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Jiang D, Lang X, Wang D, Zhang XY. Gender differences in risk factors for suicide attempts among young, first-episode and drug-naive major depressive disorder patients with anxiety symptoms. Front Psychiatry 2024; 15:1424103. [PMID: 39176231 PMCID: PMC11338873 DOI: 10.3389/fpsyt.2024.1424103] [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: 04/27/2024] [Accepted: 07/24/2024] [Indexed: 08/24/2024] Open
Abstract
Background Suicide attempts and anxiety are common commodities in patients with major depressive disorder (MDD), and suicide attempts are often associated with anxiety symptoms. Studies have found gender differences in several aspects of MDD; however, gender differences in suicide attempts in young first-episode and drug-naive (FEDN) MDD patients with anxiety remain unknown. This study aimed to investigate potential gender differences in the prevalence of suicide attempts and associated risk factors among young FEDN MDD patients with anxiety in a Chinese Han population. Methods A cross-sectional study was conducted on 1289 young patients with FEDN MDD. Demographics, clinical characteristics, and biochemical parameters of patients were collected. Results Suicide attempters accounted for 23.80% and 26.12% of male and female FEDN MDD patients with anxiety, respectively, with no significant gender differences. Binary logistic regression analyses showed that anxiety, clinical global impression severity, and thyroid peroxidase antibody significantly predicted suicide attempts in both male and female FEDN MDD patients with anxiety, while body mass index significantly predicted suicide attempts only in males, and psychotic symptoms predicted suicide attempts only in females. Conclusion The present study represents the first large-scale investigation of gender differences in the prevalence of suicide attempts and related risk factors among young FEND MDD patients with anxiety in the Chinese Han population. The results indicate that risk factors associated with suicide attempts vary by gender among young FEND MDD patients with anxiety, although a comparable rate of suicide attempts was observed in both female and male patients.
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Affiliation(s)
- Donghong Jiang
- School of Psychology, Shenzhen University, Shenzhen, China
- Psychological Counselling Centre, Shenzhen University, Shenzhen, China
| | - XiaoE Lang
- Department of Psychiatry, First Hospital of Shanxi Medical University, Taiyuan, China
| | - Dongmei Wang
- Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences (CAS), Beijing, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Xiang-Yang Zhang
- Affiliated Mental Health Center of Anhui Medical University, Hefei, China
- Hefei Fourth People’s Hospital, Hefei, China
- Anhui Mental Health Center, Hefei, China
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Yavuz BE, Turan S, Mutlu C, Çamlı ŞE. A comparison of the social cognition and neurocognitive characteristics of adolescents with suicide behavior, adolescent with depression and healthy controls. Suicide Life Threat Behav 2024; 54:785-797. [PMID: 38738815 DOI: 10.1111/sltb.13090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Revised: 03/31/2024] [Accepted: 04/18/2024] [Indexed: 05/14/2024]
Abstract
INTRODUCTION Deficits in neurocognition and social-cognition have been suggested to be an endophenotype for suicidal behavior. We aimed to compare the social-cognition and neurocognitive characteristics of adolescents diagnosed with depression with and without suicidal behavior and to investigate whether these functions predict suicide. METHOD Adolescents diagnosed with Major Depressive Disorder (MDD) with suicidal behavior (n = 42); MDD without suicidal behavior (n = 44) and age- and sex-matched controls (n = 43) were included. The University of Pennsylvania Computerized Neurobehavioral Test Battery and Autism Spectrum Screening Questionnaire (ASSQ) were used to evaluate social-cognition and neurocognitive characteristics. RESULTS Several neurocognitive domain values of MDD groups, were significantly different from the control group. Neutral emotion recognition task (p = 0.025) and ASSQ scores were found to be significantly impaired in the patient groups (p < 0.001). Logistic regression analysis showed that, only the increase in the Suicide Probability Scale score was found to be significant as a risk factor predicting suicide (p = 0.007, OR: 1.246). CONCLUSION While the neurocognitive and social-cognitive performances of adolescents with MDD were significantly lower than the control group, these performances in the two depression groups were similar. When the predictors of suicidal behavior were examined, it was found that only the increase in suicidal ideation scores predicted suicide.
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Affiliation(s)
- B Ece Yavuz
- Department of Child and Adolescent Psychiatry, TC Sağlık Bakanlığı Cizre Dr. Selahattin Cizrelioğlu Devlet Hastanesi, Şırnak, Turkey
| | - Serkan Turan
- Department ofChild and Adolescent Psychiatry, Faculty of Medicine, Bursa Uludag University, Bursa, Turkey
| | - Caner Mutlu
- Department ofChild and Adolescent Psychiatry, Faculty of Medicine, Bursa Uludag University, Bursa, Turkey
| | - Şafak Eray Çamlı
- Department ofChild and Adolescent Psychiatry, Faculty of Medicine, Bursa Uludag University, Bursa, Turkey
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Shang Z, Fang C, Luo G, Lang X, Zhang X. Gender difference in the relationship between clinical symptoms, thyroid hormones, and metabolic parameters in young, first-episode and drug-naïve major depressive disorder patients with suicide attempts: A network analysis perspective. J Psychiatr Res 2024; 176:411-421. [PMID: 38959824 DOI: 10.1016/j.jpsychires.2024.06.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 04/28/2024] [Accepted: 06/24/2024] [Indexed: 07/05/2024]
Abstract
BACKGROUND Suicide attempts are one of the most serious comorbidities in patients with major depressive disorder (MDD), and the prevalence of suicide attempts is higher in younger people compared to older people, with significant gender differences. This study aimed to investigate the relationship between suicide attempts, clinical symptoms, thyroid hormones, and metabolic parameters in young first-episode and drug-naïve (FEND) MDD patients of different genders. METHODS A total of 1289 FEND MDD patients were recruited. Depression, anxiety, and psychotic symptoms were assessed using the Hamilton Depression Rating Scale (HAMD), Hamilton Anxiety Rating Scale (HAMA), and the Positive and Negative Syndrome Scale (PANSS) positive subscale, respectively. Thyroid hormones and glucolipid metabolism indicators were also tested. Network analysis was employed to delineate the interplay between thyroid dysfunction, clinical symptoms, and metabolic disorders. RESULTS Among young FEND MDD patients, the rate of suicide attempts was 17.4% in males and 19.8% in females, showing no significant gender difference in the incidence of suicide attempts (χ2 = 1.06, p = 0.303). In the network model, PANSS positive subscale (Expected Influence = 0.578) and HAMD scores (Expected Influence = 0.576) were identified as the individual symptoms that most affected male patients, whereas TSH (Thyroid-Stimulating Hormone) (Expected Influence = 0.972) and PANSS positive subscale (Expected Influence = 0.937) were identified as the individual symptoms that most affected female patients. In addition, we found that TSH (Expected Influence = 0.438) was a pivotal node connecting metabolic disturbances and clinical symptoms. CONCLUSION Our findings emphasize the important role of psychotic symptoms in young MDD patients with suicide attempts. Moreover, our results highlight the pivotal role of serum TSH levels in the pathophysiology of young female MDD patients with suicide attempts.
