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 ◽  
...  

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.

2020 ◽  
Author(s):  
Milda Sarkinaite ◽  
Rymante Gleizniene ◽  
Virginija Adomaitiene ◽  
Kristina Dambrauskiene ◽  
Nijole Raskauskiene ◽  
...  

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.


Diagnostics ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. 488
Author(s):  
Milda Sarkinaite ◽  
Rymante Gleizniene ◽  
Virginija Adomaitiene ◽  
Kristina Dambrauskiene ◽  
Nijole Raskauskiene ◽  
...  

Structural brain changes are found in suicide attempters and in patients with mental disorders. It remains unclear whether the suicidal behaviors are related to atrophy of brain regions and how the morphology of specific brain areas is changing with each suicide attempt. The sample consisted of 56 patients hospitalized after first suicide attempt (first SA) (n = 29), more than one suicide attempt (SA > 1) (n = 27) and 54 healthy controls (HC). Brain volume was measured using FreeSurfer 6.0 automatic segmentation technique. In comparison to HC, patients with first SA had significantly lower cortical thickness of the superior and rostral middle frontal areas, the inferior, middle and superior temporal areas of the left hemisphere and superior frontal area of the right hemisphere. In comparison to HC, patients after SA > 1 had a significantly lower cortical thickness in ten areas of frontal cortex of the left hemisphere and seven areas of the right hemisphere. The comparison of hippocampus volume showed a significantly lower mean volume of left and right parts in patients with SA > 1, but not in patients with first SA. The atrophy of frontal, temporal cortex and hippocampus parts was significantly higher in repeated suicide attempters than in patients with first suicide attempt.


2021 ◽  
Author(s):  
Olaoluwa O. Okusaga ◽  
Rachel L. Kember ◽  
Gina M. Peloso ◽  
Roseann E. Peterson ◽  
Marijana Vujkovic ◽  
...  

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.


Crisis ◽  
2017 ◽  
Vol 38 (6) ◽  
pp. 367-375 ◽  
Author(s):  
Leo Sher ◽  
Michael F. Grunebaum ◽  
Ainsley K. Burke ◽  
Sadia Chaudhury ◽  
J. John Mann ◽  
...  

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.


2021 ◽  
Author(s):  
Olaoluwa O Okusaga ◽  
Rachel L Kember ◽  
Gina M Peloso ◽  
Roseann E Peterson ◽  
Marijana Vujkovic ◽  
...  

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.


2021 ◽  
pp. 003022282110034
Author(s):  
Azam Farmani ◽  
Mojtaba Rahimianbougar ◽  
Yousef Mohammadi ◽  
Hossein Faramarzi ◽  
Siamak Khodarahimi ◽  
...  

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.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ji-Hun Kang ◽  
Si-Won Lee ◽  
Jae-Gu Ji ◽  
Jae-Kwang Yu ◽  
Yun-Deok Jang ◽  
...  

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.


2021 ◽  
Vol 3 (3) ◽  
Author(s):  
Tobias Teismann ◽  
Thomas Forkmann ◽  
Johannes Michalak ◽  
Julia Brailovskaia

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.


2016 ◽  
Vol 33 (S1) ◽  
pp. S601-S601
Author(s):  
E. Gattoni ◽  
A. Feggi ◽  
C. Gramaglia ◽  
P. Bergamasco ◽  
I. Coppola ◽  
...  

BackgroundSuicide attempts, defined as self-inflicted, potentially injurious behaviors with a nonfatal outcome, and with evidence of intent to die are extremely prevalent. Literature suggests that suicide is more common among males, while attempted suicide is more frequent among females. Depression, mental disorders, substance use disorders and history of suicidal behavior are important risk factors for suicide: the risk of suicide attempt is 3 to 12 times higher in psychiatric patients than in the general population.AimThe aim of our study was to compare severity of depressive symptoms in a sample of suicide attempters with a diagnosis of bipolar and related disorders or depressive disorders and in a sample of sex- and diagnosis-matched patients who do not commit a suicide attempt. The severity of attempted suicide and the suicidal risk in the hospital will be assessed as well.Material and methodsWe collected a sample of inpatients who committed a suicide attempt during 2015. For each attempter, we selected another sex- and diagnosis-matched patient with no history of attempted suicide. Socio-demographic and clinical characteristics of the sample were gathered. Assessment included: Montgomery-Asberg Depression Rating Scale (MADRS) for severity of depressive symptoms in both groups, Suicide Intent Scale (SIS) for the severity of attempted suicide and the suicidal risk with a nurse assessment for suicide.ResultsData collecting is still ongoing. We expected to find more severe symptoms in patients who attempted suicide. Clinical implication will be discussed.Disclosure of interestThe authors have not supplied their declaration of competing interest.


1996 ◽  
Vol 168 (3) ◽  
pp. 324-329 ◽  
Author(s):  
Kevin M. Malone ◽  
Elizabeth M. Corbitt ◽  
Shuhua Li ◽  
J. John Mann

BackgroundThis study employed an alternative method for assessing serotonergic function to further evaluate our finding that cerebrospinal fluid (CSF) 5-hydroxyindole acetic acid (5-HIAA) in depressed suicide attempters with a lifetime history of higher lethality suicide attempts is significantly lower compared to depressed patients who have a history of low lethality suicide attempts.MethodWe used dl-fenfluramine (60 mg) as a neuroendocrine probe to examine the serotonin system in 41 in-patients with a DSM–III–R major depressive episode, divided into two groups on the basis of a lifetime history of high or low lethality suicide attempts. Fenfluramine challenge test outcome was defined as the maximum prolactin response in the five hours following fenfluramine.ResultsPatients with a history of a higher lethality suicide attempt had a significantly lower prolactin response to fenfluramine, even when controlling for cortisol, age, sex, weight, comorbid cluster B personality disorder, pharmacokinetic and menstrual cycle effects.ConclusionsThe data provide further support for the hypothesis that serotonin dysfunction is associated with more lethal suicide attempts, and suggests that higher lethality suicide attempters or failed suicides resemble completed suicides both behaviourally and biochemically.


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