Depressed Multiple-Suicide­Attempters – A High-Risk Phenotype

Crisis ◽  
2017 ◽  
Vol 38 (6) ◽  
pp. 367-375 ◽  
Author(s):  
Leo Sher ◽  
Michael F. Grunebaum ◽  
Ainsley K. Burke ◽  
Sadia Chaudhury ◽  
J. John Mann ◽  
...  
Keyword(s):  
Family History ◽  
Suicide Attempt ◽  
Suicide Attempts ◽  
Borderline Personality ◽  
Cross Sectional ◽  
Suicide Attempters ◽  
Depressed Patients ◽  
Suicide Intent ◽  
History Of ◽  
Cross Sectional Design

Abstract. Background: There is compelling evidence that suicide attempts are among the strongest predictors of suicide and future suicide attempts. Aim: This study aimed to examine psychopathology in multiple-suicide attempters. Method: We compared the demographic and clinical features of three groups: depressed patients without a history of suicide attempts (non-attempters), depressed patients with a history of one to three suicide attempts (attempters), and depressed patients with a history of four or more suicide attempts (multiple attempters). Results: We found that attempters and multiple attempters had higher levels of depression, hopelessness, aggression, hostility, and impulsivity and were more likely to have borderline personality disorder and family history of major depression or alcohol use disorder compared with non-attempters, but did not differ between each other on these measures. Multiple attempters had greater suicidal ideation at study entry and were more likely to have family history of suicide attempt compared with attempters. Importantly, multiple attempters had greater suicide intent at the time of the most medically serious suicide attempt and more serious medical consequences during their most medically serious suicide attempt compared with attempters. Limitations: The cross-sectional design of the study. Conclusion: Our data suggest that multiple-suicide attempters require careful evaluation as their behavior can have serious medical consequences.

Psychological, Structural, Social and Economic Determinants of Suicide Attempt: Risk Assessment and Decision Making Strategies

2021 ◽  
pp. 003022282110034
Author(s):  
Azam Farmani ◽  
Mojtaba Rahimianbougar ◽  
Yousef Mohammadi ◽  
Hossein Faramarzi ◽  
Siamak Khodarahimi ◽  
...  
Keyword(s):  
Risk Assessment ◽  
Suicide Attempt ◽  
Suicide Attempts ◽  
Psychological Services ◽  
Cross Sectional ◽  
Economic Determinants ◽  
History Of ◽  
Cross Sectional Design ◽  
High Level ◽  
Risk Assessment And Management

The aim of this research was to conduct a risk assessment and management of psychological, structural, social and economic determinants (PSSED) in a suicide attempt. The sample consisted of 353 individuals who had a recorded history of suicidal attempt; and 20 professional individuals by purposive sampling method within a descriptive cross-sectional design. Worksheets for RAM and AHP were used for data collection in this study. The rate of suicide attempt was 7.21 per 100,000 population in this study. Analysis showed that depression and mental disorders; personality disorders; family problems; socio-cultural and economic problems; lack of awareness; and low level of education have a high level of risk for suicide attempts. Psychiatric and psychological services; awareness and knowledge of life skills; medical services to dysfunctional families; development of community-based planning for PSSED of suicide; and employment and entrepreneurship services may lower suicide attempt risk.

scholarly journals History of suicide attempts and COVID-19 infection in Veterans with schizophrenia or schizoaffective disorder: moderating effects of age and body mass index

2021 ◽  
Author(s):  
Olaoluwa O. Okusaga ◽  
Rachel L. Kember ◽  
Gina M. Peloso ◽  
Roseann E. Peterson ◽  
Marijana Vujkovic ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Suicide Attempt ◽  
Body Mass ◽  
Schizoaffective Disorder ◽  
Suicide Attempts ◽  
Medical Center ◽  
Cross Sectional ◽  
Suicide Attempters ◽  
History Of ◽  
The Relationship

