships among authors and affiliated countries, besides co-occurrences of author keywords from the Scopus database. Using 'suicidal ideation' as the keyword on Scopus, this bibliometric analysis explored the global pattern of suicidal ideation research published between 1960 and 2020 and retrieved 3,061 records. Seven out of 15 most productive universities from the world's top 100 best universities were found in the leading countries lists. The United States was found as dominating the research area with 80% of the publications. In conclusion, the study found that researchers have made significant progress in the research area of suicidal ideation over the years; however, the topic still warrants further analysis to understand suicidality from a broader perspective.
Collapse
Affiliation(s)
- Nurul Hidayah Mohamad Farok
- School of Human Resource Development and Psychology, Faculty of Social Sciences and Humanities, Universiti Teknologi Malaysia, Johor, Malaysia
| | - Norashikin Mahmud
- School of Human Resource Development and Psychology, Faculty of Social Sciences and Humanities, Universiti Teknologi Malaysia, Johor, Malaysia
| |
Collapse
|
22
|
de Figueiredo JM, Zhu B, Patel AS, Kohn R, Koo BB, Louis ED. Differential impact of resilience on demoralization and depression in Parkinson disease. Front Psychiatry 2023; 14:1207019. [PMID: 37559912 PMCID: PMC10408307 DOI: 10.3389/fpsyt.2023.1207019] [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: 04/17/2023] [Accepted: 06/19/2023] [Indexed: 08/11/2023] Open
Abstract
OBJECTIVES The objective of this study was to study the interrelations of demoralization, depression, and resilience in patients with Parkinson disease, and, more specifically, to determine if higher resilience in patients with Parkinson disease is associated with lower demoralization, lower depression, or both. METHODS Outpatients with Parkinson disease (N = 95) were assessed for demoralization, depression, and resilience, as well as sociodemographic, clinical, and treatment-related variables. Bivariable associations, standard regressions, linear regression with copula correction, and correspondence analysis were used to analyze the data. RESULTS Although the bivariable association between resilience and depression was statistically significant, the association ceased to be significant when demoralization was taken into consideration in both standard regressions and linear regression with copula correction. By contrast, the association between resilience and demoralization was significant when depression was not taken into consideration and continued to be significant when depression was taken into consideration. Correspondence analysis revealed that low resilience was strongly related to demoralization combined with depression, whereas normal resilience was closely correlated with depression without demoralization. CONCLUSION These results expand our understanding of resilience by suggesting that it is a mechanism evolved to reduce or prevent demoralization and not just depression. Reducing demoralization and strengthening resilience as part of a comprehensive treatment plan are likely to improve the prognosis of Parkinson disease.
Collapse
Affiliation(s)
- John M. de Figueiredo
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
| | - Boheng Zhu
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
| | - Amar S. Patel
- Department of Neurology, Yale University School of Medicine, New Haven, CT, United States
| | - Robert Kohn
- Department of Psychiatry, Brown University School of Medicine, Providence, RI, United States
| | - Brian B. Koo
- Department of Neurology, Yale University School of Medicine, New Haven, CT, United States
| | - Elan D. Louis
- Department of Neurology, Yale University School of Medicine, New Haven, CT, United States
| |
Collapse
|
23
|
Shunkai L, Chen P, Zhong S, Chen G, Zhang Y, Zhao H, He J, Su T, Yan S, Luo Y, Ran H, Jia Y, Wang Y. Alterations of insular dynamic functional connectivity and psychological characteristics in unmedicated bipolar depression patients with a recent suicide attempt. Psychol Med 2023; 53:3837-3848. [PMID: 35257645 DOI: 10.1017/s0033291722000484] [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: 11/05/2022]
Abstract
BACKGROUND Mounting evidence showed that insula contributed to the neurobiological mechanism of suicidal behaviors in bipolar disorder (BD). However, no studies have analyzed the dynamic functional connectivity (dFC) of insular Mubregions and its association with personality traits in BD with suicidal behaviors. Therefore, we investigated the alterations of dFC variability in insular subregions and personality characteristics in BD patients with a recent suicide attempt (SA). METHODS Thirty unmedicated BD patients with SA, 38 patients without SA (NSA) and 35 demographically matched healthy controls (HCs) were included. The sliding-window analysis was used to evaluate whole-brain dFC for each insular subregion seed. We assessed between-group differences of psychological characteristics on the Minnesota Multiphasic Personality Inventory-2. Finally, a multivariate regression model was adopted to predict the severity of suicidality. RESULTS Compared to NSA and HCs, the SA group exhibited decreased dFC variability values between the left dorsal anterior insula and the left anterior cerebellum. These dFC variability values could also be utilized to predict the severity of suicidality (r = 0.456, p = 0.031), while static functional connectivity values were not appropriate for this prediction. Besides, the SA group scored significantly higher on the schizophrenia clinical scales (p < 0.001) compared with the NSA group. CONCLUSIONS Our findings indicated that the dysfunction of insula-cerebellum connectivity may underlie the neural basis of SA in BD patients, and highlighted the dFC variability values could be considered a neuromarker for predictive models of the severity of suicidality. Moreover, the psychiatric features may increase the vulnerability of suicidal behavior.
Collapse
Affiliation(s)
- Lai Shunkai
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou, China
- Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Pan Chen
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou, China
- Institute of Molecular and Functional Imaging, Jinan University, Guangzhou, China
| | - Shuming Zhong
- Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Guanmao Chen
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou, China
- Institute of Molecular and Functional Imaging, Jinan University, Guangzhou, China
| | - Yiliang Zhang
- Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Hui Zhao
- Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Jiali He
- Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Ting Su
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou, China
- Institute of Molecular and Functional Imaging, Jinan University, Guangzhou, China
| | - Shuya Yan
- School of Management, Jinan University, Guangzhou, China
| | - Yange Luo
- School of Management, Jinan University, Guangzhou, China
| | - Hanglin Ran
- School of Management, Jinan University, Guangzhou, China
| | - Yanbin Jia
- Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Ying Wang
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou, China
- Institute of Molecular and Functional Imaging, Jinan University, Guangzhou, China
| |
Collapse
|
24
|
Castro Moreno LS, Fuertes Valencia LF, Pacheco García OE, Muñoz Lozada CM. Risk factors associated with suicide attempt as predictors of suicide, Colombia, 2016-2017. REVISTA COLOMBIANA DE PSIQUIATRIA (ENGLISH ED.) 2023; 52:176-184. [PMID: 37863768 DOI: 10.1016/j.rcpeng.2021.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Accepted: 03/23/2021] [Indexed: 10/22/2023]
Abstract
BACKGROUND Suicidal behaviour is the cause of half of all violent deaths. It is considered to be a public health problem with one million victims a year. Suicide attempt is the most important risk factor. In Colombia, in 2017 the suicide attempt rate was 51.8/100,000 inhabitants, and the fatality rate reached 10.0/100,000. The objective is to identify suicide attempt factors associated with death and determine survival after the attempt for 2 years. MATERIAL AND METHODS Retrospective cohort study and survival analysis. A total of 42,594 records of the suicide attempt surveillance system databases and 325 records of death by suicide in 2016 and 2017 were analysed. The risk factors were examined and a χ2-test and multivariate analysis and logistic regression were performed. Cumulative survival probability was calculated using the Kaplan-Meier method. A Cox regression model was applied to determine the proportional relationship of the suicide attempt variables that are related to suicide. RESULTS Men die by suicide 4.5 times more often than women. One in four suicide victims had made at least one prior suicide attempt. The attempt factors related with death by suicide were: male gender (HR = 2.99; 95% CI, 2.27-3.92), adulthood (over 29 years, HR = 2.38; 95% CI, 1.90-2.99), living in a rural area (HR = 2.56; 95% CI, 2.04-3.20), chronic disease history (HR = 2.43; 95% CI, 1.66-3.57) and depression disorder (HR = 1.94; 95% CI, 1.55-2.41). Some 50% of suicide deaths occur up to 560 days after the suicide attempt. CONCLUSIONS The risk of suicide is highest in male patients, with a history of depression, chronic illness and exposure to heavy workloads.
Collapse
Affiliation(s)
- Luz Stella Castro Moreno
- Entrenamiento Programa de Epidemiología de Campo (FETP), Instituto Nacional de Salud, Bogotá, Colombia.
| | | | - Oscar Eduardo Pacheco García
- Grupo de Formación de Talento Humano para la Vigilancia en Salud Pública, Dirección de Vigilancia y Análisis del Riesgo en Salud Pública, Instituto Nacional de Salud, Bogotá, Colombia
| | - Claudia Marcela Muñoz Lozada
- Grupo de Formación de Talento Humano para la Vigilancia en Salud Pública, Dirección de Vigilancia y Análisis del Riesgo en Salud Pública, Instituto Nacional de Salud, Bogotá, Colombia
| |
Collapse
|
25
|
Trombello JM, Kulikova A, Mayes TL, Nandy K, Carmody T, Bart G, Nunes EV, Schmitz J, Kalmin M, Shoptaw S, Trivedi MH. Psychometrics of the Concise Health Risk Tracking Self-Report (CHRT-SR 16) Assessment of Suicidality in a Sample of Adults with Moderate to Severe Methamphetamine Use Disorder: Findings from the ADAPT-2 Randomized Trial. Neuropsychiatr Dis Treat 2023; 19:1443-1454. [PMID: 37377462 PMCID: PMC10292610 DOI: 10.2147/ndt.s406909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 04/28/2023] [Indexed: 06/29/2023] Open
Abstract
Background The co-occurrence of suicidality and substance use disorders has been well established, but rating scales to examine suicidal behavior and risk are sparse among participants with substance use disorders. We examined the psychometric properties of the 16-item Concise Health Risk Tracking Scale - Self Report (CHRT-SR16) to measure suicidality among adults with moderate-to-severe methamphetamine use disorder. Methods Participants (n = 403) with moderate-to-severe methamphetamine use disorder completed the CHRT-SR16 as part of a randomized, double-blind, placebo-controlled pharmacotherapy trial. The CHRT-SR16 factor structure was assessed using confirmatory factor analysis (CFA). Internal consistency was estimated with coefficients alpha (α) and omega (ω), test-retest reliability with intraclass correlation coefficient (ICC) and standard error of measurement, and convergent validity using Spearman's ρ rank order correlation coefficient test between CHRT-SR16 factors and the Patient Health Questionnaire (PHQ-9). The analyses utilized baseline and week 1 data (for test-retest reliability only). Results CFA revealed a seven-factor model of Pessimism, Helplessness, Social Support, Despair, Impulsivity, Irritability, and Suicidal Thoughts as the best-fitting model. The CHRT-SR16 also exhibited strong internal consistency (α = 0.89; ω = 0.89), test-retest reliability (ICC = 0.78) and convergent validity with the PHQ-9 total score (ρ = 0.62). Conclusion The CHRT-SR16 showed strong psychometric properties in a sample of participants with primary methamphetamine use disorder. Clinicaltrialsgov Identifier NCT03078075.
