Suicide attempters: Clinical characteristics and management

2016 ◽  
Vol 33 (S1) ◽  
pp. S601-S601
Author(s):  
E. Gattoni ◽  
A. Feggi ◽  
C. Gramaglia ◽  
P. Bergamasco ◽  
I. Coppola ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Suicide Attempt ◽  
Clinical Characteristics ◽  
Depressive Disorders ◽  
Attempted Suicide ◽  
Rating Scale ◽  
Suicide Attempts ◽  
Suicidal Risk ◽  
Suicide Attempters ◽  
History Of

BackgroundSuicide attempts, defined as self-inflicted, potentially injurious behaviors with a nonfatal outcome, and with evidence of intent to die are extremely prevalent. Literature suggests that suicide is more common among males, while attempted suicide is more frequent among females. Depression, mental disorders, substance use disorders and history of suicidal behavior are important risk factors for suicide: the risk of suicide attempt is 3 to 12 times higher in psychiatric patients than in the general population.AimThe aim of our study was to compare severity of depressive symptoms in a sample of suicide attempters with a diagnosis of bipolar and related disorders or depressive disorders and in a sample of sex- and diagnosis-matched patients who do not commit a suicide attempt. The severity of attempted suicide and the suicidal risk in the hospital will be assessed as well.Material and methodsWe collected a sample of inpatients who committed a suicide attempt during 2015. For each attempter, we selected another sex- and diagnosis-matched patient with no history of attempted suicide. Socio-demographic and clinical characteristics of the sample were gathered. Assessment included: Montgomery-Asberg Depression Rating Scale (MADRS) for severity of depressive symptoms in both groups, Suicide Intent Scale (SIS) for the severity of attempted suicide and the suicidal risk with a nurse assessment for suicide.ResultsData collecting is still ongoing. We expected to find more severe symptoms in patients who attempted suicide. Clinical implication will be discussed.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Resilience and attempted suicide in depressed patients

2017 ◽  
Vol 41 (S1) ◽  
pp. s887-s887
Author(s):  
E. Gattoni ◽  
C. Gramaglia ◽  
D. Marangon ◽  
A. Feggi ◽  
C. Delicato ◽  
...  
Keyword(s):  
Coping Strategies ◽  
Clinical Characteristics ◽  
Depressive Disorders ◽  
Attempted Suicide ◽  
Suicide Ideation ◽  
Rating Scale ◽  
Suicide Attempts ◽  
Depressed Patients ◽  
Resilience Scale ◽  
Depressive Episodes

IntroductionAmong the patients, 6.6% with past-year major depressive disorders attempt suicide in their life. Resilience (the ability to respond positively to adversity) and coping strategies (the ability to manage living stresses) may be protective factors against suicide ideation and behavior. A study conducted on 100 abstinent substance dependent patients suggested that suicide attempters had significantly lower resilience scale scores. Other authors demonstrated that intrinsic religiosity, resilience, quality of life were associated with previous suicide attempts in depressed patients.AimTo examine the correlation among resilience, coping strategies and sociodemographic and clinical characteristics in depressed patients.MethodsFrom December 1st 2014 to December 31st 2015 we recruited inpatients and outpatients aged > 18 years with a diagnosis of depression (current or past). At baseline, patients were assessed with Montgomery Asberg Depression Rating Scale, Resilience Scale for Adult and Brief-COping with problems experienced; sociodemographic and clinical characteristics were gathered. Follow-up was conducted after 1 year in order to assess the possible presence of further depressive episodes and suicide attempts. Analysis was performed with SPSS.Results and discussionData collection are still ongoing; results and implications will be discussed. We expect to find higher attempted suicide rates in patients with lower resilience and less coping strategies.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Neuropsychological deficits in past suicide attempters with varying levels of depression severity

2014 ◽  
Vol 44 (14) ◽  
pp. 2965-2974 ◽  
Author(s):  
J. G. Keilp ◽  
S. R. Beers ◽  
A. K. Burke ◽  
N. M. Melhem ◽  
M. A. Oquendo ◽  
...  
Keyword(s):  
Working Memory ◽  
Major Depression ◽  
Rating Scale ◽  
Suicide Attempts ◽  
Past History ◽  
Clinical State ◽  
Suicide Attempters ◽  
History Of ◽  
Attention Memory ◽  
Interference Processing

