Risk factors for suicide attempts in patients with bipolar disorder misdiagnosed with major depressive disorder: results from a national survey in China

2020 ◽  
Author(s):  
Lin Chen ◽  
Yu-Yu Xu ◽  
Jing-Ge Du ◽  
Li-Min Xin ◽  
Su-Li Wang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Bipolar Disorder ◽  
Suicidal Ideation ◽  
Clinical Characteristics ◽  
Suicide Attempts ◽  
Multiple Logistic Regression ◽  
Regression Analyses ◽  
Major Depressive ◽  
Suicide Attempters ◽  
Depressive Episodes

Abstract Background: Bipolar disorder (BD) is a kind of mental disorder with the greatest risk of suicide, but it is often misdiagnosed as major depressive disorder (MDD) clinically. This study aimed to analyze the sociodemographic factors and clinical characteristics associated with suicide attempts (SA) in patients with BD misdiagnosed with MDD in China. Methods: A total of 1487 MDD patients were consecutively enrolled in 13 mental health centers in China. Data on patients’ sociodemographic and clinical characteristics were collected using a standardized protocol. Of these, 306 BD patients were misdiagnosed with MDD according to the Mini International Neuropsychiatric Interview (MINI). Suicide attempters and non-attempters were classified by the suicidality module of the MINI. Multiple logistic regression analyses were performed to assess the association between the independent variables of interest and SA in BD patients misdiagnosed with MDD. Results: Of the 306 BD patients misdiagnosed with MDD, 225 (73.5%) were non-attempters and 81 (26.5%) were attempters. Compared to non-attempters, attempters were older (Z =2.2, p = 0.03) and had more admissions(χ2 =6.1, p = 0.013), more frequent depressive episodes, more atypical characteristics (e.g. increased appetite, weight gain, and more sleep time)(χ2 = 5.8, p = 0.016), more suicidal ideation (χ2 = 27.3, p < 0.001), more psychotic symptoms (χ2 = 7.4, p = 0.006) and more seasonal depressive episodes (χ2 = 5.6, p = 0.018). Multiple logistic regression analyses revealed that attempters were characterized by more suicidal ideation (OR = 5.7, 95% CI: 2.6–12.5) and frequent depressive episodes (OR = 2.4, 95% CI: 1.3–4.6). The limitations of this study include its cross-sectional design and data collection by suicide attempters’ retrospective recall. Conclusions: The findings of this study suggest that BD patients misdiagnosed with MDD are at a higher risk of suicide, and more frequent depressive episodes and suicidal ideation are risk factors for attempted suicide. Early identification of and interventions for these risk factors might reduce the risk of suicide in BD patients misdiagnosed with MDD.

scholarly journals Prospective study of risk factors for attempted suicide among patients with DSM–IV major depressive disorder

2005 ◽  
Vol 186 (4) ◽  
pp. 314-318 ◽  
Author(s):  
T. Petteri Sokero ◽  
Tarja K. Melartin ◽  
Heikki J. Rytsälä ◽  
Ulla S. Leskelä ◽  
Paula S. Lestelä-Mielonen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Attempted Suicide ◽  
Suicide Attempts ◽  
Structured Interviews ◽  
Major Depressive ◽  
Dsm Iv ◽  
Major Depressive Episodes ◽  
Depressive Episodes

BackgroundThere are few prospective studies on risk factors for attempted suicide among psychiatric out- and in-patients with major depressive disorder.AimsTo investigate risk factors for attempted suicide among psychiatric out- and in-patients with major depressive disorder inthe city of Vantaa, Finland.MethodThe Vantaa Depression Study included 269 patients with DSM–IV major depressive disorder diagnosed using semi-structured interviews and followed up at 6- and 18-month interviews with a life chart.ResultsDuring the 18-month follow-up, 8% of the patients attempted suicide. The relative risk of an attempt was 2.50 during partial remission and 7.54 during a major depressive episode, compared with full remission (P<0.001). Numerous factors were associated with this risk, but lacking a partner, previous suicide attempts and total time spent in major depressive episodes were the most robust predictors.ConclusionsSuicide attempts among patients with major depressive disorder are strongly associated with the presence and severity of depressive symptoms and predicted by lack of partner, previous suicide attempts and time spent in depression. Reducing the time spent depressed is a credible preventive measure.

scholarly journals Global and reflective rumination are related to suicide attempts among patients experiencing major depressive episodes