Collapse
Affiliation(s)
- Joseph M Trombello
- Center for Depression Research and Clinical Care, Peter O’Donnell Jr. Brain Institute and Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Alexandra Kulikova
- Department of Educational Psychology, University of North Texas, Denton, TX, USA
| | - Taryn L Mayes
- Center for Depression Research and Clinical Care, Peter O’Donnell Jr. Brain Institute and Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Karabi Nandy
- Center for Depression Research and Clinical Care, Peter O’Donnell Jr. Brain Institute and Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
- Peter O’Donnell Jr. School of Public Health, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Thomas Carmody
- Center for Depression Research and Clinical Care, Peter O’Donnell Jr. Brain Institute and Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
- Peter O’Donnell Jr. School of Public Health, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Gavin Bart
- Department of Medicine, University of Minnesota, Hennepin County Medical Center, Minneapolis, MN, USA
| | - Edward V Nunes
- Department of Psychiatry, Columbia University Irving Medical Center and New York State Psychiatric Institute, New York, NY, USA
| | - Joy Schmitz
- Faillace Department of Psychiatry and Behavioral Sciences, University of Texas (UT Health) at Houston, Houston, TX, USA
| | - Mariah Kalmin
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA, USA
| | - Steven Shoptaw
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA, USA
| | - Madhukar H Trivedi
- Center for Depression Research and Clinical Care, Peter O’Donnell Jr. Brain Institute and Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
| |
Collapse
|
26
|
Scheunemann J, Kühn S, Biedermann SV, Lipp M, Peth J, Gallinat J, Jelinek L. Implicit cognitions on self-injurious and suicidal behavior in borderline personality disorder. J Behav Ther Exp Psychiatry 2023; 79:101836. [PMID: 36709601 DOI: 10.1016/j.jbtep.2023.101836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Revised: 01/12/2023] [Accepted: 01/19/2023] [Indexed: 01/22/2023]
Abstract
BACKGROUND AND OBJECTIVES Performance on implicit measures of suicidality has been associated with suicidal and nonsuicidal self-injury. Despite the high prevalence of self-harm in patients with borderline personality disorder (BPD), no previous study has assessed implicit measures in this patient group. METHODS Forty patients with BPD and 25 healthy controls completed three implicit association tests (IATs) (Death words - Me/Others words, Self-Harm pictures - Me/Others, and Self-Harm pictures - Good/Bad words) and a subliminal priming task (effect of the primes "dying"/"growing" on the categorization speed of positive/negative adjectives) as well as measures of psychopathology (suicidal ideation, previous nonsuicidal self-injury, borderline symptomatology, depression, and hopelessness). RESULTS Patients with BPD had higher scores on all three IATs than healthy controls. The subliminal priming procedure did not reveal group differences. Correlations between implicit measures and psychopathology among patients with BPD were mostly weak and nonsignificant with a few exceptions: Positive correlations were observed between IAT Self-Harm - Good/Bad and lifetime frequency of nonsuicidal self-injury, between IAT Self-Harm - Me/Others and depression, and between IAT Death - Me/Others and depression. Correlations between implicit measures were weak to moderate. LIMITATIONS The study was cross-sectional only, and the study had reduced power as the sample size was limited. CONCLUSIONS As expected, patients with BPD had higher scores than healthy controls on the IATs, which indicates higher implicit self-identification with self-harm and death as well as stronger implicit positive attitudes towards self-harm. The mostly weak correlations between implicit and explicit measures speak against the discriminative value of IATs in patients with BPD.
Collapse
Affiliation(s)
- Jakob Scheunemann
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Germany.
| | - Simone Kühn
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Germany; Lise Meitner Group for Environmental Neuroscience, Max Planck Institute for Human Development, Germany
| | - Sarah V Biedermann
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Germany
| | - Michael Lipp
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Germany
| | - Judith Peth
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Germany
| | - Jürgen Gallinat
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Germany
| | - Lena Jelinek
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Germany
| |
Collapse
|
27
|
Miranda R, Wheeler A, Chapman JE, Ortin-Peralta A, Mañaná J, Rosario-Williams B, Andersen S. Future-oriented repetitive thought, depressive symptoms, and suicide ideation severity: Role of future-event fluency and depressive predictive certainty. J Affect Disord 2023; 335:401-409. [PMID: 37217102 DOI: 10.1016/j.jad.2023.05.050] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 04/30/2023] [Accepted: 05/15/2023] [Indexed: 05/24/2023]
Abstract
BACKGROUND Knowing how future-oriented repetitive thought - i.e., repeated consideration of whether positive or negative outcomes will happen in one's future - leads to hopelessness-related cognitions may elucidate the role of anticipating the future in depressive symptoms and suicide ideation. This study examined future-event fluency and depressive predictive certainty - i.e., the tendency to make pessimistic future-event predictions with certainty - as mechanisms explaining the relation between future-oriented repetitive thought, depressive symptoms, and suicide ideation. METHODS Young adults (N = 354), oversampled for suicide ideation or attempt history, completed baseline measures of pessimistic future-oriented repetitive thought (i.e., the degree to which people consider whether negative outcomes will happen or positive outcomes will not happen in their futures), future-event fluency, depressive predictive certainty, depressive symptoms, and suicide ideation severity and were followed up 6 months later (N = 324). RESULTS Pessimistic future-oriented repetitive thought predicted depressive predictive certainty at 6-months, partially mediated by lower positive but not increased negative future-event fluency. There was an indirect relationship between pessimistic future-oriented repetitive thought and 6-month suicide ideation severity via 6-month depressive predictive certainty through 6-month depressive symptoms, and also via 6-month depressive symptoms (but not depressive predictive certainty) alone. LIMITATIONS Lack of an experimental design limits inferences about causality, and a predominantly female sample may limit generalizability by sex. CONCLUSION Clinical interventions should address pessimistic future-oriented repetitive thought - and its impact on how easily people can think about positive future outcomes - as one potential way to reduce depressive symptoms and, indirectly, suicide ideation.
Collapse
Affiliation(s)
- Regina Miranda
- Hunter College, City University of New York, United States of America; The Graduate Center, City University of New York, United States of America.
| | - Alyssa Wheeler
- Hunter College, City University of New York, United States of America; Weill Cornell Medicine, United States of America
| | | | - Ana Ortin-Peralta
- Hunter College, City University of New York, United States of America; Yeshiva University, United States of America
| | - Jhovelis Mañaná
- Hunter College, City University of New York, United States of America
| | | | | |
Collapse
|
28
|
Amerio A, Natale A, Gnecco GB, Lechiara A, Verrina E, Bianchi D, Fusar-Poli L, Costanza A, Serafini G, Amore M, Aguglia A. The Role of Gender in Patients with Borderline Personality Disorder: Differences Related to Hopelessness, Alexithymia, Coping Strategies, and Sensory Profile. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:medicina59050950. [PMID: 37241182 DOI: 10.3390/medicina59050950] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 05/08/2023] [Accepted: 05/12/2023] [Indexed: 05/28/2023]
Abstract
Background and Objectives: Gender differences are poorly investigated in patients with borderline personality disorder (BPD), although they could be useful in determining the most appropriate pharmacological and non-pharmacological treatment. The aim of the present study was to compare sociodemographic and clinical characteristics and the emotional and behavioral dimensions (such as coping, alexithymia, and sensory profile) between males and females with BPD. Material and Methods: Two hundred seven participants were recruited. Sociodemographic and clinical variables were collected through a self-administered questionnaire. The Adolescent/Adult Sensory Profile (AASP), Beck Hopelessness Scale (BHS), Coping Orientation to Problems Experienced (COPE), and Toronto Alexithymia Scale (TAS-20) were administered. Results: Male patients with BPD showed more involuntary hospitalizations and greater use of alcohol and illicit substances compared to females. Conversely, females with BPD reported more frequent medication abuse than males. Furthermore, females had high levels of alexithymia and hopelessness. Regarding coping strategies, females with BPD reported higher levels of "restraint coping" and "use of instrumental social support" at COPE. Finally, females with BPD had higher scores in the Sensory Sensitivity and Sensation Avoiding categories at the AASP. Conclusions: Our study highlights gender differences in substance use, emotion expression, future vision, sensory perception, and coping strategies in patients with BPD. Further gender studies may clarify these differences and guide the development of specific and differential treatments in males and females with BPD.