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Affiliation(s)
- ZhaoXuan Shang
- Department of Psychology and Cognitive Science, East China Normal University, Shanghai, China
| | - ChunQing Fang
- Department of Psychology and Cognitive Science, East China Normal University, Shanghai, China
| | - GuoShuai Luo
- Laboratory of Biological Psychiatry, Institute of Mental Health, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, Tianjin, China
| | - XiaoE Lang
- Department of Psychiatry, First Hospital of Shanxi Medical University, Taiyuan, China
| | - XiangYang Zhang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China.
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Ding M, Lang X, Wang J, Shangguan F, Zhang XY. Prevalence, demographic characteristics, and clinical features of suicide risk in first episode drug-naïve schizophrenia patients with comorbid severe anxiety. J Psychiatr Res 2024; 176:232-239. [PMID: 38889553 DOI: 10.1016/j.jpsychires.2024.06.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 05/19/2024] [Accepted: 06/10/2024] [Indexed: 06/20/2024]
Abstract
BACKGROUND Both anxiety symptoms and suicide risk are common in schizophrenia. However, previous findings about the association between anxiety and suicide risk in schizophrenia were controversial. This study is the first to examine the prevalence of suicide risk and related demographic, clinical features in a large sample of first episode drug-naïve (FEDN) schizophrenia patients with comorbid severe anxiety. METHODS In total, 316 patients with FEDN schizophrenia were enrolled in this study. Patients' symptoms were assessed using the Hamilton Depression Scale (HAMD), Hamilton Anxiety Rating Scale (HAMA), and Positive and Negative Syndrome Scale (PANSS). Serum levels of glucose, insulin, uric acid, and lipids including total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C), were evaluated. RESULTS In the current study, 56.3% patients presented comorbid severe anxiety. The rate of suicide risk was higher in the severe anxiety group (55.6%) than in the mild-moderate anxiety group (33.3%). The interactions among severe anxiety, uric acid and HDL-C were associated with suicide risk. Compared with patients with normal uric acid, those with abnormal uric acid exhibited a stronger association between HAMA scores and HAMD-suicide item scores. This enhanced association was also observed for patients with abnormal HDL-C levels. CONCLUSIONS In FEDN schizophrenia patients with comorbid severe anxiety, our findings suggested a high incidence of suicide risk. Abnormal levels of uric acid and low levels of HDL-C, as well as high depression may be associated with an increased risk of suicide in FEDN schizophrenia patients with comorbid severe anxiety.
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Affiliation(s)
- Mengjie Ding
- Key Laboratory of Learning and Cognition, School of Psychology, Capital Normal University, Beijing, 100037, China.
| | - Xiaoe Lang
- Department of Psychiatry, The First Clinical Medical College, Shanxi Medical University, Shanxi, 030000, China.
| | - Junhan Wang
- Key Laboratory of Learning and Cognition, School of Psychology, Capital Normal University, Beijing, 100037, China.
| | - Fangfang Shangguan
- Key Laboratory of Learning and Cognition, School of Psychology, Capital Normal University, Beijing, 100037, China.
| | - Xiang-Yang Zhang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, 100101, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, 100101, China.
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Kassahun GT, Addis F, Mossie TB, Belete H, Munie BM. Suicidal behavior and associated factors among holy water users at Northwest, Ethiopia, 2023: an institution based cross-sectional study. Front Psychiatry 2024; 15:1398363. [PMID: 38863616 PMCID: PMC11165697 DOI: 10.3389/fpsyt.2024.1398363] [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: 03/09/2024] [Accepted: 05/01/2024] [Indexed: 06/13/2024] Open
Abstract
Background Suicide is a serious cause of mortality that affects families, communities, and the entire country. Because of a lack of national systematic reporting for cause-specific mortality, a high level of stigma, and religious non-acceptance, suicidal behavior is an under-reported and concealed cause of death in the majority of low- and middle-income countries. Objective The aim of this study was to assess the prevalence of suicidal behavior and associated factors among holy water users at the Andassa Saint George Monastery, 2023. Methods An institution-based cross-sectional study was conducted at the Andassa Saint George Monastery from 5 April to 5 May 2023. A systematic random sampling method was utilized to select 423 study participants and the Suicidal Behaviors Questionnaire-Revised was used to assess suicidal behavior. The data were gathered using the epicollect5 software with a face-to-face interview method then exported to SPSS-25 for analysis. A binary logistic regression model was used and all variables in a bivariate analysis with a p-value of less than 0.25 were entered into a multivariable logistic regression model, and statistical significance was declared at a p-value of less than 0.05. Results The prevalence of suicidal behavior among holy water users was 9.7% (95% CI: 7.1-12.4). Being female [2.632 (1.206-5.748)], living alone [2.52 (1.06-5.97)], and having depression [3.03 (1.32-6.99)], epilepsy [3.82 (1.28-11.40)], and diabetes mellitus [3.37 (1.229-9.25)] were significantly associated with suicidal behavior. Conclusion In this study, almost 1 in 10 had engaged in suicidal behavior in their lifetime. Several risk factors for suicidal behavior were identified, including being female, living alone, and having diabetes mellitus, epilepsy, and depression.
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Affiliation(s)
- Gedefaw Tegegne Kassahun
- Department of Psychiatry, Debre Markos Comprehensive Specialized Hospital, Amhara Regional Health Bureau, Debre Markos, Ethiopia
| | - Fikir Addis
- Department of Psychiatry, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Tilahun Belete Mossie
- Department of Psychiatry, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Habte Belete
- Department of Psychiatry, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Birhanu Mengist Munie
- Department of Psychiatry, College of Medicine and Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
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Wang T, Yang L, Yang L, Liu BP, Jia CX. The relationship between psychological pain and suicidality in patients with major depressive disorder: A meta-analysis. J Affect Disord 2024; 346:115-121. [PMID: 37926158 DOI: 10.1016/j.jad.2023.10.160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Revised: 10/30/2023] [Accepted: 10/31/2023] [Indexed: 11/07/2023]
Abstract
OBJECTIVE To systematically review the association between psychological pain and suicidality in patients with major depressive disorder (MDD). METHOD The databases of PubMed, Web of Science and PsycINFO were used to search and articles were screened for inclusion and exclusion criteria until February 2022. Two researchers independently screened the papers, extracted data, and evaluated the risk of bias of the included studies. Comprehensive Meta-Analysis software (CMA) was used for meta-analysis and the combined OR (95 % CI) values were calculated. RESULTS A total of 7 articles were included, with a sample size of 1364. The present study showed that psychological pain was a risk factor for suicidality in patients with MDD (OR = 1.322, 95 % CI:1.165-1.500). After Duval and Tweedie trim and fill to rectify potential publication bias, psychological pain was still a risk factor for suicidality in patients with MDD [OR = 1.196 (95 % CI: 1.030-1.388), P < 0.001]. Subgroup analyses showed that average age ≥ 40 [r = 0.57 (95 % CI: 0.32-0.81), P < 0.001] was moderating variable for psychological pain and suicidality. CONCLUSIONS Reducing psychological pain in MDD patients is somewhat important for preventing their suicidality, especially for the patients with advancing age.
