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Boldrini M, Xiao Y, Sing T, Zhu C, Jabbi M, Pantazopoulos H, Gürsoy G, Martinowich K, Punzi G, Vallender EJ, Zody M, Berretta S, Hyde TM, Kleinman JE, Marenco S, Roussos P, Lewis DA, Turecki G, Lehner T, Mann JJ. Omics approaches to investigate the pathogenesis of suicide. Biol Psychiatry 2024:S0006-3223(24)01352-0. [PMID: 38821194 DOI: 10.1016/j.biopsych.2024.05.017] [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: 01/08/2024] [Revised: 05/17/2024] [Accepted: 05/23/2024] [Indexed: 06/02/2024]
Abstract
Suicide is the second leading cause of death in U.S. adolescents and young adults, and generally associated with a psychiatric disorder. Suicidal behavior has a complex etiology and pathogenesis. Moderate heritability suggests genetic causes. Associations between childhood and recent life adversity indicate contributions from epigenetic factors. Genomic contributions to suicide pathogenesis remain largely unknown. This paper is based on a workshop held to design strategies to identify molecular drivers of suicide neurobiology that would be putative new treatment targets. The panel determined that, while bulk tissue studies provide comprehensive information, single-nucleus approaches identifying cell-type specific changes are needed. While single nuclei techniques lack information on cytoplasm, processes, spines, and synapses, spatial multiomic technologies on intact tissue detect cell alterations specific to brain tissue layers and subregions. Because suicide has genetic and environmental drivers, multiomic approaches combining cell-type specific epigenome, transcriptome, and proteome provide a more complete picture of pathogenesis. To determine the direction of effect of suicide risk gene variants on RNA and protein expression, and how these interact with epigenetic marks, single nuclei and spatial multiomics quantitative trait loci maps should be integrated with whole genome sequencing and genome-wide association databases. The workshop concluded with the recommendation for the formation of an international suicide biology consortium that will bring together brain banks and investigators with expertise in cutting-edge omics technologies to delineate the biology of suicide and identify novel potential treatment targets to be tested in cellular and animal models for drug and biomarkers discovery, to guide suicide prevention.
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Affiliation(s)
- Maura Boldrini
- Department of Psychiatry, Columbia University, New York, NY; Division of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, New York, NY.
| | - Yang Xiao
- Department of Biomedical Engineering, Columbia University, New York, NY
| | - Tarjinder Sing
- Department of Psychiatry, Columbia University, New York, NY; Division of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, New York, NY; New York Genome Center, New York, NY
| | - Chenxu Zhu
- Department of Physiology and Biophysics, Institute for Computational Biomedicine, Weill Cornell Medicine, New York, NY; New York Genome Center, New York, NY
| | - Mbemba Jabbi
- Department of Psychiatry and Behavioral Sciences, Mulva Clinics for the Neurosciences, Dell Medical School, The University of Texas at Austin, Austin, TX
| | - Harry Pantazopoulos
- Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, Jackson, MS
| | - Gamze Gürsoy
- New York Genome Center, New York, NY; Departments of Biomedical Informatics and Computer Science, Columbia University, New York, NY
| | - Keri Martinowich
- Lieber Institute for Brain Development, Department of Psychiatry and Behavioral Sciences, Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Giovanna Punzi
- Lieber Institute for Brain Development, Department of Psychiatry and Behavioral Sciences, Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Eric J Vallender
- Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, Jackson, MS
| | | | - Sabina Berretta
- Department of Psychiatry, Harvard Brain Tissue Resource Center, Harvard Medical School, McLean Hospital, Belmont, MA
| | - Thomas M Hyde
- Lieber Institute for Brain Development, Department of Psychiatry and Behavioral Sciences, Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Joel E Kleinman
- Lieber Institute for Brain Development, Department of Psychiatry and Behavioral Sciences, Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Stefano Marenco
- Human Brain Collection Core (HBCC), National Institute of Mental Health's (NIMH) Division of Intramural Research Programs (DIRP), Bethesda, MD
| | - Panagiotis Roussos
- Center for Precision Medicine and Translational Therapeutics; Mental Illness Research Education, and Clinical Center (VISN 2 South), James J. Peters VA Medical Center, Bronx, NY, USA
| | - David A Lewis
- Department of Psychiatry, Douglas Institute, McGill University, Montréal, QC, Canada
| | - Gustavo Turecki
- Departments of Psychiatry and Neuroscience, University of Pittsburgh, Pittsburgh, PA
| | | | - J John Mann
- Department of Psychiatry, Columbia University, New York, NY; Division of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, New York, NY
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Oquendo MA, Galfalvy HC, Choo TH, Herzog S, Burke AK, Sublette ME, Mann JJ, Stanley BH. Occurrence and characteristics of suicidal ideation in psychiatrically healthy individuals based on ecological momentary assessment. Mol Psychiatry 2024:10.1038/s41380-024-02560-2. [PMID: 38729992 DOI: 10.1038/s41380-024-02560-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Revised: 04/03/2024] [Accepted: 04/10/2024] [Indexed: 05/12/2024]
Abstract
Decedents with no known mental disorder comprise 5-40% of suicides, suggesting that suicide ideation (SI) and behavior may occur in the psychiatrically healthy with important implications for suicide risk screening. Healthy Volunteers (HV) and patients with Major Depressive Disorder (MDD) provided 7 days of Ecological Momentary Assessment (EMA) data about SI and stressors. Longitudinal mixed effects logistic regression models compared HV and patient SI and stressors. Mixed effects linear regression models compared HVs' and patients' SI score change from the previous epoch's SI score when each stressor occurred. HVs (n = 42) reported less frequent (p < 0.001) and less intense SI (p < 0.003) than patients (n = 80), yet did endorse SI and/or SI-related items in 44% of EMA epochs, endorsing SI items in 25% of epochs with non-zero SI scores. For 7 of 8 stressors, patients reported stressors more often than HVs (all p < 0.001) responding to them with increased SI (0.0001 < p < 0.0472). HVs were relatively resilient to stressors, reporting SI increases only in response to neglect (p < 0.0147). Although SI and SAs are documented among psychiatrically healthy individuals, scientific attention to these observations has been scant. Real-time SI measurement showed that HVs' SI was less pronounced than MDD patients', but was endorsed, nonetheless. Patients were more likely to report stressors than HVs, perhaps due to greater sensitivity to the environment, and reported SI in response to stressors, which was less common in HVs. Both MDD patients and HVs most often manifested passive SI (viz, "decreased wish to live"). However, passive SI (viz, "desire for death"), may predict suicide, even absent SI per se (thinking about killing yourself). This study validates the utility of real-time SI assessment, showing that HVs endorse SI items in 11% of epochs, which implies that suicide risk screening focused on those with mental disorders may be too narrow an approach.
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Affiliation(s)
- Maria A Oquendo
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
| | - Hanga C Galfalvy
- Vagelos College of Physicians and Surgeons, Columbia University and New York State Psychiatric Institute, New York, NY, USA
| | - Tse-Hwei Choo
- Vagelos College of Physicians and Surgeons, Columbia University and New York State Psychiatric Institute, New York, NY, USA
| | - Sarah Herzog
- Vagelos College of Physicians and Surgeons, Columbia University and New York State Psychiatric Institute, New York, NY, USA
| | - Ainsley K Burke
- Vagelos College of Physicians and Surgeons, Columbia University and New York State Psychiatric Institute, New York, NY, USA
| | - M Elizabeth Sublette
- Vagelos College of Physicians and Surgeons, Columbia University and New York State Psychiatric Institute, New York, NY, USA
| | - J John Mann
- Vagelos College of Physicians and Surgeons, Columbia University and New York State Psychiatric Institute, New York, NY, USA
| | - Barbara H Stanley
- Vagelos College of Physicians and Surgeons, Columbia University and New York State Psychiatric Institute, New York, NY, USA
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Pitman A, Logeswaran Y, McDonald K, Cerel J, Lewis G, Erlangsen A. Investigating risk of self-harm and suicide on anniversaries after bereavement by suicide and other causes: a Danish population-based self-controlled case series study. Epidemiol Psychiatr Sci 2023; 32:e53. [PMID: 37551142 PMCID: PMC10465319 DOI: 10.1017/s2045796023000653] [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: 02/10/2023] [Revised: 06/28/2023] [Accepted: 07/13/2023] [Indexed: 08/09/2023] Open
Abstract
AIMS To investigate mechanisms of suicide risk in people bereaved by suicide, prompted by observations that bereaved people experience higher levels of distress around dates of emotional significance. We hypothesised that suicide-bereaved first-degree relatives and partners experience an increased risk of self-harm and suicide around dates of (i) anniversaries of the death and (ii) the deceased's birthday, compared with intervening periods. METHODS We conducted a self-controlled case series study using national register data on all individuals living in Denmark from 1 January 1980 to 31 December 2016 and who were bereaved by the suicide of a first-degree relative or partner (spouse or cohabitee) during that period, and who had the outcome (any episode of self-harm or suicide) within 5 years and 6 weeks of the bereavement. We compared relative incidence of suicidal behaviour in (i) the first 30 days after bereavement and (ii) in the aggregated exposed periods (6 weeks either side of death anniversaries; 6 weeks either side of the deceased's birthdays) to the reference (aggregated unexposed intervening periods). As an indirect comparison, we repeated these models in people bereaved by other causes. RESULTS We found no evidence of an elevated risk of suicidal behaviour during periods around anniversaries of a death or the deceased's birthdays in people bereaved by suicide (adjusted incidence rate ratio [IRRadj] = 1.00; 95% confidence interval [CI] = 0.87-1.16) or other causes (IRRadj = 1.04; 95% CI = 1.00-1.08) compared with intervening periods. Rates were elevated in the 30 days immediately after bereavement by other causes (IRRadj: 1.95, 95% CI: 1.77-2.22). CONCLUSIONS Although people bereaved by suicide are at elevated risk of self-harm and suicide, our findings do not suggest that this risk is heightened around emotionally significant anniversaries. Bereavement care should be accessible at all points after a traumatic loss as needs will differ over the grief trajectory.