Introduction: Relative to the general population, patients with schizophrenia or schizoaffective disorder have higher rates of suicide attempts and mortality from COVID-19 infection. Therefore, determining whether a history of suicide attempt is associated with COVID-19 in patients with schizophrenia or schizoaffective disorder has implications for COVID-19 vulnerability stratification in this patient population. Methods: We carried out cross-sectional analyses of electronic health records (EHR) of veterans with a diagnosis of schizophrenia or schizoaffective disorder that received treatment at any United States Veterans Affairs Medical Center between January 1, 2020 to January 31, 2021. We used logistic regression to estimate unadjusted and adjusted (including age, sex, race, marital status, body mass index (BMI), and a medical comorbidity score) odds ratios (ORs) for COVID-19 positivity in suicide attempters relative to non-attempters. Results: A total of 101,032 Veterans [mean age 56.67 ± 13.13 years; males 91,715 (90.8%)] were included in the analyses. There were 2,703 (2.7%) suicide attempters and 719 (0.7%) patients were positive for COVID-19. The association between history of suicide attempt and COVID-19 positivity was modified by age and BMI, such that the relationship was only significant in patients younger than 59 years, and in obese (BMI ≥ 30) patients (adjusted OR 3.42, 95% CI 2.02 - 5.79 and OR 2.85, 95% CI 1.65 - 4.94, respectively). Conclusions: Higher rates of COVID-19 in young or obese suicide attempters with a diagnosis of schizophrenia or schizoaffective disorder might be due to elevated risk for the infection in this sub-group of patients.

scholarly journals Volumetric MRI analysis of brain structures in patients with history of first and repeated suicide attempts: a cross sectional study

2020 ◽  
Author(s):  
Milda Sarkinaite ◽  
Rymante Gleizniene ◽  
Virginija Adomaitiene ◽  
Kristina Dambrauskiene ◽  
Nijole Raskauskiene ◽  
...  
Keyword(s):  
Suicide Attempt ◽  
Left Hemisphere ◽  
Cortical Thickness ◽  
Suicide Attempts ◽  
Right Hemisphere ◽  
Brain Structures ◽  
Brain Regions ◽  
Cross Sectional ◽  
Suicide Attempters ◽  
History Of

Abstract Background Structural brain changes are found in suicide attempters, as well as in patients with mental disorders. It remains unclear whether the suicidal behavior is related to atrophy of brain regions and how the morphology of specific brain areas is changing with each suicide attempt. This cross-sectional study examined volumetric differences in brain regions among patients with history of first and repeated suicide attempts in comparison to healthy controls (HC). Methods The sample consisted of 56 adults, non-psychotic patients without cognitive impairment and any organic brain disorders hospitalized after first suicide attempt (first SA) (n=29) and more than one suicide attempt (SA>1) during the lifetime (n=27); and 54 adult volunteers without history of mental disorder and suicide attempts, designated as HC. The MRI data were collected using 1.5 T Siemens Avanto scanner. Brain cortical thickness, grey and white matter volumes were measured using FreeSurfer 6.0 automatic segmentation technique. Results In comparison to HC, patients with first SA had 3.5, 3.58 and 4.19% significantly lower mean cortical thickness of the superior and rostral middle frontal areas of the left hemisphere and superior frontal area of the right hemisphere, respectively; 4.09, 4.02 and 4.49% lower mean cortical thickness of the inferior, middle and superior temporal areas of the left hemisphere, respectively. In comparison to HC, patients after SA>1 had a significantly lower mean cortical thickness (from 4.02 to 8.33%) in ten areas of frontal cortex of the left hemisphere and seven areas of the right hemisphere; from 3.90 to 6.04% difference in six areas of temporal cortex in both hemispheres. The comparison of hippocampus volume showed a significantly lower mean volume (7.86 to 9.89%) of left and right parts in patients with SA>1, but not in patients with first SA. Conclusions Hospitalized suicide attempters had lower frontal and temporal cortical thickness and smaller parts of hippocampus than HC; these differences were significantly higher in repeated suicide attempters than in patients with first SA. Our findings suggest that repeated suicidal behavior is associated with intensifying atrophy of specific brain structures, independently of diagnosis of depressive disorders.

scholarly journals Volumetric MRI Analysis of Brain Structures in Patients With History of First and Repeated Suicide Attempts: A Cross Sectional Study

2020 ◽  
Author(s):  
Milda Sarkinaite ◽  
Rymante Gleizniene ◽  
Virginija Adomaitiene ◽  
Kristina Dambrauskiene ◽  
Nijole Raskauskiene ◽  
...  
Keyword(s):  
Suicide Attempt ◽  
Left Hemisphere ◽  
Cortical Thickness ◽  
Suicide Attempts ◽  
Right Hemisphere ◽  
Brain Structures ◽  
Brain Regions ◽  
Cross Sectional ◽  
Suicide Attempters ◽  
History Of

