Depression and Suicide in Early Onset Schizophrenia

2011 ◽  
Vol 26 (S2) ◽  
pp. 2012-2012
Author(s):  
G. Zalsman

PurposeSuicide is a major cause of death in adolescents with first-episode schizophrenia (FES). We compared suicide-related traits between subjects with FES and with other psychopathologies in order to evaluate risk factors for suicidal behavior.Subjects and methodsTwenty-five inpatient adolescents with FES and a control group of 28 psychiatric inpatients matched for gender and age were assessed for depression, anger, criminal behavior, aggression, and suicidal ideation, risk and potential.ResultsThe adolescents with FES had significantly lower depression (p=0.003) anger (p=0.025) and criminal behavior (p=0.022) than did the controls. However, while suicide ideation was greater in the subjects with FES (p=0.003), suicide risk was significantly lower than controls (p=0.004).DiscussionDecreased levels of both depression and anger as part of affective constriction in the schizophrenia group could explain why the increased suicide ideation did not lead to a higher suicide risk in these inpatients.ConclusionThis study highlights the importance of distinguishing between suicidal ideation and actual suicide risk. We demonstrated that thoughts of suicide do not necessarily translate into an actual risk of suicidal behavior in adolescents with schizophrenia.

Crisis ◽  
2014 ◽  
Vol 35 (6) ◽  
pp. 388-397 ◽  
Author(s):  
Lea Shelef ◽  
Yossi Levi-Belz ◽  
Eyal Fruchter

Background: The phenomenon of suicide and suicidal behaviors during military service is universal, with a recent dramatic rise in some armies. Aims: The aim of this study was to shed light on the role of dissociation and habituation as facilitators of suicidal behavior, beyond other well-established risk factors of stress, such as depression and hopelessness. Method: The study group included 167 soldiers, aged 18–21 years divided into three research groups: soldiers who made suicide attempts, soldiers who were psychologically treated, and a control group of soldiers having no history of mental health treatment. All subjects completed a suicide ideation scale and instruments measuring stress, mental pain, bodily dissociation, and habituation. Results: Suicide attempters had higher levels of subjective stress as well as depression and hopelessness compared with the psychologically treated and control groups. Using regression analysis, suicide facilitators of dissociation and habituation explained a significant proportion of the suicidal ideation variance, above and beyond the contribution of stress, depression, and hopelessness. A combined effect of stress and facilitating factors amplifies the level of suicidal ideation among soldiers. Conclusion: Identifying psychological facilitators of suicide-like dissociation and habituation may contribute to understanding suicidal behavior in soldiers and assist in developing effective suicide-prevention initiatives in the military setting.


Crisis ◽  
2001 ◽  
Vol 22 (2) ◽  
pp. 54-60 ◽  
Author(s):  
Lisheng Du ◽  
Gabor Faludi ◽  
Miklos Palkovits ◽  
David Bakish ◽  
Pavel D. Hrdina

Summary: Several lines of evidence indicate that abnormalities in the functioning of the central serotonergic system are involved in the pathogenesis of depressive illness and suicidal behavior. Studies have shown that the number of brain and platelet serotonin transporter binding sites are reduced in patients with depression and in suicide victims, and that the density of 5-HT2A receptors is increased in brain regions of depressed in suicide victims and in platelets of depressed suicidal patients. Genes that code for proteins, such as tryptophan hydroxylase, 5-HT transporter, and 5-HT2A receptor, involved in regulating serotonergic neurotransmission, have thus been major candidate genes for association studies of suicide and suicidal behavior. Recent studies by our group and by others have shown that genetic variations in the serotonin-system-related genes might be associated with suicidal ideation and completed suicide. We have shown that the 102 C allele in 5-HT2A receptor gene was significantly associated with suicidal ideation (χ2 = 8.5, p < .005) in depressed patients. Patients with a 102 C/C genotype had a significantly higher mean HAMD item #3 score (indication of suicidal ideation) than T/C or T/T genotype patients. Our results suggest that the 102T/C polymorphism in 5-HT2A receptor gene is primarily associated with suicidal ideation in patients with major depression and not with depression itself. We also found that the 5-HT transporter gene S/L polymorphism was significantly associated with completed suicide. The frequency of the L/L genotype in depressed suicide victims was almost double of that found in control group (48.6% vs. 26.2%). The odds ratio for the L allele was 2.1 (95% CI 1.2-3.7). The association between polymorphism in serotonergic genes and suicidality supports the hypothesis that genetic factors can modulate suicide risk by influencing serotonergic activity.


