Decision Making Under Ambiguity and Under Risk in Depressed Suicide Attempters, Depressed Non-Attempters and Healthy Controls

2017 ◽  
Vol 41 (S1) ◽  
pp. S291-S292
Author(s):  
E.A. Deisenhammer ◽  
S.K. Schmid ◽  
G. Kemmler ◽  
B. Moser ◽  
M. Delazer
Keyword(s):  
Decision Making ◽  
Iowa Gambling Task ◽  
Suicide Attempts ◽  
Control Group ◽  
Healthy Controls ◽  
Suicide Attempters ◽  
Lifetime History ◽  
Study Results ◽  
History Of ◽  
Risky Decisions

IntroductionStudy results on decision-making (DM) abilities in suicidal individuals are conflicting. Most studies have focused on DM under ambiguity and included patients with a lifetime history of suicide attempts.ObjectiveTo assess DM abilities with two different instruments in recent suicide attempters.MethodsThe study sample consisted of three groups. Group 1 (SA) were currently depressed inpatients having attempted suicide within the previous six months. Group 2 (NSA) consisted of depressed inpatients without a lifetime history of suicide attempts. Group 3 (CG) was a healthy control group. Besides depression severity, impulsiveness and suicidal intent (SA group only) DM was assessed using the Iowa gambling task (IGT) for DM under ambiguity and the game of dice task (GDT) for DM under risk.ResultsA total of 78 participants (SA group, n = 21; NSA group, n = 31; CG, n = 26) were included into the study. Significant between group differences were found regarding marital status, current partnership, smoking status, depression score, impulsiveness score and family history of psychiatric disorders (all discriminating controls from patients but not between SA and NSA groups). The three groups did not differ with regard to IGT scores. Concerning GDT, the SA group showed significantly lower scores compared to the two other groups, implying a readiness for more risky decisions in suicide attempters versus non-attempters and controls.ConclusionSuicide attempters appear to make more risky decisions compared to depressed non-attempters as well as healthy controls even if the DM under ambiguity patterns do not differ.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Decision making and vulnerability to suicidal behaviour in elderly

2011 ◽  
Vol 26 (S2) ◽  
pp. 2164-2164 ◽  
Author(s):  
P. Courtet ◽  
M. Wyart ◽  
I. Jaussent ◽  
K. Ritchie ◽  
F. Jollant
Keyword(s):  
Decision Making ◽  
Suicidal Behaviour ◽  
Iowa Gambling Task ◽  
Past History ◽  
Health Concern ◽  
Suicide Attempters ◽  
Completed Suicide ◽  
Cognitive Patterns ◽  
History Of ◽  
Suicidal Patients

Suicide is a major public health concern, especially for older adults, who have higher rates of completed suicide than any other age group in most countries of the world. However, understanding suicidal behaviour remains a challenging task particularly among the elders who have been poorly studied. Decision making has been recently found to be altered in suicide attempters under 65.To test wether decision making would be a neuropsychological trait of vulnerability to suicidal behaviours, the authors used the Iowa Gambling Task to investigate normothymic non demented elders with a history of suicidal behaviour (N = 35) and compared it to decision making in non suicide attempters with a past history of depression (N = 52) and comparison subjects (N = 43). The data also were compared to those of similar groups of younger normothymic subjects. Moreover, the old suicidal patients were assessed according to the age at the onset of suicidal behaviour (before or after 60).Old suicide attempters did not significantly differ from the other aged groups and according to the age of first suicidal behaviour. Old suicide attempters presented better performances than that of younger suicidal patients.Vulnerability to suicidal behaviour in older people may proceed from cognitive processes which are different from the ones involved in suicidal vulnerability of younger subjects. These results are preliminary and further studies are needed to explore vulnerability cognitive patterns to suicide among elders.

scholarly journals Bipolar disorder first episode and suicidal behavior: are there differences according to type of suicide attempt?

