Resilience and attempted suicide in depressed patients

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.

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Suicide attempters: Clinical characteristics and management

European Psychiatry ◽

10.1016/j.eurpsy.2016.01.2242 ◽

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.

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Dermal reactivity and resilience in a sample of depressed patients

European Psychiatry ◽

10.1016/j.eurpsy.2016.01.2232 ◽

2016 ◽

Vol 33 (S1) ◽

pp. S598-S598

Author(s):

I. Coppola ◽

E. Gattoni ◽

C. Gramaglia ◽

S. Di Marco ◽

C. Delicato ◽

...

Keyword(s):

Depressive Disorders ◽

Attempted Suicide ◽

Suicide Attempts ◽

Bipolar Depression ◽

Response To Treatment ◽

Depressed Patients ◽

Resilience Scale ◽

History Of ◽

Competing Interest ◽

The Impact

BackgroundMental disorders are considered a risk factor for suicide: for example, the lifetime risk of suicide is estimated to be 4%–8% in people with mood disorders. The literature suggests that a history of suicide attempts is significantly related to electrodermal hyporeactivity and that patients with violent suicide attempters exhibit faster habituation of the electrodermal response to repeated neutral tones than patients with non-violent attempts. The impact of depressive symptoms on suicidal ideation may be moderated by resilience. Resilience refers to the ability to maintain o regain mental health despite experiencing adversity. In bipolar and depressive disorders, resilience may influence severity of episodes, frequency of relapse and response to treatment.AimThe objective of our study was to assess the possible correlation among attempted suicide, resilience and dermal reactivity in a sample of depressed patients.MethodsWe recruited patients with depressive disorders and bipolar depression; data about socio-demographic, clinical features, severity of attempted suicide and suicidal risk were gathered. Patients filled in the Resilience Scale for Adult (RSA). Moreover, for each patient we performed the Edor test in order to assess dermal reactivity.ResultsData collection is still ongoing. We expect to find lower levels of resilience in those patients who are hyporeactive and attempted suicide. Moreover, we hypothesize that suicide attempts in the group of hyporeactive patients would be characterized by planning and greater severity. Clinical implications will be discussed.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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Psychosocial and clinical characteristics of depressed patients with metabolic syndrome

European Psychiatry ◽

10.1016/j.eurpsy.2016.01.302 ◽

2016 ◽

Vol 33 (S1) ◽

pp. S158-S159

Author(s):

M. Martinac ◽

D. Babić ◽

M. Pavlović

Keyword(s):

Physical Activity ◽

Metabolic Syndrome ◽

Clinical Characteristics ◽

Complex Disease ◽

Rating Scale ◽

Dietary Habits ◽

Suicide Attempts ◽

Cross Sectional ◽

Depressed Patients ◽

The Metabolic Syndrome

IntroductionDepression is a complex disease associated with sleep, appetite and body weight disturbances as well as with the level of physical activity, all of which may be the risk factors for the development of metabolic disorders. Different physiological mechanisms as well as psychosocial factors such as gender, age, smoking, stress level, nutrition and level of physical activity can affect the metabolic syndrome (MS) development in depressed patients. It is considered that chronic stress causes depression and subsequent poor lifestyle that can lead to the MS development, which results in increased incidence of cardiovascular disease.AimTo determine the psychosocial and clinical characteristics of depressed patients with MS diagnosis.MethodsCross-sectional study was conducted on a sample of 80 patients suffering from depressive disorder. The structured socio-demographic questionnaire, MINI questionnaire, Hamilton Rating Scale for Depression (HAMD-17) and the Clinical Global Impression Scale (CGI) were used as diagnostic instruments. MS diagnosis was made according to NCEP/ATP III criteria.ResultsDepressive patients with MS diagnosis had a significantly higher frequency of suicide attempts, while MS diagnosis significantly more frequently was present in female patients. Increased intake of carbohydrates was an important characteristic of the depression as well as MS.ConclusionFurther studies are needed in order to explain the observed gender differences, and whether interventions focused on the treatment of depression may contribute to the acceptance of healthy lifestyles, particularly in changing of dietary habits, and thus indirectly contribute to the reduction of MS frequency.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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

Journal of Clinical Medicine ◽

10.3390/jcm8111966 ◽

2019 ◽

Vol 8 (11) ◽

pp. 1966 ◽

Cited By ~ 2

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.