Collapse
Affiliation(s)
- Andrea Amerio
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Section of Psychiatry, University of Genoa, 16132 Genoa, Italy
- IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy
| | - Antimo Natale
- Department of Psychiatry, Adult Psychiatry Service (APS), University Hospitals of Geneva (HUG), 1205 Geneva, Switzerland
| | - Giovanni Battista Gnecco
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Section of Psychiatry, University of Genoa, 16132 Genoa, Italy
| | - Alessio Lechiara
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Section of Psychiatry, University of Genoa, 16132 Genoa, Italy
| | - Edoardo Verrina
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Section of Psychiatry, University of Genoa, 16132 Genoa, Italy
| | - Davide Bianchi
- Department of Mental Health and Pathological Addictions, Lavagna Local Health Authority, 16033 Lavagna, Italy
| | - Laura Fusar-Poli
- Department of Brain and Behavioral Sciences, University of Pavia, 27100 Pavia, Italy
| | - Alessandra Costanza
- Department of Psychiatry, Adult Psychiatry Service (APS), University Hospitals of Geneva (HUG), 1205 Geneva, Switzerland
- Department of Psychiatry, Faculty of Medicine, Geneva University (UNIGE), 1211 Geneva, Switzerland
- Department of Psychiatry, Faculty of Biomedical Sciences, University of Italian Switzerland (USI), 6900 Lugano, Switzerland
| | - Gianluca Serafini
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Section of Psychiatry, University of Genoa, 16132 Genoa, Italy
- IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy
| | - Mario Amore
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Section of Psychiatry, University of Genoa, 16132 Genoa, Italy
| | - Andrea Aguglia
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Section of Psychiatry, University of Genoa, 16132 Genoa, Italy
- IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy
| |
Collapse
|
29
|
Goodkin K, Evering TH, Anderson AM, Ragin A, Monaco CL, Gavegnano C, Avery RJ, Rourke SB, Cysique LA, Brew BJ. The comorbidity of depression and neurocognitive disorder in persons with HIV infection: call for investigation and treatment. Front Cell Neurosci 2023; 17:1130938. [PMID: 37206666 PMCID: PMC10190964 DOI: 10.3389/fncel.2023.1130938] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Accepted: 03/07/2023] [Indexed: 05/21/2023] Open
Abstract
Depression and neurocognitive disorder continue to be the major neuropsychiatric disorders affecting persons with HIV (PWH). The prevalence of major depressive disorder is two to fourfold higher among PWH than the general population (∼6.7%). Prevalence estimates of neurocognitive disorder among PWH range from 25 to over 47% - depending upon the definition used (which is currently evolving), the size of the test battery employed, and the demographic and HIV disease characteristics of the participants included, such as age range and sex distribution. Both major depressive disorder and neurocognitive disorder also result in substantial morbidity and premature mortality. However, though anticipated to be relatively common, the comorbidity of these two disorders in PWH has not been formally studied. This is partly due to the clinical overlap of the neurocognitive symptoms of these two disorders. Both also share neurobehavioral aspects - particularly apathy - as well as an increased risk for non-adherence to antiretroviral therapy. Shared pathophysiological mechanisms potentially explain these intersecting phenotypes, including neuroinflammatory, vascular, and microbiomic, as well as neuroendocrine/neurotransmitter dynamic mechanisms. Treatment of either disorder affects the other with respect to symptom reduction as well as medication toxicity. We present a unified model for the comorbidity based upon deficits in dopaminergic transmission that occur in both major depressive disorder and HIV-associated neurocognitive disorder. Specific treatments for the comorbidity that decrease neuroinflammation and/or restore associated deficits in dopaminergic transmission may be indicated and merit study.
Collapse
Affiliation(s)
- Karl Goodkin
- Department of Psychiatry, School of Medicine, The University of Texas Rio Grande Valley, Harlingen, TX, United States
- Institute of Neuroscience, School of Medicine, The University of Texas Rio Grande Valley, Harlingen, TX, United States
| | - Teresa H. Evering
- Division of Infectious Diseases, Department of Medicine, Weill Cornell Medicine, New York, NY, United States
| | - Albert M. Anderson
- Division of Infectious Diseases, Department of Medicine, School of Medicine, Emory University, Atlanta, GA, United States
| | - Ann Ragin
- Department of Radiology, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Cynthia L. Monaco
- Division of Infectious Diseases, Department of Medicine, University of Rochester School of Medicine and Dentistry, Rochester, NY, United States
- Department of Microbiology and Immunology, University of Rochester School of Medicine and Dentistry, Rochester, NY, United States
- Del Monte Institute of Neuroscience, University of Rochester School of Medicine and Dentistry, Rochester, NY, United States
| | - Christina Gavegnano
- Department of Pathology, Emory School of Medicine, Emory University, Atlanta, GA, United States
- Department of Pharmacology, Emory School of Medicine, Emory University, Atlanta, GA, United States
- Department of Chemical Biology, Emory School of Medicine, Emory University, Atlanta, GA, United States
- Center for the Study of Human Health, Emory College of Arts and Sciences, Emory University, Atlanta, GA, United States
- Atlanta Veteran’s Affairs Medical Center, Atlanta, GA, United States
- Center for Bioethics, Harvard Medical School, Harvard University, Boston, MA, United States
| | - Ryan J. Avery
- Division of Nuclear Medicine, Department of Radiology, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Sean B. Rourke
- MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Lucette A. Cysique
- School of Psychology, Faculty of Science, University of New South Wales, Sydney, NSW, Australia
| | - Bruce J. Brew
- Department of Neurology, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia
- Department of Neurology, Faculty of Medicine, University of Notre Dame, Sydney, NSW, Australia
| |
Collapse
|
30
|
Guo Y, Zhang J, Guo Y, Cui Y, Huang X, Cui Y, Fu J, Wang K, Yu F. Psychosocial predictors of persistent suicidal ideation among Chinese adolescents: A longitudinal study. J Affect Disord 2023; 334:137-144. [PMID: 37119869 DOI: 10.1016/j.jad.2023.04.090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2022] [Revised: 04/06/2023] [Accepted: 04/24/2023] [Indexed: 05/01/2023]
Abstract
BACKGROUND Suicide is the fourth leading cause of death among adolescents. Studies have shown that persistent suicidal ideation has a more important effect on suicidal behavior. The objective of this study was to identify predictors of persistent suicidal ideation. METHODS Data were collected from 4225 Chinese middle and high school students. These adolescents were assessed for suicidal ideation at baseline and the second year. We used multinomial logistic regression (n = 4171) for the predictive effect of these factors on persistent suicidal ideation. We controlled for gender, residence, clinical diagnosis, clinical diagnosis family, suicide planning, and suicide attempts. RESULTS Depressive symptoms are essential in predicting persistent suicidal ideation (OR = 14.0; p < 0.001). Persistent suicidal ideation was predicted by sleep disorders, such as poor sleep quality (OR = 2.3; p = 0.008), difficulty falling asleep (OR = 2.4; p = 0.005), frequently midnight awakening (OR = 1.9; p = 0.044), and frequent nightmares (OR = 2.1; p = 0.040). There was a significant association between concern with persistent ideation and parental-peer alienation (OR for father, 1.9[p = 0.024]; OR for mother, 3.1[p < 0.001]; OR for peer, 2.3[p = 0.003]). LIMITATIONS All measures are based on self-report rather than objective assessment or clinical diagnostic assessment. CONCLUSIONS Persistent suicidal ideation had a more important role in influencing suicide planning and attempt. Interventions targeting sleep disorders and attention to attachments in the home and school are particularly important in preventing persistent suicidal ideation in adolescents.
Collapse
Affiliation(s)
- Yang Guo
- School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China
| | - Jingyi Zhang
- School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China
| | - Yaru Guo
- School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China
| | - Yanan Cui
- School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China
| | - Xinyu Huang
- School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China
| | - Yuqiu Cui
- School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China
| | - Jiyi Fu
- Psychiatry Department of Hefei Fourth People's Hospital, Hefei, China
| | - Kai Wang
- School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China; Department of Neurology, The First Affiliated Hospital of Anhui Medical University, The School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China; Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, China; Collaborative Innovation Center of Neuropsychiatric Disorders and Mental Health, Anhui, China.
| | - Fengqiong Yu
- School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China; Research Center for Translational Medicine, The Second Hospital of Anhui Medical University, Hefei, China; Department of Neurology, The First Affiliated Hospital of Anhui Medical University, The School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China; Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, China.
| |
Collapse
|
31
|
Yohannes K, Gezahegn M, Birhanie M, Simachew Y, Moges A, Ayano G, Toitole KK, Mokona H, Abebe L. Suicidality and homelessness: prevalence and associated factors of suicidal behaviour among homeless young adults in Southern Ethiopia. BMC Psychol 2023; 11:121. [PMID: 37072864 PMCID: PMC10111304 DOI: 10.1186/s40359-023-01162-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 04/06/2023] [Indexed: 04/20/2023] Open
Abstract
BACKGROUND Research indicates that homelessness is associated with an increased risk of suicide. While street homelessness is a global problem, it is a disproportionately serious concern in low- and middle-income countries such as Ethiopia. Despite their high risk of suicidal thoughts and attempts, there has been limited research on this subject among homeless young people in Ethiopia. Therefore, we assessed the prevalence and factors contributing to suicidal behaviour among homeless young people in the southern region of this country. METHODS We conducted a community-based cross-sectional study from 15 June to 15 August 2020 involving 798 homeless young adults in four southern Ethiopian towns and cities. The Suicide Behaviour Questionnaire-Revised (SBQ-R) was used to assess suicidal behaviour. Data were coded and entered into Epi-Data version 7 and analysed using SPSS version 20. We conducted a multivariable logistic regression analysis to identify factors associated with suicidal behaviour. Variables with a p-value of < 0.05 were considered statistically significant. An adjusted odds ratio with a 95% confidence interval was determined to indicate the association's strength. RESULTS The overall prevalence of suicidal behaviour among young homeless individuals was 38.2% (95% CI: 34.8%, 41.5%). The lifetime prevalence of suicidal ideation, planning and attempt was 10.7% (95% CI: 8.6-12.9%), 5.1% (95% CI: 3.6-6.6%) and 3% (95% CI: 1.9-4.3%), respectively. A longer duration of homelessness (1-2 years) (AOR = 2.244, 95% CI: 1.447-3.481), stressful life events (AOR = 1.655, 95% CI: 1.132-2.418) and the stigma associated with homelessness (AOR = 1.629, 95% CI: 1.149-1.505) were significantly associated with suicidal behaviour. CONCLUSION The results of our study indicate that suicide is a serious public health problem among homeless young people in southern Ethiopia. We have found associations between suicidal behaviour and stressful events, homelessness lasting for one to two years and stigma. Our study suggests that policymakers and programme planners need to develop a strategy for preventing, detecting and managing suicidal behaviour among street-dwelling homeless young adults, a vulnerable and understudied population. A community-based suicide prevention campaign is also essential for street-dwelling homeless young people in Ethiopia.
Collapse
Affiliation(s)
- Kalkidan Yohannes
- Department of Psychiatry, College of Medicine and Health Sciences, Dilla University, Dilla, Ethiopia.