2009 ◽  
Vol 31 (2) ◽  
pp. 114-118 ◽  
Author(s):  
Fernando Silva Neves ◽  
Leandro Fernandes Malloy-Diniz ◽  
Izabela Guimarães Barbosa ◽  
Paulo Marcos Brasil ◽  
Humberto Corrêa
Keyword(s):  
Bipolar Disorder ◽  
Logistic Regression ◽  
Suicidal Behavior ◽  
Suicide Attempts ◽  
First Episode ◽  
Mean Square ◽  
Suicide Attempters ◽  
Lifetime History ◽  
Bipolar Ii ◽  
History Of

OBJECTIVE: The objective of this study was to test the hypothesis that the polarity of the first mood episode may be a marker for suicidal behavior, particularly the violent subtype. METHOD: One hundred and sixty-eight patients diagnosed with bipolar disorder (DSM-IV) were grouped according to type of first episode: depression or manic/hypomanic. Groups were compared for demographic and clinical variables. We performed logistic regression in order to test the association between first episode polarity and suicidal behavior. RESULTS: We found that depressed patients have a lifetime history of more suicide attempts. However, univariate analysis of number of suicide attempts showed that the best model fits the bipolar II subtype (mean square = 15.022; p = 0.010) and lifetime history of psychotic episodes (mean square = 17.359; p = 0.021). Subgrouping the suicide attempts by subtype (violent or non-violent) revealed that manic/hypomanic patients had a greater tendency toward attempting violent suicide (21.2 vs. 14.7%, X² = 7.028, p = 0.03). Multiple logistic regression analysis confirmed this result. CONCLUSION: Depressed patients had more suicide attempts over time, which could be explained by the higher prevalence of bipolar II subtype in this group, whereas manic/hypomanic patients had a lifelong history of more frequent violent suicide attempts, not explained by any of the variables studied. Our results support the evidence that non-violent suicide attempters and violent suicide attempters tend to belong to different phenotypic groups.

C-reactive protein levels are related to suicidality in euthymic patients with bipolar disorder

2016 ◽  
Vol 33 (S1) ◽  
pp. S337-S337
Author(s):  
M. Pantovic Stefanovic ◽  
B. Dunjic-Kostic ◽  
M. Lackovic ◽  
A. Damjanovic ◽  
A. Jovanovic ◽  
...  
Keyword(s):  
Suicide Attempts ◽  
Previous History ◽  
Control Group ◽  
Healthy Controls ◽  
C Reactive Protein ◽  
Course Of Illness ◽  
Protein Levels ◽  
Reactive Protein ◽  
History Of ◽  
Competing Interest

IntroductionImmune alterations are believed to be an important part in etiopathogenesis of affective disorders. However, it is not clear if the altered immune mediators are related to distinct disorders or particular psychopathology.AimsThe aim of our study was to explore the differences in C-reactive protein levels (CRP) between euthymic BD patients and healthy controls, as well as to explore the relationship between CRP and lifetime presented psychopathology within BD.MethodsThe study group consisted of 83 patients diagnosed with BD, compared to the healthy control group (n = 73) and matched according to age, gender, and body mass index (BMI). Lifetime psychopathology has been assessed according to predominant polarity as well as previous history of suicide attempts and psychotic episodes.ResultsThe CRP levels were significantly higher in BD patients when compared to healthy controls. After covarying for confounders, we observed that CRP levels, in euthymic BD patients, were related to number of previous suicide attempts, but not other indicators of lifetime psychopathology.ConclusionsBD patients per se, and particularly those with more suicide attempts, are more likely to present with proinflammatory state, even when in remission. Previous history of suicide attempts could bear specifically vulnerable endophenotype within BD. Systemic, longitudinal monitoring of the course of illness, and potential inflammatory mediators that underlie its systemic nature is warranted.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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 Toxoplasma gondii Infection by Serological and Molecular Methods in Schizophrenia Patients with and without Suicide Attempts: An Age-Sex-Matched Case-Control Study

2021 ◽  
Author(s):  
Özer Akgül ◽  
Ömer Faruk Demirel ◽  
Cana Poyraz Aksoy ◽  
Ezgi Tanrıöver Aydın ◽  
Nuray Uysal ◽  
...  
Keyword(s):  
Case Control Study ◽  
Suicide Attempts ◽  
Case Control ◽  
Control Group ◽  
Study Results ◽  
Healthy Control ◽  
History Of ◽  
Matched Case ◽  
Toxoplasma Gondii Infection ◽  
Control Study