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hao Tang ◽  
Tingting Xiong ◽  
Jiabo Shi ◽  
Yu Chen ◽  
Xiaoxue Liu ◽  
...  
Keyword(s):  
Risk Factor ◽  
Suicide Attempts ◽  
Binary Logistic Regression ◽  
Binary Logistic Regression Analysis ◽  
Major Depressive ◽  
Suicide Attempters ◽  
Episode Frequency ◽  
Major Depressive Episodes ◽  
Depressive Episodes ◽  
The Relationship

Abstract Background Recent attention has focused on the role of rumination in suicidality, with evidence indicating that rumination may be positively related to suicidal ideation. There remains disagreement on the nature of the relationship between rumination and suicide attempts, especially in major affective disorders. This study was designed to identify whether rumination is a risk factor for attempted suicide. Methods A total of 309 patients with major depressive episodes were recruited for this study, including 170 patients with major depression and 139 patients with bipolar disorder. All participants were categorized into two groups based on a series of clinical assessments: suicide attempters (n = 87) and non-suicide attempters (n = 222). Rumination was evaluated with the Ruminative Responses Scale. A binary logistic regression analysis was carried out to evaluate the relationship between rumination and suicide attempts. Results Both global ruminative levels and the two subtypes of rumination, brooding and reflection, were significantly higher in the suicide attempters than the non-suicide attempters. After controlling for age, current depression and anxiety symptoms, and episode frequency, it was found that global rumination and reflection (but not brooding) were positively associated with suicide attempts. Conclusion These results suggest that rumination may be a risk factor for suicide attempts and highlight the maladaptive nature of reflection in patients with major depressive episodes.

scholarly journals Hippocampal Subfield Volumes in Major Depressive Disorder Adolescents with a History of Suicide Attempt

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Qi Zhang ◽  
Su Hong ◽  
Jun Cao ◽  
Yi Zhou ◽  
Xiaoming Xu ◽  
...  
Keyword(s):  
Major Depressive Disorder ◽  
Suicide Attempt ◽  
Depressive Disorder ◽  
Suicidal Behavior ◽  
Clinical Characteristics ◽  
Suicide Attempts ◽  
Healthy Controls ◽  
Major Depressive ◽  
Suicide Attempters ◽  
Functional Studies

Suicidal behavior is a leading cause of death and often commences during adolescence/young adulthood (15~29 years old). The hippocampus, which consists of multiple functionally specialized subfields, may contribute to the pathophysiology of depression and suicidal behavior. We aimed to investigate the differences of hippocampal subfield volume between major depressive disorder (MDD) patients with and without suicide attempts and healthy controls in adolescents and young adults. A total of 40 MDD suicide attempters (MDD+SA), 27 MDD patients without suicide attempt (MDD-SA), and 37 healthy controls (HC) were recruited. High-resolution T1 MRI images were analyzed with the automated hippocampal substructure module in FreeSurfer 6.0. Volume differences among the groups were analyzed by a generalized linear model controlling for intracranial cavity volume (ICV). The relationship between hippocampal subfield volumes and clinical characteristics (HAM-D and SSI scores) was assessed using two-tailed partial correlation controlling for ICV in MDD+SA and MDD-SA. We found that MDD-SA had significantly smaller bilateral hippocampal fissure volume than HC and MDD+SA. No significant correlation was observed between hippocampal subfield volume and clinical characteristics (HAM-D and SSI scores) in MDD+SA and MDD-SA. Adolescent/young adult suicide attempters with MDD suicide attempters have larger bilateral hippocampal fissures than depressed patients without suicide attempts, independently from clinical characteristics. Within the heterogeneous syndrome of major depressive disorder that holds a risk for suicidality for subgroups, hippocampal morphology may help to explain or possibly predict such risk, yet longitudinal and functional studies are needed for understanding the biological mechanisms underlying.