- SWEDESD, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
| | - Melkamu Gezahegn
- Department of Sociology, Institute of Behavioural science, Dilla University, Dilla, Ethiopia
| | - Mekonnen Birhanie
- School of Public Health, College of Medicine and Health Science, Dilla University, Dilla, Ethiopia
| | - Yilkal Simachew
- School of Public Health, College of Medicine and Health Science, Hawassa University, Hawassa, Ethiopia
| | - Awoke Moges
- Addis Ababa University, Addis Ababa, Ethiopia
| | - Getinet Ayano
- Research and Training Department, Amanuel Mental Specialized Hospital, Addis Ababa, Ethiopia
- School of Population Health, Curtin University, Perth, WA, Australia
| | | | - Hirbaye Mokona
- Department of Psychiatry, College of Medicine and Health Sciences, Dilla University, Dilla, Ethiopia
- Department of Psychiatry, College of Medicine and Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Lulu Abebe
- Department of Psychiatry, College of Medicine and Health Sciences, Dilla University, Dilla, Ethiopia
| |
Collapse
|
32
|
Fujieda M, Uchida K, Ikebe S, Kimura A, Kimura M, Watanabe T, Sakamoto H, Matsumoto T, Uchimura N. Fatigue on Waking, Insomnia, and Workplace Relationship Problems May Help to Detect Suicidal Ideation among New Middle-Aged Primary Care Patients: A 6-Month Prospective Study in Japan. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20085547. [PMID: 37107831 PMCID: PMC10138726 DOI: 10.3390/ijerph20085547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 03/27/2023] [Accepted: 04/13/2023] [Indexed: 05/11/2023]
Abstract
Signs of suicidal depression often go undetected in primary care settings. This study explored predictive factors for depression with suicidal ideation (DSI) among middle-aged primary care patients at 6 months after an initial clinic visit. New patients aged 35-64 years were recruited from internal medicine clinics in Japan. Baseline characteristics were elicited using self-administered and physician questionnaires. DSI was evaluated using the Zung Self-Rating Depression Scale and the Profile of Mood States at enrollment and 6 months later. Multiple logistic regression analysis was conducted to calculate adjusted odds ratios for DSI. Sensitivity, specificity, and likelihood ratios for associated factors were calculated. Among 387 patients, 13 (3.4%) were assessed as having DSI at 6 months. Adjusted for sex, age, and related factors, significant odds ratios for DSI were observed for "fatigue on waking ≥1/month" (7.90, 95% confidence intervals: 1.06-58.7), "fatigue on waking ≥1/week" (6.79, 1.02-45.1), "poor sleep status" (8.19, 1.05-63.8), and "relationship problems in the workplace" (4.24, 1.00-17.9). Fatigue on waking, sleep status, and workplace relationship problems may help predict DSI in primary care. Because the sample size in this investigation was small, further studies with larger samples are needed to confirm our findings.
Collapse
Affiliation(s)
- Megumi Fujieda
- Department of Neuropsychiatry, Kurume University School of Medicine, 67 Asahi-machi, Kurume 830-0011, Fukuoka, Japan
- Department of Environmental Medicine, Kurume University School of Medicine, 67 Asahi-machi, Kurume 830-0011, Fukuoka, Japan
- Department of Healthcare Management, College of Healthcare Management, 960-4 Takayanagi, Setaka-machi, Miyama 835-0018, Fukuoka, Japan
- Correspondence: ; Tel.: +81-942-31-7564
| | - Katsuhisa Uchida
- Mental Health and Welfare Center of Shizuoka Prefectural Government, 2-20 Ariake-cho, Suruga-ku, Shizuoka-shi 422-8031, Shizuoka, Japan
| | - Shinichiro Ikebe
- Fuji Medical Association, 2850 Denbo, Fuji 417-0061, Shizuoka, Japan
| | - Akihiro Kimura
- Fuji Medical Association, 2850 Denbo, Fuji 417-0061, Shizuoka, Japan
| | - Masashi Kimura
- Fuji Medical Association, 2850 Denbo, Fuji 417-0061, Shizuoka, Japan
| | - Toshiaki Watanabe
- Fuji Medical Association, 2850 Denbo, Fuji 417-0061, Shizuoka, Japan
| | - Hisako Sakamoto
- Mental Health and Welfare Center of Shizuoka Prefectural Government, 2-20 Ariake-cho, Suruga-ku, Shizuoka-shi 422-8031, Shizuoka, Japan
| | - Teruaki Matsumoto
- Shizuoka General Hospital, 4-27-1 Kitaando, Aoi-ku, Shizuoka-shi 420-8527, Shizuoka, Japan
| | - Naohisa Uchimura
- Department of Neuropsychiatry, Kurume University School of Medicine, 67 Asahi-machi, Kurume 830-0011, Fukuoka, Japan
| |
Collapse
|
33
|
Bianchi R, Cavalcante DC, Queirós C, Santos BDM, Verkuilen J, Schonfeld IS. Validation of the Occupational Depression Inventory in Brazil: A study of 1612 civil servants. J Psychosom Res 2023; 167:111194. [PMID: 36801658 DOI: 10.1016/j.jpsychores.2023.111194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Revised: 11/29/2022] [Accepted: 02/09/2023] [Indexed: 02/17/2023]
Abstract
OBJECTIVE The Occupational Depression Inventory (ODI) assesses work-attributed depressive symptoms. The ODI has demonstrated robust psychometric and structural properties. To date, the instrument has been validated in English, French, and Spanish. This study examined the psychometric and structural properties of the ODI's Brazilian-Portuguese version. METHODS The study involved 1612 civil servants employed in Brazil (MAGE = 44, SDAGE = 9; 60% female). The study was conducted online across all Brazilian states. RESULTS Exploratory structural equation modeling (ESEM) bifactor analysis indicated that the ODI meets the requirements for essential unidimensionality. The general factor accounted for 91% of the common variance extracted. We found measurement invariance to hold across sexes and age groups. Consistent with these findings, the ODI showed strong scalability (H = 0.67). The instrument's total score accurately ranked respondents on the latent dimension underlying the measure. Furthermore, the ODI exhibited excellent total-score reliability (e.g., McDonald's ω = 0.93). Occupational depression correlated negatively with work engagement and each of its components (vigor, dedication, and absorption), speaking to the ODI's criterion validity. Finally, the ODI helped clarify the issue of burnout-depression overlap. Relying on ESEM confirmatory factor analysis (CFA), we found burnout's components to correlate more strongly with occupational depression than with each other. Using a higher-order ESEM-within-CFA framework, we found a correlation of 0.95 between burnout and occupational depression. CONCLUSION The ODI displays robust psychometric and structural properties within the Brazilian context. The ODI constitutes a valuable resource for occupational health specialists and may help advance research on job-related distress.
Collapse
Affiliation(s)
- Renzo Bianchi
- Department of Psychology, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.
| | - Danísio Calixto Cavalcante
- Faculty of Psychology and Education Sciences, University of Porto, Porto, Portugal; National Institute of Social Security, Fortaleza, Ceará, Brazil
| | - Cristina Queirós
- Faculty of Psychology and Education Sciences, University of Porto, Porto, Portugal
| | | | - Jay Verkuilen
- The Graduate Center of the City University of New York, New York City, NY, USA
| | - Irvin Sam Schonfeld
- Department of Psychology, The City College and the Graduate Center of the City University of New York, New York City, NY, USA
| |
Collapse
|
34
|
Min S, Shin D, Rhee SJ, Park CHK, Yang JH, Song Y, Kim MJ, Kim K, Cho WI, Kwon OC, Ahn YM, Lee H. Acoustic Analysis of Speech for Screening for Suicide Risk: Machine Learning Classifiers for Between- and Within-Person Evaluation of Suicidality. J Med Internet Res 2023; 25:e45456. [PMID: 36951913 PMCID: PMC10131783 DOI: 10.2196/45456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Revised: 02/21/2023] [Accepted: 02/26/2023] [Indexed: 03/01/2023] Open
Abstract
BACKGROUND Assessing a patient's suicide risk is challenging for health professionals because it depends on voluntary disclosure by the patient and often has limited resources. The application of novel machine learning approaches to determine suicide risk has clinical utility. OBJECTIVE This study aimed to investigate cross-sectional and longitudinal approaches to assess suicidality based on acoustic voice features of psychiatric patients using artificial intelligence. METHODS We collected 348 voice recordings during clinical interviews of 104 patients diagnosed with mood disorders at baseline and 2, 4, 8, and 12 months after recruitment. Suicidality was assessed using the Beck Scale for Suicidal Ideation and suicidal behavior using the Columbia Suicide Severity Rating Scale. The acoustic features of the voice, including temporal, formal, and spectral features, were extracted from the recordings. A between-person classification model that examines the vocal characteristics of individuals cross sectionally to detect individuals at high risk for suicide and a within-person classification model that detects considerable worsening of suicidality based on changes in acoustic features within an individual were developed and compared. Internal validation was performed using 10-fold cross validation of audio data from baseline to 2-month and external validation was performed using data from 2 to 4 months. RESULTS A combined set of 12 acoustic features and 3 demographic variables (age, sex, and past suicide attempts) were included in the single-layer artificial neural network for the between-person classification model. Furthermore, 13 acoustic features were included in the extreme gradient boosting machine learning algorithm for the within-person model. The between-person classifier was able to detect high suicidality with 69% accuracy (sensitivity 74%, specificity 62%, area under the receiver operating characteristic curve 0.62), whereas the within-person model was able to predict worsening suicidality over 2 months with 79% accuracy (sensitivity 68%, specificity 84%, area under receiver operating characteristic curve 0.67). The second model showed 62% accuracy in predicting increased suicidality in external sets. CONCLUSIONS Within-person analysis using changes in acoustic features within an individual is a promising approach to detect increased suicidality. Automated analysis of voice can be used to support the real-time assessment of suicide risk in primary care or telemedicine.