BackgroundOur previous work identified deficits in interference processing and learning/memory in past suicide attempters who were currently depressed and medication-free. In this study, we extend this work to an independent sample studied at various stages of illness and treatment (mild symptoms, on average) to determine if these deficits in past suicide attempters are evident during a less severe clinical state.MethodA total of 80 individuals with a past history of major depression and suicide attempt were compared with 81 individuals with a history of major depression and no lifetime suicide attempts on a battery of neurocognitive measures assessing attention, memory, abstract/contingent learning, working memory, language fluency and impulse control.ResultsPast attempters performed more poorly in attention, memory and working memory domains, but also in an estimate of pre-morbid intelligence. After correction for this estimate, tests that had previously distinguished past attempters – a computerized Stroop task and the Buschke Selective Reminding Test – remained significantly worse in attempters. In a secondary analysis, similar differences were found among those with the lowest levels of depression (Hamilton Depression Rating Scale score <10), suggesting that these deficits may be trait markers independent of current symptomatology.ConclusionsDeficits in interference processing and learning/memory constitute an enduring defect in information processing that may contribute to poor adaptation, other higher-order cognitive impairments and risk for suicidal behavior.

Increased risk of attempted suicide in Australian veterans is associated with total and permanent incapacitation, unemployment and posttraumatic stress disorder severity

2017 ◽  
Vol 52 (6) ◽  
pp. 552-560 ◽  
Author(s):  
Katelyn Kerr ◽  
Madeline Romaniuk ◽  
Sarah McLeay ◽  
Andrew Khoo ◽  
Michael T Dent ◽  
...  
Keyword(s):  
Posttraumatic Stress Disorder ◽  
Suicide Attempt ◽  
Posttraumatic Stress ◽  
Attempted Suicide ◽  
Suicide Attempts ◽  
Stress Disorder ◽  
Self Report ◽  
Depression Symptoms ◽  
Increased Risk ◽  
History Of

Background: Military veterans have higher rates of suicidality and completed suicides compared to the general population. Previous research has demonstrated suicidal behaviour is higher in US combat veterans who are younger, suffer from posttraumatic stress disorder, depression and anxiety and score lower on measures of health. However, research on predictors of suicide for Australian veterans is limited. The aim of this study was to identify significant demographic and psychological differences between veterans with posttraumatic stress disorder who had attempted suicide and those with posttraumatic stress disorder who had not, as well as determine predictors of suicide attempts within an Australian cohort. Methods: A retrospective analysis was conducted on 229 ex-service personnel diagnosed with posttraumatic stress disorder who had attended a Military Service Trauma Recovery Day Program as outpatients at Toowong Private Hospital from 2007 to 2014. Patients completed a battery of mental health self-report questionnaires assessing symptoms of posttraumatic stress disorder, alcohol use, anger, depression, anxiety and quality of life. Demographic information and self-reported history of suicide attempts were also recorded. Results: Results indicated the average age was significantly lower, and the rates of posttraumatic stress disorder, anger, anxiety and depression symptoms were significantly higher in those veterans with history of a suicide attempt. Multivariate logistic regression analyses indicated posttraumatic stress disorder symptom severity, unemployment or total and permanent incapacity pension status significantly predicted suicide attempt history. Conclusion: Among a cohort of Australian veterans with posttraumatic stress disorder, psychopathology severity, unemployment and total and permanent incapacity status are significantly associated with suicidality. This study highlights the importance of early identification of posttraumatic stress disorder and psychopathology, therapeutic and social engagement, and prioritisation of tangible employment options or meaningful and goal-directed activities for veterans deemed unable to work.

Factors Associated with Repeated Suicide Attempts

Crisis ◽  
2009 ◽  
Vol 30 (2) ◽  
pp. 73-78 ◽  
Author(s):  
Carlos Filinto da Silva Cais ◽  
Sabrina Stefanello ◽  
Marisa Lúcia Fabrício Mauro ◽  
Gisleine Vaz Scavacini de Freitas ◽  
Neury José Botega
Keyword(s):  
Clinical Characteristics ◽  
Attempted Suicide ◽  
Intervention Study ◽  
Suicide Attempts ◽  
Treatment Strategies ◽  
Specific Treatment ◽  
Suicide Attempters ◽  
Psychometric Scales ◽  
Standardized Interview ◽  
First Time