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Affiliation(s)
- Alexandra Pitman
- UCL Division of Psychiatry, University College London (UCL), London, UK
- Camden and Islington NHS Foundation Trust, St Pancras Hospital, London, UK
| | | | - Keltie McDonald
- UCL Division of Psychiatry, University College London (UCL), London, UK
| | - Julie Cerel
- College of Social Work, University of Kentucky, Lexington, KY, USA
| | - Gemma Lewis
- UCL Division of Psychiatry, University College London (UCL), London, UK
| | - Annette Erlangsen
- Danish Research Institute for Suicide Prevention, Psychiatric Centre Copenhagen, Hellerup, Copenhagen, Denmark
- Copenhagen Research Centre for Mental Health, Mental Health Center Copenhagen, Mental Health Services, Capital Region of Denmark, Hellerup, Copenhagen, Denmark
- Department of Mental Health, Johns Hopkins School of Public Health, Baltimore, MD, USA
- Centre for Mental Health Research, Research School of Population Health, The Australian National University, Canberra, Australia
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Zhong J, Huang XJ, Wang XM, Xu MZ. The mediating effect of distress tolerance on the relationship between stressful life events and suicide risk in patients with major depressive disorder. BMC Psychiatry 2023; 23:118. [PMID: 36814223 PMCID: PMC9945729 DOI: 10.1186/s12888-023-04600-7] [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: 12/28/2022] [Accepted: 02/08/2023] [Indexed: 02/24/2023] Open
Abstract
BACKGROUND Despite widespread acknowledgment of the impact of stressful life events on suicide risk, the understanding of the psychological mechanisms underlying the relationship between stressful life events and suicide risk in major depressive disorder (MDD) remain unclear. This study aim to examine whether the distress tolerance mediates the relationship between the stressful life events and suicide risk in patients with MDD. METHODS A cross-sectional study was carried out among 125 Chinese patients with MDD, mean age was 27.05 (SD=0.68) and 68.8% were females. The 17-item Hamilton Depression Rating scale (HAMD-17), the validated Chinese version of the Mini International Neuropsychiatric Interview (MINI) suicide module, Life Events Scale (LES) and Distress Tolerance Scale (DTS) were utilized to evaluate depressive symptoms, stressful life events, levels of distress tolerance, and suicide risk, respectively. Mediation analyses was used to test the mediation effect of distress tolerance on the relationship between stressful life events and suicide risk. RESULTS The ratio of suicide risk in patients with MDD was 75.2%. Pearson correlation analysis showed that stressful life events were positively correlated with suicide risk(r=0.182, p<0.05). Stressful life events(r=-0.323, p<0.01) and suicide risk(r=-0.354, p<0.01) were negatively correlated with distress tolerance. Mediation analyses showed that the direct path from stressful life events to suicide risk was not significant (B= 0.012, 95% confidence interval (CI) [-0.017, 0.042]). Stressful life events affected suicide risk indirectly through distress tolerance (B= 0.018, 95% CI [0.007, 0.031]), and the mediating effect accounted for 60.0% of the total effect. CONCLUSION Distress tolerance completely played a mediating role between stressful life events and suicide risk. Further suicide prevention and intervention strategies should focus on increasing levels of distress tolerance in patients with MDD.
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Affiliation(s)
- Jing Zhong
- grid.284723.80000 0000 8877 7471School of Public Health, Southern Medical University, Guangzhou, Guangdong People’s Republic of China ,grid.284723.80000 0000 8877 7471Guangdong Mental Health Center, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, 510120 Guangdong People’s Republic of China
| | - Xiao-Jie Huang
- grid.284723.80000 0000 8877 7471Guangdong Mental Health Center, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, 510120 Guangdong People’s Republic of China
| | - Xue-Mei Wang
- grid.411866.c0000 0000 8848 7685Guangdong Provincial Hospital of Traditional Chinese Medicine, Guangdong Provincial Academy of Chinese Medical Sciences, and The Second Clinical College, Guangzhou University of Chinese Medicine, Guangzhou, People’s Republic of China
| | - Ming-Zhi Xu
- School of Public Health, Southern Medical University, Guangzhou, Guangdong, People's Republic of China. .,Guangdong Mental Health Center, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, 510120, Guangdong, People's Republic of China.
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5
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Olfson M, Cosgrove CM, Altekruse SF, Wall MM, Blanco C. Living Alone and Suicide Risk in the United States, 2008‒2019. Am J Public Health 2022; 112:1774-1782. [PMID: 36383944 PMCID: PMC9670225 DOI: 10.2105/ajph.2022.307080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/05/2022] [Indexed: 11/17/2022]
Abstract
Objectives. To evaluate the association between living alone and suicide and how it varies across sociodemographic characteristics. Methods. A nationally representative sample of adults from the 2008 American Community Survey (n = 3 310 000) was followed through 2019 for mortality. Cox models estimated hazard ratios of suicide across living arrangements (living alone or with others) at the time of the survey. Total and sociodemographically stratified models compared hazards of suicide of people living alone to people living with others. Results. Annual suicide rates per 100 000 person-years were 23.0 among adults living alone and 13.2 among adults living with others. The age-, sex-, and race/ethnicity-adjusted hazard ratio of suicide for living alone was 1.75 (95% confidence interval = 1.64, 1.87). Adjusted hazards of suicide associated with living alone varied across sociodemographic groups and were highest for adults with 4-year college degrees and annual incomes greater than $125 000 and lowest for Black individuals. Conclusions. Living alone is a risk marker for suicide with the strongest associations for adults with the highest levels of income and education. Because these associations were not controlled for psychiatric disorders, they should be interpreted as noncausal. (Am J Public Health. 2022;112(12):1774-1782. https://doi.org/10.2105/AJPH.2022.307080).
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Affiliation(s)
- Mark Olfson
- Mark Olfson and Melanie M. Wall are with the Vagelos College of Physicians and Surgeons and Mailman School of Public Health, Columbia University, and with the New York State Psychiatric Institute, New York, NY. Candace M. Cosgrove is with the US Census Bureau, Suitland, MD. Sean F. Altekruse is with National Heart, Lung, and Blood Institute, Division of Cardiovascular Sciences, Bethesda, MD. Carlos Blanco is with the National Institute on Drug Abuse, Division of Epidemiology, Services, and Prevention Research, Rockville, MD
| | - Candace M Cosgrove
- Mark Olfson and Melanie M. Wall are with the Vagelos College of Physicians and Surgeons and Mailman School of Public Health, Columbia University, and with the New York State Psychiatric Institute, New York, NY. Candace M. Cosgrove is with the US Census Bureau, Suitland, MD. Sean F. Altekruse is with National Heart, Lung, and Blood Institute, Division of Cardiovascular Sciences, Bethesda, MD. Carlos Blanco is with the National Institute on Drug Abuse, Division of Epidemiology, Services, and Prevention Research, Rockville, MD
| | - Sean F Altekruse
- Mark Olfson and Melanie M. Wall are with the Vagelos College of Physicians and Surgeons and Mailman School of Public Health, Columbia University, and with the New York State Psychiatric Institute, New York, NY. Candace M. Cosgrove is with the US Census Bureau, Suitland, MD. Sean F. Altekruse is with National Heart, Lung, and Blood Institute, Division of Cardiovascular Sciences, Bethesda, MD. Carlos Blanco is with the National Institute on Drug Abuse, Division of Epidemiology, Services, and Prevention Research, Rockville, MD
| | - Melanie M Wall
- Mark Olfson and Melanie M. Wall are with the Vagelos College of Physicians and Surgeons and Mailman School of Public Health, Columbia University, and with the New York State Psychiatric Institute, New York, NY. Candace M. Cosgrove is with the US Census Bureau, Suitland, MD. Sean F. Altekruse is with National Heart, Lung, and Blood Institute, Division of Cardiovascular Sciences, Bethesda, MD. Carlos Blanco is with the National Institute on Drug Abuse, Division of Epidemiology, Services, and Prevention Research, Rockville, MD
| | - Carlos Blanco
- Mark Olfson and Melanie M. Wall are with the Vagelos College of Physicians and Surgeons and Mailman School of Public Health, Columbia University, and with the New York State Psychiatric Institute, New York, NY. Candace M. Cosgrove is with the US Census Bureau, Suitland, MD. Sean F. Altekruse is with National Heart, Lung, and Blood Institute, Division of Cardiovascular Sciences, Bethesda, MD. Carlos Blanco is with the National Institute on Drug Abuse, Division of Epidemiology, Services, and Prevention Research, Rockville, MD
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6
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Machado CDS, Ballester PL, Cao B, Mwangi B, Caldieraro MA, Kapczinski F, Passos IC. Prediction of suicide attempts in a prospective cohort study with a nationally representative sample of the US population. Psychol Med 2022; 52:2985-2996. [PMID: 33441206 DOI: 10.1017/s0033291720004997] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
BACKGROUND There is still little knowledge of objective suicide risk stratification. METHODS This study aims to develop models using machine-learning approaches to predict suicide attempt (1) among survey participants in a nationally representative sample and (2) among participants with lifetime major depressive episodes. We used a cohort called the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) that was conducted in two waves and included a nationally representative sample of the adult population in the United States. Wave 1 involved 43 093 respondents and wave 2 involved 34 653 completed face-to-face reinterviews with wave 1 participants. Predictor variables included clinical, stressful life events, and sociodemographic variables from wave 1; outcome included suicide attempt between wave 1 and wave 2. RESULTS The model built with elastic net regularization distinguished individuals who had attempted suicide from those who had not with an area under the ROC curve (AUC) of 0.89, balanced accuracy 81.86%, specificity 89.22%, and sensitivity 74.51% for the general population. For participants with lifetime major depressive episodes, AUC was 0.89, balanced accuracy 81.64%, specificity 85.86%, and sensitivity 77.42%. The most important predictor variables were a diagnosis of borderline personality disorder, post-traumatic stress disorder, and being of Asian descent for the model in all participants; and previous suicide attempt, borderline personality disorder, and overnight stay in hospital because of depressive symptoms for the model in participants with lifetime major depressive episodes. Random forest and artificial neural networks had similar performance. CONCLUSIONS Risk for suicide attempt can be estimated with high accuracy.
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Affiliation(s)
- Cristiane Dos Santos Machado
- Laboratory of Molecular Psychiatry, Centro de Pesquisa Experimental (CPE) e Centro de Pesquisa Clínica (CPC), Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil
- Department of Psychiatry, Faculty of Medicine, Graduate Program in Psychiatry and Behavioral Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Pedro L Ballester
- Neuroscience Graduate Program, McMaster University, Hamilton, ON, Canada
| | - Bo Cao
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Benson Mwangi
- Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Marco Antonio Caldieraro
- Laboratory of Molecular Psychiatry, Centro de Pesquisa Experimental (CPE) e Centro de Pesquisa Clínica (CPC), Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil
- Department of Psychiatry, Faculty of Medicine, Graduate Program in Psychiatry and Behavioral Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Flávio Kapczinski
- Laboratory of Molecular Psychiatry, Centro de Pesquisa Experimental (CPE) e Centro de Pesquisa Clínica (CPC), Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil
- Department of Psychiatry, Faculty of Medicine, Graduate Program in Psychiatry and Behavioral Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- Department of Psychiatry and Behavioural Neurosciences, McMaster University and St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada
| | - Ives Cavalcante Passos
- Laboratory of Molecular Psychiatry, Centro de Pesquisa Experimental (CPE) e Centro de Pesquisa Clínica (CPC), Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil
- Department of Psychiatry, Faculty of Medicine, Graduate Program in Psychiatry and Behavioral Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
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Lin J, Su Y, Lv X, Liu Q, Wang G, Wei J, Zhu G, Chen Q, Tian H, Zhang K, Wang X, Zhang N, Yan H, Wang Y, Yu X, Si T. Childhood adversity, adulthood adversity and suicidal ideation in Chinese patients with major depressive disorder: in line with stress sensitization. Eur Arch Psychiatry Clin Neurosci 2022; 272:887-896. [PMID: 34985583 DOI: 10.1007/s00406-021-01375-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Accepted: 12/16/2021] [Indexed: 01/10/2023]
Abstract
The stress sensitization model indicates that early adversity (e.g., childhood stress) sensitizes individuals to subsequent proximal stress (e.g., stressful life events in adult life), thereby increasing their vulnerability to psychiatric disorders. However, the effect of stress sensitization on suicidality in patients with major depressive disorder (MDD) has not been previously investigated. Data for the present study were derived from the Objective Diagnostic Markers and Personalized Intervention in MDD Patients (ODMPIM) study. The psychiatric diagnosis and suicidal ideation were evaluated by the Mini-International Neuropsychiatric Interview (M.I.N.I.). We used a multiple logistic analysis to examine the association among childhood adversity (CA), adulthood adversity (AA) and suicidal ideation. Among 1084 MDD patients, 48.6% had suicidal ideation and 65.6% experienced life adversity during their childhood or adulthood. Patients who reported suicidal ideation were more likely to report CA (46.7% vs. 38.7%, P = 0.008) or AA (49.5% vs. 40.9%, P = 0.004) than patients without suicidal ideation. Patients who experienced two waves of adversity (both CA and AA) were associated with higher rates of suicidal ideation (odds ratio = 1.68, 95% CI = 1.19-2.37, P = 0.003); however, neither CA nor AA alone was associated with suicidal ideation. This study first verifies the hypothesis of stress sensitization on suicidal ideation in patients with MDD. Focusing on stress sensitization may enhance the early identification of MDD patients at suicidal risk and the ability to provide timely and appropriate intervention. Clinicaltrials.gov identifier: NCT02023567.
