Impulsive-aggressive behaviours and completed suicide across the life cycle: a predisposition for younger age of suicide

2007 ◽  
Vol 38 (3) ◽  
pp. 407-417 ◽  
Author(s):  
A. McGirr ◽  
J. Renaud ◽  
A. Bureau ◽  
M. Seguin ◽  
A. Lesage ◽  
...  

BackgroundIt is unclear whether the association between impulsive-aggressive behaviours and suicide exists across different ages.MethodVia psychological autopsy, we examined a total of 645 subjects aged 11–87 years who died by suicide. Proxy-based interviews were conducted using the SCID-I & SCID-II or K-SADS interviews and a series of behavioural and personality-trait assessments. Secondarily, 246 living controls were similarly assessed.ResultsHigher levels of impulsivity, lifetime history of aggression, and novelty seeking were associated with younger age of death by suicide, while increasing levels of harm avoidance were associated with increasing age of suicide. This effect was observed after accounting for age-related psychopathology (current and lifetime depressive disorders, lifetime anxiety disorders, current and lifetime substance abuse disorders, psychotic disorders and cluster B personality disorders). Age effects were not due to the characteristics of informants, and such effects were not observed among living controls. When directly controlling for major psychopathology, the interaction between age, levels of impulsivity, aggression and novelty seeking predicted suicide status while controlling for the independent contributions of age and these traits.ConclusionsHigher levels of impulsive-aggressive traits play a greater role in suicide occurring among younger individuals, with decreasing importance with increasing age.

2005 ◽  
Vol 17 (3) ◽  
pp. 341-351 ◽  
Author(s):  
JEFFREY L. CUMMINGS

Psychogeriatrics began as an extension of psychiatry, with an emphasis on the unique manifestation of psychiatric disorders in the elderly. Early in the history of psychogeriatrics there was an emphasis on late-onset or late-enduring depression; paraphrenia and late-onset psychotic disorders; the late-life phases of schizophrenia; and anxiety and substance abuse disorders in the elderly. Growing recognition of the increasing frequency of Alzheimer's disease (AD) in the course of aging and the high prevalence of behavioral disturbances in patients with AD led psychogeriatricians to study the diagnosis and management of this disorder.


1999 ◽  
Vol 11 (4) ◽  
pp. 385-397 ◽  
Author(s):  
F. M. Baker ◽  
Lenore J. Launer ◽  
Monique M. R. Breteler ◽  
Albert Hofman

Background: Ommoord District residents of Rotterdam, The Netherlands, age 55 and older, completed a two-stage interview to assess the risk factors for chronic disease and disability. Methods: In the in-home Stage I interview (N = 7,983), demographic data and medical history were collected by a trained lay interviewer. During Stage II, a physician interview and examination were conducted at the study center. Subjects (N = 7,129) were asked about their history of psychiatric disorders and 6,596 responded. Results: The lifetime prevalence of self-reported psychiatric disorders was 5.44% for unipolar and bipolar depressive disorders combined, 0.27% for psychotic disorders, 0.08% for alcoholism, 0.05% for drug addiction, and 3.71% for other diagnoses. Residents reporting a psychiatric diagnosis of depression were more likely to be currently taking an antidepressant medication (p < .001) and an antipsychotic medication (p < .0001), to be in current outpatient treatment (p < .001), to have been hospitalized for psychiatric illness (p < .001), to have undergone electroconvulsive treatments (p < .001), and to report a history of having made suicide attempts (p < .001). Conclusion: The self-reported lifetime prevalence of affective disorders was similar to the rates found in the Stirling County Study (Canada) and the Epidemiologic Catchment Area Survey (United States). The lower prevalence rates of the other psychiatric disorders may reflect underreporting or an age cohort effect, or may be due to the nonresponse bias.


Crisis ◽  
1996 ◽  
Vol 17 (3) ◽  
pp. 123-127 ◽  
Author(s):  
H Sorri ◽  
M Henriksson ◽  
J Lönnqvist

Using data from a nationwide psychological autopsy study of all suicides in Finland occurring over a 1-year period, the authors investigated religiosity and its types among suicide victims. Overt active religiosity was identified in 245 (18%) of the victims. A history of psychiatric inpatient treatment and psychotic and depressive disorders diagnosed in psychiatric care were more common among the religious victims than among the nonreligious. The burden of major mental disorders seems to have been heavier among religious than nonreligious victims. The type of religiosity of victims was qualitatively characterized into four categories: (1) help-seeking from a religious congregation, (2) conflict with a religious congregation, (3) private religiosity, and (4) abandoned religiosity. Further research needs to address the psychological contents and psychiatric implications of different types of religiosity among suicidal individuals.


