Self-Image and Risk of Suicide in Eating Disorders

2017 ◽  
Vol 41 (S1) ◽  
pp. S281-S281
Author(s):  
A. Birgegård ◽  
M. Andersen
Keyword(s):  
Eating Disorders ◽  
Suicide Risk ◽  
Suicide Attempts ◽  
High Specificity ◽  
Lower Sensitivity ◽  
Longitudinal Models ◽  
Self Image ◽  
Competing Interest ◽  
Separate Regression ◽  
Variance Explained

IntroductionSuicide risk is increased in eating disorders (ED), and detection is key to prevention. Self-image as operationalized in the structural analysis of social behavior (SASB) model has been shown to be associated with symptoms, treatment dropout, and outcome. SASB is a circumplex organizing self-directed behaviors along affiliation (love vs. hate) and autonomy (set free vs. control) dimensions. In a recent study, SASB related to health care-detected suicide attempts in ED. Methodology in that study ensured high specificity but risked lower sensitivity in suicide variables, and with such a high-threat outcome, research is needed on additional variables related to risk.Objectives and aimsWe aimed to study associations between SASB self-image and clinician- and self-rated suicidality at presentation and predicted over 12 months in ED patients.MethodsAdult patients (n = 551) from a Swedish clinical database included 19% anorexia, 32% bulimia, 7% binge ED, and 42% other ED. We ran separate regression models for these diagnostic groups using SASB questionnaire data, also controlling for general psychiatric and ED symptoms, and in longitudinal models including baseline of each outcome.ResultsSASB alone was associated with suicidality at presentation (9–67% variance explained) and predictively over 12 months (7–29%), and in the majority of models explained additional variance beyond baseline and clinical variables. Both affiliation and autonomy related to dependent variables in diagnosis-specific patterns.ConclusionsThe findings have implications for both theory and detection tools for suicide risk, as well as suggesting intervention targets to mitigate risk in treatment based on the well-validated SASB theory.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Characteristics of suicide attempters with a high lethality means

2017 ◽  
Vol 41 (S1) ◽  
pp. s889-s889
Author(s):  
C.T. Lee ◽  
S.Y. Lee ◽  
K.U. Lee ◽  
H.K. Lee ◽  
Y.S. Kweon
Keyword(s):  
Clinical Judgment ◽  
Suicide Risk ◽  
Suicide Attempts ◽  
Demographic Variables ◽  
Suicide Attempters ◽  
Exact Test ◽  
Factors Associated ◽  
History Of ◽  
Competing Interest ◽  
Lethal Means

IntroductionSuicide attempts with higher lethality increase the likelihood of suicide completion. Accumulating knowledge on risk factors contributing to higher suicide lethality may help clinicians to allocate their limited resources to more endangered people.ObjectivesTo explore the factors associated with higher lethality in suicide attempts.MethodsAll suicide attempters, who visited the emergency department of Uijeongbu St. Mary's hospital from January 2014 to December 2015, were reviewed retrospectively. We compared between the high vs. the low lethality group, of which had been recorded based on clinical judgment using t-test or Chi2/Fisher's exact test with two-sided P-value of 0.05.ResultsAmong the 753 suicide attempters, the assessed lethality was recorded in 736 cases. Low and highly lethal attempters were 426 (57.9%) and 310 (42.1%), respectively. For demographic variables, the high lethality attempters were significantly more likely to be older (48.3 vs. 44.78; P = 0.009), unemployed (61.0% vs. 56.5%; P = 0.042, without religion (90.9% vs. 84.9%; P = 0.017). For clinical variables, the high lethality attempters were significantly more likely have hopelessness (67.7% vs. 58.2%; P = 0.013) and a history of schizophrenia (4.5% vs. 1.4%; P = 0.023, while they did display any difference for mood disorders. The low lethality suicide attempts were more frequent in patients with comorbid personality disorders (9.2% vs. 4.9%; P = 0.031).ConclusionsThese results are in line with literatures reporting higher suicide risk in people, who are old, unemployed, not having a religion, psychotic and hopeless. These may have been moderated by committing a higher lethal means of suicide at least in part and warrants additional investigations.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Psychiatric comorbidity and suicide risk in patients with psoriasis

2016 ◽  
Vol 33 (S1) ◽  
pp. S395-S396 ◽  
Author(s):  
M. Pompili ◽  
M. Innamorati ◽  
D. Erbuto ◽  
A. Costanzo
Keyword(s):  
Suicidal Ideation ◽  
Suicide Risk ◽  
Psychiatric Comorbidity ◽  
Rating Scale ◽  
Suicide Attempts ◽  
The Other ◽  
Depression And Anxiety ◽  
Melanoma Patients ◽  
Competing Interest ◽  
Hamilton Rating Scale

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.