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Affiliation(s)
- Jingyu Lin
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital, Beijing, 100101, China
| | - Yunai Su
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital, Beijing, 100101, China.
| | - Xiaozhen Lv
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital, Beijing, 100101, China
| | - Qi Liu
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital, Beijing, 100101, China
| | - Gang Wang
- Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Jing Wei
- Peking Union Medical College (PUMC), Beijing, China
| | - Gang Zhu
- First Hospital of China Medical University, Shenyang, China
| | | | | | - Kerang Zhang
- Department of Psychiatry, First Hospital of Shanxi Medical University, Taiyuan, China
| | - Xueyi Wang
- First Hospital of Hebei Medical University, Shijiazhuang, China
| | - Nan Zhang
- Tianjin Medical University General Hospital, Tianjin, China
| | - Hong Yan
- 306Th Hospital of PLA, Beijing, 100101, China
| | - Ying Wang
- 984Th Hospital of PLA, Beijing, China
| | - Xin Yu
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital, Beijing, 100101, China
| | - Tianmei Si
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital, Beijing, 100101, China.
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8
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Oquendo MA, Galfalvy HC, Choo TH, Kandlur R, Burke AK, Sublette ME, Miller JM, Mann JJ, Stanley BH. Highly variable suicidal ideation: a phenotypic marker for stress induced suicide risk. Mol Psychiatry 2021; 26:5079-5086. [PMID: 32576966 PMCID: PMC7755748 DOI: 10.1038/s41380-020-0819-0] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Revised: 05/31/2020] [Accepted: 06/10/2020] [Indexed: 11/24/2022]
Abstract
Suicidal behavior (SB) can be impulsive or methodical; violent or not; follow a stressor or no obvious precipitant. This study tested whether childhood trauma, affective lability, and aggressive and impulsive traits predicted greater SI variability. We also assessed whether affective lability, aggressive or impulsive traits explain childhood trauma's effects on SI variability and whether those with highly variable SI respond to stressful events with increases in SI. Finally, we assessed variable SI's trajectory over 2 years. Depressed participants (n = 51) had ecological momentary assessments (EMA) over 7 days at baseline, 3, 6, 12, 18, and 24 months. SI variability was assessed using the square Root of the Mean Square of Successive Deviations. Mixed Effects Models were fit as appropriate. Childhood trauma was associated with subsequent aggression. Physical abuse predicted both aggression and affective lability as well as SI variability, but not impulsivity. In two-predictor models, physical abuse's effect on SI variability was no longer significant, when controlling for the effect of higher aggression and impulsivity. Those with high SI variability exhibited greater increases in SI after stressors compared with those with less variability. We did not find that SI variability changed over time, suggesting it might be trait-like, at least over 2 years. Variable SI predisposes to marked SI increases after stressful events and may be a trait increasing risk for impulsive SB, at least over 2 years.
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Affiliation(s)
- Maria A Oquendo
- University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA, USA.
| | - Hanga C Galfalvy
- Columbia University, Vagelos College of Physicians and Surgeons, New York, NY, USA
| | - Tse-Hwei Choo
- Columbia University, Vagelos College of Physicians and Surgeons, New York, NY, USA
| | | | - Ainsley K Burke
- Columbia University, Vagelos College of Physicians and Surgeons, New York, NY, USA
| | - M Elizabeth Sublette
- Columbia University, Vagelos College of Physicians and Surgeons, New York, NY, USA
| | - Jeffrey M Miller
- Columbia University, Vagelos College of Physicians and Surgeons, New York, NY, USA
| | - J John Mann
- Columbia University, Vagelos College of Physicians and Surgeons, New York, NY, USA
| | - Barbara H Stanley
- Columbia University, Vagelos College of Physicians and Surgeons, New York, NY, USA
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9
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Stanley B, Itzhaky L, Oquendo MA. Identifying Neurobiological Underpinnings of Two Suicidal Subtypes. JOURNAL OF PSYCHIATRY AND BRAIN SCIENCE 2021; 6:e210016. [PMID: 34926832 PMCID: PMC8681698 DOI: 10.20900/jpbs.20210016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Despite substantial suicide prevention efforts, US suicide rates continue to climb, currently reaching about 14 per 100,000 individuals. Suicidal behavior has been linked to neurobiological, neurocognitive and behavioral factors; however, integrative, multi-modal studies are rare. Furthermore, prospective studies, crucial to understanding future risk factors, have focused on a single predictor and a single outcome, implying that suicidal behavior is homogeneous. But recent research shows suicidal behavior is complex and heterogeneous, with the possible existence of subtypes. The present report describes a project testing a model that posits two putative subtypes, using a prospective, multi-model design. The subtypes differ in regard to the patterns of suicidal ideation and underlying mechanisms. One hundred subjects diagnosed with a Major Depressive episode, half of whom have attempted suicide in the past, are enrolled and followed for two years, notably the highest risk period for suicidal behavior. Baseline assessments include a clinical assessment, neurocognitive and behavioral tasks, Ecological Momentary Assessments (EMA), PET imaging, and a cognitive emotion regulation task in the MRI scanner. The follow-up assessment includes a clinical assessment and EMA. The study findings have the potential to pave the way for a clearer understanding of suicidal ideation and behaviors and to improve our ability to treat those at risk for suicide by developing tailored approaches that will allow for more accurate pharmacological and psychosocial interventions.
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Affiliation(s)
- Barbara Stanley
- Division of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, Unit 42, 1051 Riverside Drive, New York, NY 10032, USA
- Columbia University College of Physicians and Surgeons, New York, NY 10032, USA
| | - Liat Itzhaky
- Division of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, Unit 42, 1051 Riverside Drive, New York, NY 10032, USA
- Columbia University College of Physicians and Surgeons, New York, NY 10032, USA
| | - Maria A. Oquendo
- Perelman School of Medicine, University of Pennsylvania, 3535 Market Street, Suite 200, Philadelphia, PA 19104, USA
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10
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Hoertel N, Cipel H, Blanco C, Oquendo MA, Ellul P, Leaune E, Limosin F, Peyre H, Costemale-Lacoste JF. Cerebrospinal fluid levels of monoamines among suicide attempters: A systematic review and random-effects meta-analysis. J Psychiatr Res 2021; 136:224-235. [PMID: 33618064 DOI: 10.1016/j.jpsychires.2021.01.045] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 01/20/2021] [Accepted: 01/26/2021] [Indexed: 11/20/2022]
Abstract
BACKGROUND It remains unclear whether the dopaminergic and noradrenergic systems may be implied in suicide attempt risk. In addition, although the serotonergic system has been extensively studied, no formal meta-analysis has been performed to examine its association with suicide attempt. METHODS Using PRISMA methodology, we performed a systematic literature review and random-effects meta-analyses of the differences in cerebrospinal fluid (CSF) levels of 5-HIAA, HVA and MHPG between suicide attempters and individuals who never attempted suicide. RESULTS We identified 30 studies including 937 suicide attempters and 1128 non-attempters; 29 of them measured CSF levels of 5-HIAA, 22 measured CSF levels of HVA and 14 measured CSF levels of MHPG. CSF levels of 5-HIAA and HVA were significantly lower in suicide attempters than in non-attempters [SMD = -0.43 (95% CI: -0.71 to -0.15; p < 0.01) and SMD = -0.45 (95% CI: -0.72 to -0.19; p < 0.01), respectively]. We did not find a significant association between CSF MHPG levels and suicide attempt. LIMITATIONS Our analyses relied on a limited number of studies of good quality and most studies included small sample sizes. CONCLUSION Both serotonin and dopamine systems may play a role in suicide attempt risk. Our findings suggest that a silo approach to biomarkers should be phased out in favor of the study of multiple systems in parallel and in the same populations to progress in the identification of the biological components independently associated with suicide risk, with the goal of identifying new treatment targets and improving suicide risk prediction.
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Affiliation(s)
- Nicolas Hoertel
- Université de Paris, Faculté de Santé, UFR de Médecine, Paris, France; AP-HP, Hôpital Corentin-Celton, DMU Psychiatrie et Addictologie, Département de Psychiatrie, France; INSERM, Institut de Psychiatrie et Neurosciences de Paris (IPNP), UMR_S1266, Paris, France
| | - Hélène Cipel
- Université de Paris, Faculté de Santé, UFR de Médecine, Paris, France
| | - Carlos Blanco
- Division of Epidemiology, Services, and Prevention Research, National Institute on Drug Abuse, Bethesda, MD, USA
| | - Maria A Oquendo
- Perelman School of Medicine, University of Pennsylvania, USA
| | - Pierre Ellul
- Child and Adolescent Psychiatry, Robert Debré Hospital, Paris Diderot University, Sorbonne Paris Cité, Paris, France
| | - Edourd Leaune
- CPS/Psymobile - CH Le Vinatier / IRPhiL - Université Lyon 3, France
| | - Frédéric Limosin
- Université de Paris, Faculté de Santé, UFR de Médecine, Paris, France; AP-HP, Hôpital Corentin-Celton, DMU Psychiatrie et Addictologie, Département de Psychiatrie, France; INSERM, Institut de Psychiatrie et Neurosciences de Paris (IPNP), UMR_S1266, Paris, France
| | - Hugo Peyre
- Child and Adolescent Psychiatry, Robert Debré Hospital, Paris Diderot University, Sorbonne Paris Cité, Paris, France
| | - Jean-François Costemale-Lacoste
- GHU Paris, Psychiatrie et Neurosciences, Paris University, France; INSERM UMRS 1178, CESP, Team « MOODS », Le Kremlin-Bicêtre, France.
