History of suicide attempts in pediatric bipolar disorder: factors associated with increased risk

BackgroundIndividuals with a mental health disorder appear to be at increased risk of medical illness.AimsTo examine rates of medical illnesses in patients with bipolar disorder (n = 1720) and to examine the clinical course of the bipolar illness according to lifetime medical illness burden.MethodParticipants recruited within the UK were asked about the lifetime occurrence of 20 medical illnesses, interviewed using the Schedules for Clinical Assessment in Neuropsychiatry (SCAN) and diagnosed according to DSM-IV criteria.ResultsWe found significantly increased rates of several medical illnesses in our bipolar sample. A high medical illness burden was associated with a history of anxiety disorder, rapid cycling mood episodes, suicide attempts and mood episodes with a typically acute onset.ConclusionsBipolar disorder is associated with high rates of medical illness. This comorbidity needs to be taken into account by services in order to improve outcomes for patients with bipolar disorder and also in research investigating the aetiology of affective disorder where shared biological pathways may play a role.Declarations of interestNone.

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Dissecting clinical heterogeneity of bipolar disorder using multiple polygenic risk scores

10.1101/2020.03.31.20044800 ◽

2020 ◽

Author(s):

Brandon J. Coombes ◽

Matej Markota ◽

J. John Mann ◽

Colin Colby ◽

Eli Stahl ◽

...

Keyword(s):

Bipolar Disorder ◽

Psychiatric Disorders ◽

Suicide Attempts ◽

Risk Scores ◽

Rapid Cycling ◽

Clinical Heterogeneity ◽

Polygenic Risk ◽

Clinical Observations ◽

History Of ◽

Dsm Iv

AbstractBipolar disorder (BD) has high clinical heterogeneity, frequent psychiatric comorbidities, and elevated suicide risk. To determine genetic differences between common clinical sub-phenotypes of BD, we performed a systematic PRS analysis using multiple polygenic risk scores (PRSs) from a range of psychiatric, personality, and lifestyle traits to dissect differences in BD sub-phenotypes in two BD cohorts: the Mayo Clinic BD Biobank (N = 968) and Genetic Association Information Network (N = 1001). Participants were assessed for history of psychosis, early-onset BD, rapid cycling (defined as four or more episodes in a year), and suicide attempts using questionnaires and the Structured Clinical Interview for DSM-IV. In a combined sample of 1969 bipolar cases (45.5% male), those with psychosis had higher PRS for SCZ (OR = 1.3 per S.D.; p = 3e-5) but lower PRSs for anhedonia (OR = 0.87; p = 0.003) and BMI (OR = 0.87; p = 0.003). Rapid cycling cases had higher PRS for ADHD (OR = 1.23; p = 7e-5) and MDD (OR = 1.23; p = 4e-5) and lower BD PRS (OR = 0.8; p = 0.004). Cases with a suicide attempt had higher PRS for MDD (OR = 1.26; p = 1e-6) and anhedonia (OR = 1.22; p = 2e-5) as well as lower PRS for educational attainment (OR = 0.87; p = 0.003). The observed novel PRS associations with sub-phenotypes align with clinical observations such as rapid cycling BD patients having a greater lifetime prevalence of ADHD. Our findings confirm that genetic heterogeneity underlies the clinical heterogeneity of BD and consideration of genetic contribution to psychopathologic components of psychiatric disorders may improve genetic prediction of complex psychiatric disorders.

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Psychotic symptoms in pediatric bipolar disorder and family history of psychiatric illness

Journal of Affective Disorders ◽

10.1016/j.jad.2006.05.022 ◽

2006 ◽

Vol 96 (1-2) ◽

pp. 127-131 ◽

Cited By ~ 10

Author(s):

Richard Rende ◽

Boris Birmaher ◽

David Axelson ◽

Michael Strober ◽

Mary Kay Gill ◽

...

Keyword(s):

Bipolar Disorder ◽

Family History ◽

Psychiatric Illness ◽

Psychotic Symptoms ◽

Pediatric Bipolar Disorder ◽

History Of

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Factors Associated With Suicide Attempts in 648 Patients With Bipolar Disorder in the Stanley Foundation Bipolar Network

The Journal of Clinical Psychiatry ◽

10.4088/jcp.v64n0503 ◽

2003 ◽

Vol 64 (5) ◽

pp. 506-515 ◽

Cited By ~ 238

Author(s):

Gabriele S. Leverich ◽

Lori L. Altshuler ◽

Mark A. Frye ◽

Trisha Suppes ◽

Paul E. Keck ◽

...