Abstract Background: Structural brain changes are found in suicide attempters, as well as in patients with mental disorders. It remains unclear whether the suicidal behavior is related to atrophy of brain regions and how the morphology of specific brain areas is changing with each suicide attempt. This cross-sectional study examined volumetric differences in brain regions among patients with history of first and repeated suicide attempts in comparison to healthy controls (HC).Methods: The sample consisted of 56 adults, non-psychotic patients without cognitive impairment and any organic brain disorders hospitalized after first suicide attempt (first SA) (n=29) and more than one suicide attempt (SA>1) during the lifetime (n=27); and 54 adult volunteers without history of mental disorder and suicide attempts, designated as HC. The MRI data were collected using 1.5 T Siemens Avanto scanner. Brain cortical thickness, grey and white matter volumes were measured using FreeSurfer 6.0 automatic segmentation technique.Results: In comparison to HC, patients with first SA had 3.5, 3.58 and 4.19% significantly lower mean cortical thickness of the superior and rostral middle frontal areas of the left hemisphere and superior frontal area of the right hemisphere, respectively; 4.09, 4.02 and 4.49 % lower mean cortical thickness of the inferior, middle and superior temporal areas of the left hemisphere, respectively. In comparison to HC, patients after SA>1 had a significantly lower mean cortical thickness (from 4.02 to 8.33%) in ten areas of frontal cortex of the left hemisphere and seven areas of the right hemisphere; from 3.90 to 6.04% difference in six areas of temporal cortex in both hemispheres. The comparison of hippocampus volume showed a significantly lower mean volume (7.86 to 9.89%) of left and right parts in patients with SA>1, but not in patients with first SA. Conclusions: Hospitalized suicide attempters had lower frontal and temporal cortical thickness and smaller parts of hippocampus than HC; these differences were significantly higher in repeated suicide attempters than in patients with first SA. Our findings suggest that repeated suicidal behavior is associated with intensifying atrophy of specific brain structures, independently of diagnosis of depressive disorders.

scholarly journals History of suicide attempts and COVID-19 infection in Veterans with schizophrenia or schizoaffective disorder: effect modification by age and obesity

2021 ◽  
Author(s):  
Olaoluwa O Okusaga ◽  
Rachel L Kember ◽  
Gina M Peloso ◽  
Roseann E Peterson ◽  
Marijana Vujkovic ◽  
...  
Keyword(s):  
Suicide Attempt ◽  
Schizoaffective Disorder ◽  
Suicide Attempts ◽  
Medical Center ◽  
Strong Predictor ◽  
Effect Modification ◽  
Cross Sectional ◽  
Suicide Attempters ◽  
History Of

Introduction: Patients with schizophrenia or schizoaffective disorder have a high risk of suicide, and a history of suicide attempt is a strong predictor of suicide; therefore, determining whether a history of suicide attempt is associated with COVID-19 in patients with schizophrenia or schizoaffective disorder has implications for suicide prevention in this patient population. Methods: We carried out cross-sectional analyses of electronic health records (EHR) of Veterans with a diagnosis of schizophrenia or schizoaffective disorder that received treatment at any United States Veterans Affairs Medical Center from January 1, 2020 to January 31, 2021. Logistic regression was applied to estimate unadjusted and adjusted (including age, sex, race, marital status, BMI, and a medical comorbidity score) odds ratios (ORs) for COVID-19 positivity in suicide attempters relative to non-attempters. Results: A total of 101,032 Veterans [mean age 56.67 SD 13.13 years; males 91,715 (90.8%)] were included in the analyses. There were 2,703 (2.7%) suicide attempters and 719 (0.7%) patients were positive for COVID-19. There was effect modification by age and BMI in the association of history of suicide attempt with COVID-19 positivity such that the association was only significant in patients younger than 59 years and in obese (BMI ≥ 30) patients respectively (adjusted OR 3.42, 95% CI 2.02 - 5.79 and OR 2.85, 95% CI 1.65 - 4.94 respectively). Conclusions: Young or obese suicide attempters with a diagnosis of schizophrenia or schizoaffective disorder have higher rates of COVID-19 diagnosis; due to possible long-term neuropsychiatric sequelae of infection with SARS-CoV-2, such patients should be monitored closely.

scholarly journals Functional network alterations differently associated with suicidal ideas and acts in depressed patients: an indirect support to the transition model

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Gerd Wagner ◽  
Meng Li ◽  
Matthew D. Sacchet ◽  
Stéphane Richard-Devantoy ◽  
Gustavo Turecki ◽  
...  
Keyword(s):  
Suicide Attempt ◽  
Suicide Attempts ◽  
Past History ◽  
Transition Model ◽  
Suicide Attempters ◽  
Distinct Subgroup ◽  
Depressed Patients ◽  
History Of ◽  
Suicidal Thoughts And Behaviors ◽  
Suicidal Ideas