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11
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Massó Rodriguez A, Hogg B, Gardoki-Souto I, Valiente-Gómez A, Trabsa A, Mosquera D, García-Estela A, Colom F, Pérez V, Padberg F, Moreno-Alcázar A, Amann BL. Clinical Features, Neuropsychology and Neuroimaging in Bipolar and Borderline Personality Disorder: A Systematic Review of Cross-Diagnostic Studies. Front Psychiatry 2021; 12:681876. [PMID: 34177664 PMCID: PMC8220090 DOI: 10.3389/fpsyt.2021.681876] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 05/14/2021] [Indexed: 12/28/2022] Open
Abstract
Background: Bipolar Disorder (BD) and Borderline Personality Disorder (BPD) have clinically been evolving as separate disorders, though there is still debate on the nosological valence of both conditions, their interaction in terms of co-morbidity or disorder spectrum and their distinct pathophysiology. Objective: The objective of this review is to summarize evidence regarding clinical features, neuropsychological performance and neuroimaging findings from cross-diagnostic studies comparing BD and BPD, to further caracterize their complex interplay. Methods: Using PubMed, PsycINFO and TripDataBase, we conducted a systematic literature search based on PRISMA guidelines of studies published from January 1980 to September 2019 which directly compared BD and BPD. Results: A total of 28 studies comparing BD and BPD were included: 19 compared clinical features, 6 neuropsychological performance and three neuroimaging abnormalities. Depressive symptoms have an earlier onset in BPD than BD. BD patients present more mixed or manic symptoms, with BD-I differing from BPD in manic phases. BPD patients show more negative attitudes toward others and self, more conflictive interpersonal relationships, and more maladaptive regulation strategies in affective instability with separate pathways. Impulsivity seems more a trait in BPD rather than a state as in BD. Otherwise, BD and BPD overlap in depressive and anxious symptoms, dysphoria, various abnormal temperamental traits, suicidal ideation, and childhood trauma. Both disorders differ and share deficits in neuropsychological and neuroimaging findings. Conclusion: Clinical data provide evidence of overlapping features in both disorders, with most of those shared symptoms being more persistent and intense in BPD. Thus, categorical classifications should be compared to dimensional approaches in transdiagnostic studies investigating BPD features in BD regarding their respective explanatory power for individual trajectories. Systematic Review Registration: The search strategy was pre-registered in PROSPERO: CRD42018100268.
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Affiliation(s)
- Anna Massó Rodriguez
- Institute of Neuropsychiatry and Addiction, Parc de Salut Mar, Barcelona, Spain
- Centro Salud Mental Infanto-Juvenil, Parc de Salut Mar, Barcelona, Spain
| | - Bridget Hogg
- Centre Fòrum Research Unit, Institute of Neuropsychiatry and Addiction, Parc de Salut Mar, Barcelona, Spain
- Mental Health Research Group, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
- PhD Progamme, Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Itxaso Gardoki-Souto
- Centre Fòrum Research Unit, Institute of Neuropsychiatry and Addiction, Parc de Salut Mar, Barcelona, Spain
- Mental Health Research Group, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
- PhD Progamme, Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Alicia Valiente-Gómez
- Institute of Neuropsychiatry and Addiction, Parc de Salut Mar, Barcelona, Spain
- Centre Fòrum Research Unit, Institute of Neuropsychiatry and Addiction, Parc de Salut Mar, Barcelona, Spain
- Mental Health Research Group, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental, Madrid, Spain
| | - Amira Trabsa
- Institute of Neuropsychiatry and Addiction, Parc de Salut Mar, Barcelona, Spain
- Centre Fòrum Research Unit, Institute of Neuropsychiatry and Addiction, Parc de Salut Mar, Barcelona, Spain
- PhD Progamme, Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Dolores Mosquera
- Instituto de Investigación y Tratamiento del Trauma y los Trastornos de la Personalidad (INTRA-TP) Center, A Coruña, Spain
| | - Aitana García-Estela
- Mental Health Research Group, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental, Madrid, Spain
| | - Francesc Colom
- Institute of Neuropsychiatry and Addiction, Parc de Salut Mar, Barcelona, Spain
- Mental Health Research Group, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental, Madrid, Spain
- Departament of Basic, Evolutive and Education Psychology, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Victor Pérez
- Institute of Neuropsychiatry and Addiction, Parc de Salut Mar, Barcelona, Spain
- Mental Health Research Group, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental, Madrid, Spain
| | - Frank Padberg
- Department of Psychiatry and Psychotherapy, Klinikum der Universität München, Munich, Germany
| | - Ana Moreno-Alcázar
- Centre Fòrum Research Unit, Institute of Neuropsychiatry and Addiction, Parc de Salut Mar, Barcelona, Spain
- Mental Health Research Group, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental, Madrid, Spain
| | - Benedikt Lorenz Amann
- Institute of Neuropsychiatry and Addiction, Parc de Salut Mar, Barcelona, Spain
- Centre Fòrum Research Unit, Institute of Neuropsychiatry and Addiction, Parc de Salut Mar, Barcelona, Spain
- Mental Health Research Group, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental, Madrid, Spain
- Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
- *Correspondence: Benedikt Lorenz Amann
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12
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Aouidad A, Cohen D, Mirkovic B, Pellerin H, Garny de La Rivière S, Consoli A, Gérardin P, Guilé JM. Borderline personality disorder and prior suicide attempts define a severity gradient among hospitalized adolescent suicide attempters. BMC Psychiatry 2020; 20:525. [PMID: 33148207 PMCID: PMC7643473 DOI: 10.1186/s12888-020-02930-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2020] [Accepted: 10/23/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Borderline personality disorder (BPD) and history of prior suicide attempt (SA) have been shown to be high predictors for subsequent suicide. However, no previous study has examined how both factors interact to modify clinical and suicide severity among adolescents. METHODS This study presents a comprehensive assessment of 302 adolescents (265 girls, mean age = 14.7 years) hospitalized after a SA. To test clinical interactions between BPD and history of prior SA, the sample was divided into single attempters without BPD (non-BPD-SA, N = 80), single attempters with BPD (BPD-SA, N = 127) and multiple attempters with BPD (BPD-MA, N = 95). RESULTS Univariate analyses revealed a severity gradient among the 3 groups with an additive effect of BPD on the clinical and suicide severity already conferred by a history of SA. This gradient encompassed categorical (anxiety and conduct disorders and non-suicidal-self-injury [NSSI]) and dimensional comorbidities (substance use and depression severity) and suicide characteristics (age at first SA). According to regression analyses, the BPD-MA group that was associated with the most severe clinical presentation also showed specific features: the first SA at a younger age and a higher prevalence of non-suicidal self-injury (NSSI) and anxiety disorders. The BPD-MA group was not associated with higher impulsivity or frequency of negative life events. CONCLUSIONS Based on these findings and to improve youth suicide prevention, future studies should systematically consider BPD and the efficacy of reinforcing early interventions for anxiety disorders and NSSI.
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Affiliation(s)
| | - David Cohen
- grid.462015.40000 0004 0617 9849Institut des Systemes Intelligents et de Robotique, Paris, France
| | - Bojan Mirkovic
- grid.417615.00000 0001 2296 5231Hopital Charles Nicolle, Rouen, France
| | - Hugues Pellerin
- grid.411439.a0000 0001 2150 9058Hopital Universitaire Pitie Salpetriere, Paris, France
| | | | - Angèle Consoli
- grid.411439.a0000 0001 2150 9058Hopital Universitaire Pitie Salpetriere, Paris, France
| | | | - Jean-Marc Guilé
- grid.134996.00000 0004 0593 702XCentre Hospitalier Universitaire Amiens-Picardie, Amiens, France
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13
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Su YA, Lin JY, Liu Q, Lv XZ, Wang G, Wei J, Zhu G, Chen QL, Tian HJ, Zhang KR, Wang XY, Zhang N, Wang Y, Haroon E, Yu X, Si TM. Associations among serum markers of inflammation, life stress and suicide risk in patients with major depressive disorder. J Psychiatr Res 2020; 129:53-60. [PMID: 32570089 DOI: 10.1016/j.jpsychires.2020.06.008] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Revised: 05/05/2020] [Accepted: 06/03/2020] [Indexed: 01/10/2023]
Abstract
BACKGROUND Patients with major depressive disorder (MDD) are at high risk for suicide. As the worst outcome of MDD and common self-concealment in patients with suicide risk, studies of biomarkers may provide useful tools for suicide prevention and treatment. METHODS This study recruited 168 patients with MDD from the Objective Diagnostic Markers and Personalized Intervention in MDD patients (ODMPIM), including 50 patients with suicide risk. Based on previous evidence and hypothesis, 23 targeted serum biomarkers involving immune-inflammation, neurotrophins, hypothalamic-pituitary-adrenal (HPA) axis and metabolism, were measured. We used path analysis and principal components analysis (PCA) to clarify the associations among serum biomarkers, childhood adversities, adulthood life events, severity of depression and suicide risk. RESULTS We identified that patients with suicide risk had a higher level of inflammatory markers in serum than patients without suicide risk (P < 0.001), especially chemokine (C-X-C motif) ligand 1 (CXCL-1). After using the Bonferroni correction, there were no differences in biomarkers related to neurotrophins, HPA-axis and metabolism. In addition, a higher proportion of patients with suicide risk had adulthood adversity (assessed by Life Events Scale) (P = 0.003). Intriguingly, path analysis demonstrated that the association between adulthood adversity and suicide risk mainly depended on severity of depression and inflammatory index. CONCLUSION This study highlights the possible role of inflammation involved in suicide risk of MDD patients. Inflammatory markers have the potential for early identification and then reducing suicidal behaviors or becoming novel treatment targets in suicide risk management.
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Affiliation(s)
- Yun-Ai Su
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Jing-Yu Lin
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Qi Liu
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Xiao-Zhen Lv
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Gang Wang
- Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Jing Wei
- Peking Union Medical College (PUMC), Beijing, China
| | - Gang Zhu
- The First Hospital of China Medical University, Shenyang, China
| | | | | | - Ke-Rang Zhang
- Department of Psychiatry, First Hospital of Shanxi Medical University, Taiyuan, China
| | - Xue-Yi Wang
- The First Hospital of Hebei Medical University, Shijiazhuang, China
| | - Nan Zhang
- Tianjin Medical University General Hospital, Tianjin, China
| | - Ying Wang
- The 984th Hospital of PLA, Beijing, China
| | - Ebrahim Haroon
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Xin Yu
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China.
| | - Tian-Mei Si
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China.