Collapse
Affiliation(s)
- Sooyeon Min
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Daun Shin
- Department of Psychiatry, Korea University College of Medicine, Seoul, Republic of Korea
| | - Sang Jin Rhee
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea
| | - C Hyung Keun Park
- Department of Psychiatry, Asan Medical Center, Seoul, Republic of Korea
| | - Jeong Hun Yang
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea
| | - Yoojin Song
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea
| | - Min Ji Kim
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Kyungdo Kim
- Department of Biomedical Engineering, Duke University, Durham, NC, United States
| | - Won Ik Cho
- Department of Electrical and Computer Engineering, Seoul National University, Seoul, Republic of Korea
| | | | - Yong Min Ahn
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Hyunju Lee
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea
| |
Collapse
|
35
|
Jeon ME, Gomez MM, Stewart RA, Joiner TE. Acute suicidal affective disturbance and borderline personality disorder symptoms: Distinct yet correlated constructs. J Affect Disord 2023; 325:62-72. [PMID: 36586595 DOI: 10.1016/j.jad.2022.12.131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 09/08/2022] [Accepted: 12/23/2022] [Indexed: 12/30/2022]
Abstract
OBJECTIVE Acute Suicidal Affective Disturbance (ASAD) has been proposed to address the need for a suicide-specific diagnostic entity that better accounts for the psychological symptoms that may emerge during an acute suicidal crisis and that may precede imminent suicidal behaviors. However, additional research is needed to establish ASAD's delimitation from preexisting psychological disorders, especially disorders that include suicidal thoughts and behaviors in their diagnostic criteria such as borderline personality disorder (BPD). METHODS We estimated two Gaussian graphical models (GGMs), exploratory factor analysis (EFA) models, and confirmatory factor analysis models in a sample of psychiatric outpatients (N = 460) to examine the structure of ASAD and BPD symptoms. RESULTS Our estimated models showed while most ASAD and BPD symptoms largely shared associations with other symptoms belonging to their respective disorder construct, strong associations connected some ASAD symptoms with BPD symptoms, which, in a network model, emerged in the form of nonzero edges among those symptoms, and in EFA models, as factors that featured both ASAD and BPD symptoms as indicators. CONCLUSIONS Our findings suggest the network structure of the proposed criteria of ASAD features symptoms that are largely distinct to ASAD but do include symptoms that share meaningful correlations with BPD symptoms that suggest ASAD and BPD are correlated constructs.
Collapse
Affiliation(s)
- Min Eun Jeon
- Department of Psychology, Florida State University, Tallahassee, FL, USA.
| | - Marielle M Gomez
- Department of Psychology, Florida State University, Tallahassee, FL, USA
| | - Rochelle A Stewart
- Department of Psychology, Florida State University, Tallahassee, FL, USA
| | - Thomas E Joiner
- Department of Psychology, Florida State University, Tallahassee, FL, USA
| |
Collapse
|
36
|
Xi W, Banerjee S, Olfson M, Alexopoulos GS, Xiao Y, Pathak J. Effects of social deprivation on risk factors for suicidal ideation and suicide attempts in commercially insured US youth and adults. Sci Rep 2023; 13:4151. [PMID: 36914764 PMCID: PMC10011396 DOI: 10.1038/s41598-023-31387-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 03/10/2023] [Indexed: 03/16/2023] Open
Abstract
We used US nationwide commercial insurance claims data (2011-2015) to study the effect of social deprivation on clinical and demographic risk factors for suicidal ideation (SI) and suicide attempts (SA) among US youth and adults < 65 years, after having a mental health or substance use disorder-related outpatient encounter. Neighborhood social deprivation level was summarized by the quintile of social deprivation index (SDI) at individuals' zip code level. Cox proportional hazard models were used to evaluate the effect of social deprivation on demographic and clinical risk factors for SI and SA. The study cohort consisted of 317,383 individuals < 65 years, with 124,424 aged < 25 (youth) and 192,959 aged between 25 and 64 (adults). Neighborhood social deprivation impacted risk factors for SI and SA differently for youth and adults. Among youth, SDI interacted with multiple risk factors for both SI and SA. The effects of the risk factors were larger on youth from middle socioeconomic neighborhoods. Among adults, risk of SI was the strongest in the most deprived neighborhoods, but risk of SA did not vary by neighborhood deprivation level. Our findings suggest community-based suicide prevention initiatives should be tailored according to neighborhood deprivation level and the targeted individual's age to maximize the impact.
Collapse
Affiliation(s)
- Wenna Xi
- Department of Population Health Sciences, Weill Cornell Medicine, New York, NY, 10065, USA
| | - Samprit Banerjee
- Department of Population Health Sciences, Weill Cornell Medicine, New York, NY, 10065, USA
| | - Mark Olfson
- Department of Psychiatry, New York State Psychiatric Institute, Columbia University Irving Medical Center, New York, NY, 10032, USA
| | | | - Yunyu Xiao
- Department of Population Health Sciences, Weill Cornell Medicine, New York, NY, 10065, USA
| | - Jyotishman Pathak
- Department of Population Health Sciences, Weill Cornell Medicine, New York, NY, 10065, USA. .,Department of Psychiatry, Weill Cornell Medicine, White Plains, NY, 10605, USA.
| |
Collapse
|
37
|
Cai H, Li ZL, He F, Li SY, Zhao YJ, Zhang WY, Zhang Y, Su Z, Jackson T, Xiang YT, Tang YL. Suicide ideation and anhedonia among clinically stable adolescents with the recurrent depressive disorder during the COVID-19 pandemic: A network perspective. J Affect Disord 2023; 324:317-324. [PMID: 36549344 DOI: 10.1016/j.jad.2022.12.052] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2022] [Revised: 12/12/2022] [Accepted: 12/14/2022] [Indexed: 12/23/2022]
Abstract
BACKGROUND Anhedonia is a suicide risk factor among adolescent patients with recurrent depressive disorder (depression hereafter). This study examined associations between suicidal ideation (SI) and residual depressive symptoms (RSD), including anhedonia, among clinically stable adolescents with depression. METHOD A network analysis was performed to examine the association between RDS and SI among adolescents with depression. Node-specific predictive betweenness was computed to examine short paths between anhedonia and SI. Additionally, a Network Comparison Test (NCT) was conducted to examine gender differences in derived network model characteristics. RESULTS The network analysis identified close associations of PHQ9 ("Suicide ideation") with PHQ1 ("Anhedonia") as well as some other RDS including PHQ6 ("Guilt"), PHQ2 ("Sad mood") and PHQ8 ("Motor disturbances"). Additionally, PHQ2 ("Sad mood") and PHQ4 ("Fatigue") were the main bridge nodes linking anhedonia and SI. Comparisons of network models did not find significant differences in network global strength or edge weights. LIMITATION Causal relations between anhedonia and SI could not be determined due to the cross-sectional study design. CONCLUSIONS SI was directly related to Anhedonia in addition to Guilt, Sad mood and Motor disturbances. Sad mood and Fatigue were the main bridge nodes linking Anhedonia and SI. To reduce the risk of SI among clinically stable adolescents with depression during the COVID-19 pandemic, specific RDS including Anhedonia, Guilt, Sad mood, Motor disturbances and Fatigue should be targeted in interventions.
Collapse
Affiliation(s)
- Hong Cai
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, & Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, China; Centre for Cognitive and Brain Sciences, University of Macau, Macao SAR, China; Institute of Advanced Studies in Humanities and Social Sciences, University of Macau, Macao SAR, China
| | - Zong-Lei Li
- Department of Psychiatry, Xiamen Xianyue Hospital, Xiamen, China
| | - Fan He
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital & the Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Shu-Ying Li
- Department of Psychiatry, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yan-Jie Zhao
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital & the Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Wu-Yang Zhang
- Department of Pediatric Development and Behavior, The third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yao Zhang
- Huashan Hospital, Fudan University, Shanghai, China
| | - Zhaohui Su
- School of Public Health, Southeast University, Nanjing, China
| | - Todd Jackson
- Department of Psychology, University of Macau, Macao SAR, China
| | - Yu-Tao Xiang
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, & Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, China; Centre for Cognitive and Brain Sciences, University of Macau, Macao SAR, China; Institute of Advanced Studies in Humanities and Social Sciences, University of Macau, Macao SAR, China.
| | - Yi-Lang Tang
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, & Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao.
| |
Collapse
|
38
|
Ssewamala FM, Brathwaite R, Neilands TB. Economic Empowerment, HIV Risk Behavior, and Mental Health Among School-Going Adolescent Girls in Uganda: Longitudinal Cluster-Randomized Controlled Trial, 2017‒2022. Am J Public Health 2023; 113:306-315. [PMID: 36603167 PMCID: PMC9932384 DOI: 10.2105/ajph.2022.307169] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/03/2022] [Indexed: 01/07/2023]
Abstract
Objectives. To investigate the long-term (12- and 24-month) impact of an economic empowerment intervention on HIV risk behaviors and mental health among school-going adolescent girls in Uganda. Methods. A total of 1260 girls aged 14 to 17 years were randomized at the school level to (1) standard health and sex education (controls; n = 408 students; n = 16 schools), (2) 1-to-1 matched savings youth development account (YDA; n = 471 students; n = 16 schools), or (3) combination intervention (YDA and multiple family group [YDA+MFG]; n = 15 schools; n = 381 students). Mixed-effects models were fitted. Results. YDA and YDA+MFG girls had significantly lower depressive symptoms and better self-concept than controls at 24 months. Only YDA+MFG girls had significantly lower hopelessness levels than controls. There were no significant study group differences at 12 and 24 months for sexual risk-taking behavior and attitudes. There was no significant difference between YDA and YDA+MFG groups for all outcomes. Conclusions. Providing YDA and MFG can positively improve adolescent girls' mental health, but our analyses showed no significant differences across groups on sexual risk-taking behaviors. Future studies may consider replicating these interventions and analyses in older populations, including those transitioning into young adults. Trial Registration. ClinicalTrials.gov Identifier: NCT03307226. (Am J Public Health. 2023;113(3):306-315. https://doi.org/10.2105/10.2105/AJPH.2022.307169).