2018 ◽  
Vol 34 (4) ◽  
pp. 265-271 ◽  
Author(s):  
Milena Zucca ◽  
Elisa Rubino ◽  
Alessandro Vacca ◽  
Flora Govone ◽  
Annalisa Gai ◽  
...  

Aim: The purpose of the study was to determine the prevalence of suicidal ideation and attempts in patients with behavioral variant frontotemporal dementia (bvFTD), evaluating possible risk factors for suicidality. Methods: Risk of suicide was assessed using the Scale for Suicide Ideation (SSI) in 35 patients with bvFTD and 25 controls. Results: According to SSI, 40% of patients with bvFTD had suicidal ideation in comparison to 8% of controls ( P = .009). Four patients with bvFTD have attempted suicide versus none control ( P = .006). Patients with bvFTD with suicide risk showed higher levels of anxiety, depression, stress, and hopelessness than patients without suicide risk ( P < .001). Patients who attempted suicide were younger and had a longer disease duration than those with only suicide ideation. Intriguingly, 40% of patients with parkinsonism presented high level of suicide ideation. Conclusions: Our findings show that patients with bvFTD have a high risk of suicide. Additional studies in larger populations are needed to confirm our results.


10.2196/17758 ◽  
2020 ◽  
Vol 22 (7) ◽  
pp. e17758 ◽  
Author(s):  
Diana Ramírez-Cifuentes ◽  
Ana Freire ◽  
Ricardo Baeza-Yates ◽  
Joaquim Puntí ◽  
Pilar Medina-Bravo ◽  
...  

Background Suicide risk assessment usually involves an interaction between doctors and patients. However, a significant number of people with mental disorders receive no treatment for their condition due to the limited access to mental health care facilities; the reduced availability of clinicians; the lack of awareness; and stigma, neglect, and discrimination surrounding mental disorders. In contrast, internet access and social media usage have increased significantly, providing experts and patients with a means of communication that may contribute to the development of methods to detect mental health issues among social media users. Objective This paper aimed to describe an approach for the suicide risk assessment of Spanish-speaking users on social media. We aimed to explore behavioral, relational, and multimodal data extracted from multiple social platforms and develop machine learning models to detect users at risk. Methods We characterized users based on their writings, posting patterns, relations with other users, and images posted. We also evaluated statistical and deep learning approaches to handle multimodal data for the detection of users with signs of suicidal ideation (suicidal ideation risk group). Our methods were evaluated over a dataset of 252 users annotated by clinicians. To evaluate the performance of our models, we distinguished 2 control groups: users who make use of suicide-related vocabulary (focused control group) and generic random users (generic control group). Results We identified significant statistical differences between the textual and behavioral attributes of each of the control groups compared with the suicidal ideation risk group. At a 95% CI, when comparing the suicidal ideation risk group and the focused control group, the number of friends (P=.04) and median tweet length (P=.04) were significantly different. The median number of friends for a focused control user (median 578.5) was higher than that for a user at risk (median 372.0). Similarly, the median tweet length was higher for focused control users, with 16 words against 13 words of suicidal ideation risk users. Our findings also show that the combination of textual, visual, relational, and behavioral data outperforms the accuracy of using each modality separately. We defined text-based baseline models based on bag of words and word embeddings, which were outperformed by our models, obtaining an increase in accuracy of up to 8% when distinguishing users at risk from both types of control users. Conclusions The types of attributes analyzed are significant for detecting users at risk, and their combination outperforms the results provided by generic, exclusively text-based baseline models. After evaluating the contribution of image-based predictive models, we believe that our results can be improved by enhancing the models based on textual and relational features. These methods can be extended and applied to different use cases related to other mental disorders.


Author(s):  
Catarina Magalhães Porto ◽  
Natalia Santos Barbosa da Silva ◽  
Cecília Magalhães Porto Lira ◽  
Rayana Porpino Magalhães ◽  
José Luiz Oliveira Magalhães ◽  
...  