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The Role of Past Suicidal Behavior on Current Suicidality: A Retrospective Study in the Israeli Military

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18020649 ◽

2021 ◽

Vol 18 (2) ◽

pp. 649

Author(s):

Leah Shelef ◽

Jessica M Rabbany ◽

Peter M Gutierrez ◽

Ron Kedem ◽

Ariel Ben Yehuda ◽

...

Keyword(s):

Suicide Attempt ◽

Suicidal Behavior ◽

Military Service ◽

Suicide Ideation ◽

Rating Scale ◽

Suicide Attempts ◽

Significant Risk ◽

Significant Risk Factor ◽

Severity Rating ◽

Significant Difference

Past suicide attempts are a significant risk factor for future suicidality. Therefore, the present military-based study examined the past suicidal behavior of soldiers who recently made a severe suicide attempt. Our sample consisted of 65 active-duty soldiers (61.5% males), between the ages of 18 and 28 years old (M = 20.4, SD ± 1.3). The inclusion criterion was a recent severe suicide attempt, requiring at least a 24 h hospitalization. This sample was divided into two groups, according to previous suicidal behavior, namely whether their first suicide attempt was before or after enlistment (n = 25; 38.5% and n = 40; 61.5%, respectively). We then examined the lethality and intent of the recent event in regard to this division. Four measures were used to assess the subjects’ suicidal characteristics: the Columbia Suicide Severity Rating Scale, the Self-Harm Behavior Questionnaire, the Suicidal Behaviors Questionnaire-Revised, and the Beck Scale for Suicide Ideation. No significant difference in the severity of the suicide attempts (either actual or potential severity) were found between those who had suicide attempts before enlistment and those who had their first attempt in the service. As a matter of fact, most of the suicide attempts that occurred for the first time during military service had used a violent method (58.3%, n = 21). Finally, using multivariate analyses, we found that current thoughts and behavior, rather than past suicidality, was the strongest predictor for the lethality of suicide attempts.

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Treatment of bipolar depression with supraphysiologic doses of levothyroxine: a randomized, placebo-controlled study of comorbid anxiety symptoms

International Journal of Bipolar Disorders ◽

10.1186/s40345-019-0155-y ◽

2019 ◽

Vol 7 (1) ◽

Author(s):

Maximilian Pilhatsch ◽

Thomas J Stamm ◽

Petra Stahl ◽

Ute Lewitzka ◽

Anne Berghöfer ◽

...

Keyword(s):

Bipolar Disorder ◽

Rating Scale ◽

Bipolar Depression ◽

Phenotypic Expression ◽

Anxiety Symptoms ◽

Controlled Study ◽

Double Blind ◽

Comorbid Anxiety ◽

Depressed Patients ◽

Depressive Episodes

Abstract Background Symptoms of anxiety co-occur in a variety of disorders including in depressive episodes of bipolar disorder and in patients with thyrotoxicosis. Treatment of refractory bipolar disorder with supraphysiologic doses of levothyroxine (L-T4) has been shown to improve the phenotypic expression of the disorder and is associated with an increase of circulating thyroid hormones. However, it might be associated with somatic and mental adverse effects. Here we report the investigation of the influence of treatment with supraphysiologic doses of L-T4 on symptoms of anxiety in patients with refractory bipolar depression. Methods Post-hoc analysis from a 6-week, multi-center, randomized, double-blind, placebo-controlled study of the effects of supraphysiologic L-T4 treatment on anxiety symptoms in bipolar depression. Anxiety symptoms were measured weekly with the Hamilton anxiety/somatization factor (HASF) score of the Hamilton Depression Rating Scale (HAMD) and the State- and Trait Anxiety Inventory (STAI). Results Treatment of both groups was associated with a significant reduction in anxiety symptoms (p < 0.001) with no statistical difference between groups (LT-4: from 5.9 (SD = 2.0) at baseline to 3.7 (SD = 2.4) at study end; placebo: from 6.1 (SD = 2.4) at baseline to 4.4 (SD = 2.8) at study end; p = 0.717). Severity of anxiety at baseline did not show a statistically significant correlation to the antidepressive effect of treatment with supraphysiologic doses of L-T4 (p = 0.811). Gender did not show an influence on the reduction of anxiety symptoms (females: from 5.6 (SD = 1.7) at baseline to 3.5 (SD = 2.4) at study end; males: from 6.1 (SD = 2.3) at baseline to 4.0 (SD = 2.4) at study end; p = 0.877). Conclusions This study failed to detect a difference in change of anxiety between bipolar depressed patients treated with supraphysiologic doses of L-T4 or placebo. Comorbid anxiety symptoms should not be considered a limitation for the administration of supraphysiologic doses of L-T4 refractory bipolar depressed patients. Trial registration ClinicalTrials, ClinicalTrials.gov identifier: NCT01528839. Registered 2 June 2012—Retrospectively registered, https://clinicaltrials.gov/ct2/show/study/NCT01528839