Background: This study compares sociodemographic and clinical characteristics of 102 first-time hospital-treated suicide attempters (first-evers) with a group of 101 repeat suicide attempters (repeaters) consecutively admitted to a general hospital in Brazil, during the intake phase of the WHO Multisite Intervention Study on Suicidal Behaviors (SUPRE-MISS). Aims: To compare sociodemographic and clinical characteristics of first-time hospital-treated suicide attempters (first-evers) with a group of repeat suicide attempters (repeaters). Methods: A standardized interview and psychometric scales were administered to all patients. Results: Repetition was associated with being of female sex (OR = 2.7; 95% confidence interval (CI) = 1.2–6.2), a housewife (OR = 3.8; 95% CI = 1.2–11.8), and having a score above median on the Beck Depression Inventory (OR = 5.2; 95% CI = 1.7–15.6). Conclusions: The findings suggest that repeaters, namely, depressed housewives who have attempted suicide previously, need specific treatment strategies in order to avoid future suicide attempts.

scholarly journals Risk Factors for Serious Suicide Attempts: Difference Between Older and Younger Attempters in the Emergency Department

2021 ◽  
Vol 11 ◽  
Author(s):  
Dong Wook Kim ◽  
Seo Eun Cho ◽  
Jae Myeong Kang ◽  
Soo Kyun Woo ◽  
Seung-Gul Kang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Older Adults ◽  
Emergency Department ◽  
Suicide Attempt ◽  
Old Age ◽  
Rating Scale ◽  
Suicide Attempts ◽  
Interpersonal Stress ◽  
Suicide Attempters ◽  
Male Sex

Objective: Suicide attempts of the older adults are known to be more serious than that of the younger adults. Despite its major social impact in South Korea, the behavioral mechanism of serious suicide attempt (SSA) in old people remains to be elucidated. Thus, we investigated the risk factors for SSA in older and younger suicide attempters in the emergency department.Methods: Demographic data, clinical information, and the level of seriousness of suicide with Risk Rescue Rating Scale were compared between older (age ≥65) and younger (age &lt;65) adults who visited the emergency department for a suicide attempt. Regression analyses were performed to identify the risk factors for SSA in these two groups.Results: Among 370 patients, 37 were older adults (10%; aged 74.41 ± 6.78), more likely to have another medical disease (p &lt; 0.001), and a higher suicide completion rate (16.2 vs. 5.4%, p = 0.023). In the younger group, old age (B = 0.090, p &lt; 0.001), male sex (B = −0.038, p = 0.019), and impression of schizophrenia (B = 0.074, p = 0.027) were associated with a higher risk-rescue ratio and interpersonal stress condition was associated with a lower risk-rescue ratio (B = −0.045, p = 0.006). In the older group, however, no variables were included significant in the regression model for the Risk Rescue Rating Scale.Conclusions: Demographic and clinical factors such as old age, male sex, interpersonal stress, and impression of schizophrenia were associated with lethality in the younger suicide attempters. However, no factors were associated with SSA in the older adult group. Different mechanisms may underly the lethality in old age suicide.

scholarly journals Connectome Analysis of Brain Functional Network Alterations in Depressive Patients with Suicidal Attempt

2019 ◽  
Vol 8 (11) ◽  
pp. 1966 ◽  
Author(s):  
Jun-Cheng Weng ◽  
Yu-Syuan Chou ◽  
Yuan-Hsiung Tsai ◽  
Chun-Te Lee ◽  
Ming-Hong Hsieh ◽  
...  
Keyword(s):  
Suicide Attempt ◽  
Depressive Disorders ◽  
Rating Scale ◽  
Suicide Attempts ◽  
Imaging System ◽  
Brain Regions ◽  
Healthy Controls ◽  
Depressed Patients ◽  
The Brain ◽  
Healthy Participants

Our study aimed to clarify the neuroimaging correlates of suicide attempt by comparing differences in functional magnetic resonance imaging (fMRI) among depressed suicide attempters, depressed patients without suicide attempt history, and healthy controls through comprehensive and novel fMRI analyses and methods in the same study population. The association between depression severity and aspects of the brain imaging was also discussed. Our study recruited 109 participants who were assigned to three groups: 33 depressed patients with suicide attempt (SA), 32 depressed patients without suicide attempt (NS), and 44 healthy controls (HC). All participants were scanned using a 3 T MRI imaging system to obtain resting-state functional images. In seed-based correlation analysis, we found altered functional connectivity in some brain regions of the SA compared with the NS or HC, especially in the hippocampus and thalamus. In the voxel-based analysis, our results showed differential activation and regional homogeneity of the temporal lobe and several brain regions in the SA compared with the NS and HC. We also found that some brain areas correlated with the Hamilton Depression Rating Scale (HAM-D), anxiety, and depression scores, especially in the frontal and temporal lobes. Graph theoretical analysis (GTA) and network-based statistical (NBS) analyses revealed different topological organization as well as slightly better global integration and worse local segregation of the brain network (i.e., more like a random network) in depressed participants compared with healthy participants. We concluded that the brain function of major depressive disorders with and without suicide attempts changed compared with healthy participants.