2019 ◽  
Author(s):  
Thomas M Olino ◽  
Daniel Klein ◽  
John Seeley

Background: Most studies examining predictors of onset of depression focus on variable centered regression methods that focus on effects of multiple predictors. In contrast, person-centered approaches develop profiles of factors and these profiles can be examined as predictors of onset. Here, we developed profiles of adolescent psychosocial and clinical functioning among adolescents without a history of major depression. Methods: Data come from a subsample of participants from the Oregon Adolescent Depression Project who completed self-report measures of functioning in adolescence and completed diagnostic and self-report measures at follow-up assessments up to approximately 15 years after baseline. Results: We identified four profiles of psychosocial and clinical functioning: Thriving; Average Functioning; Externalizing Vulnerability and Family Stress; and Internalizing Vulnerability at the baseline assessment of participants without a history of depression at the initial assessment in mid- adolescence. Classes differed in the likelihood of onset and course of depressive disorders, experience of later anxiety and substance use disorders, and psychosocial functioning in adulthood. Moreover, the predictive utility of these classes was maintained when controlling for multiple other established risk factors for depressive disorders. Conclusions: This work highlights the utility of examining multiple factors simultaneously to understand risk for depression.


2019 ◽  
Vol 16 (3) ◽  
pp. 250-257 ◽  
Author(s):  
Jiann-Der Lee ◽  
Ya-Han Hu ◽  
Meng Lee ◽  
Yen-Chu Huang ◽  
Ya-Wen Kuo ◽  
...  

Background and Purpose: Recurrent ischemic strokes increase the risk of disability and mortality. The role of conventional risk factors in recurrent strokes may change due to increased awareness of prevention strategies. The aim of this study was to explore the potential risk factors besides conventional ones which may help to affect the advances in future preventive concepts associated with one-year stroke recurrence (OSR). Methods: We analyzed 6,632 adult patients with ischemic stroke. Differences in clinical characteristics between patients with and without OSR were analyzed using multivariate logistic regression and classification and regression tree (CART) analyses. Results: Among the study population, 525 patients (7.9%) had OSR. Multivariate logistic regression analysis revealed that male sex (OR 1.243, 95% CI 1.025 – 1.506), age (OR 1.015, 95% CI 1.007 - 1.023), and a prior history of ischemic stroke (OR 1.331, 95% CI 1.096 – 1.615) were major factors associated with OSR. CART analysis further identified age and a prior history of ischemic stroke were important factors for OSR when classified the patients into three subgroups (with risks of OSR of 8.8%, 3.8%, and 12.5% for patients aged > 57.5 years, ≤ 57.5 years/with no prior history of ischemic stroke, and ≤ 57.5 years/with a prior history of ischemic stroke, respectively). Conclusions: Male sex, age, and a prior history of ischemic stroke could increase the risk of OSR by multivariate logistic regression analysis, and CART analysis further demonstrated that patients with a younger age (≤ 57.5 years) and a prior history of ischemic stroke had the highest risk of OSR.


Author(s):  
Paul W Turke

Abstract The severity of COVID-19 is age-related, with the advantage going to younger age groups. Five reasons are presented. The first two are well-known, are being actively researched by the broader medical community, and therefore are discussed only briefly here. The third, fourth, and fifth reasons derive from evolutionary life history theory, and potentially fill gaps in current understanding of why and how young and old age groups respond differently to infection with SARS-CoV-2. Age of onset of generalized somatic aging, and the timing of its progression, are identified as important causes of these disparities, as are specific antagonistic pleiotropic tradeoffs in immune system function.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Maiko Maruyama-Inoue ◽  
Tatsuya Inoue ◽  
Shaheeda Mohamed ◽  
Yoko Kitajima ◽  
Shoko Ikeda ◽  
...  

AbstractThe purpose of this study was to report the incidence of elevated intraocular pressure (IOP) after intravitreal injection (IVI) of anti-vascular endothelial growth factor (VEGF) in Japanese patients with age-related macular degeneration (AMD). A retrospective study of chart review of patients who underwent ≥ 10 intravitreal anti-VEGF injections between April 2009 and December 2019 was conducted. Elevated IOP was defined as IOP ≥ 25 mmHg at one visit. Cases with elevated IOP resulting from IVI were identified. Furthermore, the association between elevated IOP and some parameters, as the risk factors that influence elevated IOP, was investigated. A total of 402 eyes of 370 patients were included in this study. Twenty-eight eyes of 26 patients (7.0%) were identified as cases with elevated IOP after IVI. The mean time of elevation after baseline was 50.6 ± 26.5 months. History of glaucoma (p = 0.021; odds ratio, 5.85), treatment modality (p = 0.019; odds ratio, 6.32), and total number of injections (p = 0.003; odds ratio, 1.03) were significantly associated with elevated IOP. A late complication of elevated IOP is associated with IVI in patients with AMD. Particularly, history of glaucoma and treat and extend regimen with frequent injections were found to be risk factors of elevated IOP.