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Psychological Resilience and Suicide Attempt in Patients With Bipolar Disorder: An Exploratory Study

Journal of the American Psychiatric Nurses Association ◽

10.1177/10783903211050682 ◽

2021 ◽

pp. 107839032110506

Author(s):

María Luisa Fernández-Rocha ◽

Mariano García-Izquierdo ◽

María Isabel Ríos-Rísquez

Keyword(s):

Suicide Risk ◽

Suicide Attempts ◽

Bipolar Affective Disorder ◽

Recovery Process ◽

Psychological Resilience ◽

Positive Coping ◽

Resilience Scale ◽

The Unemployed ◽

Depressive Episodes

BACKGROUND: Patients with bipolar affective disorder (BPAD) have a suicide risk of up to 30 times higher than the general population. There is increasing interest in analyzing the effects of resilience in psychiatric diseases and its relationship to other factors such as suicide risk. AIM: The main objective of this study was to analyze the relationship between psychological resilience and suicide attempts, along with other relevant clinical and sociodemographic variables in euthymic patients with BPAD. METHODS: Eighty six outpatients, more than 18 years old, mostly men (60.5%) with BPAD type 1, 2, mixed, and unspecified, in euthymic phase receiving antidepressant and/or euthimizing treatment, participated in the study. Sociodemographic and clinical variables were assessed by means of a questionnaire and psychological resilience by means of Connor-Davidson’s 10-item Resilience Scale. RESULTS: Patients with previous autolytic attempts scored significantly lower in resilience than those who had not attempted suicide ( T = 3.30; p ≤ .001; 20.61 ± 6.58 vs. 26.52 ± 7.29). Patients diagnosed with BPAD scored significantly lower than other samples of university participants, workers, and the unemployed. The number of depressive episodes experienced was negatively and significantly associated with resilience scores ( r = −.28; p < .01). CONCLUSIONS: Patients diagnosed with BPAD who had made autolytic attempts had lower resilience scores than those who had not made them and lower scores than other general nonpsychiatric samples. The promotion of resilience in patients diagnosed with BPAD would facilitate a more adaptive and positive coping with the disease and their recovery process.

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Risk factors for suicide attempts in patients with bipolar disorder misdiagnosed with major depressive disorder: results from a national survey in China

10.21203/rs.3.rs-16989/v1 ◽

2020 ◽

Author(s):

Lin Chen ◽

Yu-Yu Xu ◽

Jing-Ge Du ◽

Li-Min Xin ◽

Su-Li Wang ◽

...

Keyword(s):

Risk Factors ◽

Bipolar Disorder ◽

Suicidal Ideation ◽

Clinical Characteristics ◽

Suicide Attempts ◽

Multiple Logistic Regression ◽

Regression Analyses ◽

Major Depressive ◽

Suicide Attempters ◽

Depressive Episodes

Abstract Background: Bipolar disorder (BD) is a kind of mental disorder with the greatest risk of suicide, but it is often misdiagnosed as major depressive disorder (MDD) clinically. This study aimed to analyze the sociodemographic factors and clinical characteristics associated with suicide attempts (SA) in patients with BD misdiagnosed with MDD in China. Methods: A total of 1487 MDD patients were consecutively enrolled in 13 mental health centers in China. Data on patients’ sociodemographic and clinical characteristics were collected using a standardized protocol. Of these, 306 BD patients were misdiagnosed with MDD according to the Mini International Neuropsychiatric Interview (MINI). Suicide attempters and non-attempters were classified by the suicidality module of the MINI. Multiple logistic regression analyses were performed to assess the association between the independent variables of interest and SA in BD patients misdiagnosed with MDD. Results: Of the 306 BD patients misdiagnosed with MDD, 225 (73.5%) were non-attempters and 81 (26.5%) were attempters. Compared to non-attempters, attempters were older (Z =2.2, p = 0.03) and had more admissions(χ2 =6.1, p = 0.013), more frequent depressive episodes, more atypical characteristics (e.g. increased appetite, weight gain, and more sleep time)(χ2 = 5.8, p = 0.016), more suicidal ideation (χ2 = 27.3, p < 0.001), more psychotic symptoms (χ2 = 7.4, p = 0.006) and more seasonal depressive episodes (χ2 = 5.6, p = 0.018). Multiple logistic regression analyses revealed that attempters were characterized by more suicidal ideation (OR = 5.7, 95% CI: 2.6–12.5) and frequent depressive episodes (OR = 2.4, 95% CI: 1.3–4.6). The limitations of this study include its cross-sectional design and data collection by suicide attempters’ retrospective recall. Conclusions: The findings of this study suggest that BD patients misdiagnosed with MDD are at a higher risk of suicide, and more frequent depressive episodes and suicidal ideation are risk factors for attempted suicide. Early identification of and interventions for these risk factors might reduce the risk of suicide in BD patients misdiagnosed with MDD.