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Affiliation(s)
- Tao Wang
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Li Yang
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Lan Yang
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Bao-Peng Liu
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Cun-Xian Jia
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China.
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Abu Khait A, Menger A, Rababa M, Moldovan T, Lazenby M, Shellman J. The mediating role of religion and loneliness on the association between reminiscence functions and depression: a call to advance older adults' mental health. Psychogeriatrics 2024; 24:58-71. [PMID: 37953694 DOI: 10.1111/psyg.13041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 10/09/2023] [Accepted: 10/16/2023] [Indexed: 11/14/2023]
Abstract
BACKGROUND Current literature lacks evidence about the relationship between reminiscence functions and depression and the mediating role of clinical constructs such as loneliness and religion. The study aimed to examine the mediating effects of loneliness and religion on the association between reminiscence functions and depression in a sample of older Jordanian adults. METHODS An anonymous online cross-sectional survey was employed to collect data from 365 older Jordanian adults. Convenience and snowball sampling methods were used to recruit participants through social media. RESULTS In the depression model, Bitterness Revival and Intimacy Maintenance factors, educational level, and Intrinsic Religiosity were statistically significant predictors of depression. Bitterness Revival and Intimacy Maintenance factors, work sector, and Intrinsic Religiosity were statistically significant predictors of loneliness. Loneliness has a negative, partial mediating effect on Intimacy Maintenance and depression. CONCLUSION Depression caused by significant losses in the Arab Jordanian environment might be mitigated by Intimacy Maintenance by reducing feelings of loneliness. Understanding how Intimacy Maintenance correlates with depression through loneliness could help psychiatric nurses develop psychosocial interventions that reduce depression among older adults.
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Affiliation(s)
- Abdallah Abu Khait
- Department of Community and Mental Health Nursing, Faculty of Nursing, The Hashemite University, Zarqa, Jordan
| | - Austin Menger
- Department of Statistics, University of Connecticut, Storrs, Connecticut, USA
| | - Mohammad Rababa
- Department of Adult Health Nursing, Faculty of Nursing, Jordan University of Science and Technology, Irbid, Jordan
| | - Theodora Moldovan
- Department of Mathematics and Statistics, Connecticut College, New London, Connecticut, USA
| | - Mark Lazenby
- Sue & Bill Gross School of Nursing, University of California, Irvine, California, USA
| | - Juliette Shellman
- School of Nursing, University of Connecticut, Storrs, Connecticut, USA
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Su Y, Ye C, Xin Q, Si T. Major depressive disorder with suicidal ideation or behavior in Chinese population: A scoping review of current evidence on disease assessment, burden, treatment and risk factors. J Affect Disord 2023; 340:732-742. [PMID: 37619652 DOI: 10.1016/j.jad.2023.08.106] [Citation(s) in RCA: 3] [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: 02/23/2023] [Revised: 07/28/2023] [Accepted: 08/21/2023] [Indexed: 08/26/2023]
Abstract
BACKGROUND Identifying and managing major depressive disorder (MDD) patients with suicidal ideation or behavior (MDSI) is critical for reducing the disease burden. This scoping review aims to map the existing evidence related to MDSI in the Chinese population. METHOD A scoping review was conducted to summarize the published evidence regarding epidemiology or disease burden, evaluation, diagnosis, management, and prognosis of MDSI. The search strategy imposed restriction on English or Chinese publications between 1 January 2011 and 28 February 2022. RESULTS Of the 14,005 identified records, 133 met the eligibility criteria and were included for analysis. The included studies were characterized as high heterogeneity in evaluation of suicidal ideation or behavior. Compared with MDD patients without suicidal ideation or behavior, MDSI patients were more likely to suffer from psychological and somatic symptoms, social function impairment, and lower quality of life. Younger age, female gender, longer disease course, and comorbid psychological or physical symptoms were consistently found to be risk factors of suicidal ideation or behavior. Relevant research gaps remain regarding comprehensive evaluation of standard clinical diagnosis, disease burden, social-cultural risk factors, and effectiveness of interventions targeting MDSI. Studies with large sample size, representative population are warranted to provide high-quality evidence. CONCLUSIONS MDD patients with suicidal ideation or behavior should be prioritized in treatment and resource allocation. Heterogeneity exists in the definition and evaluation of MDSI in different studies. To better inform clinical practice, it is imperative to establish a unified standard for evaluation and diagnosis of suicidal ideation or behavior among MDD population.
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Affiliation(s)
- Yun'Ai Su
- Peking University Sixth Hospital, Beijing, China; Peking University Institute of Mental Health, Beijing, China; NHC Key Laboratory of Mental Health (Peking University), Beijing, China; National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Chong Ye
- Xi'an Janssen Pharmaceutical Ltd, Beijing, China
| | - Qin Xin
- Xi'an Janssen Pharmaceutical Ltd, Beijing, China
| | - Tianmei Si
- Peking University Sixth Hospital, Beijing, China; Peking University Institute of Mental Health, Beijing, China; NHC Key Laboratory of Mental Health (Peking University), Beijing, China; National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China.
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Song X, Liu X, Zhou Y, Zhang X. Prevalence and correlates of suicide attempts in young patients with first-episode and drug-naïve major depressive disorder: A large cross-sectional study. J Affect Disord 2023; 340:340-346. [PMID: 37541596 DOI: 10.1016/j.jad.2023.08.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 07/07/2023] [Accepted: 08/01/2023] [Indexed: 08/06/2023]
Abstract
BACKGROUND Few studies in China have reported factors influencing suicide attempt in young first-episode drug-free (FEDN) MDD patients. This study aimed to investigate the incidence and potential relevant factors of suicide attempt among young Chinese patients with FEDN MDD to prevent suicidal behavior in this population. METHODS We recruited 1076 FEDN MDD outpatients aged 18-45 years. Patients' mental states were measured by the Hamilton Anxiety Scale (HAMA), Hamilton Depression Scale (HAMD), Positive and Negative Syndrome Scale (PANSS) positive subscale, and Clinical Global Impression Severity Scale (CGIS). Fasting blood glucose, lipid levels, and thyroid function parameters were also measured. RESULTS The prevalence of suicide attempt for FEDN MDD patients was 18.31 %. Compared to patients without suicide attempt, patients with suicide attempt had an older age of onset, higher HAMA, HAMD, PANSS-positive subscale and CGI-S scores, higher blood pressure, fasting blood glucose, thyroid peroxidases antibody (A-TPO), anti-thyroglobulin (A-TG), thyroid stimulating hormone (TSH), low-density lipoprotein cholesterol (LDL-C), and total cholesterol (TC), but lower high-density lipoprotein cholesterol (HDLC) (all p < 0.05). Logistic regression analysis showed that duration of illness, hypertension, PANSS-positive subscale, HAMA and CGI-S scores, and A-TPO, LDL-C, TC, and HDL-C were associated with suicide attempt in patients with MDD. LIMITATIONS The main limitations are cross-sectional design and inability to control selection bias. CONCLUSIONS This study suggests that young patients with FEDN MDD have a high rate of suicide attempts. Several clinical and metabolic indicators related to lipids and thyroid function may be involved in suicide attempts in FEDN MDD patients.