Associations Between Substance Use Disorders and Suicidal Ideation: An Investigation of Latino Emerging Adults

2018 ◽  
Vol 7 (1) ◽  
pp. 21-30
Author(s):  
Emily A. Limas ◽  
Ellen L. Vaughan
Keyword(s):  
Substance Use ◽  
Suicidal Ideation ◽  
Emerging Adults ◽  
Substance Use Disorders ◽  
Regression Analyses ◽  
Major Depressive ◽  
The Past ◽  
Religiosity And Depression ◽  
Major Depressive Episodes ◽  
Depressive Episodes

Suicide is ranked as the second leading cause of death among emerging adults (aged 18–25 years). The purpose of this study was to test the associations between substance use disorders and suicidal ideation while controlling for religiosity and depression, among Latino emerging adults. Participants were 3,372 Latino, noninstitutionalized, U.S. residents aged 18- to 25-year-old who participated in the 2011 National Survey on Drug Use and Health. Binomial logistic regression analyses tested the relationships between major depressive episodes (MDEs), substance abuse/dependence, and past-year suicidal ideation. Results showed that substance use disorders and MDEs were both associated with increased odds of suicidal ideation in emerging adult Latinos within the past year. Clinical and research implications as well as study limitations are discussed.

scholarly journals Suicidal ideation and suicide attempts in bipolar disorder type I: an update for the clinician

2009 ◽  
Vol 31 (3) ◽  
pp. 271-280 ◽  
Author(s):  
Lena Nabuco de Abreu ◽  
Beny Lafer ◽  
Enrique Baca-Garcia ◽  
Maria A. Oquendo
Keyword(s):  
Risk Factors ◽  
Bipolar Disorder ◽  
Suicidal Ideation ◽  
Suicidal Behavior ◽  
Suicide Ideation ◽  
Suicide Attempts ◽  
Clinical Samples ◽  
Type I ◽  
History Of ◽  
Axis I

OBJECTIVE: This article reviews the evidence for the major risk factors associated with suicidal behavior in bipolar disorder. METHOD: Review of the literature studies on bipolar disorder, suicidal behavior and suicidal ideation. RESULTS: Bipolar disorder is strongly associated with suicide ideation and suicide attempts. In clinical samples between 14-59% of the patients have suicide ideation and 25-56% present at least one suicide attempt during lifetime. Approximately 15% to 19% of patients with bipolar disorder die from suicide. The causes of suicidal behavior are multiple and complex. Some strong predictors of suicidal behavior have emerged in the literature such as current mood state, severity of depression, anxiety, aggressiveness, hostility, hopelessness, comorbidity with others Axis I and Axis II disorders, lifetime history of mixed states, and history of physical or sexual abuse. CONCLUSION: Bipolar disorder is the psychiatric condition associated with highest lifetime risk for suicide attempts and suicide completion. Thus it is important to clinicians to understand the major risk factors for suicidal behavior in order to choose better strategies to deal with this complex behavior.

Covariate Health Determinants of Suicidal Ideation, Suicide Plans, and Suicide Attempts among African American Males with and without Major Depressive Episodes

2021 ◽  
Author(s):  
Areen Omary
Keyword(s):  
African American ◽  
Suicidal Ideation ◽  
African American Males ◽  
Depressive Episode ◽  
Major Depressive Episode ◽  
Suicide Attempts ◽  
African American Men ◽  
Major Depressive ◽  
Major Depressive Episodes ◽  
Depressive Episodes

Objectives. To examine if major depressive episodes can predict risk chances for suicidal ideation, suicide plans, and suicide attempts among African American males while adjusting for covariates of age, education, and income. Methods. Data from the 2018 National Survey on Drug Use and Health were extracted and analyzed. We found data for 2,301 adult African American men with and without major depressive episodes, representing a population size of 13,210,069.53 in the United States. Results. African American men with major depressive episodes were at higher risk for suicidal ideation and suicide planning than their counterparts without a major depressive episode. However, the two groups with and without major depressive episodes had equal risk chances for suicide attempts. Conclusions. A closer examination of suicide covariate variables among African American men with and without a major depressive episode furnishes critical distinctions between the two populations. This can facilitate more responsive, tailored suicide prevention strategies for the male African American population, especially among the at-risk male adults in this group with major depressive episodes.

Attachment Organization in Suicide Prevention Research

Crisis ◽  
2014 ◽  
Vol 35 (1) ◽  
pp. 60-66 ◽  
Author(s):  
Amanda Venta ◽  
Carla Sharp
Keyword(s):  
Risk Factors ◽  
Suicidal Ideation ◽  
Suicide Attempt ◽  
Interpersonal Relationships ◽  
Suicide Ideation ◽  
Suicide Attempts ◽  
Critical Role ◽  
Self Report ◽  
Future Research ◽  
Self Harm