scholarly journals Suicidal patients in a psychiatric emergency unit: clinical characteristics and aggression profile

2019 ◽  
Vol 41 (1) ◽  
pp. 9-17
Author(s):  
Vítor Crestani Calegaro ◽  
Cleonice Zatti ◽  
Andre Goettems Bastos ◽  
Lucia Helena Machado Freitas
Keyword(s):  
Suicide Attempt ◽  
Clinical Characteristics ◽  
Rating Scale ◽  
Psychiatric Emergency ◽  
Future Research ◽  
Recent Attempt ◽  
Prior History ◽  
History Of ◽  
Psychiatric Rating Scale ◽  
Suicidal Patients

Abstract Objective To explore and describe a profile of patients admitted to a psychiatric emergency facility, comparing patients with and without a recent suicide attempt in terms of their clinical characteristics and aggression. Methods This was an exploratory comparative study where patients were assessed using the Brief Psychiatric Rating Scale (BPRS) and the Overt Aggression Scale (OAS). Participants with a suicide attempt in the last 24 hours (SA) were compared to participants with a prior history of suicide attempt but no recent attempt (PHSA). Results 63 individuals (SA: 26; PHSA: 37) were selected. Both groups had similar demographic and clinical characteristics. The most prevalent diagnoses were mood (57.1%) and personality (50.8%) disorders. The majority of patients in both groups had a history of aggression episodes. Physical aggression in the week prior to admission was more prevalent in the PHSA group (51.4 vs. 19.2%, p = 0.017). The PHSA group also presented higher activation scores (p = 0.025), while the SA group presented higher affect scores on BPRS dimensions (p = 0.002). Conclusion The majority of individuals with a history of suicide attempt also presented a history of aggression. Inpatients with recent suicide attempt were hospitalized mainly due to the risk of suicide, while those with no recent suicide attempt were hospitalized mainly due to the risk of hetero-aggression. These findings support the hypothesis of an aggressive profile in suicidal patients and may open up a path for future research.

Prolactin Response to Fenfluramine and Suicide Attempt Lethality in Major Depression

1996 ◽  
Vol 168 (3) ◽  
pp. 324-329 ◽  
Author(s):  
Kevin M. Malone ◽  
Elizabeth M. Corbitt ◽  
Shuhua Li ◽  
J. John Mann
Keyword(s):  
Suicide Attempt ◽  
Suicide Attempts ◽  
Challenge Test ◽  
Major Depressive ◽  
Suicide Attempters ◽  
Lifetime History ◽  
Serotonin System ◽  
History Of ◽  
Serotonergic Function ◽  
Prolactin Response

BackgroundThis study employed an alternative method for assessing serotonergic function to further evaluate our finding that cerebrospinal fluid (CSF) 5-hydroxyindole acetic acid (5-HIAA) in depressed suicide attempters with a lifetime history of higher lethality suicide attempts is significantly lower compared to depressed patients who have a history of low lethality suicide attempts.MethodWe used dl-fenfluramine (60 mg) as a neuroendocrine probe to examine the serotonin system in 41 in-patients with a DSM–III–R major depressive episode, divided into two groups on the basis of a lifetime history of high or low lethality suicide attempts. Fenfluramine challenge test outcome was defined as the maximum prolactin response in the five hours following fenfluramine.ResultsPatients with a history of a higher lethality suicide attempt had a significantly lower prolactin response to fenfluramine, even when controlling for cortisol, age, sex, weight, comorbid cluster B personality disorder, pharmacokinetic and menstrual cycle effects.ConclusionsThe data provide further support for the hypothesis that serotonin dysfunction is associated with more lethal suicide attempts, and suggests that higher lethality suicide attempters or failed suicides resemble completed suicides both behaviourally and biochemically.

scholarly journals History of suicide attempts and COVID-19 infection in Veterans with schizophrenia or schizoaffective disorder: moderating effects of age and body mass index