Keyword(s):

Bipolar Disorder ◽

Suicide Attempts ◽

Factors Associated

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Study of Risk Factors Associated with Suicide Attempt in Patients with Bipolar Disorder Type I

Journal of Neurosciences in Rural Practice ◽

10.1055/s-0040-1709347 ◽

2020 ◽

Vol 11 (02) ◽

pp. 291-298

Author(s):

Karthick Subramanian ◽

Vikas Menon ◽

Siddharth Sarkar ◽

Vigneshvar Chandrasekaran ◽

Nivedhitha Selvakumar

Keyword(s):

Risk Factors ◽

Bipolar Disorder ◽

Logistic Regression ◽

Family History ◽

Suicide Attempt ◽

Coping Strategies ◽

Binary Logistic Regression ◽

Type I ◽

Factors Associated ◽

History Of

Abstract Background Suicide is the leading contributor to mortality in bipolar disorder (BD). A history of suicidal attempt is a robust predictive marker for future suicide attempts. Personality profiles and coping strategies are the areas of contemporary research in bipolar suicides apart from clinical and demographic risk factors. However, similar research in developing countries is rarer. Objectives The present study aimed to identify the risk factors associated with suicidal attempts in BD type I (BD-I). Materials and Methods Patients with BD-I currently in clinical remission (N = 102) were recruited. Sociodemographic details and the clinical data were collected using a semistructured pro forma. The psychiatric diagnoses were confirmed using the Mini-International Neuropsychiatric Interview 5.0. The National Institute of Mental Health–Life Chart Methodology Clinician Retrospective Chart was used to chart the illness course. Presumptive Stressful Life Events Scale, Coping Strategies Inventory Short Form, Buss–Perry aggression questionnaire, Past Feelings and Acts of Violence, and Barratt Impulsivity scale were used to assess the patient’s stress scores, coping skills, aggression, violence, and impulsivity, respectively. Statistical Analysis Descriptive statistics were used for demographic details and characteristics of the illness course. Binary logistic regression analyses were performed to identify the predictors for lifetime suicide attempt in BD-I. Results A total of 102 patients (males = 49 and females = 53) with BD-I were included. Thirty-seven subjects (36.3%) had a history of suicide attempt. The illness course in suicide attempters more frequently had an index episode of depression, was encumbered with frequent mood episodes, especially in depression, and had a higher propensity for psychiatric comorbidities. On binary logistic regression analysis, the odds ratios (ORs) for predicting a suicide attempt were highest for positive family history of suicide (OR: 13.65, 95% confidence interval [CI]: 1.28–145.38, p = 0.030), followed by the presence of an index depressive episode (OR: 6.88, 95% CI: 1.70–27.91, p = 0.007), and lower scores on problem-focused disengagement (OR: 0.72, 95% CI: 0.56–0.92, p = 0.009). Conclusion BD-I patients with lifetime suicide attempt differ from non-attempters on various course-related and temperamental factors. However, an index episode depression, family history of suicide, and lower problem-focused engagement can predict lifetime suicide attempt in patients with BD-I.

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Risk Factors for Cardiovascular Events in Patients on Antidementia Medications

American Journal of Alzheimer s Disease & Other Dementias® ◽

10.1177/1533317520922380 ◽

2020 ◽

Vol 35 ◽

pp. 153331752092238

Author(s):

Meiqi He ◽

James M. Stevenson ◽

Yuting Zhang ◽

Inmaculada Hernandez

Keyword(s):

