Genetic Counselling in Psychiatric Disorder with High Suicide Risk

2017 ◽  
Vol 41 (S1) ◽  
pp. S101-S101
Author(s):  
D. Cozman ◽  
R. Moldovan ◽  
B. Nemes

IntroductionA better understanding of the genomics of mental illnesses allowed genetic counselling to be provided to individuals with severe mental illness and their families.AimThe present study was aimed at assessing the efficacy of genetic counselling for severe mental illnesses with high suicide risk.MethodAssessment was performed before and after genetic counselling session. Measures used were evaluation of traumatic events in childhood, multidimensional scale for perception of social support (SMSSP), positive and negative affect schedule (PANAS-X), Brief Psychiatric Rating Scale (BPRS), Paykel questionnaire and Genetic Counselling Outcome Scale (GCOS). Paykel's questionnaire consists of five questions about suicidal thoughts and attempts, including: life-weariness, death wishes, suicidal ideation, suicidal plans and suicide attempts. Intervention and assessment lasted approximately one and a half hour. Data from 48 patients was analysed.ResultsMean age of participants was M = 38.4, SD = 9.7, and the group was batter represented by females (57%). The participants had various diagnoses, 22% had schizophrenia, 36% bipolar disorder and 42% recurrent depressive disorder. Forty percent of participants reported suicidal ideation and 22,5% had a past history of suicide attempt. Genetic counselling had a direct positive influence upon GCOS specific items and reduced the Paykel scores among participants presenting with suicidal ideation.ConclusionGenetic counselling offers information about the disorder, the role of genetics and the impact of environmental factors. Preliminary data suggest that providing genetic counselling decreases the suicidal ideation frequency.Disclosure of interestThe authors have not supplied their declaration of competing interest.

2016 ◽  
Vol 33 (S1) ◽  
pp. S395-S396 ◽  
Author(s):  
M. Pompili ◽  
M. Innamorati ◽  
D. Erbuto ◽  
A. Costanzo

IntroductionPsoriasis has a significant impact on the mental and emotional functioning.ObjectiveIt has been reported that the risk of psychiatric comorbidity increases with the severity of the disorder, and the most frequent associations appear to be those with depression and anxiety.AimsTo analyze the association between psoriasis, mental disorders and suicidal ideation in a sample of patients affected by psoriasis. To investigate the differences between psoriasis patients and patients with other dermatologic diseases.MethodsParticipants were 242 consecutive patients (142 women and 100 men), 112 patients with psoriasis (46.3%), 77 with melanoma (31.8%) and 53 with allergy (21.0%). All patients were administered a structured sociodemographic interview and the following measures: the Hamilton Rating Scale for Depression (HAM-D) and the Hamilton Rating Scale for Anxiety (HAM-A). We also assessed current and previous suicidal ideation and previous suicide attempts.ResultsPatients with psoriasis (compared to other groups of patients) more frequently had a comorbid mood disorder (16.1% vs 3.9% and 0.0%, respectively for patients with melanoma and patients with allergy; χ22 = 14.98; P < 0.001), past suicidal ideation (33.9% vs 15.6% and 18.9%, respectively for patients with melanoma and patients with allergy; χ22 = 2.05; P < 0.01) and attempts (6.3% vs 0.0% and 0.0%, for the other groups of patients; χ22 = 8.37; P < 0.05). Patients with psoriasis reported higher HAM-D scores than melanoma patients.ConclusionsThe clinical evaluation of patients with psoriasis should include the assessment of psychiatric comorbidities and the routinely assessment of suicide risk.Disclosure of interestThe authors have not supplied their declaration of competing interest.


Author(s):  
Brian Rothberg ◽  
Robert E. Feinstein

All psychiatric assessments should include screening for recent suicidal ideation and past suicide behavior. The Columbia-Suicide Severity Rating Scale (C-SSRS) provides a reliable objective assessment of suicide risk. A history of past suicide attempts is a risk factor for future suicide, and risk is increased by more serious, more frequent, or more recent attempts. Over 90% of individuals who die by suicide have at least one psychiatric disorder. Patients with schizophrenia, alcohol and other substance use disorders, and borderline and antisocial personality disorders are at increased risk for suicide. Familial transmission of suicide risk appears to occur independent of the familial risk for psychiatric disorders; impulsivity seems to be an inherited trait that makes individuals more vulnerable to suicide. Hospitalization should be considered if suicidal ideation is present in a patient who is psychotic or who has a history of past attempts, particularly if near lethal, and may be the safest option in patients with other contributing medical conditions, limited family or social support, or lack of access to timely outpatient follow-up.


SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A294-A295
Author(s):  
Emma Palermo ◽  
Jennifer Goldschmied ◽  
Elaine Boland ◽  
Elizabeth A Klingaman ◽  
Philip Gehrman ◽  
...  

Abstract Introduction Military personnel are at an increased risk for suicide compared to the general population, making it important to develop a deeper understanding of which factors contribute to this elevated risk. Given that suicidal ideation (SI) is one of the strongest predictors of suicide attempts, understanding factors that underlie SI may improve prevention efforts. Insomnia and depression both serve as independent risk factors for SI, and therefore the aim of this study was to examine the extent to which depressive symptoms moderate the association between insomnia and SI. Methods Data were obtained from the All Army Study of the Army Study to Assess Risk and Resilience in Servicemembers (STARRS). Soldiers (n=21,450) completed questions related to suicidal ideation (5 items), depressive symptoms (9 items), and insomnia (5 items) based on symptom presence in the past 30 days. Items in each domain were summed to create a total severity score. GEE models using a negative binomial linking function were conducted to examine the impact of depression, insomnia, and their interaction on SI. Results Both depression (χ2 =117.56, p&lt;0.001) and insomnia (χ2=11.79, p=0.0006) were found to have significant main effects on SI, and there was a significant interaction effect (χ2=4.52, p=0.0335). Follow up simple effects revealed that insomnia was no longer significantly associated with SI when depression severity was low, but was associated with SI in the presence of greater depression severity (χ2=2.91, p=0.0882). Conclusion In a large sample of Army soldiers, depression significantly moderated the association between SI and insomnia, such that insomnia seems to amplify the effects of depression on SI. These findings highlight the importance of addressing insomnia severity as a mean of reducing SI in those with depression, potentially allowing for intervention prior to a suicide attempt. Support (if any) Perlis: K24AG055602 & R01AG041783. This publication is based on public use data from Army STARRS (Inter-university Consortium for Political and Social Research, University of Michigan- http://doi.org/10.3886/ICPSR35197-v1), funded by U.S. NIMH-U01MH087981.


2014 ◽  
Vol 44 (14) ◽  
pp. 2965-2974 ◽  
Author(s):  
J. G. Keilp ◽  
S. R. Beers ◽  
A. K. Burke ◽  
N. M. Melhem ◽  
M. A. Oquendo ◽  
...  

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.


2018 ◽  
Vol 5 ◽  
Author(s):  
Anvita Bhardwaj ◽  
Christine Bourey ◽  
Sauharda Rai ◽  
Ramesh Prasad Adhikari ◽  
Carol M. Worthman ◽  
...  

Background.Suicide risk reduction is crucial for 15–29-year-old youth, who account for 46% of suicide deaths in low- and middle-income countries. Suicide predictors in high-resource settings, specifically depression, do not adequately predict suicidality in these settings. We explored if interpersonal violence (IPV) was associated with suicidality, independent of depression, in Nepal.Methods.A longitudinal cohort of child soldiers and matched civilian children, enrolled in 2007 after the People's War in Nepal, were re-interviewed in 2012. The Depression Self-Rating Scale and Composite International Diagnostic Interview assessed depression and suicidality, respectively. Non-verbal response cards were used to capture experiences of sexual and physical IPV.Results.One of five participants (19%) reported any lifetime suicidal ideation, which was associated with sexual IPV, female gender, former child soldier status and lack of support from teachers. Among young men, the relationship between sexual IPV and suicidality was explained by depression, and teacher support reduced suicidality. Among young women, sexual IPV was associated with suicidality, independent of depression; child soldier status increased suicidality, and teacher support decreased suicidality. Suicide plans were associated with sexual IPV but not with depression. One of 11 female former child soldiers (9%) had attempted suicide.Conclusion.Sexual IPV is associated with suicidal ideation and plans among conflict-affected young women, independent of depression. Reducing suicide risk among women should include screening, care, and prevention programs for sexual IPV. Programs involving teachers may be particularly impactful for reducing suicidality among IPV survivors.


1997 ◽  
Vol 16 (2) ◽  
pp. 69-89 ◽  
Author(s):  
D. L. Paproski

This study explores how five British Columbia First Nations women moved through suicidal ideation and intention in their youth. Much of their healing process was facilitated by a reconnection to their cultural identity and traditional native spirituality. Phenomenological research methods were used to guide the interview process, analysis, and the interpretation of unstructured interviews. Each transcribed interview was analyzed for themes and developed into a narrative. Several procedures were used to examine the validity of the analysis and interpretation, including participant review of the findings. Three of the 12 themes that emerged suggest common experiences surrounding suicide attempts or ideation. These experiences suggest that the impact of separation from family, community, and culture was significant for each of these women. Nine of the 12 major themes describe a variety of healing experiences for these five women, involving elders or other role models, professional counsellors, family, and community. As a consequence of their healing experiences, all participants reported an increased sense of personal empowerment, a positive view of themselves, and a commitment to a positive future for themselves and other First Nations people. The significance of cultural connections and native spirituality may have important implications for the intervention and prevention of suicide in First Nations youth.