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14
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Suicidal ideation and behavior in adults with major depressive disorder treated with vortioxetine: post hoc pooled analyses of randomized, placebo-controlled, short-term and open-label, long-term extension trials. CNS Spectr 2020; 25:352-362. [PMID: 31199210 DOI: 10.1017/s109285291900097x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVES This study aimed to evaluate the risk of suicidal ideation and behavior associated with vortioxetine treatment in adults with major depressive disorder (MDD). METHODS Suicide-related events were evaluated post hoc using 2 study pools: one short-term pool of 10 randomized, placebo-controlled studies (6-8 weeks) and another long-term pool that included 3 open-label extension studies (52 weeks). Evaluation of suicide-related events was performed using Columbia-Suicide Severity Rating Scale (C-SSRS) scores and treatment-emergent adverse events (TEAEs) data. RESULTS At baseline, the percentage of patients reporting any C-SSRS ideation or behavior events in short-term studies was similar between placebo (14.7%), vortioxetine (19.8%, 13.0%, 11.2%, and 13.7% for 5-, 10-, 15-, and 20-mg groups, respectively), and duloxetine active reference (13.2%) and did not change throughout the 6- to 8-week treatment period for placebo (17.0%), vortioxetine (19.3%, 13.5%, 12.6%, and 15% for 5-, 10-, 15-, and 20-mg groups, respectively), or duloxetine (11.3%). The incidence of suicide-related events for TEAEs in the short-term pool was 0.4% for placebo, 0.2% or 1.0% for vortioxetine 5 mg or 10 mg, and 0.7% each for vortioxetine 15 mg and 20 mg, as well as duloxetine. After 52-week treatment with vortioxetine, suicidal ideation based on C-SSRS was 9.8%, C-SSRS suicidal behavior was 0.2%, and the incidence of suicide-related events based on TEAEs was <1%. There were no completed suicides in any study. CONCLUSIONS Vortioxetine is not associated with increased risk of suicidal ideation or behavior in MDD patients.
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15
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Howarth EJ, O'Connor DB, Panagioti M, Hodkinson A, Wilding S, Johnson J. Are stressful life events prospectively associated with increased suicidal ideation and behaviour? A systematic review and meta-analysis. J Affect Disord 2020; 266:731-742. [PMID: 32217256 DOI: 10.1016/j.jad.2020.01.171] [Citation(s) in RCA: 45] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2019] [Revised: 12/11/2019] [Accepted: 01/28/2020] [Indexed: 01/08/2023]
Abstract
BACKGROUND Stressful life events are a risk factor for suicidal ideation and behaviour, but the strength and nature of this association is unclear. This review examined the prospective relationship between stressful life events and subsequent suicidal ideation and behaviours. METHODS Five databases were searched from inception to April 2019. Eligible studies included observational, quantitative longitudinal cohort studies with adult or adolescent samples. A random-effects meta-analysis model was used to examine the prospective relationship between stressful life events and subsequent suicidal ideation and behaviours. Sub-group analyses examined moderating factors. RESULTS Eight studies were identified in the systematic review, and seven studies comprising 2,639 participants were included in the meta-analysis. Six studies investigated suicidal ideation and one investigated suicidal behaviours. Stressful life events were associated with a 37% higher odds of subsequently reported suicidal ideation and behaviours combined (Odds Ratio (OR): 1.37, 95% CI: 1.10 to 1.70), and a 45% increased risk for suicidal ideation (OR: 1.45, 95% CI: 1.20 to 1.75). This association was stronger in males, young adults, and studies with shorter term follow-up. LIMITATIONS The analyses indicated statistical heterogeneity was high (I2 = 76. 48, 95% CI: 55.0 to 87.7%) and there was evidence of publication bias. CONCLUSIONS Stressful life events were shown to increase the risk of subsequently reported suicidal ideation and behaviours. These findings suggest that the experience of stressful life events should be incorporated into clinical suicide risk assessments and suicide interventions could include a component on developing resilience and adaptive coping to stressful life events.
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Affiliation(s)
- Emma J Howarth
- Clinical Psychology Training Programme, University of Leeds, Leeds, United Kingdom.
| | - Daryl B O'Connor
- School of Psychology, University of Leeds, Leeds, United Kingdom
| | - Maria Panagioti
- NIHR Greater Manchester Patient Safety Translational Research Centre, NIHR School for Primary Care Research, Division of Population Health, Health Services Research and Primary Care, University of Manchester, Manchester, United Kingdom
| | - Alexander Hodkinson
- NIHR School for Primary Care Research, Manchester Academic Health Science Centre, University of Manchester, Manchester, United Kingdom
| | - Sarah Wilding
- School of Psychology, University of Leeds, Leeds, United Kingdom
| | - Judith Johnson
- School of Psychology, University of Leeds, Leeds, United Kingdom; Bradford Institute for Health Research, Bradford Royal Infirmary, Bradford, United Kingdom; School of Public Health and Community Medicine, University of New South Wales, Sydney, Australia
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16
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Lin J, Su Y, Lv X, Liu Q, Wang G, Wei J, Zhu G, Chen Q, Tian H, Zhang K, Wang X, Zhang N, Wang Y, Yu X, Si T. Perceived stressfulness mediates the effects of subjective social support and negative coping style on suicide risk in Chinese patients with major depressive disorder. J Affect Disord 2020; 265:32-38. [PMID: 31959583 DOI: 10.1016/j.jad.2020.01.026] [Citation(s) in RCA: 56] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2019] [Revised: 12/05/2019] [Accepted: 01/05/2020] [Indexed: 01/31/2023]
Abstract
BACKGROUND Risk factors for suicide have been widely investigated in patients with major depressive disorder (MDD); However, far less research has been conducted on protective factors for suicide. METHODS The diagnosis of MDD and suicide risk were evaluated by the Mini-International Neuropsychiatric Interview (MINI). Social support and coping behaviors were assessed by the Social Support Rate Scale (SSRS) and Simplified Coping Style Questionnaire (SCSQ), respectively. Life stressors were captured by the Life Events Scale (LES). Severity of depression was assessed by 17-item Hamilton Depression Rating Scale (HAMD-17). Logistic regression analysis and path analyses were used to test the association of protective factors, risk factors, life stress and suicide risk. RESULTS Patients with suicide risk showed a significantly lower level of subjective social support (adjusted P < 0.012), a higher level of perceived stressfulness (P < 0.001) and negative coping style (P = 0.008) compared with patients without suicide risk. Path analysis showed that perceived stressfulness can mediate the protective effect of subjective social support and deleterious effect of negative coping style on suicide risk. LIMITATIONS Cross-sectional design, and retrospective recall of stressful life events. CONCLUSIONS This study suggests that subjective social support and negative coping style may be regarded as a protective factor and a risk factor for suicide risk in MDD patients, respectively, and perceived stressfulness mediates their roles in suicide. Further suicide prevention and intervention strategies should focus on increasing individual subjective social support and improving coping strategies to enhance their resilience.
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Affiliation(s)
- Jingyu Lin
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing 100191, China
| | - Yunai Su
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing 100191, China.
| | - Xiaozhen Lv
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing 100191, China
| | - Qi Liu
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing 100191, China
| | - Gang Wang
- Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Jing Wei
- Peking Union Medical College (PUMC), Beijing, China
| | - Gang Zhu
- The First Hospital of China Medical University, Shenyang, China
| | | | | | - Kerang Zhang
- Department of Psychiatry, First Hospital of Shanxi Medical University, Taiyuan, China
| | - Xueyi Wang
- The First Hospital of Hebei Medical University, Shijiazhuang, China
| | - Nan Zhang
- Tianjin Medical University General Hospital, Tianjin, China
| | - Ying Wang
- The 984th hospital of PLA, Beijing, China
| | - Xin Yu
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing 100191, China
| | - Tianmei Si
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing 100191, China.
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17
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Weissman MM, Pathak J, Talati A. Personal Life Events-A Promising Dimension for Psychiatry in Electronic Health Records. JAMA Psychiatry 2020; 77:115-116. [PMID: 31642873 PMCID: PMC7328014 DOI: 10.1001/jamapsychiatry.2019.3217] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Myrna M. Weissman
- Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York; and Division of Translational Epidemiology, New York State Psychiatric Institute, New York
| | - Jyotishman Pathak
- Department of Psychiatry, Weill Medical College, Cornell University, New York, New York; and Department of Healthcare Policy and Research, Weill Medical College, Cornell University, New York, New York
| | - Ardesheer Talati
- Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York; and Division of Translational Epidemiology, New York State Psychiatric Institute, New York
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18
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Serafini G, Gonda X, Canepa G, Geoffroy PA, Pompili M, Amore M. Recent Stressful Life Events in Euthymic Major Depressive Disorder Patients: Sociodemographic and Clinical Characteristics. Front Psychiatry 2020; 11:566017. [PMID: 33024438 PMCID: PMC7516258 DOI: 10.3389/fpsyt.2020.566017] [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: 05/26/2020] [Accepted: 08/17/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Stressful life events (SLE) may influence the illness course and outcome. This study aimed to characterize socio-demographic and clinical features of euthymic major depressive disorder (MDD) outpatients with SLE compared with those without. METHODS The present sample included 628 (mean age=55.1 ± 16.1) currently euthymic MDD outpatients of whom 250 (39.8%) reported SLE and 378 (60.2%) did not. RESULTS After univariate analyses, outpatients with SLE were most frequently widowed and lived predominantly with friends/others. Moreover, relative to outpatients without SLE, those with SLE were more likely to have a family history of suicidal behavior, manifested melancholic features, report a higher Coping Orientation to the Problems Experienced (COPE) positive reinterpretation/growth and less likely to have a comorbid panic disorder, residual interepisodic symptoms, use previous psychiatric medications, and currently use of antidepressants. Having a family history of suicide (OR=9.697; p=≤.05), history of psychotropic medications use (OR=2.888; p=≤.05), and reduced use of antidepressants (OR=.321; p=.001) were significantly associated with SLE after regression analyses. Mediation analyses showed that the association between current use of antidepressants and SLE was mediated by previous psychiatric medications. CONCLUSION Having a family history of suicide, history of psychotropic medications use, and reduced use of antidepressants is linked to a specific "at risk" profile characterized by the enhanced vulnerability to experience SLE.