Background: One of the risk factors for suicide includes the presence of depressive disorder and symptoms, which may be related to the reduction of 25-hydroxyvitamin D serum levels. In this scenario, evidence shows vitamin D deficiency as an important aspect, directly related to depressive disorder chronicity. Objective: To assess the association between Vitamin D serum levels and the intensity of depressive symptoms and suicidal behavior in a clinical sample of depressed patients. Methods: A cross-sectional study with 146 patients aged between 18 and 59, seen in two psychiatry ambulatories. Data collection involved measurement of serum 25-hydroxyvitamin D levels and assessment of the intensity of depressive symptoms and suicide risk. Results: In the sample, 35% presented low Vitamin D serum levels and, in these individuals, the incidence of family history of Depressive Disorder (95.2%) and chronicity of severe depressive symptoms (47.8%) was higher. As to suicidal behavior, both groups presented high active suicide risk, with higher rates in the group with hypovitaminosis D. Only suicidal ideation was linked to lower Vitamin D levels (67.4% p= 0,005). Conclusion: In this study, hypovitaminosis D was associated with negative mental health outcomes, such as more severe chronicity of depressive symptoms and suicidal behavior, characterized by active suicidal ideation.


2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Mi Yang ◽  
Shan Gao ◽  
Xiangyang Zhang

Abstract Cognitive impairment is viewed as a core symptom of schizophrenia (SCZ), but its pathophysiological mechanism remains unclear. White matter (WM) disruption is considered to be a central abnormality that may contribute to cognitive impairment in SCZ patients. However, few studies have addressed the association between cognition and WM integrity in never-treated first-episode (NTFE) patients with SCZ. In this study, we used the MATRICS Consensus Cognitive Battery (MCCB) to evaluate cognitive function in NTFE patients (n = 39) and healthy controls (n = 30), and associated it with whole-brain fractional anisotropy (FA) values obtained via voxel-based diffusion tensor imaging. We found that FA was lower in five brain areas of SCZ patients, including the cingulate gyrus, internal capsule, corpus callosum, cerebellum, and brainstem. Compared with the healthy control group, the MCCB’s total score and 8 out of 10 subscores were significantly lower in NTFE patients (all p < 0.001). Moreover, in patients but not healthy controls, the performance in the Trail Making Test was negatively correlated with the FA value in the left cingulate. Our findings provide evidence that WM disconnection is involved in some cognitive impairment in the early course of SCZ.


2019 ◽  
Vol 49 (16) ◽  
pp. 2789-2800 ◽  
Author(s):  
Christopher R. Hagan ◽  
Megan L. Rogers ◽  
Amy M. Brausch ◽  
Jennifer J. Muehlenkamp ◽  
Thomas E. Joiner

AbstractBackgroundInteroceptive deficits (ID) have been associated with non-suicidal self-injury (NSSI) and suicidal behavior in multiple studies. Many of these studies are limited in scope, and have not fully examined possible mechanisms explaining how ID affect suicidal behavior.MethodsThis study assesses how self-reported ID relate to suicide ideation and attempts in six distinct and geographically diverse samples of adults (n = 2706) and one sample of adolescents (n = 436). Participants responded to a variety of self-report questionnaires and interviews.ResultsContrary to our hypothesis, self-reported ID were only associated with suicidal ideation in two samples, one of which was the adolescent sample. Largely consistent with our predictions, self-reported ID exhibited an indirect effect on suicide attempts through versatility of NSSI in four of the five adult samples tested. Finally, the indirect effects of self-reported ID on suicide attempts through NSSI versatility did not act indirectly through behaviorally assessed pain tolerance.ConclusionsWe found that, in adults, self-reported ID are not associated with suicidal ideation, but are connected with a history of suicide attempts, through an indirect effect via NSSI. Our findings also indicate that the mechanism of action leading from self-reported ID to suicidal behavior may differ between adolescents and adults, and relate to suicidal behavior independent of pain tolerance. Clinical implications and future directions are discussed.