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Plasma redox and inflammatory patterns during major depressive episodes: a cross-sectional investigation in elderly patients with mood disorders

CNS Spectrums ◽

10.1017/s1092852920001443 ◽

2020 ◽

pp. 1-11

Author(s):

Barbara Carpita ◽

Laura Betti ◽

Lionella Palego ◽

Natalia Bartolommei ◽

Lucia Chico ◽

...

Keyword(s):

Mood Disorders ◽

Daily Living ◽

Suicide Ideation ◽

Rating Scale ◽

Glutathione Transferase ◽

Redox Systems ◽

Cross Sectional ◽

Antioxidant Power ◽

Major Depressive Episodes ◽

Depressive Episodes

Abstract Background. While both depression and aging have been associated with oxidative stress and impaired immune response, little is known about redox patterns in elderly depressed subjects. This study investigates the relationship between redox/inflammatory patterns and depression in a sample of elderly adults. Methods. The plasma levels of the advanced products of protein oxidation (AOPP), catalase (CAT), ferric reducing antioxidant power (FRAP), glutathione transferase (GST), interleukin 6 (IL-6), superoxide dismutase (SOD), total thiols (TT), and uric acid (UA) were evaluated in 30 patients with mood disorders with a current depressive episode (depressed patients, DP) as well as in 30 healthy controls (HC) aged 65 years and over. Subjects were assessed with the Hamilton Depression Rating Scale (HAM-D), the Hamilton Rating Scale for Anxiety (HAM-A), the Geriatric Depression Rating Scale (GDS), the Scale for Suicide Ideation (SSI), the Reason for Living Inventory (RFL), the Activities of Daily Living (ADL), and the Instrumental Activity of Daily Living (IADL). Results. DP showed higher levels than HC of AOPP and IL-6, while displaying lower levels of FRAP, TT, and CAT. In the DP group, specific correlations were found among biochemical parameters. SOD, FRAP, UA, and TT levels were also significantly related to psychometric scale scores. Conclusion. Specific alterations of redox systems are detectable among elderly DP.

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Motivations behind suicide attempts: A study in the ER of Maggiore hospital – Novara

European Psychiatry ◽

10.1016/j.eurpsy.2017.02.462 ◽

2017 ◽

Vol 41 (S1) ◽

pp. S398-S399

Author(s):

D. Marangon ◽

C. Gramaglia ◽

E. Gattoni ◽

M. Chiarelli Serra ◽

C. Delicato ◽

...

Keyword(s):

Data Collection ◽

Life Events ◽

Clinical Characteristics ◽

Attempted Suicide ◽

Suicide Attempts ◽

Point Of View ◽

Psychiatric Disease ◽

Positive Relation ◽

Clinical Point ◽

Competing Interest

IntroductionA previous study, conducted in the province of Novara stated that, from an epidemiological and clinical point of view, being a female, being a migrant, as well as being in the warmer months of the year, or suffering from an untreated psychiatric disease are associated with suicide attempts. Literature suggests there is a positive relation between negative life events and suicidal behaviours. In this study, we intend to deepen knowledge, individuating motivations and meanings underlying suicidal behaviours. This appears a meaningful approach to integrate studies and initiatives in order to prevent suicide and suicidal behaviours.AimTo examine possible correlation between socio-demographic and clinical characteristics and motivations underlying suicide attempts.MethodsPatients aged > 16 years admitted for attempted suicide in the Emergency Room of the AOU Maggiore della Carità Hospital, Novara, Italy, were studied retrospectively from the 1st January 2015 to the 31st December 2016. Each patient was assessed by an experienced psychiatrist with a clinical interview; socio-demographic and clinical features were gathered. Analysis were performed with SPSS.Results and discussionData collection are still ongoing; results and implications will be discussed. We expect to find different motivations in relation to socio-demographic and clinical characteristics [1,2].Disclosure of interestThe authors have not supplied their declaration of competing interest.

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