Insidious: The relationship between patients and their eating disorders and its impact on ED symptoms, illness duration and self-image

2017 ◽  
Vol 41 (S1) ◽  
pp. S552-S552
Author(s):  
E. Forsén Mantilla ◽  
A. Birgegård
Keyword(s):  
Eating Disorders ◽  
Interpersonal Relationships ◽  
Real Life ◽  
True Self ◽  
Illness Duration ◽  
Self Image ◽  
Not Otherwise Specified ◽  
Higher Ed ◽  
Competing Interest ◽  
The Relationship

Patients with eating disorders (EDs) often spontaneously talk about their disorder in terms of a symbolic other (a demon, a voice, a guardian). Further, externalizing exercises where patients are encouraged to separate their true self from their ED self are common in some treatment approaches. Yet, no previous quantitative study has investigated this phenomenon. We examined the patient-ED relationship (using the interpersonal structural analysis of social behavior methodology) and its implications for ED symptoms, illness duration and self-image. Participants were 16–25 year old female patients (N = 150) diagnosed with anorexia nervosa (N = 55), bulimia nervosa (N = 33) or eating disorder not otherwise specified (N = 62). Results suggested that patients had comprehensible and organized relationships with their EDs. EDs were primarily experienced as acting critical and controlling towards patients. Higher ED control was associated with more ED symptoms and longer illness duration, especially when coupled with patient submission. Patients reacting more negatively towards their EDs than their EDs were acting towards them had lower symptom levels and more positive self-images. Externalizing one's ED, relating to it like a symbolic other, seemed to make sense to patients and depending on its quality seemed to influence ED symptoms, illness duration and self-image. We put forward both clinical and theoretical implications based on the assumption that the patient-ED relationship may function in similar ways as real-life interpersonal relationships do.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Predicting suicidal behavior by an accurate monitoring of RNA editing biomarkers in blood samples

2017 ◽  
Vol 41 (S1) ◽  
pp. s893-s894
Author(s):  
D. Weissmann ◽  
B. Vire ◽  
S. Van der Laan ◽  
N. Salvetat ◽  
S. Pointet ◽  
...  
Keyword(s):  
Rna Editing ◽  
Suicidal Behavior ◽  
Suicide Attempts ◽  
Relative Proportion ◽  
High Specificity ◽  
Blood Samples ◽  
Predictive Algorithm ◽  
Specificity And Sensitivity ◽  
History Of ◽  
Competing Interest

IntroductionPredicting suicidal behaviors is one of the most complex challenges of daily psychiatric practices. Alterations of RNA editing of neurotransmitter receptors and other proteins have been shown to be involved in etiology of different psychiatric disorders and linked to suicidal behavior. Additionally, an increase in expression levels of ADARs, the RNA editing enzymes, has also been observed.ObjectiveThe objective of the present study was to test whether modifications in RNA editing profile of prime targets allow identifying disease-relevant blood biomarkers and evaluating suicide risk in patients.MethodsA clinical study was performed to identify an RNA editing signature in blood of depressed patients with and without history of suicide attempts. Patient's samples were drawn in PAXgene tubes and analyzed on Alcediag's proprietary RNA editing platform using NGS. In addition, gene expression analysis by quantitative PCR was performed.ResultsWe generated a predictive algorithm comprising various selected biomarkers to detect patients with a high risk to attempt suicide. We evaluated the diagnostic performance using the relative proportion of the phosphodiesterase 8A (PDE8A) mRNA editing at different sites as well as the expression of PDE8A and the ADARs. The significance of these biomarkers for suicidality was evaluated using the receiver–operating characteristic (ROC) curve. The generated algorithm comprising the biomarkers was found to have strong diagnostic performances with high specificity and sensitivity.ConclusionsWe developed tools to measure disease–specific biomarkers in blood samples of patients for identifying individuals at the greatest risk for future suicide attempts.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Intramuscular ketamine in depression, suicidal thoughts and anxiety: A report on two cases

2017 ◽  
Vol 41 (S1) ◽  
pp. S420-S420
Author(s):  
M. Cigognini ◽  
R. Moreno
Keyword(s):  
Side Effects ◽  
Suicide Risk ◽  
Suicide Attempts ◽  
Bipolar Depression ◽  
Vital Signs ◽  
Hospital Setting ◽  
Medical Monitoring ◽  
Promising Alternative ◽  
Treatment Of Depression ◽  
Competing Interest