Collapse
Affiliation(s)
- Fred M Ssewamala
- Fred M. Ssewamala and Rachel Brathwaite are with the International Center for Child Health and Development, Brown School, Washington University in St Louis, MO. Torsten B. Neilands is with the Division of Prevention Science, University of California, San Francisco
| | - Rachel Brathwaite
- Fred M. Ssewamala and Rachel Brathwaite are with the International Center for Child Health and Development, Brown School, Washington University in St Louis, MO. Torsten B. Neilands is with the Division of Prevention Science, University of California, San Francisco
| | - Torsten B Neilands
- Fred M. Ssewamala and Rachel Brathwaite are with the International Center for Child Health and Development, Brown School, Washington University in St Louis, MO. Torsten B. Neilands is with the Division of Prevention Science, University of California, San Francisco
| |
Collapse
|
39
|
Scanferla E, de Bienassis K, Pachoud B, Gorwood P. How subjective well-being, patient-reported clinical improvement (PROMs) and experience of care (PREMs) relate in an acute psychiatric care setting? Eur Psychiatry 2023; 66:e26. [PMID: 36797203 PMCID: PMC10044307 DOI: 10.1192/j.eurpsy.2023.12] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/18/2023] Open
Abstract
BACKGROUND Patient-reported outcome measures (PROMs) and patient-reported experience measures (PREMs) are increasingly acknowledged as critical tools for enhancing patient-centred, value-based care. However, research is lacking on the impact of using standardized patient-reported indicators in acute psychiatric care. The aim of this study was to explore whether subjective well-being indicators (generic PROMs) are relevant for evaluating the quality of hospital care, distinct from measures of symptom improvement (disease-specific PROMs) and from PREMs. METHODS Two hundred and forty-eight inpatients admitted to a psychiatric university hospital were included in the study between January and June 2021. Subjective well-being was assessed using standardized generic PROMs on well-being, symptom improvement was assessed using standardized disease-specific PROMs, and experience of care using PREMs. PROMs were completed at admission and discharge, PREMs were completed at discharge. Clinicians rated their experience of providing treatment using adapted PREMs items. RESULTS Change in subjective well-being (PROMs) at discharge was significantly (p < 0.001), but moderately (r2 = 28.5%), correlated to improvement in symptom outcomes, and weakly correlated to experience of care (PREMs) (r2 = 11.0%), the latter being weakly explained by symptom changes (r2 = 6.9%). Patients and clinicians assessed the experience of care differently. CONCLUSIONS This study supports the case for routinely measuring patients' subjective well-being to better capture the unmet needs of patients undergoing psychiatric hospital treatment, and the use of standardized patient-reported measures as key indicators of high quality of care across mental health services.
Collapse
Affiliation(s)
- Elisabetta Scanferla
- CMME, GHU Paris Psychiatrie et Neurosciences, Hôpital Sainte-Anne, Paris, France.,Université Paris Cité, ED 450, Paris, France
| | | | | | - Philip Gorwood
- CMME, GHU Paris Psychiatrie et Neurosciences, Hôpital Sainte-Anne, Paris, France.,Université Paris Cité, INSERM, U1266 (Institute of Psychiatry and Neuroscience of Paris), Paris, France
| |
Collapse
|
40
|
Fartacek C, Kunrath S, Aichhorn W, Plöderl M. Therapeutic alliance and change in suicide ideation among psychiatric inpatients at risk for suicide. J Affect Disord 2023; 323:793-798. [PMID: 36529412 DOI: 10.1016/j.jad.2022.12.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 09/14/2022] [Accepted: 12/10/2022] [Indexed: 12/23/2022]
Abstract
BACKGROUND Therapeutic alliance is thought to be essential in the treatment of suicidality. Surprisingly, studies about the association between therapeutic alliance and change in suicide ideation over the course of treatment are sparse and reported inconsistent results. Furthermore, theoretically important moderators were rarely explored empirically. METHODS We investigated the association between therapeutic alliance and change in suicide ideation (difference between intake and discharge), unadjusted and adjusted for potential confounding variables (diagnoses, sociodemographics etc.) in a sample of 351 inpatients treated in a psychiatric department specialized in crisis intervention and suicide prevention. We also explored if the association was moderated by suicide ideation at intake, history of suicide attempts, and borderline personality disorder (BPD). We ran sensitivity analyses for different diagnostic subgroups, history of suicide attempts, and a quantitative measure of BPD symptoms. RESULTS We found a moderate association between therapeutic alliance and change in suicide ideation (r = 0.30, p < 0.01). This association remained robust after accounting for potentially confounding variables. Suicide ideation at intake, history of suicide attempts, and BPD were not statistically significant moderators. Sensitivity analyses led to similar results. LIMITATIONS Therapeutic alliance was assessed only at the end of treatment and causality cannot be inferred from our study method. CONCLUSIONS Therapeutic alliance was a robust correlate of improvement in suicide ideation among psychiatric inpatients at risk for suicide, independent from diagnostic groups and other patient characteristics. Our results support the crucial role of therapeutic alliance in the treatment of patients at risk for suicide.
Collapse
Affiliation(s)
- Clemens Fartacek
- Department for Inpatient Psychotherapy and Crisis Intervention, University Clinic for Psychiatry, Psychotherapy, and Psychosomatics, Paracelsus Medical University, Salzburg, Austria; Department of Clinical Psychology, University Clinic for Psychiatry, Psychotherapy, and Psychosomatics, Paracelsus Medical University, Salzburg, Austria; Institute of Synergetics and Psychotherapy Research, University Clinic of Psychiatry, Psychotherapy and Psychosomatics, Paracelsus Medical University, Salzburg, Austria.
| | - Sabine Kunrath
- California Institute for Telecommunications and Information Technology (Calit2), Irvine, CA, USA
| | - Wolfgang Aichhorn
- Institute of Synergetics and Psychotherapy Research, University Clinic of Psychiatry, Psychotherapy and Psychosomatics, Paracelsus Medical University, Salzburg, Austria
| | - Martin Plöderl
- Department for Inpatient Psychotherapy and Crisis Intervention, University Clinic for Psychiatry, Psychotherapy, and Psychosomatics, Paracelsus Medical University, Salzburg, Austria; Department of Clinical Psychology, University Clinic for Psychiatry, Psychotherapy, and Psychosomatics, Paracelsus Medical University, Salzburg, Austria
| |
Collapse
|
41
|
Guo Z, Yang T, He Y, Tian W, Wang C, Zhang Y, Liu J, Liu X, Zhu X, Wu S. The Relationships Between Suicidal Ideation, Meaning in Life, and Affect: a Network Analysis. Int J Ment Health Addict 2023:1-20. [PMID: 36776916 PMCID: PMC9904259 DOI: 10.1007/s11469-023-01019-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/20/2023] [Indexed: 02/10/2023] Open
Abstract
Transitioning from holistic analysis to a fine-grained level analysis may provide further understanding of psychopathology. This study aimed to explore dimension-level relationships between suicidal ideation, meaning in life, and affect in a joint framework using network analysis and to identify potential prevention and intervention targets to address suicidal ideation. A total of 852 healthy adults aged 18-35 years completed self-report scales to assess suicidal ideation, meaning in life, and affect. A regularized partial correlation network was then built to examine the links between these dimensions. Expected influence and bridge expected influence values were calculated for each node. The prevalence of suicidal ideation was 4.2%. The search for and presence of meaning in life and positive and negative affect exhibited distinct and complex links to the three dimensions of suicidal ideation (pessimism, sleep, and despair). The important central nodes were search for meaning in life, sleep, despair, and positive affect, while the critical bridge nodes were positive affect, negative affect, and presence of meaning in life. These findings provide further understanding of the specific roles of meaning in life and affect in suicidal ideation. The identified nodes may be promising targets for prevention and intervention for suicidal ideation.
Collapse
Affiliation(s)
- Zhihua Guo
- Department of Military Medical Psychology, Air Force Medical University, No. 169 West Changle Road, Xi’an, Shaanxi Province, 710032 China
| | - Tianqi Yang
- Department of Military Medical Psychology, Air Force Medical University, No. 169 West Changle Road, Xi’an, Shaanxi Province, 710032 China
| | - Yang He
- Department of Military Medical Psychology, Air Force Medical University, No. 169 West Changle Road, Xi’an, Shaanxi Province, 710032 China
| | - Wenqing Tian
- Department of Military Medical Psychology, Air Force Medical University, No. 169 West Changle Road, Xi’an, Shaanxi Province, 710032 China
| | - Chaoxian Wang
- 94995 Troops of People’s Liberation Army, Beijing, China
| | - Yinling Zhang
- Department of Nursing, Air Force Medical University, Xi’an, China
| | - Jianjun Liu
- Outpatient Department, PLA Air Force 986 Hospital, Xi’an, China
| | - Xufeng Liu
- Department of Military Medical Psychology, Air Force Medical University, No. 169 West Changle Road, Xi’an, Shaanxi Province, 710032 China
| | - Xia Zhu
- Department of Military Medical Psychology, Air Force Medical University, No. 169 West Changle Road, Xi’an, Shaanxi Province, 710032 China
| | - Shengjun Wu
- Department of Military Medical Psychology, Air Force Medical University, No. 169 West Changle Road, Xi’an, Shaanxi Province, 710032 China
| |
Collapse
|
42
|
Grigutytė N, Mikuličiūtė V, Petraškaitė K, Kairys A. Beck Scales (BDI-II, BAI, BHS, BSS, and CBOCI): Clinical and Normative Samples’ Comparison and Determination of Clinically Relevant Cutoffs. PSICHOLOGIJA 2023. [DOI: 10.15388/psichol.2022.61] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
This article aims to evaluate 5 Beck scales – Beck Depression Inventory-II (BDI-II), Beck Anxiety Inventory (BAI), Beck Hopelessness Scale (BHS), Beck Suicidal Ideation Scale (BSS), and Clark–Beck Obsession-Compulsion Inventory (CBOCI) – comparing clinical and normative samples, and to determine clinically relevant cutoffs. The clinical sample consisted of 242 persons aged 18–74; 39 percent were men and 61 percent were women. The normative sample consisted of 1296 persons aged 18–95; 44 percent were men and 56 percent were women. In order to compare the estimates of the normative and clinical samples of the Beck scales, a paired data study sample was formed – 230 participants from the clinical and normative groups each. The clinical sample was divided into four groups according to the primary diagnoses: 107 (46.5%) patients were diagnosed with mood (affective) disorder (F30–F39), 38 (16.5%) with neurophysical stress and somatoform disorders (F40–F49), 51 (22.2%) with disorders due to the use of psychoactive substances (F10–F19), 34 (14.8%) with high risk of suicide (X60–X84; Z91.5; R45.81). 27 percent of patients had comorbid diagnoses. The results show high internal consistency of the Beck scales in all samples. The discrimination abilities of all five Beck scales are good; the cutoffs for each Beck scale in four clinical groups are estimated. Both the total clinical sample and the 4 clinical sample groups had significantly higher BDI-II, BAI, BHS, BSS, and CBOCI scores than the normative sample. In conclusion, the Beck scales alone are not sufficient for making a decision about the clinical diagnosis.