Introduction: The opinion that latent T. gondii infection is having a broadly asymptomatic projection has now been interrogated, in specific due to the echoed association between the latent infection and an elevated incidence of schizophrenia or even suicide attempts. Notwithstanding conducted studies aimed to understand this feasible link are restricted. Methods: In the present case-control study, we focused to illuminate the relationship between the serological and molecular presence of T. gondii and schizophrenia with or without the suicide attempts by comparing it with healthy individuals. A total of 237 participants (117 in schizophrenia; 120 in healthy control) were included in this study. Results: Overall, latent T. gondii infections were found statistically higher in 63 (53.8%) of the 117 patients with schizophrenia and in 33 (27.5%) of the 120 controls (p < 0.001). In schizophrenia patients, seroprevalence T. gondii was again found to be statistically higher in suicide attempters (59.6%), compared to no history of suicide attempts (48.3%) (p < 0.05). The molecular positivity rate of T. gondii DNA was higher in the schizophrenia group, compared to the healthy control group (p < 0.05), whereas the history of suicide attempts was not statistically associated (p = 0.831) with T. gondii DNA positivity by PCR. Conclusion: This case-control study enlightens additional demonstration to the belief that T. gondii infection would be an underlying component for the pathophysiology of schizophrenia. Regardless of the clarity results of this study, this supposition warrants further endorsement.

scholarly journals Influence Factors for Decision-Making Performance of Suicide Attempters and Suicide Ideators: The Roles of Somatic Markers and Explicit Knowledge

2021 ◽  
Vol 12 ◽  
Author(s):  
Lingling Wang ◽  
Jingmin Li ◽  
Hailing Liu ◽  
Zhongpeng Wang ◽  
Li Yang ◽  
...  
Keyword(s):  
Decision Making ◽  
Subjective Experience ◽  
Explicit Knowledge ◽  
Iowa Gambling Task ◽  
Influence Factors ◽  
Healthy Controls ◽  
Gambling Task ◽  
Suicide Attempters ◽  
Somatic Markers ◽  
Skin Conductance Responses

Impaired decision-making has been observed in suicide attempters during the Iowa Gambling Task (IGT). Decision-making performance is influenced by somatic markers and explicit knowledge, but it is still unclear of the influencing role on decision-making performance in suicidal individuals. We aimed to investigate whether there is a decision-making deficit in suicide attempters, suicide ideators, as well as the distinct roles of somatic markers and explicit knowledge wherein. Thirteen suicide attempters, 23 suicide ideators, and 19 healthy controls performed the IGT. Both somatic markers (by the skin conductance responses, SCRs) and explicit knowledge (by the subjective experience rating and a list of questions) were recorded. No significant differences were found among the three groups on IGT performance, explicit knowledge, and anticipatory SCRs. IGT Performance of suicide attempters was positively correlated with explicit knowledge index while behavior performance was positively associated with the SCRs in healthy controls. These results indicate that the suicide attempters seem to apply a compensatory strategy by mostly utilizing explicit knowledge to perform normally as healthy controls in the IGT.

scholarly journals Prefrontal activation in suicide attempters during decision making with emotional feedback

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Adrián Alacreu-Crespo ◽  
Emilie Olié ◽  
Emmanuelle Le Bars ◽  
Fabienne Cyprien ◽  
Jérémy Deverdun ◽  
...  
Keyword(s):  
Decision Making ◽  
Iowa Gambling Task ◽  
Anterior Cingulate ◽  
Suicide Attempters ◽  
Risky Choices ◽  
Emotional Face Processing ◽  
Expected Outcome ◽  
History Of ◽  
Emotional Face ◽  
History Of Depression