AbstractThe transition from suicidal ideas to a suicide act is an important topic of research for the identification of those patients at risk of acting out. We investigated here whether specific brain activity and connectivity measures at rest may be differently associated with suicidal thoughts and behaviors. A large sample of acutely depressed patients with major depressive disorder was recruited in three different centers (Montreal/Canada, Stanford/USA, and Jena/Germany), covering four different phenotypes: patients with a past history of suicide attempt (n = 53), patients with current suicidal ideas but no past history of suicide attempt (n = 40), patients without current suicidal ideation nor past suicide attempts (n = 42), and healthy comparison subjects (n = 107). 3-T resting-state functional magnetic resonance imaging (fMRI) measures of the amplitude of low-frequency fluctuation (ALFF) and degree centrality (DC) were obtained and examined in a whole-brain data-driven analysis. Past suicide attempt was associated with a double cortico-subcortical dissociation in ALFF values. Decreased ALFF and DC values mainly in a frontoparietal network and increased ALFF values in some subcortical regions (hippocampus and thalamus) distinguished suicide attempters from suicide ideators, patient controls, and healthy controls. No clear neural differences were identified in relation to suicidal ideas. Suicide attempters appear to be a distinct subgroup of patients with widespread brain alterations in functional activity and connectivity that could represent factors of vulnerability. Our results also indirectly support at the neurobiological level the relevance of the transition model described at the psychological and clinical levels. The brain bases of suicidal ideas occurrence in depressed individuals needs further investigations.

scholarly journals Characteristics of suicide attempters with family history of suicide attempt: a retrospective chart review

2009 ◽  
Vol 9 (1) ◽  
Author(s):  
Makiko Nakagawa ◽  
Chiaki Kawanishi ◽  
Tomoki Yamada ◽  
Yoko Iwamoto ◽  
Ryoko Sato ◽  
...  
Keyword(s):  
Family History ◽  
Suicide Attempt ◽  
Chart Review ◽  
Retrospective Chart Review ◽  
Suicide Attempters ◽  
History Of

scholarly journals Psychiatric Co-Morbidities of Suicide Attempters: A Cross Sectional Observation in a Tertiary Care Hospital of North India

2021 ◽  
Vol 6 (2) ◽  
pp. 40-46
Author(s):  
Shaveta Bhagat ◽  
Mohammad Maqbool Dar ◽  
Ibrar Ahmed
Keyword(s):  
Family History ◽  
General Hospital ◽  
Psychiatric Illness ◽  
Care Hospital ◽  
Cross Sectional ◽  
Suicide Attempters ◽  
Increased Risk ◽  
Co Morbidity ◽  
History Of ◽  
Suicide Attempted

Background: Psychiatric disorders are at increased risk for suicide. Attempted suicide is a common clinical problem in a general hospital. It has a serious clinical and socio-economical impact too. Aims: This study was carried out to assess the prevalence of psychiatric co-morbidities of suicide attempters attending the emergency. Material and methods: This study was a cross sectional, observational study which was conducted at the Community General Hospital Unit, Institute of Mental Health and Neurosciences-Kashmir an associated hospital of Government Medical College Srinagar among the suicide patients attending the outpatient service and inpatient services of the hospital fulfilling inclusion and exclusion criteria over a period of one and a half year, from November 2017 to May 2019. Written informed consent was obtained in a simple and easily understandable unambiguous language. For the diagnosis of psychiatric comorbidity, we used MINI International Neuropsychiatric Interview Schedule Plus (MINI PLUS). A p-value of <0.05 was taken as statistically significant. Results: A total of 221 cases who had been admitted following unsuccessful suicide attempts to the emergency and psychiatry department were taken up for the study. They were evaluated in detail with regards to past attempt of suicide, family history of psychiatric illness or suicide and the presence of psychiatric co-morbidity and the results have been presented below in tabulated and graphical forms. 77.4% of the attempters had no history of psychiatric illness in their family while 22.6% of patients did have family history of a psychiatric illness. 98.2% of attempters had no family history of suicide while 1.8% of the patients gave a family history of suicide. 21.26% males and 54.75% females had associated psychiatric co-morbidities and 23.9% had no associated psychiatric co-morbidities. Conclusion: The most common psychiatric morbidity associated with suicide was found to be major depressive disorder. Most importantly, the suicide attempters should be looked with sympathy rather than with a grimace on face. Such people should not be stigmatized and we should not let their shoulders drop. Keywords: Depression, Bipolar Disorder, Morbidity, Suicide.