Background: Identifying risk factors for suicide-related thoughts and behaviors (SRTB) is essential among adolescents in whom SRTB remain a leading cause of death. Although many risk factors have already been identified, influential theories now suggest that the domain of interpersonal relationships may play a critical role in the emergence of SRTB. Because attachment has long been seen as the foundation of interpersonal functioning, we suggest that attachment insecurity warrants attention as a risk factor for SRTB. Aims: This study sought to explore relations between attachment organization and suicidal ideation, suicide attempts, and self-harm in an inpatient adolescent sample, controlling for demographic and psychopathological covariates. Method: We recruited 194 adolescents from an inpatient unit and assigned them to one of four attachment groups (secure, preoccupied, dismissing, or disorganized attachment). Interview and self-report measures were used to create four variables reflecting the presence or absence of suicidal ideation in the last year, single lifetime suicide attempt, multiple lifetime suicide attempts, and lifetime self-harm. Results: Chi-square and regression analyses did not reveal significant relations between attachment organization and SRTB, although findings did confirm previously established relations between psychopathology and SRTB, such that internalizing disorder was associated with increased self-harm, suicide ideation, and suicide attempt and externalizing disorder was associated with increased self-harm. Conclusion: The severity of this sample and methodological differences from previous studies may explain the nonsignificant findings. Nonsignificant findings may indicate that the relation between attachment organization and SRTB is moderated by other factors that should be explored in future research.

Suicide Attempts Among Depressed Inpatients with Depressive Disorder in a Malaysian Sample

Crisis ◽  
2011 ◽  
Vol 32 (5) ◽  
pp. 283-287 ◽  
Author(s):  
L. F. Chan ◽  
T. Maniam ◽  
A. S. Shamsul
Keyword(s):  
Risk Factors ◽  
Suicidal Ideation ◽  
Suicide Attempt ◽  
Depressive Disorder ◽  
Suicide Attempts ◽  
Psychosocial Risk Factors ◽  
Psychosocial Risk ◽  
Life Event ◽  
Axis I ◽  
A Current

Background: Depressed inpatients constitute a high-risk population for suicide attempts. Aims: To describe the interactions of clinical and psychosocial risk factors influencing suicide attempts among a Malaysian sample of depressed inpatients. Methods: Seventy-five subjects were diagnosed with a depressive disorder according to the Structured Clinical Interview for DSM-IV Axis I Disorders-Clinical Version (SCID-CV). Data on suicide attempts, suicidal ideation (Scale for Suicidal Ideation, SSI), depression severity (Beck’s Depression Inventory, BDI), recent life-event changes (Social Readjustment Rating Scale, SRRS), sociodemographic and other relevant clinical factors were collected. Results: A third of the subjects presented after a current suicide attempt. Significant factors for a current suicide attempt were race, religion, recent life-event changes, suicidal ideation, and alcohol use disorder. Independent predictive risk factors for a current suicide attempt were Chinese race, recent marital separation, major mortgage or loans, and being newly diagnosed with depression. Any recent change in personal habits was shown to be a protective factor against current suicide attempt. Age and gender were nonsignificant factors. Conclusions: The findings are generally consistent with existing studies and highlight the role of psychosocial risk factors.

Substance Abuse and Drug-Related Death, Suicidal Ideation, and Suicide: A Review

Crisis ◽  
1999 ◽  
Vol 20 (1) ◽  
pp. 28-35 ◽  
Author(s):  
Annie Mino ◽  
Arnaud Bousquet ◽  
Barbara Broers
Keyword(s):  
Public Health ◽  
Risk Factors ◽  
Substance Abuse ◽  
Suicidal Ideation ◽  
Family Support ◽  
Drug Users ◽  
Suicide Attempts ◽  
Public Health Problem ◽  
Major Public Health Problem ◽  
Hiv Epidemic

The high mortality rate among drug users, which is partly due to the HIV epidemic and partly due to drug-related accidental deaths and suicides, presents a major public health problem. Knowing more about prevalence, incidence, and risk factors is important for the development of rational preventive and therapeutic programs. This article attempts to give an overview of studies of the relations between substance abuse, suicidal ideation, suicide, and drug-related death. Research in this field is hampered by the absence of clear definitions, and results of studies are rarely comparable. There is, however, consensus about suicidal ideation being a risk factor for suicide attempts and suicide. Suicidal ideation is also a predictor of suicide, especially among drug users. It is correlated with an absence of family support, with the severity of the psychosocial dysfunctioning, and with multi-drug abuse, but also with requests for treatment. Every clinical examination of a drug user, not only of those who are depressed, should address the possible presence of suicidal ideation, as well as its intensity and duration.

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