IntroductionSeveral studies have shown that ketamine, an antagonist of NMDA receptors, represents a promising alternative in the treatment of depression. The therapeutic use of ketamine, commonly used at a dose of 0.5 mg/kg, and in a single application IV has been short and requires monitoring in a hospital setting. IM use has been shown to be effective in treating depression and suicide risk, and have low side effect profile.MethodsTwo patients diagnosed with bipolar depression and suicide risk were submitted to ketamine IM application (0.75 mg/kg), receiving one application of ketamine IM every two days, totaling 4 applications. Patients were under medical monitoring for 2 hours after injection verifying vital signs and potential side effects. Responses were measured using BDI, BAI and BSI.AimTo evaluate response of ketamine IM injections on depressive, suicidal and anxious symptoms.SummaryCase 1: female, 20 years old, single with three recent suicide attempts, symptomatic for two months. Started lithium 450 mg daily. Side effects of ketamine were nausea, drowsiness and paresthesia. Case 2: female, 24 years old, single with symptoms lasting for six years. Started aripiprazole 5–10 mg and 25 mg lamotrigine concomitantly. Side effects of dry mouth, dizziness and dissociation.ConclusionsThe use of ketamine IM showed reduction of 75.5%–83.3%–85.7% (case 1) and 71.4%–77.2%–60.8% (case 2) in BDI, BAI and BSI, respectively as well as safety and tolerability in use.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Comparative analysis of suicidality in two Bulgarian regions

2017 ◽  
Vol 41 (S1) ◽  
pp. S403-S403
Author(s):  
K. Stoychev ◽  
V. Nakov ◽  
D. Dekov ◽  
M. Baltov ◽  
R. Dinolova-Hodzhadzhikova ◽  
...  
Keyword(s):  
Suicidal Behavior ◽  
Suicide Risk ◽  
Suicide Attempts ◽  
Population Aging ◽  
Psychotic Symptoms ◽  
Prevention Interventions ◽  
Health Related ◽  
Competing Interest ◽  
Methods Of Suicide ◽  
Old Females

IntroductionSuicidality is still an understudied problem in Bulgaria especially on a subnational (regional) level.ObjectivesTo collect data on suicidality in two major regions of Bulgaria with a population over 250,000 each (Plovdiv and Pleven) for a six years period (2009–2015).AimsTo analyze demographic, health-related and other characteristics associated with suicidal behavior as well as motives and methods of suicide.MethodsData were extracted from relevant documentation (medical records, public health reports, etc.) and statistically processed upon collection.ResultsMajority of suicide victims were males between 45 and 64 years while most suicide attempts occurred among 18–29 years old females.Leading method of suicide was hanging, followed by jumping from high places and use of firearm.Prevailing suicidal motives were psychotic symptoms, serious somatic illnesses and family problems. Depression accounted for 25% of all suicide cases and in another 25% motivation could not be identified because of insufficient data.The proportion of unemployed among suicide committers was not significantly higher than that of employed and retired.ConclusionsSevere mental disorders are a major trigger of suicidal behavior.Personal relationships should be targeted by suicide prevention interventions.Somatic illnesses are increasingly important suicide risk factor driven by the ongoing process of population aging.Frontline healthcare professionals should be trained to explore underlying suicidal motives and actively probe for depression in each case of suicidal behavior.Unemployment related suicide risk is most likely mediated through an adaptation crisis mechanism induced by the abrupt change of social status.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Is prior suicide attempt a reliable indicator of short-term suicide risk amongst patients admitted to an acute suicide inpatient intervention unit in India?

2017 ◽  
Vol 41 (S1) ◽  
pp. s889-s889
Author(s):  
S. Mishra
Keyword(s):  
High Risk ◽  
Suicide Attempt ◽  
Suicide Risk ◽  
Suicide Attempts ◽  
Recent Attempt ◽  
Short Term ◽  
Competing Interest ◽  
Indian Men ◽  
Traditional Pattern ◽  
Suicidal Patients

IntroductionTraditionally past suicide attempt is considered a strong reliable factor in predicting an immediate or short-term suicide risk. Considering the complex interplay of different variables associated with suicide, the absence of past attempts may not prove to be of lesser risk for a consequent attempt.AimTo compare sociodemographic and clinical correlates within high-risk suicidal patients who have made a recent suicide attempt in the presence versus absence of past suicide attempts.MethodsRetrospective review of patient's records admitted to intensive care unit, applied suicide intervention and supportive treatment (ASIST) between 1st January 2015 and 31st May 2016 was conducted. Data was extracted for all consecutive admissions to ASIST, of adults (16 to 60 years) male patients with high risk for suicide.ResultsOut of 109 at risk inpatients, 31% were recent attempters without past attempts and 13.5% were recent and past attempters. Rest included past attempters without recent attempt and non-attempters. Except for poor coping skills, which were significantly higher (Chi2= 13.97; P = 0.001) in the group consisting recent and past attempters, all other relevant sociodemographic and illness related correlates were comparable across these groups.ConclusionSuicide risk may be associated with multiple factors. Apart from past attempts, a faulty coping style can be associated with risk for further attempts. Other correlates like age, marital status, employment and illness profile did not follow the traditional pattern in our study which makes them equally important while addressing suicide risk in Indian men.Disclosure of interestThe author has not supplied his/her declaration of competing interest.