Cardiovascular Events ◽

Heart Rhythm ◽

Combined Model ◽

Factors Associated ◽

C Statistic ◽

Five Factors ◽

Heart Rhythm Disorders ◽

Increased Risk ◽

History Of ◽

Β Blockers

Objective: To identify characteristics associated with an increased risk of cardiovascular events in patients diagnosed with Alzheimer disease (AD) and treated with antidementia medications. Methods: Demographics, diagnoses, and medication usage of 30 433 Medicare patients were analyzed using 2006 to 2013 claims data and a combined model of screening, ranking and stepwise logistic regressions to evaluate factors associated with composite outcomes of 6 cardiovascular events. Results: Incidence rate of at least 1 cardiovascular event was 25.1%. Fifty-five factors were identified from the 10 381 candidate variables by the combined model with a c-statistic of 67% and an accuracy of 75%. Factors associated with increased risk of cardiovascular events include history of heart rhythm disorders, alteration of consciousness (odds ratio [OR]: 1.25; 95% confidence interval [CI]: 1.14-1.36), and usage of β-blockers (OR: 1.19; 95% CI: 1.13-1.27). Conclusions: Clinicians should consider the increased risk of cardiovascular events in patients with AD with heart rhythm disorders and on β-blockers.

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Antiepileptic drugs and suicide-related outcomes in bipolar disorder: A descriptive review of published data

Mental Health Clinician ◽

10.9740/mhc.2018.05.138 ◽

2018 ◽

Vol 8 (3) ◽

pp. 138-147 ◽

Cited By ~ 6

Author(s):

Charles F. Caley ◽

Emily Perriello ◽

Julia Golden

Keyword(s):

Bipolar Disorder ◽

Antiepileptic Drugs ◽

Suicide Attempts ◽

Reference Group ◽

Lithium Treatment ◽

Reporting Rate ◽

Published Data ◽

Suicide Death ◽

Suicidal Thinking ◽

Increased Risk

Abstract Introduction: In January 2008 the US Food and Drug Administration issued a warning to healthcare professionals about the potential for an increased risk of suicidal thinking and behavior associated with antiepileptic drugs (AEDs). Given that AEDs are important for treating bipolar disorder (BD), a better understanding of suicide-related events is necessary. Methods: A PubMed search was performed using the following search terms: anticonvulsant OR valpro* OR carbamazepine OR lamotrigine OR oxcarbazepine OR topiramate AND bipolar AND suicid*. The objective was to identify published investigations reporting rate and/or risk data of suicide-related outcomes in BD patients treated with AED monotherapy. Results: The search identified 323 reviewable citations, with 13 of these studies (4.0%) being reviewed. Valproate was studied most often, and lithium treatment was frequently used as a reference group. Carbamazepine and lamotrigine had small treatment exposure durations. Suicide attempts and suicide deaths were studied the most; a few trials investigated suicidal thinking and/or hospitalizations for suicidal behavior. Suicide attempt rates occurred in the following order: no treatment > carbamazepine > valproate > lithium, while suicide death rates were: no treatment > valproate > lithium > carbamazepine. For valproate, the risk of suicide attempts and suicide death appeared higher than lithium, but lower than no treatment. Discussion: Investigating suicide-related events for AEDs in BD is difficult; more data are necessary for valproate, carbamazepine, and lamotrigine. An improved understanding of AED treatment and suicide-related events in BD may help pharmacists become more effective at supporting their patients with BD.

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P5341Predictive factors of atherosclerotic cardiovascular diseases events in HIV-HVC co-infected patients: results from hepavih ANRS co13 cohort

European Heart Journal ◽

10.1093/eurheartj/ehz746.0309 ◽

2019 ◽

Vol 40 (Supplement_1) ◽

Author(s):

F Boccara ◽

B K Tan ◽

M Chalouni ◽

D Salmon Ceron ◽

A Cinaud ◽

...

Keyword(s):