2019 ◽  
Vol 217 (6) ◽  
pp. 693-700 ◽  
Author(s):  
Thomas Niederkrotenthaler ◽  
Benedikt Till

BackgroundAwareness materials featuring ways of coping with suicidal ideation can reduce suicidal ideation, the so-called Papageno effect. All of the previous experimental studies on this subject have been conducted with individuals not at risk of suicide.AimsTo assess effects of suicide awareness materials in a sample of individuals with recent suicidal ideation. Trial registration: German Clinical Trial Registry ID number DRKS00013613.MethodAdults (n = 266) with recent self-reported suicidal ideation or attempt were randomised to read an educative article featuring a lay individual with personal experience of suicidality (n = 86), a similar article featuring a mental health expert (n = 90), or an unrelated article (n = 90) in a double-blind online randomised controlled trial. Questionnaire data were collected before (T1) and immediately after exposure (T2) as well as 1 week later (study end-point, T3) and analysed with linear mixed models. The primary outcome was suicide risk as assessed using the Survival and Coping Beliefs subscale of the Reasons for Living Inventory (RFLI); secondary outcomes were suicide-prevention knowledge and mood.ResultsThere was an immediate beneficial effect on suicide risk in the intervention group exposed to the message delivered by the individual with personal experience (group 1) as compared with the control group that was maintained until the study end-point (study end-point: RFLI score mean difference from baseline within group 1 MD = −0.36 (95% CI −0.66 to −0.06), mean difference compared with control group MD = −0.71 (95% CI −1.27 to −0.14); d = −0.18). The effect was particularly pronounced for individuals with recent suicide attempt (RFLI score at T3, compared with control group: MD = −1.55 (95% CI −2.52 to −0.57); d = −0.23). Participants in this group also showed increased prevention-related knowledge compared with the control group.ConclusionsIndividuals with a recent suicide attempt appear to benefit from a printed narrative of positive coping with suicidal ideation. The intervention materials do not increase short-term suicide risk.


2011 ◽  
Vol 26 (S2) ◽  
pp. 1528-1528
Author(s):  
H. Wang ◽  
X. Liu ◽  
Y. Fang

IntroductionCognitive dysfunction was thought to be one of the core features of schizophrenia. And the executive function of the patients was paid more attention by more and more researchers and clinicians.ObjectivesTo investigate the executive function and the learning ability of the patients with first-episode schizophrenia, and their relationships with psychiatric symptoms.MethodsFifty cases of first-episode schizophrenia patients and fifty age- and gender-matched healthy controls were tested by a computerized version of Tower of London (TOL) test. The scores of the Positive and Negative Syndrome Scale(PANSS) in the group of schizophrenia patients were over 60.ResultsThe numbers of the correct answer [x1 :(14.62 ± 4.12), x2: (14.80 ± 4.70)] during the first session and the second session of the TOL test of the patients group were significantly lower than that of the control group [x1: (17.48 ± 3.79), x2:(18.68 ± 3.19)], and the reaction times [t1: (9.27 ± 4.37) seconds, t2: (9.51 ± 5.58) seconds] of the two sessions of TOL were longer than the control group [t1: (7.28 ± 2.04) seconds, t2: (6.67 ± 1.51) seconds], P < 0.01. For the control group, x2 was significantly greater than x1, and t2 shorter than t1 (P < 0.01), while for the patients group, there was no difference between the performances of the first session and the second session. The scores of TOL in the schizophrenia patients were correlated with the negative symptom score of PANSS (P < 0.05) and were not correlated with the scores of other subscales of PANSS (P > 0.05).ConclusionsThe executive function and the learning ability of schizophrenia are impaired and the cognitive dysfunction is correlated with negative symptoms.


CNS Spectrums ◽  
2007 ◽  
Vol 12 (2) ◽  
pp. 156-162 ◽  
Author(s):  
Kelly Posner ◽  
Glenn A. Melvin ◽  
Barbara Stanley ◽  
Maria A. Oquendo ◽  
Madelyn Gould

ABSTRACTSuicide remains a leading cause of death among youth, and suicide ideation and behavior are relatively common in both normal and clinical populations. Clinicians working with young people must assess for the presence of suicidal ideation, suicidal behavior, and other risk factors, in order to determine the level of risk. This paper provides the clinician with a summary of risk factors for youth suicide, as well as providing standardized terminology to enhance assessment of suicidal ideation and behavior.


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