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Affiliation(s)
- Gianluca Serafini
- Section of Psychiatry, Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Genoa, Italy.,IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Xenia Gonda
- Department of Psychiatry and Psychotherapy, St. Rokus Clinical Center, Semmelweis University, Budapest, Hungary.,MTA-SE Neuropsychopharmacology Research Group, Hungarian Academy of Sciences and Semmelweis University, Budapest, Hungary.,NAP-2-SE New Antidepressant Target Research Group, Hungarian Brain Research Programme, Semmelweis University, Budapest, Hungary
| | - Giovanna Canepa
- Section of Psychiatry, Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Genoa, Italy.,IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Pierre A Geoffroy
- Department of Psychiatry and Addiction Medicine, AP-HP, Hopital Bichat-Claude Bernard, Paris, France.,NeuroDiderot, Inserm, Paris University, Paris, France
| | - Maurizio Pompili
- Department of Neurosciences, Suicide Prevention Center, Sant'Andrea Hospital, University of Rome, Rome, Italy
| | - Mario Amore
- Section of Psychiatry, Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Genoa, Italy.,IRCCS Ospedale Policlinico San Martino, Genoa, Italy
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19
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Aaltonen KI, Rosenström T, Jylhä P, Holma I, Holma M, Pallaskorpi S, Riihimäki K, Suominen K, Vuorilehto M, Isometsä ET. Do Suicide Attempts of Mood Disorder Patients Directly Increase the Risk for a Reattempt? Front Psychiatry 2020; 11:547791. [PMID: 33324247 PMCID: PMC7725715 DOI: 10.3389/fpsyt.2020.547791] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Accepted: 09/09/2020] [Indexed: 12/31/2022] Open
Abstract
Background: Preceding suicide attempts strongly predict future suicidal acts. However, whether attempting suicide per se increases the risk remains undetermined. We longitudinally investigated among patients with mood disorders whether after a suicide attempt future attempts occur during milder depressive states, indicating a possible lowered threshold for acting. Methods: We used 5-year follow-up data from 581 patients of the Jorvi Bipolar Study, Vantaa Depression Study, and Vantaa Primary Care Depression Study cohorts. Lifetime suicide attempts were investigated at baseline and during the follow-up. At follow-up interviews, life-chart data on the course of the mood disorder were generated and suicide attempts timed. By using individual-level data and multilevel modeling, we investigated at each incident attempt the association between the lifetime ordinal number of the attempt and the major depressive episode (MDE) status (full MDE, partial remission, or remission). Results: A total of 197 suicide attempts occurred among 90 patients, most during MDEs. When the dependencies between observations and individual liabilities were modeled, no association was found between the number of past suicide attempts at the time of each attempt and partial remissions. No association between adjusted inter-suicide attempt times and the number of past attempts emerged during follow-up. No indication for direct risk-increasing effects was found. Conclusion: Among mood disorder patients, repeated suicide attempts do not tend to occur during milder depressive states than in the preceding attempts. Previous suicide attempts may indicate underlying diathesis, future risk being principally set by the course of the disorder itself.
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Affiliation(s)
- Kari I Aaltonen
- Department of Psychiatry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.,Mental Health Unit, Finnish Institute of Health and Welfare, Helsinki, Finland
| | - Tom Rosenström
- Department of Psychiatry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.,Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland
| | - Pekka Jylhä
- Department of Psychiatry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.,Mental Health Unit, Finnish Institute of Health and Welfare, Helsinki, Finland
| | - Irina Holma
- Department of Psychiatry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.,Mental Health Unit, Finnish Institute of Health and Welfare, Helsinki, Finland
| | - Mikael Holma
- Department of Psychiatry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.,Mental Health Unit, Finnish Institute of Health and Welfare, Helsinki, Finland
| | - Sanna Pallaskorpi
- Department of Psychiatry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.,Mental Health Unit, Finnish Institute of Health and Welfare, Helsinki, Finland
| | - Kirsi Riihimäki
- Mental Health Unit, Finnish Institute of Health and Welfare, Helsinki, Finland
| | - Kirsi Suominen
- Department of Mental Health and Substance Abuse Services, Department of Health and Social Services, Helsinki, Finland
| | - Maria Vuorilehto
- Department of Psychiatry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.,Mental Health Unit, Finnish Institute of Health and Welfare, Helsinki, Finland
| | - Erkki T Isometsä
- Department of Psychiatry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.,Mental Health Unit, Finnish Institute of Health and Welfare, Helsinki, Finland
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20
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Tietbohl-Santos B, Chiamenti P, Librenza-Garcia D, Cassidy R, Zimerman A, Manfro GG, Kapczinski F, Passos IC. Risk factors for suicidality in patients with panic disorder: A systematic review and meta-analysis. Neurosci Biobehav Rev 2019; 105:34-38. [DOI: 10.1016/j.neubiorev.2019.07.022] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Revised: 07/29/2019] [Accepted: 07/30/2019] [Indexed: 12/22/2022]
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21
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Lu J, Li S, Li H, Mou T, Zhou L, Huang B, Huang M, Xu Y. Changes In Plasma NPY, IL-1β And Hypocretin In People Who Died By Suicide. Neuropsychiatr Dis Treat 2019; 15:2893-2900. [PMID: 31632037 PMCID: PMC6791488 DOI: 10.2147/ndt.s219962] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Accepted: 09/12/2019] [Indexed: 12/31/2022] Open
Abstract
PURPOSE There is growing evidence showing that inflammatory cytokines and neuropeptides may be involved in the pathophysiology of suicidal behavior. However, studies have yielded contradictory data, and no biological markers that help predict suicide have been identified. This study aimed to identify biological patterns, such as NPY, IL-1β and hypocretin plasma levels, in people who died by suicide. PATIENTS AND METHODS Twenty-two people who died by suicide compared with 22 controls matched for age and sex were studied. In suicide and control subjects, we estimated the levels of NPY, IL-1β and hypocretin in plasma using enzyme-linked immunosorbent assay. The data are presented as the median (25th-75th percentile). RESULTS We found (1) a significant elevation in plasma NPY levels in suicide subjects versus control subjects (suicide: 11.38 (9.380-16.55); controls: 8.95 (7.590-10.93); P=0.013), and plasma NPY concentrations were approximately 62% higher in suicide subjects than those in control subjects; (2) a significant decrease in plasma IL-1β concentrations between suicide and control subjects (suicide: 121.1 (82.97-143.0); controls: 425.9 (233.1-835.3); P<0.001) as well as a decrease in IL-1β concentrations by almost 80%; and (3) no significant difference in plasma hypocretin levels between suicide and control subjects (suicide: 16.62 (13.62-25.77); controls: 21.63 (14.97-29.72); P=0.356). CONCLUSION Our results suggest that plasma NPY and IL-1β were related with suicide behavior rather than to suicide causes or suicide method. Specific combinations of plasma biomarkers may discriminate between types of suicidal behaviors and indicate increased risk for future suicide attempts.
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Affiliation(s)
- Jing Lu
- The Key Laboratory of Mental Disorder Management in Zhejiang Province, Department of Psychiatry, First Affiliated Hospital, College of Medicine, Zhejiang University, Zhejiang University Brain Research Institute, Hangzhou, Zhejiang Province, People's Republic of China
| | - Shangda Li
- The Key Laboratory of Mental Disorder Management in Zhejiang Province, Department of Psychiatry, First Affiliated Hospital, College of Medicine, Zhejiang University, Zhejiang University Brain Research Institute, Hangzhou, Zhejiang Province, People's Republic of China
| | - Haimei Li
- The Key Laboratory of Mental Disorder Management in Zhejiang Province, Department of Psychiatry, First Affiliated Hospital, College of Medicine, Zhejiang University, Zhejiang University Brain Research Institute, Hangzhou, Zhejiang Province, People's Republic of China
| | - Tingting Mou
- The Key Laboratory of Mental Disorder Management in Zhejiang Province, Department of Psychiatry, First Affiliated Hospital, College of Medicine, Zhejiang University, Zhejiang University Brain Research Institute, Hangzhou, Zhejiang Province, People's Republic of China
| | - Lihong Zhou
- Institute of Criminal Science and Technology, Hangzhou Public Security Bureau, Hangzhou, Zhejiang Province, People's Republic of China
| | - Bochao Huang
- The Key Laboratory of Mental Disorder Management in Zhejiang Province, Department of Psychiatry, First Affiliated Hospital, College of Medicine, Zhejiang University, Zhejiang University Brain Research Institute, Hangzhou, Zhejiang Province, People's Republic of China
| | - Manli Huang
- The Key Laboratory of Mental Disorder Management in Zhejiang Province, Department of Psychiatry, First Affiliated Hospital, College of Medicine, Zhejiang University, Zhejiang University Brain Research Institute, Hangzhou, Zhejiang Province, People's Republic of China
| | - Yi Xu
- The Key Laboratory of Mental Disorder Management in Zhejiang Province, Department of Psychiatry, First Affiliated Hospital, College of Medicine, Zhejiang University, Zhejiang University Brain Research Institute, Hangzhou, Zhejiang Province, People's Republic of China
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22
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Paul E. Proximally-occurring life events and the first transition from suicidal ideation to suicide attempt in adolescents. J Affect Disord 2018; 241:499-504. [PMID: 30149338 DOI: 10.1016/j.jad.2018.08.059] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2018] [Revised: 07/31/2018] [Accepted: 08/12/2018] [Indexed: 11/18/2022]
Abstract
BACKGROUND Informed by diathesis-stress models of suicide risk, this paper investigated the role of proximally-occurring stressful life events in the first transition from suicidal ideation to suicide attempt in adolescence. Interactions between stressful life events and psychiatric disorders in relation to this progression were also examined. METHODS Data are from a subsample (N = 928) of adolescents with lifetime suicidal ideation from the National Comorbidity Survey-Adolescent Supplement. Logistic regression analyses compared adolescents who had transitioned to a first suicide attempt (n = 81) in the year prior to the study to adolescents with suicidal ideation only (n = 847). RESULTS Multivariate logistic regressions implicated increased risk for progression from suicidal ideation to a first suicide attempt in the presence of a recent romantic break-up as well as more recent stressful life events. However, among adolescents with suicidal ideation and either a recent romantic break-up or above-average recent stressors, neither a disruptive behavior disorder, mood disorder, nor a substance use disorder intensified the risk for progressing to a first suicide attempt. LIMITATIONS Analyses are cross-sectional and therefore limit causal inferences. CONCLUSIONS Findings underscore the importance of comprehensive suicide risk evaluations that consider proximally-occurring interpersonal stressors which may influence the first transition from thinking about suicide to acting in adolescence.
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Affiliation(s)
- Elise Paul
- Department of Human Development, Cornell University, G78 Martha van Rensselaer Hall, Ithaca, NY 14853, United States.
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23
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Olié E, Courtet P. Interest of neuroimaging of social exclusion in suicide. J Neurosci Res 2018; 98:581-587. [PMID: 30171628 DOI: 10.1002/jnr.24314] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2018] [Revised: 07/20/2018] [Accepted: 07/24/2018] [Indexed: 12/24/2022]
Abstract
With one million deaths worldwide, suicide is a major health issue. The frequency of life events preceding suicidal act is high and raises the question of their role in suicidal process. At biological level, dysfunctional neural processing of social exclusion may participate in suicidal risk through an increased perception of social adversity in vulnerable subjects. The purpose of this narrative review is to discuss neuroimaging findings related to social exclusion and loneliness, and to open new perspectives to investigate sensitivity to social stress in suicide.