Abstract Emotional feedback, such as faces showing emotions, can influence decision making. Decision making and emotional face processing, mainly mediated by the prefrontal and cingulate cortices, are impaired in suicide attempters. Here, we used functional MRI (fMRI) to study prefrontal activation in suicide attempters during a modified version of the Iowa Gambling Task (IGT) that included emotional face feedback. We randomly distributed the 116 euthymic women (n = 45 suicide attempters, n = 41 affective controls with history of depression without suicide attempt, and n = 30 healthy controls) included in the study in three emotional IGT groups: concordant (safe and risky choices followed by happy and angry faces, respectively), discordant (safe and risky choices followed by angry and happy faces, respectively), and neutral condition (safe and risky choices followed by neutral faces). Considering the two IGT phases (ambiguous and risky), we then analyzed five regions of interest during the risky vs. safe choices: orbitofrontal (OFC), anterior cingulate (ACC), ventrolateral (VLPFC), medial (MPFC) and dorsal prefrontal (DPFC) cortices. We found: (1) impaired decision making and increased DPFC and OFC activation in suicide attempters vs. controls in the discordant condition during the risky phase; (2) reduced VLPFC activation in suicide attempters in the concordant condition during the ambiguous phase; and (3) decreased OFC, ACC and DPFC activation in both control groups in the concordant condition during the ambiguous phase. Suicide attempters showed prefrontal alterations during reward-learning decision making with emotional feedback. Suicide attempters may guide their decisions to avoid social negative feedback despite the expected outcome.

Decision making in euthymic bipolar I and bipolar II disorders

2010 ◽  
Vol 41 (6) ◽  
pp. 1319-1327 ◽  
Author(s):  
D. J. Martino ◽  
S. A. Strejilevich ◽  
T. Torralva ◽  
F. Manes
Keyword(s):  
Decision Making ◽  
Bipolar Disorder ◽  
Suicide Attempt ◽  
Verbal Memory ◽  
Iowa Gambling Task ◽  
Large Population ◽  
Healthy Controls ◽  
Gambling Task ◽  
Bipolar Ii ◽  
History Of

BackgroundThe main aim of this study was to compare a large population of patients with bipolar disorder (BD) types I and II strictly defined as euthymic with healthy controls on measures of decision making. An additional aim was to compare performance on a decision-making task between patients with and without a history of suicide attempt.MethodEighty-five euthymic patients with BD-I or BD-II and 34 healthy controls were included. All subjects completed tests to assess verbal memory, attention and executive functions, and a decision-making paradigm (the Iowa Gambling Task, IGT).ResultsBoth groups of patients had worse performance than healthy controls on measures of verbal memory, attention and executive function. No significant differences were found between BD-I, BD-II and healthy controls on measures of decision making. By contrast, patients with a history of suicide attempt had lower performance in the IGT than patients without a history of suicide attempt.ConclusionsPatients with euthymic BD-I and BD-II had intact decision-making abilities, suggesting that this does not represent a reliable trait marker of the disorder. In addition, our results provide further evidence of an association between impairments in decision making and vulnerability to suicidal behavior.

Cholesterol concentrations in violent and non-violent women suicide attempters

2003 ◽  
Vol 18 (1) ◽  
pp. 23-27 ◽  
Author(s):  
J. Vevera ◽  
I. Žukov ◽  
T. Morcinek ◽  
H. Papežová
Keyword(s):  
Suicide Attempts ◽  
Analysis Of Covariance ◽  
Cholesterol Concentration ◽  
Control Group ◽  
Impulsive Behavior ◽  
Suicide Attempters ◽  
Cholesterol Levels ◽  
Significant Difference ◽  
Lower Serum Cholesterol ◽  
History Of

AbstractThe aim of this study was to evaluate whether women with a history of violent suicide attempts have lower serum cholesterol concentrations than those who attempted suicide by non-violent methods. Our retrospective study used a case-control design to compare serum total cholesterol concentration, hematocrit, red blood cell count and body mass index (BMI) in women with a history of violent (n = 19) or non-violent (n = 51) suicide attempts and of non-suicidal controls (n = 70) matched by diagnosis and age. Analysis of covariance (ANCOVA) with age as the covariate was used to analyze differences in cholesterol levels in groups according to violence. Violence was found to be a significant factor (P = 0.016). Using the Scheffé test, a significant difference (P = 0.011) was revealed between the group of violent and non-violent suicide attempters and between the violent suicide attempters and the control group. Patients with a violent suicidal attempt have significantly lower cholesterol levels than patients with non-violent attempts and the control subjects. Our findings suggest that suicide attempts should not be considered a homogenous group. They are consistent with the theory that low levels of cholesterol are associated with increased tendency for impulsive behavior and aggression and contribute to a more violent pattern of suicidal behavior.

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