Collapse
|
43
|
Al-Imam A, Motyka MA, Hoffmann B, Basil S, Al-Hemiary N. Suicidal Ideation in Iraqi Medical Students Based on Research Using PHQ-9 and SSI-C. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1795. [PMID: 36767164 PMCID: PMC9914454 DOI: 10.3390/ijerph20031795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 01/10/2023] [Accepted: 01/13/2023] [Indexed: 06/18/2023]
Abstract
Suicidal ideation is a spectrum of contemplations, wishes, and preoccupations with suicide. Its prevalence is ambiguous in Iraq, especially among the youth. We aim to survey the prevalence of suicidal ideation among Iraqi students and explore its risk factors. We surveyed Iraqi undergraduate medical students (n = 496) using two psychometric tools, the PHQ-9 and Beck's SSI-C. We also explored potential risk factors, including the students' attributes, socio-demographics, and history of mental illnesses. The current study included males (23.8%) and females (76.2%) in their early twenties (21.73 ± 0.11). Concerning PHQ-9 and SSI-C, most students had either moderate (28%) or mild depression (27.8%), while those with suicidal ideation accounted for an alarming 64.9%. The strongest association existed between the SSI-C and PHQ-9 scores (p = 0.001, OR = 4.70). Other associations existed with the personal history of mental illness (p < 0.001, OR = 2.87) and the family history of suicidality (p = 0.006, OR = 2.28). Path analysis highlighted four suicidal ideation predictors, including the PHQ-9 score (standardized estimate = 0.41, p < 0.001), personal history of mental illness (0.16, p < 0.001), previous psychiatric consultation (0.12, p = 0.002), and family history of suicidality (0.11, p = 0.005). Suicidal ideation is highly prevalent among Iraqi students. Univariable testing, multivariable analyses, and structural modeling yielded congruent results. The students' inherent rather than inherited attributes influenced the phenomenon the most, which is in harmony with Durkheim's theory on the social roots of suicide. We encourage psychiatrists and psychology counselors to be vigilant concerning these risk factors among potential suicidal ideation victims.
Collapse
Affiliation(s)
- Ahmed Al-Imam
- Department of Computer Science and Statistics, Doctoral School, Poznan University of Medical Sciences, Rokietnicka 7 St. (1st Floor), 61-806 Poznan, Poland
- Department of Anatomy and Cellular Biology, College of Medicine, University of Baghdad, Baghdad 10047, Iraq
- Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London E1 2AD, UK
| | - Marek A. Motyka
- Institute of Sociological Sciences, University of Rzeszow, 35-959 Rzeszów, Poland
| | - Beata Hoffmann
- Institute of Applied Social Sciences, University of Warsaw, 00-927 Warsaw, Poland
| | - Safwa Basil
- Department of Psychiatry, Baghdad Medical City, Baghdad 10047, Iraq
| | - Nesif Al-Hemiary
- Department of Psychiatry, College of Medicine, University of Baghdad, Baghdad 10047, Iraq
- Psychiatry Council, The Iraqi Board for Medical Specializations, Baghdad 10047, Iraq
| |
Collapse
|
44
|
Cusick M, Velupillai S, Downs J, Campion TR, Sholle ET, Dutta R, Pathak J. Portability of natural language processing methods to detect suicidality from clinical text in US and UK electronic health records. JOURNAL OF AFFECTIVE DISORDERS REPORTS 2022; 10:100430. [PMID: 36644339 PMCID: PMC9835770 DOI: 10.1016/j.jadr.2022.100430] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Background In the global effort to prevent death by suicide, many academic medical institutions are implementing natural language processing (NLP) approaches to detect suicidality from unstructured clinical text in electronic health records (EHRs), with the hope of targeting timely, preventative interventions to individuals most at risk of suicide. Despite the international need, the development of these NLP approaches in EHRs has been largely local and not shared across healthcare systems. Methods In this study, we developed a process to share NLP approaches that were individually developed at King's College London (KCL), UK and Weill Cornell Medicine (WCM), US - two academic medical centers based in different countries with vastly different healthcare systems. We tested and compared the algorithms' performance on manually annotated clinical notes (KCL: n = 4,911 and WCM = 837). Results After a successful technical porting of the NLP approaches, our quantitative evaluation determined that independently developed NLP approaches can detect suicidality at another healthcare organization with a different EHR system, clinical documentation processes, and culture, yet do not achieve the same level of success as at the institution where the NLP algorithm was developed (KCL approach: F1-score 0.85 vs. 0.68, WCM approach: F1-score 0.87 vs. 0.72). Limitations Independent NLP algorithm development and patient cohort selection at the two institutions comprised direct comparability. Conclusions Shared use of these NLP approaches is a critical step forward towards improving data-driven algorithms for early suicide risk identification and timely prevention.
Collapse
Affiliation(s)
- Marika Cusick
- WeiCornell Medicine, 402 E. 67th St., New York, NY 10065, USA, South London and Maudsley NHS Foundation Trust, London, UK, Corresponding author. (M. Cusick)
| | - Sumithra Velupillai
- IoPPN, King’s College London, London, UK, South London and Maudsley NHS Foundation Trust, London, UK
| | - Johnny Downs
- IoPPN, King’s College London, London, UK, South London and Maudsley NHS Foundation Trust, London, UK
| | - Thomas R. Campion
- WeiCornell Medicine, 402 E. 67th St., New York, NY 10065, USA, South London and Maudsley NHS Foundation Trust, London, UK
| | - Evan T. Sholle
- WeiCornell Medicine, 402 E. 67th St., New York, NY 10065, USA, South London and Maudsley NHS Foundation Trust, London, UK
| | - Rina Dutta
- IoPPN, King’s College London, London, UK, South London and Maudsley NHS Foundation Trust, London, UK
| | - Jyotishman Pathak
- WeiCornell Medicine, 402 E. 67th St., New York, NY 10065, USA, South London and Maudsley NHS Foundation Trust, London, UK
| |
Collapse
|
45
|
Crocker LD, Jurick SM, Merritt VC, Keller AV, Hoffman SN, Davey DK, Jak AJ. Mechanisms through which executive dysfunction influences suicidal ideation in combat-exposed Iraq and Afghanistan veterans. Clin Neuropsychol 2022; 36:2073-2092. [PMID: 34524071 DOI: 10.1080/13854046.2021.1974566] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
OBJECTIVE Executive dysfunction has previously been associated with suicidality, but it remains unclear how deficits in executive functioning contribute to increased suicidal thoughts and behaviors. Although it has been proposed that poorer executive functioning leads to difficulty generating and implementing appropriate coping strategies to regulate distress and inhibit suicidal thoughts and behaviors, studies have not systematically examined these relationships. Therefore, the present study examined various hypotheses to elucidate the mechanisms through which executive dysfunction influences suicidal ideation (SI) in combat-exposed Iraq/Afghanistan veterans. METHOD Veterans who endorsed SI were compared to those who denied SI on demographic and diagnostic variables and measures of neuropsychological functioning, psychological symptoms, coping styles, and combat experiences. Serial mediation models were tested to examine mechanistic relationships among executive functioning, psychological distress, coping, and SI. RESULTS Those who endorsed SI had worse executive functioning, greater psychological distress, and greater avoidant coping relative to those who denied SI. Serial mediation model testing indicated a significant indirect path, such that executive dysfunction increased psychological distress, which in turn increased avoidant coping, leading to SI. CONCLUSIONS Findings support and extend previous hypotheses regarding how executive functioning contributes to increased risk of suicidality via increased distress and avoidant coping. Intervention efforts focused on reducing suicidality may benefit from techniques that enhance executive functioning (e.g. computerized training, cognitive rehabilitation) and in turn reduce distress prior to targeting coping strategies.
Collapse
Affiliation(s)
- Laura D Crocker
- Research Service, VA San Diego Healthcare System, San Diego, CA, USA.,Center of Excellence for Stress and Mental Health, VA San Diego Healthcare System, San Diego, CA, USA
| | - Sarah M Jurick
- Center of Excellence for Stress and Mental Health, VA San Diego Healthcare System, San Diego, CA, USA.,Department of Psychiatry, School of Medicine, University of California San Diego, La Jolla, CA, USA
| | - Victoria C Merritt
- Research Service, VA San Diego Healthcare System, San Diego, CA, USA.,Center of Excellence for Stress and Mental Health, VA San Diego Healthcare System, San Diego, CA, USA.,Department of Psychiatry, School of Medicine, University of California San Diego, La Jolla, CA, USA
| | - Amber V Keller
- San Diego Joint Doctoral Program in Clinical Psychology, San Diego State University/University of California, San Diego, CA, USA
| | - Samantha N Hoffman
- San Diego Joint Doctoral Program in Clinical Psychology, San Diego State University/University of California, San Diego, CA, USA
| | - Delaney K Davey
- Research Service, VA San Diego Healthcare System, San Diego, CA, USA
| | - Amy J Jak
- Center of Excellence for Stress and Mental Health, VA San Diego Healthcare System, San Diego, CA, USA.,Department of Psychiatry, School of Medicine, University of California San Diego, La Jolla, CA, USA.,Psychology Service, VA San Diego Healthcare System, San Diego, CA, USA
| |
Collapse
|
46
|
Legrand FD, Lallement D, Kasmi S. Physical activity can reduce hopelessness among women admitted to psychiatric short stay unit following a suicide crisis. J Psychiatr Res 2022; 155:567-571. [PMID: 36201969 DOI: 10.1016/j.jpsychires.2022.09.046] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 09/02/2022] [Accepted: 09/24/2022] [Indexed: 10/31/2022]
Abstract
BACKGROUND In a growing number of countries, brief hospitalizations in psychiatric short stay units (SSUs) are proposed to patients in acute mental health crisis (typically suicide crisis). AIMS This pilot study's purpose was to assess the feasibility, acceptability, and plausible efficacy of two days of 30 min of brisk-walking/jogging compared to 30 min of sedentary activities in suicidal inpatients from a French psychiatric SSU. METHODS Twelve female adults completed the study. Participants in the brisk-walking/jogging group (n = 6) received two exercise sessions of 30 min separated by a time interval of 24 h. Participants in the control group (n = 6) did not receive the exercise intervention, but were asked to engage in sedentary activities of similar duration at the same time of the day. Measures of hopelessness and optimism/pessimism were administered at the intake and final assessments. In addition, other performance indicators were explored and provide the readers with information about the feasibility and acceptability of intervention. RESULTS Findings showed strong feasibility and acceptability (no serious adverse event, adherence and retention rates around 75%-80%, and high patients satisfaction ratings). Significant differences between groups favoring women who exercised were oberved in the score change of hopelessness (Hedges's g = -1.29, 95% CI [-2.65, -0.08]). CONCLUSION The present study provides preliminary evidence for the plausible adjunctive efficacy of physical activity to alleviate the psychological distress suffered by suicidal patients in a psychiatric SSU.