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Affiliation(s)
- Emilie Olié
- Department of Emergency Psychiatry & Post Acute Care, Academic hospital of Montpellier, Montpellier University, & INSERM U1061, Montpellier, France
| | - Philippe Courtet
- Department of Emergency Psychiatry & Post Acute Care, Academic hospital of Montpellier, Montpellier University, & INSERM U1061, Montpellier, France
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24
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Cassidy RM, Yang F, Kapczinski F, Passos IC. Risk Factors for Suicidality in Patients With Schizophrenia: A Systematic Review, Meta-analysis, and Meta-regression of 96 Studies. Schizophr Bull 2018; 44:787-797. [PMID: 29036388 PMCID: PMC6007264 DOI: 10.1093/schbul/sbx131] [Citation(s) in RCA: 103] [Impact Index Per Article: 17.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
The lifetime risk of suicide and suicide attempt in patients with schizophrenia are 5% and 25%-50%, respectively. The current meta-analysis aims to determine risk factors associated with suicidality in subjects with schizophrenia. We searched Pubmed, Web of Science, EMBASE, and the reference lists of included studies. Inclusion criteria were met if an article reported a dichotomous sample of patients with schizophrenia with suicidal ideation, attempted suicide, or suicide compared to patients without. We also performed a cohort study meta-analysis as a supplemental analysis. A total of 96 studies with 80488 participants were included in our analysis. Depressive symptoms (P < .0001), Positive and Negative Symptom Scale (PANSS) general score (P < .0001) and number of psychiatric hospitalizations (P < .0001) were higher in patients with suicide ideation. History of alcohol use (P = .0001), family history of psychiatric illness (P < .0001), physical comorbidity (P < .0001), history of depression (P < .0001), family history of suicide (P < .0001), history of drug use (P = .0024), history of tobacco use (P = .0034), being white (P = .0022), and depressive symptoms (P < .0001) were the most consistent variables associated with suicide attempts. The first two were also significant in the cohort meta-analysis. Being male (P = .0005), history of attempted suicide (P < .0001), younger age (P = .0266), higher intelligence quotient (P < .0001), poor adherence to treatment (P < .0001), and hopelessness (P < .0001) were the most consistently associated with suicide. The first three were also significant in the cohort meta-analysis. Our findings may help with future development of preventive strategies to combat suicide. Future studies may combine the above-mentioned variables by using multivariate predictive analysis techniques to objectively stratify suicidality in schizophrenia.
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Affiliation(s)
- Ryan Michael Cassidy
- McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX
| | - Fang Yang
- Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, TX
| | - Flávio Kapczinski
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Ives Cavalcante Passos
- Bipolar Disorder Program and Laboratory of Molecular Psychiatry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
- Graduation Program in Psychiatry and Department of Psychiatry, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
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25
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Bernanke J, Galfalvy HC, Mortali MG, Hoffman LA, Moutier C, Nemeroff CB, Stanley BH, Clayton P, Harkavy-Friedman J, Oquendo MA. Suicidal ideation and behavior in institutions of higher learning: A latent class analysis. J Psychiatr Res 2017; 95:253-259. [PMID: 28923719 PMCID: PMC5826724 DOI: 10.1016/j.jpsychires.2017.09.003] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2017] [Revised: 07/08/2017] [Accepted: 09/01/2017] [Indexed: 11/29/2022]
Abstract
Suicide is the second leading cause of death among undergraduate students, with an annual rate of 7.5 per 100,000. Suicidal behavior (SB) is complex and heterogeneous, which might be explained by there being multiple etiologies of SB. Data-driven identification of distinct at-risk subgroups among undergraduates would bolster this argument. We conducted a latent class analysis (LCA) on survey data from a large convenience sample of undergraduates to identify subgroups, and validated the resulting latent class model on a sample of graduate students. Data were collected through the Interactive Screening Program deployed by the American Foundation for Suicide Prevention. LCA identified 6 subgroups from the undergraduate sample (N = 5654). In the group with the most students reporting current suicidal thoughts (N = 623, 66% suicidal), 22.5% reported a prior suicide attempt, and 97.6% endorsed moderately severe or worse depressive symptoms. Notably, LCA identified a second at-risk group (N = 662, 27% suicidal), in which only 1.5% of respondents noted moderately severe or worse depressive symptoms. When graduate students (N = 1138) were classified using the model, a similar frequency distribution of groups was found. Finding multiple replicable groups at-risk for suicidal behavior, each with a distinct prevalence of risk factors, including a group of students who would not be classified as high risk with depression-based screening, is consistent with previous studies that identified multiple potential etiologies of SB.
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Affiliation(s)
- Joel Bernanke
- Department of Psychiatry, Columbia University, NY, USA; New York State Psychiatric Institute, NY, USA
| | - Hanga C Galfalvy
- Department of Psychiatry, Columbia University, NY, USA; Department of Biostatistics, Columbia University, NY, USA.
| | | | | | | | | | - Barbara H Stanley
- Department of Psychiatry, Columbia University, NY, USA; New York State Psychiatric Institute, NY, USA
| | | | | | - Maria A Oquendo
- Department of Psychiatry, Columbia University, NY, USA; New York State Psychiatric Institute, NY, USA
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26
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Bernanke JA, Stanley BH, Oquendo MA. Toward fine-grained phenotyping of suicidal behavior: the role of suicidal subtypes. Mol Psychiatry 2017; 22:1080-1081. [PMID: 28607457 PMCID: PMC5785781 DOI: 10.1038/mp.2017.123] [Citation(s) in RCA: 66] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- J A Bernanke
- Department of Psychiatry, New York State Psychiatric Institute, New York, NY, USA
| | - B H Stanley
- Department of Psychiatry, Columbia University, New York, NY, USA
| | - M A Oquendo
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
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27
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Abstract
Between 10 and 20 million people attempt suicide every year worldwide, and suicide attempts represent a major economic burden. Suicide attempters suffer from high rates of comorbidity, and comorbidity is the rule in suicide re-attempters. Comorbidity complicates treatment and prognosis and causes a more protracted course. In the present narrative review, we included these patterns of comorbidity: intra-Axis I disorders, intra-Axis II disorders, Axis I with Axis II disorders, and psychiatric with physical illnesses. We also briefly reviewed the patterns of comorbidity in suicide re-attempters. We concluded that comorbidity at different levels appears to be the rule in suicide attempters, particularly in those who re-attempt. However, several issues deserve further research regarding the patterns of comorbidity in suicide attempters.
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28
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Passos IC, Mwangi B, Cao B, Hamilton JE, Wu MJ, Zhang XY, Zunta-Soares GB, Quevedo J, Kauer-Sant'Anna M, Kapczinski F, Soares JC. Identifying a clinical signature of suicidality among patients with mood disorders: A pilot study using a machine learning approach. J Affect Disord 2016; 193:109-16. [PMID: 26773901 PMCID: PMC4744514 DOI: 10.1016/j.jad.2015.12.066] [Citation(s) in RCA: 99] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2015] [Revised: 12/09/2015] [Accepted: 12/26/2015] [Indexed: 12/31/2022]
Abstract
OBJECTIVE A growing body of evidence has put forward clinical risk factors associated with patients with mood disorders that attempt suicide. However, what is not known is how to integrate clinical variables into a clinically useful tool in order to estimate the probability of an individual patient attempting suicide. METHOD A total of 144 patients with mood disorders were included. Clinical variables associated with suicide attempts among patients with mood disorders and demographic variables were used to 'train' a machine learning algorithm. The resulting algorithm was utilized in identifying novel or 'unseen' individual subjects as either suicide attempters or non-attempters. Three machine learning algorithms were implemented and evaluated. RESULTS All algorithms distinguished individual suicide attempters from non-attempters with prediction accuracy ranging between 65% and 72% (p<0.05). In particular, the relevance vector machine (RVM) algorithm correctly predicted 103 out of 144 subjects translating into 72% accuracy (72.1% sensitivity and 71.3% specificity) and an area under the curve of 0.77 (p<0.0001). The most relevant predictor variables in distinguishing attempters from non-attempters included previous hospitalizations for depression, a history of psychosis, cocaine dependence and post-traumatic stress disorder (PTSD) comorbidity. CONCLUSION Risk for suicide attempt among patients with mood disorders can be estimated at an individual subject level by incorporating both demographic and clinical variables. Future studies should examine the performance of this model in other populations and its subsequent utility in facilitating selection of interventions to prevent suicide.
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Affiliation(s)
- Ives Cavalcante Passos
- Center of Excellence on Mood Disorder, Department of Psychiatry and Behavioral Sciences, The University of Texas Science Center at Houston, Houston, Texas, USA,Bipolar Disorder Program and Laboratory of Molecular Psychiatry, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Benson Mwangi
- Center of Excellence on Mood Disorder, Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, TX, USA.
| | - Bo Cao
- Center of Excellence on Mood Disorder, Department of Psychiatry and Behavioral Sciences, The University of Texas Science Center at Houston, Houston, Texas, USA
| | - Jane E Hamilton
- Center of Excellence on Mood Disorder, Department of Psychiatry and Behavioral Sciences, The University of Texas Science Center at Houston, Houston, Texas, USA
| | - Mon-Ju Wu
- Center of Excellence on Mood Disorder, Department of Psychiatry and Behavioral Sciences, The University of Texas Science Center at Houston, Houston, Texas, USA
| | - Xiang Yang Zhang
- Center of Excellence on Mood Disorder, Department of Psychiatry and Behavioral Sciences, The University of Texas Science Center at Houston, Houston, Texas, USA,Beijing HuiLongGuan Hospital, Peking University, Beijing, China
| | - Giovana B. Zunta-Soares
- Center of Excellence on Mood Disorder, Department of Psychiatry and Behavioral Sciences, The University of Texas Science Center at Houston, Houston, Texas, USA
| | - Joao Quevedo
- Center of Excellence on Mood Disorder, Department of Psychiatry and Behavioral Sciences, The University of Texas Science Center at Houston, Houston, Texas, USA
| | - Marcia Kauer-Sant'Anna
- Bipolar Disorder Program and Laboratory of Molecular Psychiatry, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Flávio Kapczinski
- Bipolar Disorder Program and Laboratory of Molecular Psychiatry, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Jair C. Soares
- Center of Excellence on Mood Disorder, Department of Psychiatry and Behavioral Sciences, The University of Texas Science Center at Houston, Houston, Texas, USA
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29
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SKA2 methylation is associated with decreased prefrontal cortical thickness and greater PTSD severity among trauma-exposed veterans. Mol Psychiatry 2016; 21:357-63. [PMID: 26324104 PMCID: PMC4760869 DOI: 10.1038/mp.2015.134] [Citation(s) in RCA: 77] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2015] [Revised: 07/28/2015] [Accepted: 07/29/2015] [Indexed: 11/08/2022]
Abstract
Methylation of the SKA2 (spindle and kinetochore-associated complex subunit 2) gene has recently been identified as a promising biomarker of suicide risk. Based on this finding, we examined associations between SKA2 methylation, cortical thickness and psychiatric phenotypes linked to suicide in trauma-exposed veterans. About 200 trauma-exposed white non-Hispanic veterans of the recent conflicts in Iraq and Afghanistan (91% male) underwent clinical assessment and had blood drawn for genotyping and methylation analysis. Of all, 145 participants also had neuroimaging data available. Based on previous research, we examined DNA methylation at the cytosine-guanine locus cg13989295 as well as DNA methylation adjusted for genotype at the methylation-associated single nucleotide polymorphism (rs7208505) in relationship to whole-brain cortical thickness, posttraumatic stress disorder symptoms (PTSD) and depression symptoms. Whole-brain vertex-wise analyses identified three clusters in prefrontal cortex that were associated with genotype-adjusted SKA2 DNA methylation (methylation(adj)). Specifically, DNA methylation(adj) was associated with bilateral reductions of cortical thickness in frontal pole and superior frontal gyrus, and similar effects were found in the right orbitofrontal cortex and right inferior frontal gyrus. PTSD symptom severity was positively correlated with SKA2 DNA methylation(adj) and negatively correlated with cortical thickness in these regions. Mediation analyses showed a significant indirect effect of PTSD on cortical thickness via SKA2 methylation status. Results suggest that DNA methylation(adj) of SKA2 in blood indexes stress-related psychiatric phenotypes and neurobiology, pointing to its potential value as a biomarker of stress exposure and susceptibility.