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Affiliation(s)
- Xiuli Song
- Clinical psychology, Yantai Affiliated Hospital of Binzhou Medical University, Yantai, China
| | - Xiaoran Liu
- School of Nursing, Binzhou Medical University, Yantai, China
| | | | - Xiangyang Zhang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China.
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Miola A, Tondo L, Pinna M, Contu M, Baldessarini RJ. Suicidal risk and protective factors in major affective disorders: A prospective cohort study of 4307 participants. J Affect Disord 2023; 338:189-198. [PMID: 37301296 DOI: 10.1016/j.jad.2023.06.018] [Citation(s) in RCA: 3] [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: 09/07/2022] [Revised: 05/25/2023] [Accepted: 06/04/2023] [Indexed: 06/12/2023]
Abstract
BACKGROUND Suicidal behavior is strongly associated with major affective disorders, but there is a need to quantify and compare specific risk and protective factors in bipolar disorder (BD) and major depressive disorder (MDD). METHODS In 4307 extensively evaluated major affective-disorder participants with BD (n = 1425) or MDD (n = 2882) diagnosed by current international criteria, we compared characteristics among those with versus without suicidal acts from illness-onset through 8.24 years of follow-up. RESULTS Suicidal acts were identified in 11.4 % of participants; 25.9 % were violent and 6.92 % (0.79 % of all participants) were fatal. Associated risk factors included: diagnosis (BD > MDD), manic/psychotic features in first-episodes, family history of suicide or BD, separation/divorce, early abuse, young at illness-onset, female sex with BD, substance abuse, higher irritable, cyclothymic or dysthymic temperament ratings, greater long-term morbidity, and lower intake functional ratings. Protective factors included marriage, co-occurring anxiety disorder, higher ratings of hyperthymic temperament and depressive first episodes. Based on multivariable logistic regression, five factors remained significantly and independently associated with suicidal acts: BD diagnosis, more time depressed during prospective follow-up, younger at onset, lower functional status at intake, and women > men with BD. LIMITATIONS Reported findings may or may not apply consistently in other cultures and locations. CONCLUSIONS Suicidal acts including violent acts and suicides were more prevalent with BD than MDD. Of identified risk (n = 31) and protective factors (n = 4), several differed with diagnosis. Their clinical recognition should contribute to improved prediction and prevention of suicide in major affective disorders.
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Affiliation(s)
- Alessandro Miola
- International Consortium for Mood & Psychotic Disorders Research, Mailman Research Center, McLean Hospital, Belmont, MA, United States of America; Department of Neuroscience, University of Padova, Padua, Italy.
| | - Leonardo Tondo
- International Consortium for Mood & Psychotic Disorders Research, Mailman Research Center, McLean Hospital, Belmont, MA, United States of America; Department of Psychiatry, Harvard Medical School, Boston, MA, United States of America; Lucio Bini Mood Disorder Centers, Cagliari & Rome, Italy
| | - Marco Pinna
- Lucio Bini Mood Disorder Centers, Cagliari & Rome, Italy; Section of Psychiatry, Department of Medical Science and Public Health, University of Cagliari, Cagliari, Italy
| | - Martina Contu
- Lucio Bini Mood Disorder Centers, Cagliari & Rome, Italy
| | - Ross J Baldessarini
- International Consortium for Mood & Psychotic Disorders Research, Mailman Research Center, McLean Hospital, Belmont, MA, United States of America; Department of Psychiatry, Harvard Medical School, Boston, MA, United States of America
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Huang X, Sun Y, Wu A, Zhang X. Differences in the prevalence and clinical correlates of comorbid suicide attempts in patients with early- and late-onset major depressive disorder. Front Psychiatry 2023; 14:1173917. [PMID: 37588029 PMCID: PMC10426903 DOI: 10.3389/fpsyt.2023.1173917] [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: 02/25/2023] [Accepted: 05/09/2023] [Indexed: 08/18/2023] Open
Abstract
Objective There are many studies on differences in the onset age of major depressive disorder (MDD) patients. However, study on differences in clinical correlates of suicide attempts between early- and late-onset MDD patients is limited. The aim of this study was to investigate the differences in the prevalence and clinical correlates of suicide attempts in patients with early- and late-onset MDD in China. Methods A total of 1718 adult outpatients with MDD were recruited. Demographic and clinical data were collected. The 17-item Hamilton Rating Scale for Depression (HAMD-17), Hamilton Anxiety Rating Scale (HAMA), Positive and Negative Syndrome Scale (PANSS) positive subscale, and Clinical Global Impression-Severity (CGI-S) Scales were used to assess their depressive, anxiety, psychotic symptoms, and the severity of the clinical symptoms, respectively. Results The prevalence of suicide attempts was higher in late-onset MDD patients (291/1369, 21.3%) than in early-onset MDD patients (55/349, 15.8%) (p = 0.023). However after Bonferroni correction no significant difference was found in the prevalence of suicide attempts in late-onset and late-onset MDD patients (p > 0.05). In both early- and late-onset groups, univariate analysis showed that the following characteristics were significantly associated with suicide attempts: HAMA, HAMD and PANSS positive subscale scores, thyroid stimulating hormone (TSH) levels, blood glucose levels, systolic blood pressure (SBP), and diastolic blood pressure (DBP). In both the early- and late-onset groups, the prevalence rates of severe anxiety disorder and psychotic symptoms were significantly higher in the suicide attempt group than in the non-suicide attempt group. In regression analysis, disease duration, TSH levels and HAMA score were independently associated with suicide attempts in the early-onset group, while TSH levels, HAMA and HAMD score were independently associated with suicide attempts in the late-onset group. Conclusion This study suggests that suicide attempts are not frequent in early-onset outpatients with MDD compared with late-onset, and some clinical correlates are associated with suicide attempt in early- and late-onset MDD.
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Affiliation(s)
- Xiao Huang
- Department of Anesthesiology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Yuan Sun
- Department of Pharmacy, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Anshi Wu
- Department of Anesthesiology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Xiangyang Zhang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Beijing, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
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Kern DM, Canuso CM, Daly E, Johnson JC, Fu DJ, Doherty T, Blauer‐Peterson C, Cepeda MS. Suicide-specific mortality among patients with treatment-resistant major depressive disorder, major depressive disorder with prior suicidal ideation or suicide attempts, or major depressive disorder alone. Brain Behav 2023; 13:e3171. [PMID: 37475597 PMCID: PMC10454258 DOI: 10.1002/brb3.3171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 06/20/2023] [Accepted: 07/07/2023] [Indexed: 07/22/2023] Open
Abstract
BACKGROUND The impact of treatment-resistant depression (TRD) or prior suicidal ideation/suicide attempt (SI/SA) on mortality by suicide among patients with major depressive disorder (MDD) is not well known. This retrospective, observational, descriptive cohort study characterized real-world rates of suicide-specific mortality among patients with MDD with or without TRD or SI/SA. METHODS Adult patients with MDD among commercially insured and Medicare enrollees in Optum Research Database were included and assigned to three cohorts: those with treatment-resistant MDD (TRD), those with MDD and SI/SA (MDD+SI/SA), and those with MDD without TRD or SI/SA (MDD alone). Suicide-specific mortality was obtained from the National Death Index. The effects of demographic characteristics and SI/SA in the year prior to the end of observation on suicide-specific mortality were assessed. RESULTS For the 139,753 TRD, 85,602 MDD+SI/SA, and 572,098 MDD alone cohort patients, mean age ranged from 55 to 59 years and the majority were female. At baseline, anxiety disorders were present in 53.92%, 44.11%, and 21.72% of patients with TRD, MDD+SI/SA, and MDD alone, respectively. Suicide-mortality rates in the three cohorts were 0.14/100 person-years for TRD, 0.27/100 person-years for MDD+SI/SA, and 0.04/100 person-years for MDD alone. SI/SA during the year prior to the end of observation, younger age, and male sex were associated with increased suicide risk. CONCLUSIONS Patients with TRD and MDD+SI/SA have a heightened risk of mortality by suicide compared with patients with MDD alone. Suicide rates were higher in patients with recent history versus older or no history of SI/SA, men versus women, and those of young age versus older age.