2021 ◽  
Author(s):  
Olaoluwa O. Okusaga ◽  
Rachel L. Kember ◽  
Gina M. Peloso ◽  
Roseann E. Peterson ◽  
Marijana Vujkovic ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Suicide Attempt ◽  
Body Mass ◽  
Schizoaffective Disorder ◽  
Suicide Attempts ◽  
Medical Center ◽  
Cross Sectional ◽  
Suicide Attempters ◽  
History Of ◽  
The Relationship

Introduction: Relative to the general population, patients with schizophrenia or schizoaffective disorder have higher rates of suicide attempts and mortality from COVID-19 infection. Therefore, determining whether a history of suicide attempt is associated with COVID-19 in patients with schizophrenia or schizoaffective disorder has implications for COVID-19 vulnerability stratification in this patient population. Methods: We carried out cross-sectional analyses of electronic health records (EHR) of veterans with a diagnosis of schizophrenia or schizoaffective disorder that received treatment at any United States Veterans Affairs Medical Center between January 1, 2020 to January 31, 2021. We used logistic regression to estimate unadjusted and adjusted (including age, sex, race, marital status, body mass index (BMI), and a medical comorbidity score) odds ratios (ORs) for COVID-19 positivity in suicide attempters relative to non-attempters. Results: A total of 101,032 Veterans [mean age 56.67 ± 13.13 years; males 91,715 (90.8%)] were included in the analyses. There were 2,703 (2.7%) suicide attempters and 719 (0.7%) patients were positive for COVID-19. The association between history of suicide attempt and COVID-19 positivity was modified by age and BMI, such that the relationship was only significant in patients younger than 59 years, and in obese (BMI ≥ 30) patients (adjusted OR 3.42, 95% CI 2.02 - 5.79 and OR 2.85, 95% CI 1.65 - 4.94, respectively). Conclusions: Higher rates of COVID-19 in young or obese suicide attempters with a diagnosis of schizophrenia or schizoaffective disorder might be due to elevated risk for the infection in this sub-group of patients.

scholarly journals Volumetric MRI analysis of brain structures in patients with history of first and repeated suicide attempts: a cross sectional study

2020 ◽  
Author(s):  
Milda Sarkinaite ◽  
Rymante Gleizniene ◽  
Virginija Adomaitiene ◽  
Kristina Dambrauskiene ◽  
Nijole Raskauskiene ◽  
...  
Keyword(s):  
Suicide Attempt ◽  
Left Hemisphere ◽  
Cortical Thickness ◽  
Suicide Attempts ◽  
Right Hemisphere ◽  
Brain Structures ◽  
Brain Regions ◽  
Cross Sectional ◽  
Suicide Attempters ◽  
History Of

Abstract Background Structural brain changes are found in suicide attempters, as well as in patients with mental disorders. It remains unclear whether the suicidal behavior is related to atrophy of brain regions and how the morphology of specific brain areas is changing with each suicide attempt. This cross-sectional study examined volumetric differences in brain regions among patients with history of first and repeated suicide attempts in comparison to healthy controls (HC). Methods The sample consisted of 56 adults, non-psychotic patients without cognitive impairment and any organic brain disorders hospitalized after first suicide attempt (first SA) (n=29) and more than one suicide attempt (SA>1) during the lifetime (n=27); and 54 adult volunteers without history of mental disorder and suicide attempts, designated as HC. The MRI data were collected using 1.5 T Siemens Avanto scanner. Brain cortical thickness, grey and white matter volumes were measured using FreeSurfer 6.0 automatic segmentation technique. Results In comparison to HC, patients with first SA had 3.5, 3.58 and 4.19% significantly lower mean cortical thickness of the superior and rostral middle frontal areas of the left hemisphere and superior frontal area of the right hemisphere, respectively; 4.09, 4.02 and 4.49% lower mean cortical thickness of the inferior, middle and superior temporal areas of the left hemisphere, respectively. In comparison to HC, patients after SA>1 had a significantly lower mean cortical thickness (from 4.02 to 8.33%) in ten areas of frontal cortex of the left hemisphere and seven areas of the right hemisphere; from 3.90 to 6.04% difference in six areas of temporal cortex in both hemispheres. The comparison of hippocampus volume showed a significantly lower mean volume (7.86 to 9.89%) of left and right parts in patients with SA>1, but not in patients with first SA. Conclusions Hospitalized suicide attempters had lower frontal and temporal cortical thickness and smaller parts of hippocampus than HC; these differences were significantly higher in repeated suicide attempters than in patients with first SA. Our findings suggest that repeated suicidal behavior is associated with intensifying atrophy of specific brain structures, independently of diagnosis of depressive disorders.

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