The associations among childhood maltreatment, “male depression” and suicide risk in psychiatric patients

Abstract Objective: Cholesterol is one of the cardiovascular risk factors, but also a core component of the central nervous system. Moreover, hyper-cholesterolemia and hypocholesterolemia are directly related to numerous mental illnesses too. This study intents to examine the association between cholesterol level and autolytic behavior among female psychiatric patients. Methods: The present study involves 123 female subjects, who suffered from suicidal thoughts at the moment of hospitalization. The risk of suicidal intentions was assessed by the Modified Scale for Suicide Ideation (Miller et al) and their total serum cholesterol levels were measured. We performed a case-control, analytical, randomized, observational study at the Clinical Hospital of Neurology and Psychiatry Brasov among adult female psychiatric patients admitted during 2014. Results: By our results we distinguished 3 categories: 38 patients with low suicide risk, 32 with moderate risk and 53 with high suicide risk. Significant difference can be noticed in the higher suicide risk patients’ blood cholesterol levels: 44 patients having under 4,5mmol/L total cholesterol level (83%). Although, in other two categories, this proportion is minimal: in the moderate-risk category were 8 patients, representing just 25 %, and in the low-risk category only 1 patient had her cholesterol level under 4,5mmol/L (2,6%). Conclusions: According to our results, proposing cholesterol-level as a biomarker for the determination of high-risk suicide behavior can be important. The presence of other important risk factors (sociodemographic and psychiatric variables) can increase exponentially the suicide behavior. The limitations of this study are the relatively small number of cases and the lack of longitudinal subsequent follow-up. Further investigations are needed on a larger and more heterogenous sample of patients in order to clarify this suggestive correlation.

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Are Low Brain Derived Neurotrophic Factor Levels in the Blood a Biological Marker of Suicide Risk in Psychiatric Patients? A Systematic Review

Journal of Neurology Research ◽

10.4021/jnr171e ◽

2013 ◽

Author(s):

Kavalidou

Keyword(s):

Systematic Review ◽

Neurotrophic Factor ◽

Suicide Risk ◽

Psychiatric Patients ◽

Biological Marker ◽

Brain Derived Neurotrophic Factor

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Suicide rates among patients subject to community treatment orders in England during 2009–2018

BJPsych Open ◽

10.1192/bjo.2021.1021 ◽

2021 ◽

Vol 7 (6) ◽

Author(s):

Isabelle M. Hunt ◽

Roger T. Webb ◽

Pauline Turnbull ◽

Jane Graney ◽

Saied Ibrahim ◽

...

Keyword(s):

Mental Health ◽

Suicide Risk ◽

Psychiatric Patients ◽

Case Series ◽

Population Based ◽

Time Dependent ◽

Community Treatment ◽

Community Treatment Orders ◽

Suicide Rates ◽

Discharged Patients

Background Community treatment orders (CTOs) enable patients to be treated in the community rather than under detention in hospital. Population-based studies of suicide among patients subject to a CTO are scarce. Aims To compare suicide rates among patients subject to a CTO with all discharged psychiatric patients and those detained for treatment but not subject to a CTO at discharge (‘CTO-eligible’ patients). Method From a national case series of patients who died by suicide within 12 months of contact with mental health services in England during 2009–2018, we estimated average annual suicide rates for all discharged patients, those on a CTO at the time of suicide, those ever treated under a CTO and CTO-eligible patients. Results Suicide rates for patients on a CTO at the time of suicide (191.3 per 100 000 patients) were lower than all discharged patients (482.3 per 100 000 discharges). Suicide rates were similar in those ever treated under a CTO (350.1 per 100 000 CTOs issued) and in CTO-eligible patients (382.9 per 100 000 discharges). Suicide rates within 12 months of discharge were higher in persons ever under a CTO (205.1 per 100 000 CTOs issued) than CTO-eligible patients (161.5 per 100 000 discharges), but this difference was reversed for rates after 12 months of discharge (153.2 per 100 000 CTOs issued v. 223.4 per 100 000 discharges). Conclusions CTOs may be effective in reducing suicide risk. The relative benefits of CTOs and intensive aftercare may be time-dependent, with the benefit of a CTO being less before 12 months after discharge but greater thereafter. CTO utilisation requires a careful balancing of patient safety versus autonomy.