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Affiliation(s)
- David M. Kern
- Department of EpidemiologyJanssen Research & DevelopmentTitusvilleNew JerseyUnited States
| | - Carla M. Canuso
- Department of EpidemiologyJanssen Research & DevelopmentTitusvilleNew JerseyUnited States
| | - Ella Daly
- Department of EpidemiologyJanssen Research & DevelopmentTitusvilleNew JerseyUnited States
| | | | - Dong Jing Fu
- Department of EpidemiologyJanssen Research & DevelopmentTitusvilleNew JerseyUnited States
| | - Teodora Doherty
- Department of EpidemiologyJanssen Research & DevelopmentTitusvilleNew JerseyUnited States
| | | | - M. Soledad Cepeda
- Department of EpidemiologyJanssen Research & DevelopmentTitusvilleNew JerseyUnited States
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Li Y, Liao Z, Huang Q, Wang Q, Ren H, Chen X, Lin S, Wang C, Tang Y, Hao J, Wang X, Shen H, Zhang X. Prevalence and influencing factors of suicide in first-episode and drug-naive young major depressive disorder patients with impaired fasting glucose: a cross-sectional study. Front Psychiatry 2023; 14:1171814. [PMID: 37363165 PMCID: PMC10289199 DOI: 10.3389/fpsyt.2023.1171814] [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: 02/22/2023] [Accepted: 05/22/2023] [Indexed: 06/28/2023] Open
Abstract
Background An association exists between major depression disorder (MDD), suicide attempts, and glucose metabolism, but suicide attempts in young MDD patients with comorbid impaired fasting glucose (IFG) have been less well studied. The purpose of this study was to examine the prevalence and risk factors for suicide attempts in young, first-episode, drug-naive (FEDN) MDD patients with comorbid IFG. Methods We recruited 917 young patients with FEDN MDD, 116 of whom were judged to have combined IFG because their blood glucose was >6.0. We collected anthropological and clinical data on all of them. The Hamilton Depression Scale (HAMD) score, the Hamilton Anxiety Scale (HAMA) score and the Positive and Negative Syndrome Scale (PANSS) positive subscale score were used to assess their clinical symptoms. Blood glucose, plasma thyroid function and lipid indicators were measured. Results The prevalence of suicide attempts in young MDD patients with IFG was 32.8% (38/116). Furthermore, among young MDD patients with comorbid IFG, suicide attempters had more severe depression and anxiety symptoms, more comorbid psychotic symptom, higher levels of antibody of thyroid stimulating hormone and thyroid peroxidases (TPOAb), and more severe lipid metabolism disorders than those without suicide attempts. In addition, HAMA scores and TPOAb were independently associated with suicide attempts in young patients with FEDN MDD. Conclusion Our study suggests that young MDD patients with IFG have a high rate of suicide attempts. Some clinical symptoms and thyroid function parameters may be the risk factor for suicide attempts in young MDD patients with impaired glucose metabolism.
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Affiliation(s)
- Yifan Li
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Zhenjiang Liao
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Qiuping Huang
- Department of Applied Psychology, School of Humanities and Management, Hunan University of Chinese Medicine, Changsha, China
| | - Qianjin Wang
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Honghong Ren
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Xinxin Chen
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Shuhong Lin
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Chenhan Wang
- The First Clinical Medical College of Lanzhou University, Lanzhou, China
| | - Ying Tang
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Jingyue Hao
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Xuhao Wang
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Hongxian Shen
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Xiangyang Zhang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
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14
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Huber RS, Boxer D, Smith CJ, Renshaw PF, Yurgelun-Todd DA, Kondo DG. Detailed assessment of suicidal ideation in youth with bipolar disorder versus major depressive disorder. Bipolar Disord 2023; 25:200-208. [PMID: 36606348 PMCID: PMC10525907 DOI: 10.1111/bdi.13294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
OBJECTIVES There is a critical need to better understand the factors underlying the increased suicide risk for youth with bipolar disorder (BD) in order to develop targeted prevention efforts. This study aimed to examine differences in characteristics of suicide ideation (SI) in youth with BD compared to youth with major depressive disorder (MDD) that may be associated with increased suicide risk. METHODS One hundred and fifty-one participants (92 MDD and 59 BD), ages 13-21, completed a diagnostic interview and clinical assessments. Lifetime symptoms of SI and SA were assessed using the Columbia Suicide Severity Rating Scale. Ordinal logistic regression models were used to investigate whether the diagnostic group predicted the severity and intensity of the most severe or most common SI with the age of onset, age, and gender as covariates. RESULTS Compared to MDD youth, BD youth were more likely to report experiencing more severe SI, p = 0.039, experiencing the most severe SI more frequently, p = 0.002, having less control of the most severe SI, p = 0.012, and that deterrents were less likely to stop them from acting on the most severe SI, p = 0.006. CONCLUSION This study highlights differences in the severity and intensity of SI in youth with BD and suggests that youth with BD have greater difficulty inhibiting thoughts of SI which may lead to less resistance to suicide action. Findings underscore the need for a more detailed assessment of SI in youth with BD to better understand SI as a proximal risk factor for future SA and a potential target for intervention.