Viral Load ◽

Sustained Viral Response ◽

Biological Data ◽

Personal History ◽

Hiv Viral Load ◽

Factors Associated ◽

Coronary Syndrome ◽

Increased Risk ◽

History Of

Abstract Introduction Several studies highlighted an increased risk of cardiovascular disease (CVD) in HIV-HCV co-infected patients without clearly identifying specific virologic factors associated with atherosclerotic CVD (ASCVD) events. Purpose Hence, we analyzed data collection from the French nationwide ANRS CO13 HEPAVIH cohort to determine the incidence of ASCVD events in HIV-HCV co-infected patients and the predictive factors associated with its occurrence. Methods The French multicenter nationwide ANRS CO13 HEPAVIH clinic-based cohort collected prospective clinical and biological data from HIV-HCV co-infected patients followed-up in 28 different university hospitals between December 2005 to November 2016. Participants with at least one year of follow-up were included. Primary outcome was the occurrence of major ASCVD events (cardiovascular death, acute coronary syndrome, coronary revascularization and stroke). Secondary outcomes were total ASCVD events including major ASCVD events and minor ASCVD events (peripheral arterial disease [PAD]). Incidence rates were estimated using Aalen-Johansen method and factors associated with ASCVD identified with Cox proportional hazards models. Results A total of 1213 patients were included: median age 45.4 years [42.1–49.0], 70.3% men, current smoking 70.2%, overweight 19.5%, liver cirrhosis 18.9%, chronic alcohol consumption 7.8%, diabetes mellitus (5.9%), personal history of CVD 2.7%, and statins use 4.1%. After a median follow-up of 5.1 years [3.9–7.0], 44 participants experienced at least one ASCVD event (26 major ASCVD event, and 20 a minor event). Incidences for total, major and minor ASCVD events were of 6.98 [5.19; 9.38], 4.01 [2.78; 6.00], and 3.17 [2.05; 4.92] per 1000 person-years, respectively. Personal history of CVD (Hazard Ratio (HR)=13.94 [4.25–45.66]), high total cholesterol (HR=1.63 [1.24–2.15]), low HDL cholesterol (HR=0.08 [0.02–0.34]) and undetectable HIV viral load (HR=0.41 [0.18–0.96]) were identified as independent factors associated with major ASCVD events while cirrhosis status, liver fibrosis and HCV sustained viral response were not. Cumulative incidence of CV events Conclusion HIV-HCV co-infected patients experience a high incidence of ASCVD events both coronary and peripheral artery diseases. Traditional CV risk factors are the main determinants of ASCVD whereas undetectable HIV viral load seems to be protective. Management of cholesterol abnormalities and controlling viral load are essential to modify this high cardiovascular risk. Acknowledgement/Funding Agence Natoinale de Recherche sur le SIDA et les Hépatites virales

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Risk factors for pre-eclampsia among women at antenatal booking in Kano, Northern Nigeria

Healthcare in Low-resource Settings ◽

10.4081/hls.2013.e12 ◽

2013 ◽

Vol 1 (1) ◽

pp. 12 ◽

Cited By ~ 1

Author(s):

Ibrahim A. Yakasai ◽

Imran O. Morhason-Bello

Keyword(s):

Risk Factors ◽

Early Onset ◽

Multiple Logistic Regression Analysis ◽

Control Group ◽

Northern Nigeria ◽

Degree Relative ◽

Factors Associated ◽

Increased Risk ◽

History Of ◽

At Home

Pre-eclampsia (PE) is an important cause of maternal mortality. There have been several studies on risk factors assessment with conflicting reports across the globe on this disease; however, rigorous recent evaluation of these factors is uncommon in this region. The aim of the present study was to determine the risks factors in the early-onset PE in Aminu Kano Teaching Hospital (AKTH), Kano (Northern Nigeria). We conducted a case-control study in Nigeria between April 2009 and January 2010 to identify the risk factors associated with the early-onset PE in women attending antenatal clinic in AKTH. Information on socio-cultural characteristics, medical history, previous obstetrics history, level of stress at home, and type of family were obtained and recorded in a proforma designed for the study. Multiple logistic regression analysis was used to determine the risk factors for PE at 95% confidence level. Pregnant women with early-onset PE (150 in each case and control group). Risk factors associated with increased risk of early-onset PE were: history of pre-eclampsia/eclampsia (PE/E) in a previous pregnancy [adjusted odds ratio (AOR) 2.09]; exposure to passive smoking (AOR 1.34); inadequate antenatal supervision (AOR 15.21); family history of hypertension in one or more 1st-degree relative (AOR 8.92); living in a joint family (AOR 6.93); overweight (120% to 150% of pre-pregnancy ideal body weight, AOR 4.65). Risk factors among women in Northern Nigeria are similar to those reported from other studies. Good antenatal cares, early detection, reduction of stressful conditions at home are the most important preventive measures of early-onset severe PE among these women.

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