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The Role of Demoralization and Hopelessness in Suicide Risk in Schizophrenia: A Review of the Literature

Medicina ◽

10.3390/medicina55050200 ◽

2019 ◽

Vol 55 (5) ◽

pp. 200 ◽

Cited By ~ 5

Author(s):

Isabella Berardelli ◽

Salvatore Sarubbi ◽

Elena Rogante ◽

Michael Hawkins ◽

Gabriele Cocco ◽

...

Keyword(s):

Meaning In Life ◽

Suicide Risk ◽

Psychiatric Patients ◽

Health Concern ◽

Bibliographic Databases ◽

Mental Health Concern ◽

Psychological Tools ◽

Suicide Prevention Programs ◽

The Relationship

Background and Objectives: Demoralization has been defined by hopelessness and helplessness attributable to a loss of purpose and meaning in life. Demoralization is a meaningful mental health concern, frequently associated with suicide risk in medical and psychiatric patients. The aim of this systematic review was to synthesize the recent empirical evidence on demoralization in patients with schizophrenia and to better understand the relationship between demoralization and suicide risk in patients with schizophrenia. Methods: A comprehensive literature search using key words and subject headings was performed following PRISMA guidelines with several bibliographic databases, resulting in the identification of 27 studies. Results: The findings suggested that demoralization is prevalent in patients with schizophrenia and supported the hypothesis that the association between depression and suicide is moderated by hopelessness. In clinical practice, it is important to recognize symptoms of demoralization using appropriate psychological tools to better understand the suffering of patients with schizophrenia and to implement suicide prevention programs.

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Childhood Maltreatment, Pathological Personality Dimensions, and Suicide Risk in Young Adults

Frontiers in Psychology ◽

10.3389/fpsyg.2018.00806 ◽

2018 ◽

Vol 9 ◽

Cited By ~ 6

Author(s):

Giorgio Falgares ◽

Daniela Marchetti ◽

Giovanna Manna ◽

Pasquale Musso ◽

Osmano Oasi ◽

...

Keyword(s):

Young Adults ◽

Childhood Maltreatment ◽

Suicide Risk ◽

Personality Dimensions

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Suicide in recently discharged psychiatric patients: a case-control study

Psychological Medicine ◽

10.1017/s0033291708003644 ◽

2008 ◽

Vol 39 (3) ◽

pp. 443-449 ◽

Cited By ~ 105

Author(s):

I. M. Hunt ◽

N. Kapur ◽

R. Webb ◽

J. Robinson ◽

J. Burns ◽

...

Keyword(s):

Mental Health ◽

Risk Factors ◽

Suicide Risk ◽

Case Control Study ◽

Clinical Symptoms ◽

Risk Measures ◽

Psychiatric Patients ◽

Case Control ◽

Control Study

BackgroundFew controlled studies have specifically investigated aspects of mental health care in relation to suicide risk among recently discharged psychiatric patients. We aimed to identify risk factors, including variation in healthcare received, for suicide within 3 months of discharge.MethodWe conducted a national population-based case-control study of 238 psychiatric patients dying by suicide within 3 months of hospital discharge, matched on date of discharge to 238 living controls.ResultsForty-three per cent of suicides occurred within a month of discharge, 47% of whom died before their first follow-up appointment. The first week and the first day after discharge were particular high-risk periods. Risk factors for suicide included a history of self-harm, a primary diagnosis of affective disorder, recent last contact with services and expressing clinical symptoms at last contact with staff. Suicide cases were more likely to have initiated their own discharge and to have missed their last appointment with services. Patients who were detained for compulsory treatment at last admission, or who were subject to enhanced levels of aftercare, were less likely to die by suicide.ConclusionsThe weeks after discharge from psychiatric care represent a critical period for suicide risk. Measures that could reduce risk include intensive and early community follow-up. Assessment of risk should include established risk factors as well as current mental state and there should be clear follow-up procedures for those who have self-discharged. Recent detention under the Mental Health Act and current use of enhanced levels of aftercare may be protective.