CNS Spectrums ◽  
2009 ◽  
Vol 14 (8) ◽  
pp. 431-436 ◽  
Author(s):  
Arthur Kummer ◽  
Francisco Cardoso ◽  
Antonio Lucio Teixeira

ABSTRACTObjective: To assess the frequency of suicidal ideation and suicide attempts in patients with Parkinson's disease.Methods: The Mini International Neuropsychiatric Interview (MINI), Beck Depression Inventory (BDI), and Hamilton Rating Scale for Depression (HAM-D) were administered to 90 consecutive, non-demented Parkinson's disease patients. They were also submitted to a complete neurologic examination which included brief cognitive batteries, the Mini Mental Status Exam, and Frontal Assessment Battery. We analyzed the scores of the section of the MINI related to the risk of suicide as well as the specific questions of BDI and HAM-D concerning suicidal ideation.Results: No patient had ever attempted suicide. According to MINI, suicidal ideation was present in 13 patients (14.4%) with Parkinson's disease. All instruments assessed the risk of suicide in a similar way. Suicidal ideation was associated only with lower age (P=.022), lower age of Parkinson's disease onset (P=.021), panic disorder (P=.004), social anxiety disorder (P=.007), and major depression (P<.001). Logistic regression analysis indicated that major depression was the main predictor of suicidal ideation.Conclusion: Suicide attempts seem to be uncommon in Parkinson's disease, despite the fact that the rates of suicidal ideation are possibly elevated. Depression seems to be the most important predictor of suicidal ideation in Parkinson's disease.


2019 ◽  
Vol 17 (8) ◽  
pp. 681-696 ◽  
Author(s):  
Umberto Albert ◽  
Diana De Ronchi ◽  
Giuseppe Maina ◽  
Maurizio Pompili

Background: Historically, OCD has been considered to be associated with a relatively low risk of suicide. Recent studies, on the contrary, revealed a significant association between OCD and suicide attempts and ideation. A huge variation in prevalence rates, however, is reported. Objective: To estimate prevalence rates of suicide attempts and suicidal ideation in individuals with OCD, and to identify predictors of suicide risk among subjects with OCD. Methods: We systematically reviewed the literature on suicide risk (ideation and/or attempts) and OCD. We included studies with appropriate definition of OCD, cross-sectional or prospective design, separating clinical samples from epidemiological studies, that employed a quantitative measure of suicidality and/or reported an outcome measure of the association between suicidality and OCD or examined factors associated with suicidality. Results: In clinical samples, the mean rate of lifetime suicide attempts is 14.2% (31 studies: range 6- 51.7%). Suicidal ideation is referred by 26.3-73.5% of individuals (17 studies, mean 44.1%); current suicidal ideation rate ranges between 6.4 and 75% (13 studies, mean 25.9). Epidemiological studies found that OCD increases significantly the odds of having a lifetime suicidal ideation as compared to the general population (OR: 1.9-10.3) and a history of lifetime suicide attempts (OR: 1.6- 9.9). Predictors of greater suicide risk are severity of OCD, the symptom dimension of unacceptable thoughts, comorbid Axis I disorders, severity of comorbid depressive and anxiety symptoms, past history of suicidality and some emotion-cognitive factors such as alexithymia and hopelessness. Conclusion: Overall, suicidality appears a relevant phenomenon in OCD.


2019 ◽  
pp. 1-19
Author(s):  
Jessica L. Tylicki ◽  
Martin Sellbom ◽  
Yossef S. Ben-Porath

Prior research has shown that psychopathic personality traits are differentially related to suicide risk, and limited literature also suggests the potential that such risk manifests differently across sex. The current study sought to examine whether sex moderated associations between domains from the triarchic model of psychopathy, a comprehensive perspective of psychopathy, and various suicide variables. Our sample included 1,064 criminal defendants (760 males, 304 females), who had been administered the MMPI-2-RF, from which triarchic psychopathy scales were scored. Suicide-related variables, including current suicidal ideation during interview, history of previous suicide attempts, and number of previous suicide attempts, were reliably obtained from clinical records. The MMPI-2-RF SUI (Suicide/Death Ideation) scale was also examined as a psychometric operationalization of suicidality. Results provided evidence for the general association between psychopathy-related traits and suicide-related outcomes in a manner consistent with the literature. However, these associations did not differ as a function of sex.


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