scholarly journals Changes in the pattern of suicide attempters visiting the emergency room after COVID-19 pandemic: an observational cross sectional study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ji-Hun Kang ◽  
Si-Won Lee ◽  
Jae-Gu Ji ◽  
Jae-Kwang Yu ◽  
Yun-Deok Jang ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Suicide Attempt ◽  
Systolic Blood Pressure ◽  
Emergency Room ◽  
Suicide Attempts ◽  
Educational Background ◽  
Management Program ◽  
Cross Sectional ◽  
History Of ◽  
At Home

Abstract Background This study aimed to find out the change in the rate and pattern of suicide attempts during severe acute respiratory syndrome COVID-19 pandemic period. Methods This study was a retrospective analysis of data collected as a part of an emergency room-based post-suicide management program. The data were collected through interviews and from medical records of suicide attempts, maintained in the emergency room, from January 19 to October 31, 2020, during the “COVID-19 period,” and those who attempted suicide from January 19 to October 31, 2019 “pre-COVID-19 period.” We extracted educational background, marital status, occupation, presence of domestic partner, history of mental illness, alcohol consumption, history of previous suicide attempts; suicide attempt method and location (i.e., at home or a place other than home) at the time of attempt, and whether the attempt was a mass suicide. In addition, we compared patient severity between “COVID-19 period” and “pre-COVID-19 period” using the initial KTAS (South Korean triage and acuity scale) level, consciousness level, and systolic blood pressure. In 2012, KTAS was developed through the Ministry of Health and Welfare’s research project to establish triage system in South Korea. Results The analysis of the number of suicide attempts during “pre-COVID-19 period” and “ COVID-19 period” showed that the number of suicide attempts during “COVID-19 period” (n = 440) increased compared to the “pre-COVID-19 period” (n = 400). Moreover, the method of suicide attempts during “COVID-19 period” included overdose of drugs such as hypnotics, antipsychotics, and pesticides that were already possessed by the patient increased compared to the “pre-COVID-19 period” (P < 0.05). At the time of the visit to the emergency room, high KTAS level, low level of consciousness, and low systolic blood pressure, were observed, which were significantly different between “COVID-19 period” and “pre-COVID-19 period” (P < 0.05). Conclusion With the worldwide COVID-19 virus spread, suicide rate and suicide attempts at home have significantly increased. In addition, patient severity was higher in the “COVID-19 period” than that in the “pre-COVID-19 period.” The increasing suicide attempt rate should be controlled by cooperation between the emergency room and regional organizations.

scholarly journals Repetitive negative thinking about suicide: Associations with lifetime suicide attempts

2021 ◽  
Vol 3 (3) ◽  
Author(s):  
Tobias Teismann ◽  
Thomas Forkmann ◽  
Johannes Michalak ◽  
Julia Brailovskaia
Keyword(s):  
Suicide Attempt ◽  
Suicidal Behavior ◽  
Suicide Ideation ◽  
Suicide Attempts ◽  
Clinical Sample ◽  
Cross Sectional Study ◽  
Repetitive Negative Thinking ◽  
Cross Sectional ◽  
Suicide Attempters ◽  
Negative Thinking

Background Repetitive negative thinking has been identified as an important predictor of suicide ideation and suicidal behavior. Yet, only few studies have investigated the effect of suicide-specific rumination, i.e., repetitive thinking about death and/or suicide on suicide attempt history. On this background, the present study investigated, whether suicide-specific rumination differentiates between suicide attempters and suicide ideators, is predictive of suicide attempt history and mediates the association between suicide ideation and suicide attempts. Method A total of 257 participants with a history of suicide ideation (55.6% female; Age M = 30.56, Age SD = 11.23, range: 18–73 years) completed online measures on suicidality, general and suicide-specific rumination. Results Suicide-specific rumination differentiated suicide attempters from suicide ideators, predicted suicide attempt status (above age, gender, suicide ideation, general rumination) and fully mediated the association between suicide ideation and lifetime suicide attempts. Conclusion Overall, though limited by the use of a non-clinical sample and a cross-sectional study design, the present results suggest that suicide-specific rumination might be a factor of central relevance in understanding transitions to suicidal behavior.

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