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An approach for Risk Assessment Score of Suicide Attempt (RASSA)

10.21203/rs.3.rs-191353/v1 ◽

2021 ◽

Author(s):

Ana Fructuoso ◽

Inmaculada Fierro ◽

María-Isabel Jiménez-Serranía ◽

Alfonso Carvajal Garcia-Pando

Keyword(s):

Risk Factors ◽

Risk Assessment ◽

Suicide Attempt ◽

Suicide Risk ◽

Psychiatric Patients ◽

Opioid Analgesics ◽

Health Records ◽

Assessment Score ◽

Somatic Comorbidity ◽

Clinical Records

Abstract Background: Suicide remains a leading cause of death and psychiatric population is often at increased risk for suicide. Therefore, there is a persistent need for well-designed clinical instruments that allows us to identify relevant risk factors. Our study aims to improve patient follow-up and identify possible suicide risk markers from a passage to self-harm among hospitalized psychiatric patients. Methods: This case-control study included the review of psychiatric, sociodemographic, drug use, and other health-related data, retrieved from 1,680 psychiatric patients’ health records. Differences between comparative groups were examined, and stepwise logistic regression analyses were performed to identify suicide risk factors within this population.Results: From the analysis of 560 suicide attempters’ clinical records, thirteen risk items were included in our final model, named as Risk Assessment Score of Suicide Attempt (RASSA). The factors that scored the highest in this model were ‘not taking antipsychotic medication’, ‘somatic comorbidity’, and ‘a family history of suicide’. Suffering from depression has a high score, and treatment with selective serotonin reuptake inhibitors (SSRIs) is also involved in the risk of a suicide attempt. Regarding medication use, opioid analgesics decreased the risk score, while taking non-opioid analgesics increased it. In terms of commonly abused substances, alcohol, cocaine, and amphetamine dependence increased the score. A higher risk was also associated with cannabis dependence, while tobacco use reduced it. As for demographics, the risk was significantly greater for women and subjects who were unmarried. Conclusions: The proposed model of risk assessment score of suicide attempt (RASSA) offers the possibility of establishing a suicide attempt risk based on data directly gathered from the health records of psychiatric patients. Therefore, it might be used as an initial screening test before patient evaluation and psychometric tests.

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Improving Risk Assessment with Suicidal Patients

Crisis ◽

10.1027/0227-5910/a000034 ◽

2010 ◽

Vol 31 (5) ◽

pp. 231-237 ◽

Cited By ~ 7

Author(s):

Charles Nelson ◽

Megan Johnston ◽

Amresh Shrivastava

Keyword(s):

Risk Assessment ◽

Suicide Risk ◽

Function Analysis ◽

Psychiatric Patients ◽

Assessment Tools ◽

Suicide Risk Assessment ◽

Risk Assessment Tools ◽

Admission Status ◽

Suicidal Patients ◽

New Strategies

Background: Although a number of suicide-risk assessment tools are available to clinicians, the high levels of suicide still evident in society suggest a clear need for new strategies in order to facilitate the prevention of suicidal behaviors. Aims: The present study examined the utilization of a new structured clinical interview called the Scale for Impact of Suicidality Management, Assessment, and Planning of Care (SIS-MAP). Methods: SIS-MAP ratings were obtained from a group of incoming psychiatric patients over a 6-month period at Regional Mental Health Care, St. Thomas, Canada. Results: A canonical discriminant function analysis resulted in a total 74.0% of original grouped cases correctly classified based on admission status (admitted or not; Wilks λ = .749, p < .001). The specificity of the scale was 78.1%, while the sensitivity of the scale was 66.7%. Additionally, mean total scores on the scale were used to establish clinical cutoffs to facilitate future level of care decisions. Conclusions: Preliminary analysis suggests the SIS-MAP is a valid and reliable tool for determining the level of psychiatric care needed for adults with suicidal ideation.

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