Collapse
Affiliation(s)
- Fabien D Legrand
- EA 6291, Cognition, Health, and Society, Department of Psychology, University of Reims Champagne-Ardenne, France.
| | - Dany Lallement
- EA 6291, Cognition, Health, and Society, Department of Psychology, University of Reims Champagne-Ardenne, France
| | - Souhela Kasmi
- EA 6291, Cognition, Health, and Society, Department of Psychology, University of Reims Champagne-Ardenne, France
| |
Collapse
|
47
|
Thiel AM, Spoor SP, McGinnis BL, Young KPD. Examining the association of eating psychopathology with suicidality: Comparing cross-sectional and longitudinal tests of interpersonal-psychological mediators. Eat Disord 2022; 31:320-336. [PMID: 36285369 DOI: 10.1080/10640266.2022.2135719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Eating disorders (EDs) are associated with high mortality rates from suicide. Empirical tests of the Interpersonal-Psychological Theory of Suicide (IPTS) have provided preliminary cross-sectional support for its application to individuals with EDs. Because IPTS seeks to predict development and changes in suicidal ideation (SI), longitudinal investigations are ideal. The purpose of this study was to conduct cross-sectional and longitudinal mediational tests of the effect of ED psychopathology on SI as explained by perceived burdensomeness, thwarted belongingness, and hopelessness. Participants were undergraduate students (N = 738) who completed self-report measures of ED symptoms and IPTS variables at up to three time points across 10 weeks. Multiple mediation analyses were conducted on cross-sectional and longitudinal data. Cross-sectional analyses indicate mostly consistent findings with existing literature; however, results from the longitudinal analyses failed to identify any mediational effects of ED psychopathology on SI. These differences emphasize the importance of empirical tests in both cross-sectional and longitudinal data. Given the inconsistent results, the utility of IPTS features in explaining the association between ED psychopathology and SI is unclear. Future studies should seek to replicate these findings using other methods of measurement across time (e.g., ecological momentary assessment) and within clinical ED samples.
Collapse
Affiliation(s)
- Alexandra M Thiel
- Department of Psychology, University of Wyoming, Laramie, Wyoming, USA
| | - Samantha P Spoor
- Department of Psychology, University of Wyoming, Laramie, Wyoming, USA
| | - Brooke L McGinnis
- Department of Psychology, University of Wyoming, Laramie, Wyoming, USA
| | - Kyle P De Young
- Department of Psychology, University of Wyoming, Laramie, Wyoming, USA
| |
Collapse
|
48
|
Ko H, Park D, Shin J, Yu R, Ryu V, Lee W. Cognitive profiles in bipolar I disorder and associated risk factors: Using Wechsler adult intelligence scale—IV. Front Psychol 2022; 13:951043. [PMID: 36275296 PMCID: PMC9582973 DOI: 10.3389/fpsyg.2022.951043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Accepted: 09/16/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundDespite the growing evidence of cognitive impairments in bipolar disorder (BD), little work has evaluated cognitive performances utilizing the latest version of the Wechsler Intelligence Scale-IV (WAIS-IV), which is one of the most widely used neurocognitive assessments in clinical settings. Furthermore, clinical characteristics or demographic features that negatively affect the cognitive functioning of BD were not systematically compared or evaluated. Accordingly, the present study aimed to examine the cognitive profile of bipolar I disorder (BD-I) patients and associated risk factors.MethodsParticipants included 45 patients, diagnosed with BD-I, current or most recent episode manic, and matching 46 healthy controls (HC). Cognitive performance was evaluated via WAIS-IV, and clinical characteristics of the BD-I group were examined via multiple self- and clinician-report questionnaires.ResultsMultivariate analysis of covariance (MANCOVA) results indicated that the BD-I group demonstrated significantly poorer performance compared to the HC group in subtests and indexes that reflect working memory and processing speed abilities. Redundancy analysis revealed that overall symptom severity, manic symptom severity, and anxiety were significant predictors of cognitive performance in BD-I, while age of onset, past mood disorder history, depression severity, and impulsiveness showed comparatively smaller predictive values.ConclusionThe current study suggests cognitive deterioration in the cognitive proficiency area while generalized ability, including verbal comprehension and most of the perceptual reasoning skills, remain intact in BD-I. The identified risk factors of cognitive performance provide specific clinical recommendations for intervention and clinical decision-making.
Collapse
Affiliation(s)
- Hayoung Ko
- Department of Psychology, Virginia Polytechnic Institute and State University, Blacksburg, VA, United States
| | - DongYeon Park
- Department of Psychiatry, National Center for Mental Health, Seoul, South Korea
| | - Jaehyun Shin
- School of Education, Virginia Polytechnic Institute and State University, Blacksburg, VA, United States
| | - Rina Yu
- Department of Mental Health Research, National Center for Mental Health, Seoul, South Korea
| | - Vin Ryu
- Department of Psychiatry, National Center for Mental Health, Seoul, South Korea
| | - Wonhye Lee
- Department of Clinical Psychology, National Center for Mental Health, Seoul, South Korea
- *Correspondence: Wonhye Lee,
| |
Collapse
|
49
|
Ethical and methodological challenges slowing progress in primary care-based suicide prevention: Illustrations from a randomized controlled trial and guidance for future research. J Psychiatr Res 2022; 154:242-251. [PMID: 35961180 PMCID: PMC10124132 DOI: 10.1016/j.jpsychires.2022.07.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 06/26/2022] [Accepted: 07/20/2022] [Indexed: 11/22/2022]
Abstract
INTRODUCTION Despite the pressing need for primary care-based suicide prevention initiatives and growing acknowledgement of recruitment difficulties and Institutional Review Board (IRB) challenges in suicide research, we are aware of no illustrative examples describing how IRB decisions in the design of a primary care trial can compound recruitment challenges. METHODS The CDC-funded trial (NCT02986113) of Men and Providers Preventing Suicide aimed to examine the effects of a tailored computer program encourage men with suicidal thoughts (n = 304, ages 35-64) to discuss suicide with a primary care clinician and accept treatment. Before a visit, participants viewed MAPS or a non-tailored control video. Post-visit, both arms were offered telephone collaborative care, as mandated by the institutional review board (IRB). We previously showed that exposure to MAPs led to improvements in communication about suicide in a primary care visit. In this paper, we report data on the study's primary outcome, suicide preparatory behaviors. RESULTS After screening nearly 4100 men, 48 enrolled. Recruitment challenges, which were exacerabted by an IRB mandate narrowing post-intervention patient management differences between trial arms, limited detection of the effects of MAPS on suicide preparatory behaviors. CONCLUSIONS While primary care settings are key sites for suicide prevention trials, issues such as recruitment difficulties and overly restrictive IRB requirements may limit their utility. Methodological innovation to improve recruitment and ethical guidance to inform IRB decision-making are needed.
Collapse
|
50
|
Silva C, Cero I, Ricci N, Pérez A, Conwell Y, Van Orden K. The feasibility and acceptability of using smartphones to assess suicide risk among Spanish-speaking adult outpatients. Suicide Life Threat Behav 2022; 52:918-931. [PMID: 35674249 PMCID: PMC9588541 DOI: 10.1111/sltb.12889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 04/14/2022] [Accepted: 05/23/2022] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Hispanic/Latino adults, particularly Spanish speakers, are underserved in mental healthcare, and little is known about the day-to-day variation in their suicide risk. Smartphones have the potential to overcome geographical and linguistic barriers to mental health assessment and intervention. The purpose of the current study was to examine (a) the feasibility/acceptability of smartphone-based ecological momentary assessment (EMA) to assess suicide ideation and suicide risk factors among high-risk Spanish-speaking adults and (b) the degree of within-person variation of suicide ideation and suicide risk in this population. METHOD Sixteen primary Spanish-speaking psychiatry outpatients completed EMA measures of suicide ideation and suicide risk factors four times a day for 14 days. RESULTS A majority of participants consented to active and passive remote assessments and reported the acceptability of study procedures. Adherence to EMA was high and not associated with symptom severity. EMA instances completed were not associated with symptom severity at follow-up. Average point-to-point variability in suicide ideation and risk factors were moderate to high, respectively. EMA captured more dramatic changes than standard baseline and follow-up assessments. CONCLUSIONS Results provide preliminary support for the feasibility and acceptability of using smartphones to assess suicide risk in a real-time and real-world setting among high-risk Spanish-speaking adults.
Collapse
Affiliation(s)
- Caroline Silva
- University of Rochester School of Medicine, Rochester, New York, USA
| | - Ian Cero
- University of Rochester School of Medicine, Rochester, New York, USA
| | - Nilsa Ricci
- University of Rochester School of Medicine, Rochester, New York, USA
| | - Alessandra Pérez
- University of Rochester School of Medicine, Rochester, New York, USA
| | - Yeates Conwell
- University of Rochester School of Medicine, Rochester, New York, USA
| | | |
Collapse
|