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31
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Kahn JP, Tubiana A, Cohen RF, Carli V, Wasserman C, Hoven C, Sarchiapone M, Wasserman D. Important Variables When Screening for Students at Suicidal Risk: Findings from the French Cohort of the SEYLE Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2015; 12:12277-90. [PMID: 26437422 PMCID: PMC4626968 DOI: 10.3390/ijerph121012277] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/02/2015] [Revised: 08/28/2015] [Accepted: 09/22/2015] [Indexed: 11/16/2022]
Abstract
Due to early detection of mental ill-health being an important suicide preventive strategy, the multi-centre EU funded "Saving and Empowering Young Lives in Europe" (SEYLE) study compared three school-based mental health promotion programs to a control group. In France, 1007 students with a mean age of 15.2 years were recruited from 20 randomly assigned schools. This paper explores the French results of the SEYLE's two-stage screening program (ProfScreen) and of the cross-program suicidal emergency procedure. Two-hundred-thirty-five ProfScreen students were screened using 13 psychopathological and risk behaviour scales. Students considered at risk because of a positive finding on one or more scales were offered a clinical interview and, if necessary, referred for treatment. A procedure for suicidal students (emergency cases) was set up to detect emergencies in the whole cohort (n = 1007). Emergency cases were offered the same clinical interview as the ProfScreen students. The interviewers documented their reasons for referrals in a short report. 16,2% of the ProfScreen students (38/235) were referred to treatment and 2,7% of the emergency cases (27/1007) were also referred to treatment due to high suicidal risk. Frequent symptoms in those students referred for evaluation were depression, alcohol misuse, non-suicidal self-injuries (NSSI), and suicidal behaviours. According to the multivariate regression analysis of ProfScreen, the results show that the best predictors for treatment referral were NSSI (OR 2.85), alcohol misuse (OR 2.80), and depressive symptoms (OR 1.13). Analysis of the proportion for each scale of students referred to treatment showed that poor social relationships (60%), anxiety (50%), and suicidal behaviours (50%) generated the highest rate of referrals. Qualitative analysis of clinician's motivations to refer a student to mental health services revealed that depressive symptoms (51%), anxiety (38%), suicidal behaviours (40%), and negative life events (35%) were the main reasons for referrals. Thus, not only the classical psychopathological symptoms, such as depression, anxiety, and suicidal behaviours, but also negative life events and poor social relationships (especially isolation) motivate referrals for treatment.
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Affiliation(s)
- Jean-Pierre Kahn
- Centre Hospitalier Universitaire de Nancy, Hôpitaux de Brabois, Vandoeuvre les Nancy 54511, France.
- Université de Lorraine, Faculté de Médecine, Vandoeuvre les Nancy 54505, France.
- Centre Psychothérapique de Nancy, Laxou 54520, France.
| | | | | | - Vladimir Carli
- National Centre for Suicide Research and Prevention of Mental lll-Health (NASP)/WHO Collaborating Centre for Research, Methods Development and Training in Suicide Prevention, Karolinska Institute, Stockholm SE-171 77, Sweden.
| | - Camilla Wasserman
- Department of Child and Adolescent Psychiatry, New York State Psychiatric Institute, Columbia University, New York, NY 10032, USA.
- Department of Health Sciences, University of Molise, Campobasso 86100, Italy.
| | - Christina Hoven
- Department of Child and Adolescent Psychiatry, New York State Psychiatric Institute, Columbia University, New York, NY 10032, USA.
| | - Marco Sarchiapone
- Department of Health Sciences, University of Molise, Campobasso 86100, Italy.
| | - Danuta Wasserman
- National Centre for Suicide Research and Prevention of Mental lll-Health (NASP)/WHO Collaborating Centre for Research, Methods Development and Training in Suicide Prevention, Karolinska Institute, Stockholm SE-171 77, Sweden.
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Chai J, Chen P, Feng R, Liang H, Shen X, Tong G, Cheng J, Li K, Xie S, Shi Y, Wang D. Life events and chronic physical conditions among left-behind farmers in rural China a cross-sectional study. BMC Public Health 2015; 15:594. [PMID: 26130045 PMCID: PMC4487061 DOI: 10.1186/s12889-015-1877-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2015] [Accepted: 05/27/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND This study investigates the relationships between life events and chronic physical conditions among left behind farmers, a newly emerged weak group in vast rural China. METHODS The study collected information about life events, chronic physical conditions, blood pressure and fasting blood glucose from 4681 famers living in 18 randomly selected villages (Lu'an, Anhui, China) from early November 2013 to the end of December 2013. It compared the risk and odds ratios (RRs/ORs) among different subgroups divided according two life event indices derived by adding up un-weighted-ratings and weighted-ratings based on multivariate logistic regression coefficients respectively. RESULTS A total of 4040 (86.3 % eligible) farmers completed the survey. RRs between farmers with lower than the first 1/15-percentile of life event index and with higher life event index scores ranged 1.43-5.79 for chronic gastritis and 0.42-9.07 for prostatitis, 1.01-4.97 for cervicitis/vaginitis, 1.45-3.28 for cardio-cerebrovascular diseases, 1.12-1.58 for hypertension, 1.00-1.66 for diabetes, 1.07-3.35 for pre-diabetes and 5.00-55.00 for "other chronic physical conditions". CONCLUSIONS Life events were independently linked with most of the chronic physical conditions in a dose-effectiveness way. RRs between subgroups divided by given percentile cutoff points of life event index compiled using logistic regression models turned out to be substantially higher than that between subgroups divided by same cutoff points of life event index produced via summing up the un-weighted Likert ratings of all the events studied.
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Affiliation(s)
- Jing Chai
- School of Health Services Management, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China.
| | - Penglai Chen
- School of Health Services Management, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China.
| | - Rui Feng
- School of Health Services Management, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China.
| | - Han Liang
- School of Health Services Management, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China.
| | - Xingrong Shen
- School of Health Services Management, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China.
| | - Guixian Tong
- School of Health Services Management, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China.
| | - Jing Cheng
- School of Health Services Management, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China.
| | - Kaichun Li
- Lu'an Center for Diseases Prevention and Control, Lu'an, 237000, China.
| | - Shaoyu Xie
- Lu'an Center for Diseases Prevention and Control, Lu'an, 237000, China.
| | - Yong Shi
- Lu'an Center for Diseases Prevention and Control, Lu'an, 237000, China.
| | - Debin Wang
- School of Health Services Management, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China.
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Gross JA, Bureau A, Croteau J, Galfalvy H, Oquendo MA, Haghighi F, Mérette C, Giegling I, Hodgkinson C, Goldman D, Rujescu D, Mann JJ, Turecki G. A genome-wide copy number variant study of suicidal behavior. PLoS One 2015; 10:e0128369. [PMID: 26010658 PMCID: PMC4444178 DOI: 10.1371/journal.pone.0128369] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2014] [Accepted: 03/01/2015] [Indexed: 12/22/2022] Open
Abstract
Suicide and suicide attempts are complex behaviors that result from the interaction of different factors, including genetic variants that increase the predisposition to suicidal behaviors. Copy number variations (CNVs) are deletions or duplications of a segment of DNA usually larger than one kilobase. These structural genetic changes, although quite rare, have been associated with genetic liability to mental disorders, such as autism, schizophrenia, and bipolar disorder. No genome-wide level studies have been published investigating the potential role of CNVs in suicidal behaviors. Based on single-nucleotide polymorphism array data, we followed the Penn-CNV standards to detect CNVs in 1,608 subjects, comprising 475 suicide and suicide attempt cases and 1,133 controls. Although the initial algorithms determined the presence of CNVs on chromosomes 6 and 12 in seven and eight cases, respectively, compared with none of the controls, visual inspection of the raw data did not support this finding. Furthermore we were unable to validate these findings by CNV-specific real-time polymerase chain reaction. Additionally, rare CNV burden analysis did not find an association between the frequency or length of rare CNVs and suicidal behavior in our sample population. Although our findings suggest CNVs do not play an important role in the etiology of suicidal behaviors, they are not inconsistent with the strong evidence from the literature suggesting that other genetic variants account for a portion of the total phenotypic variability in suicidal behavior.
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Affiliation(s)
- Jeffrey A. Gross
- McGill Group for Suicide Studies, Douglas Mental Health University Institute, Montreal, Quebec, Canada
| | - Alexandre Bureau
- Centre de recherche de l’Institut Universitaire en Santé Mentale de Québec, Université Laval, Quebec City, Quebec, Canada
| | - Jordie Croteau
- Centre de recherche de l’Institut Universitaire en Santé Mentale de Québec, Université Laval, Quebec City, Quebec, Canada
| | - Hanga Galfalvy
- Division of Biostatistics, Department of Psychiatry, Columbia University, New York, New York, United States of America
| | - Maria A. Oquendo
- Molecular Imaging and Neuropathology Division, Department of Psychiatry, Columbia University, New York, New York, United States of America
| | - Fatemeh Haghighi
- Division of Biostatistics, Department of Psychiatry, Columbia University, New York, New York, United States of America
| | - Chantal Mérette
- Centre de recherche de l’Institut Universitaire en Santé Mentale de Québec, Université Laval, Quebec City, Quebec, Canada
| | - Ina Giegling
- Psychiatric Clinic, Martin-Luther-Universität, Halle, Saxony-Anhalt, Germany
| | - Colin Hodgkinson
- Laboratory of Neurogenetics, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Rockville, Maryland, United States of America
| | - David Goldman
- Laboratory of Neurogenetics, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Rockville, Maryland, United States of America
| | - Dan Rujescu
- Psychiatric Clinic, Martin-Luther-Universität, Halle, Saxony-Anhalt, Germany
| | - J. John Mann
- Molecular Imaging and Neuropathology Division, Department of Psychiatry, Columbia University, New York, New York, United States of America
| | - Gustavo Turecki
- McGill Group for Suicide Studies, Douglas Mental Health University Institute, Montreal, Quebec, Canada
- * E-mail:
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Predicting suicidal behavior: are we really that far along? Comment on "Discovery and validation of blood biomarkers for suicidality". Curr Psychiatry Rep 2013; 15:424. [PMID: 24254200 PMCID: PMC3967238 DOI: 10.1007/s11920-013-0424-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
A recent publication focused on biomarkers of future suicidal behaviors identifies several genes expressed in high-risk states among four samples. We discuss the implications of this study as well as the current state of research regarding biomarkers of suicidal behavior.
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