2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Meng-qi Wang ◽  
Ran-ran Wang ◽  
Yu Hao ◽  
Wei-feng Xiong ◽  
Ling Han ◽  
...  

Abstract Background Psychotic major depression (PMD) is a subtype of depression with a poor prognosis. Previous studies have failed to find many differences between patients with PMD and those with non-psychotic major depression (NMD) or schizophrenia (SZ). We compared sociodemographic factors (including season of conception) and clinical characteristics between patients with PMD, NMD, and schizophrenia. Our aim was to provide data to help inform clinical diagnoses and future etiology research. Methods This study used data of all patients admitted to Shandong Mental Health Center from June 1, 2016 to December 31, 2017. We analyzed cases who had experienced an episode of PMD (International Classification of Diseases, Tenth Revision codes F32.3, F33.3), NMD (F32.0–2/9, F33.0–2/9), and SZ (F20–20.9). Data on sex, main discharge diagnosis, date of birth, ethnicity, family history of psychiatric diseases, marital status, age at first onset, education, allergy history, and presence of trigger events were collected. Odds ratios (OR) were calculated using logistic regression analyses. Missing values were filled using the k-nearest neighbor method. Results PMD patients were more likely to have a family history of psychiatric diseases in their first-, second-, and third-degree relatives ([OR] 1.701, 95% confidence interval [CI] 1.019–2.804) and to have obtained a higher level of education (OR 1.451, 95% CI 1.168–1.808) compared with depression patients without psychotic features. Compared to PMD patients, schizophrenia patients had lower education (OR 0.604, 95% CI 0.492–0.741), were more often divorced (OR 3.087, 95% CI 1.168–10.096), had a younger age of onset (OR 0.934, 95% CI 0.914–0.954), less likely to have a history of allergies (OR 0.604, 95% CI 0.492–0.741), and less likely to have experienced a trigger event 1 year before first onset (OR 0.420, 95% CI 0.267–0.661). Season of conception, ethnicity, and sex did not differ significantly between PMD and NMD or schizophrenia and PMD. Conclusions PMD patients have more similarities with NMD patients than SZ patients in terms of demographic and clinical characteristics. The differences found between PMD and SZ, and PMD and NMD correlated with specificity of the diseases. Furthermore, allergy history should be considered in future epidemiological studies of psychotic disorders.


2021 ◽  
pp. 197140092110006
Author(s):  
Warren Chang ◽  
Ajla Kadribegic ◽  
Kate Denham ◽  
Matthew Kulzer ◽  
Tyson Tragon ◽  
...  

Purpose A common complication of lumbar puncture (LP) is postural headaches. Epidural blood patches are recommended if patients fail conservative management. Owing to a perceived increase in the number of post-lumbar puncture headaches (PLPHs) requiring epidural blood patches at a regional hospital in our network, the decision was made to switch from 20 to 22 gauge needles for routine diagnostic LPs. Materials and methods Patients presenting for LP and myelography at one network regional hospital were included in the study. The patients were contacted by nursing staff 3 days post-procedure; those patients who still had postural headaches after conservative management and received epidural blood patches were considered positive cases. In total, 292 patients were included; 134 underwent LP with 20-gauge needles (53 male, 81 female, average age 57.7) and 158 underwent LP with 22-gauge needles (79 male, 79 female, average age 54.6). Results Of 134 patients undergoing LP with 20-gauge needles, 15 (11%) had PLPH requiring epidural blood patch (11 female, 3 male, average age 38). Of 158 patients undergoing LP with 22-gauge needles, only 5 (3%) required epidural blood patches (all female, average age 43). The difference was statistically significant ( p < 0.01). Risk factors for PLPH included female gender, younger age, lower body mass index, history of prior PLPH and history of headaches. Conclusion Switching from 20-gauge to 22-gauge needles significantly decreased the incidence of PLPH requiring epidural blood patch. Narrower gauge or non-cutting needles should be considered in patients with risk factors for PLPH, allowing for CSF requirements.


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