WSCOS 2017

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HarmResearch gave the following presentations at the 2017 3rd Annual Western States Conference on Suicide (WSCOS):

Friday, June 23rd, 2017, 10:15 am to 11 am Plenary
Friday, June 23rd, 2017, 9 am to 5 pm Posters


Friday, June 23rd, 2017 Plenary

 

Assessment and Pharmacological Treatment of Suicidality

 

David V Sheehan MD, MBA, DLFAPA 1, 2, 3

Jennifer M Giddens 2, 3, 4

1 University of South Florida College of Medicine, Tampa, FL, USA

2 Harm Research Institute, Tampa, FL, USA

3 Tampa Center for Research on Suicidality, Tampa, FL, USA

4 University of South Florida College of Arts and Sciences, Tampa, FL, USA

 

Date:  Friday, June 23rd, 2017

Time: 10:15 am to 11 am

Location:   Jordan Ballroom, Boise State University, Boise, ID

Abstract:

Long cherished views of suicide are undergoing revision. Once thought to be mainly a complication of depression, suicide rates are higher in a wide range of neuropsychiatric disorders, including schizophrenia, PTSD, panic disorder, social anxiety disorder, anorexia nervosa, substance dependence, and fibromyalgia. There is increasing evidence that suicidality may have a genetic component that may be transmitted independently of transmission of depression and other Axis I and Axis II psychiatric disorders. Inflammatory factors, autoimmune factors, and dietary intake of some substances, may also play a role in some cases.

Suicidality may not be linear as often assumed, but may follow non-linear dynamics as it changes over time. Suicidality may be a group of separate Axis I disorders, needing separate pharmacologic treatments. A classification of suicidality disorders will be presented. These revisions in our understanding of suicidality have led to calls for more sophisticated methods of assessment of suicide, the need for a phenotypic classification of suicide disorders, and improved and more targeted anti-suicidality medication treatments. It has resulted in the development of new assessment interviews and scales to capture these domains of suicidality with greater precision and reproducibility.

How to Cite:

Sheehan DV, Giddens JM. Assessment and Pharmacological Treatment of Suicidality. Keynote Presentation. Annual Conference, Western States Conference on Suicide (WSCOS), Boise, ID, June, 23, 2017.


 

Friday, June 23rd, 2017 Posters

 

Case Study of Magnesium in the Treatment of Impulse Attack Suicidality Disorder (IASD)

 

Jennifer M Giddens 1, 2, 3

David V Sheehan MD, MBA, DLFAPA 2, 3, 4

1 University of South Florida College of Arts and Sciences, Tampa, FL, USA

2 Harm Research Institute, Tampa, FL, USA

3 Tampa Center for Research on Suicidality, Tampa, FL, USA

4 University of South Florida College of Medicine, Tampa, FL, USA

 

Click here to view or download a copy of this poster

 

Date:  Friday, June 23rd, 2017

Time:  9 am to 5 pm

Location:   Jordan Ballroom, Boise State University, Boise, ID

Abstract:

Background: This case study reports on the effect of high magnesium oxide coupled with reduced dietary calcium intake (+Mg-Ca) in the treatment of Impulse Attack Suicidality Disorder (IASD).

Methods: Using several sensitive assessment instruments (S-STS, S-STS CMCM, T-CASA, SPTS) for suicidality phenomena and suicidality event tracking, the authors tracked the effect on suicidality of magnesium oxide in doses up to 1000 mg/day in 4 divided doses daily, coupled with a reduced dietary intake of calcium below 300 mg / day (<30% of Recommended Daily Intake).  The T-CASA was rated daily, and the S-STS, the S-STS CMCM, and the SPTS rated weekly over a 166-week (3.2 year) period and covering 43,690 separate suicidality events. The subject had a 25-year history of daily suicidality that did not responded to any prior treatment including 11 antidepressants, atypical antipsychotics, anticonvulsant mood stabilizers, and lithium dose.

Results: The +Mg-Ca completely eliminated the subject’s suicidality. After 6 months free of suicidality the subject stopped the magnesium, while maintaining the low calcium intake.  Within 48 hours she had a full relapse of all her prior suicidality and suicidal impulse attacks. This worsened over the ensuing week.  On restarting the magnesium the suicidality decreased over the following 8 days after which she remained suicidality free for the ensuing 7 months.

Conclusion: The data from this case study suggests that high dose magnesium oxide coupled with reduced dietary calcium intake merits further investigation for the treatment of Impulse Attack Suicidality Disorder in large double blind, placebo-controlled studies.

Learning Objectives:

Following this presentation, participants will be better able to:

1.  Understand how a +Mg-Ca (high magnesium oxide low calcium intake) regimen was used to treat a case of chronic Impulse Attack Suicidality Disorder (IASD).

2.  Identify the symptom response profile in one subject with Impulse Attack Suicidality Disorder (IASD) in response to this +Mg-Ca (high magnesium oxide low calcium intake) regimen.

Literature References:

1.  Sheehan, DV and Giddens, JM. Study of Magnesium in the Treatment of Impulse Attack Suicidality Disorder. In: Sheehan, DV and Giddens, JM. (2015). Suicidality: A Roadmap for Assessment and Treatment. (1st ed.). Tampa, FL: Harm Research Press. November 2015, p. 249-267.