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Affiliation(s)
- Rebekah S. Huber
- Department of Psychiatry, University of Utah School of Medicine, Salt Lake City, Utah, USA
| | - Danielle Boxer
- Department of Psychiatry, University of Utah School of Medicine, Salt Lake City, Utah, USA
| | - Calen J. Smith
- Department of Psychiatry, University of Utah School of Medicine, Salt Lake City, Utah, USA
| | - Perry F. Renshaw
- Department of Psychiatry, University of Utah School of Medicine, Salt Lake City, Utah, USA
- U.S. Department of Veterans Affairs, Rocky Mountain Mental Illness Research, Education and Clinical Center, Salt Lake City, Utah, USA
| | - Deborah A. Yurgelun-Todd
- Department of Psychiatry, University of Utah School of Medicine, Salt Lake City, Utah, USA
- U.S. Department of Veterans Affairs, Rocky Mountain Mental Illness Research, Education and Clinical Center, Salt Lake City, Utah, USA
| | - Douglas G. Kondo
- Department of Psychiatry, University of Utah School of Medicine, Salt Lake City, Utah, USA
- U.S. Department of Veterans Affairs, Rocky Mountain Mental Illness Research, Education and Clinical Center, Salt Lake City, Utah, USA
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15
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Xu P, Sun Y. Risk factors for suicidal attempt in patients with the melancholic subtype of depressive disorder: Implication for nursing care. Medicine (Baltimore) 2022; 101:e29713. [PMID: 35960126 PMCID: PMC9371559 DOI: 10.1097/md.0000000000029713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
The incidence of suicide in patients with depressive order is much higher than other population. We aimed to evaluate the current status and risk of suicidal attempt in patients with the melancholic subtype of depressive disorder, to provide evidence for the clinical management and nursing care of depressive disorder. Patients diagnosed as the melancholic subtype of depressive disorder and treated in our hospital from June 1, 2018 to August 31, 2021 were included. The characteristics of included patients were collected and analyzed. Pearson correlation analysis and logistic regression analysis with odd ratio and 95% confidence interval were conducted to analyze the influencing factors of suicidal attempt in patients with the melancholic subtype of depressive disorder. A total of 446 patients with melancholic subtype of depressive disorder were included, the incidence of suicidal attempt was 18.83%. Pearson correlation analysis indicated that gender (R = 0.611), alcohol drinking (R = 0.719), living situation (R = 0.812), number of previous admission to hospital (R = 0.547), sleep disorder (R = 0.612) and frequent depressive episodes (R = 0.559) were all correlated with the suicidal attempt in patients with melancholic subtype of depressive disorder (all P < 0.05). Logistic regression analysis showed that female (OR 3.115, 95%CI 2.493-3.906), alcohol drinking(OR 1.946, 95%CI 1.684-2.763), living alone (OR 2.401, 95%CI 1.915-3.008), number of previous admission to hospital ≥ 3 (OR 2.342, 95%CI 1.601-2.742), sleep disorder (OR 1.821, 95%CI 1.328-2.215) and frequent depressive episodes (OR 3.128, 95%CI 2.421-3.779) were the independent risk factors of suicidal attempt (all P < 0.05). Suicidal attempt is common in the patients with melancholic subtype of depressive disorder, and there are many related risk factors for suicidal attempt in patients with the melancholic subtype of depressive disorder.
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Affiliation(s)
- Pengfei Xu
- Department of Psychiatry, Tianjin Anding Hospital
| | - Ying Sun
- Department of Psychiatry, Tianjin Anding Hospital
- *Correspondence: Ying Sun, No. 13, Liulin Road, Hexi District, Tianjin, China (e-mail: )
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Asghar J, Tabasam M, Althobaiti MM, Adnan Ashour A, Aleid MA, Ibrahim Khalaf O, Aldhyani THH. A Randomized Clinical Trial Comparing Two Treatment Strategies, Evaluating the Meaningfulness of HAM-D Rating Scale in Patients With Major Depressive Disorder. Front Psychiatry 2022; 13:873693. [PMID: 35722557 PMCID: PMC9197773 DOI: 10.3389/fpsyt.2022.873693] [Citation(s) in RCA: 1] [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: 02/11/2022] [Accepted: 05/02/2022] [Indexed: 12/28/2022] Open
Abstract
INTRODUCTION Due to the complexity of symptoms in major depressive disorder (MDD), the majority of depression scales fall short of accurately assessing a patient's progress. When selecting the most appropriate antidepressant treatment in MDD, a multidimensional scale such as the Hamilton Depression Rating scale (HAM-D) may provide clinicians with more information especially when coupled with unidimensional analysis of some key factors such as depressed mood, altered sleep, psychic and somatic anxiety and suicidal ideation etc. METHODS HAM-D measurements were carried out in patients with MDD when treated with two different therapeutic interventions. The prespecified primary efficacy variables for the study were changes in score from baseline to the end of the 12 weeks on HAM-D scale (i.e., ≤ 8 or ≥50% response). The study involved three assessment points (baseline, 6 weeks and 12 weeks). RESULTS Evaluation of both the absolute HAM-D scores and four factors derived from the HAM-D (depressed mood, sleep, psychic and somatic anxiety and suicidal ideation) revealed that the latter showed a greater promise in gauging the anti-depressant responses. CONCLUSION The study confirms the assumption that while both drugs may improve several items on the HAM-D scale, the overall protocol may fall short of addressing the symptoms diversity in MDD and thus the analysis of factor (s) in question might be more relevant and meaningful.
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Affiliation(s)
- Junaid Asghar
- Faculty of Pharmacy, Gomal University, D. I. Khan, Pakistan
| | - Madiha Tabasam
- Faculty of Pharmacy, Gomal University, D. I. Khan, Pakistan
| | | | - Amal Adnan Ashour
- Department of Oral & Maxillofacial Surgery, Taif University, Taif, Saudi Arabia
| | - Mohammed A Aleid
- College of Education, King Faisal University, Al-Ahsa, Saudi Arabia
| | - Osamah Ibrahim Khalaf
- Al-Nahrain Nanorenewable Energy Research Center, Al-Nahrain University, Baghdad, Iraq
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Mandal T, Bairy LK, Sharma PSVN, Valaparla VL. Impact of gender, depression severity and type of depressive episode on efficacy and safety of escitalopram: an observational study on major depressive disorder patients in southern India. THE EGYPTIAN JOURNAL OF NEUROLOGY, PSYCHIATRY AND NEUROSURGERY 2021. [DOI: 10.1186/s41983-021-00302-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Antidepressant response is a complex trait influenced by clinical, demographic and genetic factors.
Objectives
To explore the influences of baseline depression severity, gender and type of depressive episode on efficacy and safety of escitalopram (10–20 mg/day) in South Indian patients with major depressive disorder (MDD).
Methods
The study was conducted on 18–65-year-old patients (n = 151) suffering from a first or recurrent episode of MDD with a 17-item Hamilton Depression Rating Scale (HDRS-17) score of ≥ 18 at baseline. Efficacy assessments were done using HDRS-17, Montgomery-Asberg Depression Rating Scale (MADRS), and Clinical Global Impression (CGI) at baseline and weeks 4, 8 and 12. Patients were monitored for adverse drug reactions (ADRs). Clinical outcomes were compared among various groups based on gender, type of depressive episode (first or recurrent episode) and baseline HDRS-17 scores (moderate depression—score between 17 and 23; severe depression—score ≥ 24).
Results
Among the 148 subjects who completed the 12-week study, 43.9% and 42.6% achieved response and remission, respectively. The decline in HDRS-17 and MADRS scores from baseline was significant (p value < 0.05) at all follow-up visits and a similar pattern was seen with CGI. Efficacy outcomes were better in the moderate baseline depression group compared with severe depression. There were no associations of efficacy with gender and type of depressive episode. A total of 247 adverse drug reactions (ADR) were reported and 119 (80.41%) subjects experienced at least one ADR during the study period. No serious ADR was reported. Male patients experienced more ADRs compared with females. The safety profile of escitalopram was similar across various groups based on baseline depression severity and type of depressive episode.