Attempted suicide in people with co-occurring bipolar and substance use disorders

2017 ◽  
Vol 41 (S1) ◽  
pp. S466-S467
Author(s):  
S. Ben Mustapha ◽  
W. Homri ◽  
L. Jouini ◽  
R. Labbane
Keyword(s):  
Suicide Risk ◽  
Suicide Attempts ◽  
Type I ◽  
Addictive Behaviors ◽  
Co Morbidity ◽  
History Of ◽  
Competing Interest ◽  
The Impact ◽  
Control Study

Aims Study the impact of SUD co-morbidity on suicide risk in patients with BD.MethodsCase-control study during a period of six months from July 2015 to December 2015. One hundred euthymic patients with BD (type I, II or unspecified) were recruited in the department of psychiatry C Razi Hospital, during their follow-up. Two groups were individualized by the presence or not of a SUD co-morbidity.ResultsThe average age of patients with SUD was 44.02 years that of the patients without SUD was 44.12 years.The sex ratio of patients with SUD was 5.25 and that of patients without SUD were 0.61.Twenty-six percent of patients with SUD comorbidity had a history of suicide attempts. Fourteen percent of patients without SUD had a history of suicide attempts.The association between SUD and history of suicide attempts was not significant (P = 0.134).The average suicide attempts were 3.08 for patients with addictive behaviors and 2.00 for patients without SUD.The association between SUD and the number of suicide attempts was not significant (P = 0.375).The means of suicide attempts used were drugs in 12% of cases, 3% of cases by phlebotomy, 3% of cases by hanging, 3% of cases immolation, 2% of cases of organophosphate ingestion, 3% of cases by defenestration, 3% of cases by the precipitation front of a vehicle and 1% of cases by drowning.ConclusionsCo-morbid SUD in individuals with BD is significantly associated with suicide attempts. Individuals with this co-morbidity should be targeted for intensive suicide prevention efforts.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Severity of traumatic events in patients with eating disorders. A case-control study

2016 ◽  
Vol 33 (S1) ◽  
pp. S165-S166
Author(s):  
A.M. Pignatelli ◽  
C. Loriedo ◽  
M. Biondi ◽  
P. Girardi ◽  
J. Vanderlinden ◽  
...  
Keyword(s):  
Eating Disorders ◽  
Childhood Abuse ◽  
Emotional Abuse ◽  
Traumatic Events ◽  
University Hospital ◽  
Traumatic Experiences ◽  
Emotional Neglect ◽  
Psychiatric Outpatient Clinic ◽  
Competing Interest ◽  
Age Range

IntroductionA high proportion of individuals with eating disorders (EDs) report childhood abuse and neglect. The prevalence of traumatic events in ED patients has been extensively investigated; less is known about their self-perceived–and reported–severity. Objectives/Aims: We aimed to assess in ED patients vs. healthy controls the severity, i.e., duration, perpetrator, and subjective impact, of sexual, physical, and emotional traumas suffered from 0 to 18 years, paying particular attention to emotional neglect.MethodsFifty-seven consecutive DSM-V ED patients (91.2% females; age range: 18–42 years) were recruited at the Psychiatric Outpatient Clinic of our University Hospital. Ninety controls (78.9% females; age range: 20–39 years) were also recruited. Among ED patients, 43.9% had restrictive anorexia nervosa (AN), 29.8% binge/purging AN, 26.3% bulimia nervosa. Individuals completed the Eating Disorder Inventory-2 (EDI-2) and the Traumatic Experiences Checklist (TEC).ResultsThe severity of all traumatic events, according to the TEC total score, was significantly higher in ED patients than controls (P < 0.001). Moreover, ED patients showed significantly higher scores with regard to emotional neglect (P < 0.001) and emotional abuse (P < 0.001). The same can be said for physical traumas (P < 0.01) and physical abuse (P < 0.01), although with a lower significance, and for sexual abuse (P < 0.05), with an even lower significance. No difference in the severity of sexual harassment was found.ConclusionsAll types of traumas, especially neglect, can occur in ED patients and controls, however they are reported as more severe by ED patients.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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