Conclusion
The study revealed that escitalopram is efficacious in south Indian MDD patients with a favourable safety profile. The efficacy was influenced by baseline depression severity whereas more ADRs were reported by male patients.
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Reddy A, Mansuri Z, Vadukapuram R, Trivedi C. Increased Suicidality and Worse Outcomes in MDD Patients With OSA: A Nationwide Inpatient Analysis of 11 Years From 2006 to 2017. J Acad Consult Liaison Psychiatry 2021; 63:46-52. [PMID: 34111622 DOI: 10.1016/j.jaclp.2021.05.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Revised: 05/02/2021] [Accepted: 05/26/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Major depressive disorder (MDD) is the most common psychiatric disorder characterized by changes in mood, cognition, and physical symptoms. MDD has an approximate 18% prevalence of comorbid OSA. Several studies have looked into plausible mechanisms that have shown a strong relationship between OSA and MDD. OBJECTIVES The primary objective of this study was to compare suicidal ideation/attempt among MDD patients with and without a comorbid diagnosis of OSA. The secondary objective was to compare the length of stay, total hospital charge, recurrent or severity of depression, and clinical comorbidities. METHODS Data were obtained from the National (Nationwide) Inpatient Sample dataset from 2006 to 2017. For data collection, we queried for all adult patients (age ≥ 18 y), with MDD as a primary indication of admission. Further, we categorized MDD patients with and without a secondary diagnosis of OSA. To reduce the imbalance in baseline characteristics between the groups, we performed one to one age-gender matching between MDD patients with and without OSA. RESULTS In the matched cohort, 79,308 patients were included in MDD with OSA and 78,792 patients in the MDD without OSA group. MDD patients with OSA were more likely to be racially white (80% vs 75%, P < 0.001), and to have more clinical comorbidities (hypertension, heart failure, obesity, and chronic lung disease). Prevalence of recurrent type of depression (77% vs 69%, P < 0.001) and moderate to severe depression (72% vs 68%, P < 0.001) was more likely in the MDD with OSA group. Further, suicidality (composite of suicidal ideation/attempt) was more in MDD with OSA (49.5%) compared to MDD without OSA (41.8%) (P < 0.001). In the multivariate analysis, MDD with OSA was associated with higher odds of suicidal ideation/act compared to MDD without OSA (adjusted odds ratio: 1.27, P < 0.001). The total length of stay was longer in the MDD with OSA group (7.4 vs 6.9 d, P < 0.001). CONCLUSIONS In our study, poorer outcomes were observed in patients with MDD and OSA. Hence, clinicians should be vigilant for symptoms of OSA in patients with recurrent MDD or treatment-resistant MDD. We recommend that a thorough suicide risk assessment should be conducted in MDD patients with OSA, and validated questionnaires should be a part of the evaluation.
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Affiliation(s)
- Abhishek Reddy
- Department of Psychiatry, Virginia Tech Carilion School of Medicine, Roanoke, VA.
| | - Zeeshan Mansuri
- Department of Psychiatry, Boston Children's Hospital/Harvard Medical School, Boston, MA
| | - Ramu Vadukapuram
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Chintan Trivedi
- Department of Research, St David's Medical Center, Austin, TX
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Basha EA, Mengistu BT, Engidaw NA, Wubetu AD, Haile AB. Suicidal Ideation and Its Associated Factors Among Patients with Major Depressive Disorder at Amanuel Mental Specialized Hospital, Addis Ababa, Ethiopia. Neuropsychiatr Dis Treat 2021; 17:1571-1577. [PMID: 34045859 PMCID: PMC8149284 DOI: 10.2147/ndt.s311514] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 05/04/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Suicidal ideation is thinking about suicide/serving as the agent of one's own death. Patients with a major depressive disorder are the highest group which are affected by suicidal ideation. It is a pre-condition for suicide attempts and to commit suicide among major depressive patients. Suicidal behavior and major depressive disorder have been becoming the main attention in recent years. In Ethiopia, there is limited knowledge of suicidal ideation among major depressive disorder patients and the factors of suicidal ideation are also limited. OBJECTIVE This study assessed the prevalence of suicidal ideation and its associated factors among major depressive disorder patients at Amanuel Mental Specialized Hospital, Ethiopia. METHODS A cross-sectional study was conducted from March 1-30, 2019. A total of 337 major depressive disorder patients were successfully interviewed using structured and pre-tested questionnaires. A systematic random sampling technique was applied. Logistic regression was applied to identify factors of suicidal ideation. Statistical significance was considered at P-value < 0.05. RESULTS In this study, the prevalence of suicidal ideation among major depressive disorder patients was 48.4%. Being female (AOR 2.4, 95% CI=1.40, 4.25), family history of suicide (AOR 3.2, 95% CI=1.26, 8.11), and having poor social support (AOR 4.2, 95% CI=2.29, 7.59) were significantly associated with suicidal ideation among patients with major depressive disorder. CONCLUSION The prevalence of suicidal ideation among major depressive disorder patients was relatively high. Hence, due attention should be given to the screening of suicidal ideation for all patients with major depressive disorder to initiate timely interventions.
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Affiliation(s)
- Elyas Adamsu Basha
- Department of Nursing, College of Health Science, Debre Berhan University, Debre Berhan, Ethiopia
| | - Bethelehem Taye Mengistu
- Department of Nursing, College of Health Science, Debre Berhan University, Debre Berhan, Ethiopia
| | - Nigus Alemnew Engidaw
- Department of Nursing, College of Health Science, Debre Berhan University, Debre Berhan, Ethiopia
| | - Abate Dargie Wubetu
- Department of Nursing, College of Health Science, Debre Berhan University, Debre Berhan, Ethiopia
| | - Assalif Beyene Haile
- Department of Midwifery, College of Health Science, Debre Berhan University, Debre Berhan, Ethiopia
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The association of clinical correlates, metabolic parameters, and thyroid hormones with suicide attempts in first-episode and drug-naïve patients with major depressive disorder comorbid with anxiety: a large-scale cross-sectional study. Transl Psychiatry 2021; 11:97. [PMID: 33542178 PMCID: PMC7862235 DOI: 10.1038/s41398-021-01234-9] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2020] [Revised: 12/09/2020] [Accepted: 12/16/2020] [Indexed: 01/30/2023] Open
Abstract
The associated factors of suicide attempts in patients with major depressive disorder (MDD) comorbid with anxiety remains unclear. To the best of our knowledge, this is the first study with a large sample size that examines the risk factors of suicide attempts in first-episode drug-naïve (FEND) MDD patients comorbid with anxiety and includes clinical correlates, metabolic parameters, and thyroid hormone levels. A total of 1718 FEDN MDD patients were enrolled. The Hamilton Depression Scale (HAMD), Hamilton Anxiety Scale (HAMA), and Positive and Negative Syndrome Scale (PANSS) were used to assess the symptoms of patients. Metabolic parameters and thyroid hormone levels were measured. The prevalence of suicide attempts in MDD patients comorbid anxiety symptoms was 24.28%, which was 9.51 times higher than that in MDD patients without anxiety symptoms (3.25%). Compared to non-attempters, MDD patients with anxiety symptoms who attempted suicide scored higher on HAMD and HAMA, and had higher systolic blood pressure, higher levels of thyroid stimulating hormone (TSH), and thyroid peroxidases antibody (TPOAb), which were also correlated with suicide attempts in MDD patients comorbid anxiety symptoms. The combination of HAMA score, HAMD score, and TSH could differentiate suicide attempters from non-suicide attempters. Further, the age of onset, illness duration, BMI, TSH, and TPOAb were associated with the times of suicide attempts in MDD patients comorbid anxiety symptoms. Our results demonstrate high prevalence of suicide attempts in MDD patients comorbid anxiety symptoms. Several clinical correlates, metabolic parameters, and thyroid hormones function contribute to the suicide attempts in MDD patients comorbid anxiety symptoms.
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21
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Liang S, Zhang J, Zhao Q, Wilson A, Huang J, Liu Y, Shi X, Sha S, Wang Y, Zhang L. Incidence Trends and Risk Prediction Nomogram for Suicidal Attempts in Patients With Major Depressive Disorder. Front Psychiatry 2021; 12:644038. [PMID: 34248696 PMCID: PMC8261285 DOI: 10.3389/fpsyt.2021.644038] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2020] [Accepted: 05/24/2021] [Indexed: 11/30/2022] Open
Abstract
Background: Major depressive disorder (MDD) is often associated with suicidal attempt (SA). Therefore, predicting the risk factors of SA would improve clinical interventions, research, and treatment for MDD patients. This study aimed to create a nomogram model which predicted correlates of SA in patients with MDD within the Chinese population. Method: A cross-sectional survey among 474 patients was analyzed. All subjects met the diagnostic criteria of MDD according to the International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10). Multi-factor logistic regression analysis was used to explore demographic information and clinical characteristics associated with SA. A nomogram was further used to predict the risk of SA. Bootstrap re-sampling was used to internally validate the final model. Integrated Discrimination Improvement (IDI) and Akaike Information Criteria (AIC) were used to evaluate the capability of discrimination and calibration, respectively. Decision Curve Analysis (DCA) and the Receiver Operating Characteristic (ROC) curve was also used to evaluate the accuracy of the prediction model. Result: Multivariable logistic regression analysis showed that being married (OR = 0.473, 95% CI: 0.240 and 0.930) and a higher level of education (OR = 0.603, 95% CI: 0.464 and 0.784) decreased the risk of the SA. The higher number of episodes of depression (OR = 1.854, 95% CI: 1.040 and 3.303) increased the risk of SA in the model. The C-index of the nomogram was 0.715, with the internal (bootstrap) validation sets was 0.703. The Hosmer-Lemeshow test yielded a P-value of 0.33, suggesting a good fit of the prediction nomogram in the validation set. Conclusion: Our findings indicate that the demographic information and clinical characteristics of SA can be used in a nomogram to predict the risk of SA in Chinese MDD patients.
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Affiliation(s)
- Sixiang Liang
- Beijing Key Laboratory of Mental Disorders, The National Clinical Research Center for Mental Disorders, The Advanced Innovation Center for Human Brain Protection, Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Jinhe Zhang
- Peking University HuiLongGuan Clinical Medical School, Beijing HuiLongGuan Hospital, Beijing, China
| | - Qian Zhao
- Beijing Key Laboratory of Mental Disorders, The National Clinical Research Center for Mental Disorders, The Advanced Innovation Center for Human Brain Protection, Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Amanda Wilson
- Department of Psychology, Faculty of Health and Life Sciences, De Montfort University, Leicester, United Kingdom
| | - Juan Huang
- Beijing Key Laboratory of Mental Disorders, The National Clinical Research Center for Mental Disorders, The Advanced Innovation Center for Human Brain Protection, Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Yuan Liu
- Beijing Key Laboratory of Mental Disorders, The National Clinical Research Center for Mental Disorders, The Advanced Innovation Center for Human Brain Protection, Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Xiaoning Shi
- Beijing Key Laboratory of Mental Disorders, The National Clinical Research Center for Mental Disorders, The Advanced Innovation Center for Human Brain Protection, Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Sha Sha
- Beijing Key Laboratory of Mental Disorders, The National Clinical Research Center for Mental Disorders, The Advanced Innovation Center for Human Brain Protection, Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Yuanyuan Wang
- Department of Psychology, Faculty of Health and Life Sciences, De Montfort University, Leicester, United Kingdom
| | - Ling Zhang
- Beijing Key Laboratory of Mental Disorders, The National Clinical Research Center for Mental Disorders, The Advanced Innovation Center for Human Brain Protection, Beijing Anding Hospital, Capital Medical University, Beijing, China
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22
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Borentain S, Nash AI, Dayal R, DiBernardo A. Patient-reported outcomes in major depressive disorder with suicidal ideation: a real-world data analysis using PatientsLikeMe platform. BMC Psychiatry 2020; 20:384. [PMID: 32703173 PMCID: PMC7376651 DOI: 10.1186/s12888-020-02758-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2019] [Accepted: 06/23/2020] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND The current analysis utilized data collected via an online patient community platform, PatientsLikeMe (PLM) to compare patient-reported experiences in patients with major depressive disorder (MDD) with suicidal ideation (MDSI) to those with MDD but without suicidal ideation. METHODS PLM members who joined PLM between May-2007 and February-2018 and reported a diagnosis of MDD were included. The MDSI cohort included patients with MDD who reported at least one suicide-related symptom at a severity greater than "none". Demographics, comorbidities, symptoms, and side-effects were compared between MDSI and MDD cohorts. Factors correlated with suicidal ideation (SI) were determined by a random forest procedure. RESULTS Patients in the MDSI cohort (n = 266) were younger (median age, 36 vs 44 years) with an earlier disease onset (before 30 years, 83% vs 71%), and a longer diagnosis latency (median, 4 vs 2 years) vs patients in the MDD cohort (n = 11,963). Majority of patients were women in both cohorts (73% vs 83%). Median number of psychiatric comorbidities was higher in the MDSI cohort (4 vs 3). Unprompted symptoms (e.g., loneliness, feeling of hopelessness, social anxiety, impulsivity, and self-hating thoughts) were more frequent in the MDSI cohort. Hopelessness, loneliness, anhedonia, social anxiety, and younger age were highly correlated with suicidal ideation. CONCLUSIONS This analysis utilized patient-reported data to better understand symptoms, experiences, and characteristics of patients with MDSI compared to patients with MDD. The results identified various risk factors correlated with suicidal ideation that may help guide clinical judgement for patients with MDD who may not voluntarily report suicidal ideation.
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Affiliation(s)
| | - Abigail I. Nash
- grid.497530.c0000 0004 0389 4927Janssen Scientific Affairs, LLC, Titusville, NJ USA
| | - Rachna Dayal
- grid.497530.c0000 0004 0389 4927Janssen Research & Development, LLC, Titusville, NJ USA
| | - Allitia DiBernardo
- grid.497530.c0000 0004 0389 4927Janssen Research & Development, LLC, Titusville, NJ USA
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