2.  Sheehan, DV and Giddens, JM. Impulse Attack Suicidality Disorder. In: Sheehan, DV and Giddens, JM. (2015). Suicidality: A Roadmap for Assessment and Treatment. (1st ed.). Tampa, FL: Harm Research Press. November 2015, p. 127-155.

How to Cite:

Giddens JM, Sheehan DV. Case Study of Magnesium in the Treatment of Impulse Attack Suicidality Disorder (IASD). Poster. Annual Conference, Western States Conference on Suicide (WSCOS), Boise, ID, June, 23, 2017.

 

 

A Classification of Suicidality Disorder Phenotypes
(12 Phenotype Version)

 

Jennifer M Giddens 1, 2, 3

David V Sheehan MD, MBA, DLFAPA 2, 3, 4

1 University of South Florida College of Arts and Sciences, Tampa, FL, USA

2 Harm Research Institute, Tampa, FL, USA

3 Tampa Center for Research on Suicidality, Tampa, FL, USA

4 University of South Florida College of Medicine, Tampa, FL, USA

 

Click here to view or download a copy of this poster

 

Date:  Friday, June 23rd, 2017

Time:  9 am to 5 pm

Location:   Jordan Ballroom, Boise State University, Boise, ID

Abstract:

Background: The view that suicidality is trans-nosological and that all forms of suicide are the same, is not consistent with response to pharmacological treatment evidence.  For example, antidepressants make suicidality better in some patients, worse in others, and are no better than placebo for a third group.  This suggests that there may be more than one type of suicidality.

Methods: We used a phenomenological approach by observing in detail and directly communicating with subjects over time about their suicidality.

Results: We developed diagnostic criteria and a related structured diagnostic interview for 12 distinct suicidality disorder phenotypes. These include 1) Impulse Attack Suicidality Disorders, 2) Homicidal Suicidality Disorders, 3) Psychotic Suicidality Disorders, 4) Obsessive Compulsive Suicidality Disorders, 5) PTSD Suicidality Disorders, 6) Eating Disorder / Malabsorption Suicidality Disorders, 7) Substance Induced Suicidality Disorders, 8) Medical Illness / Neurological Condition Induced Suicidality Disorders, 9) Anxiety Disorder Induced Suicidality Disorders, 10) Mood Disorder Induced Suicidality Disorders, 11) Life Event Induced Suicidality Disorders, and 12) Suicidality Disorders, Not Elsewhere Classified.  Among these phenotypes the description of Impulse Attack Suicidality Disorder is new and has never been described from the prospective presented.  This disorder is associated with unexpected, unprovoked attacks of an urgent need to kill oneself.

Conclusion: We offer 12 distinct suicidality disorder phenotypes.  Because these phenotypes may have a different response to treatment, each phenotype should be investigated separately when investigating anti-suicidality treatments and when investigating the relationship between genetic and other biomarkers in suicidality.

Learning Objectives:

Following this presentation, participants will be better able to:

1.  Identify the different phenotypes of suicidality disorders.

2.  Appreciate that not all clinical phenotypes of suicidality disorders have the same clinical features, natural history, response to life events, prognosis, or response to treatment.

Literature References:

1.  Spiegelberg, H. (2015, June 11). Phenomenology. Retrieved October 24, 2015, from http://www.britannica.com/topic/phenomenology

2.  Sheehan, DV and Giddens, JM. Suicidality Disorders Criteria. In: Sheehan, DV and Giddens, JM. Suicidality: A Roadmap for Assessment and Treatment. (1st ed.). Tampa, FL: Harm Research Press. November 2015, p. 82-126.

3.  Sheehan, DV and Giddens, JM. (2016). Suicidality Assessment and Documentation for Healthcare Providers: A brief, practical guide. (1st ed.). Tampa, FL: Harm Research Press. May 2016.

How to Cite:

Giddens JM, Sheehan DV. A Classification of Suicidality Disorder Phenotypes (12 Phenotypes Version). Poster. Annual Conference, Western States Conference on Suicide (WSCOS), Boise, ID, June, 23, 2017.

 

 

Suicidality: A Linear or a Non-Linear Progression Over Time?

 

David V Sheehan MD, MBA, DLFAPA 1, 2, 3

Jennifer M Giddens 2, 3, 4

1 University of South Florida College of Medicine, Tampa, FL, USA

2 Harm Research Institute, Tampa, FL, USA

3 Tampa Center for Research on Suicidality, Tampa, FL, USA

4 University of South Florida College of Arts and Sciences, Tampa, FL, USA

 

Click here to view or download a copy of this poster

 

Date:  Friday, June 23rd, 2017

Time:  9 am to 5 pm

Location:   Jordan Ballroom, Boise State University, Boise, ID

Abstract:

Objective:  To investigate whether the progression of suicidality phenomena over time is linear or non-linear.  The model of progressive, linear suicidality is a long-standing assumption in suicidality research.  Understanding the progression of suicidality over time will help researchers build better predictive models of suicidality.

Design:  We adapted methods developed by Robert Stetson Shaw, a physicist at the University of California at Santa Cruz, to analyze the progression of suicidality phenomena in 2 continuous data sets from a single case over time. These methods are used in non-linear dynamics theory / non-linear systems theory / turbulence theory / deterministic chaos and permit data to be graphically displayed in 2- and 3-dimensional space over time.

Results:  The method permitted the mathematical graphic modeling of suicidality phenomena over 3 years in the form of 2D and 3D attractor plots.  The results showed a non-linear dynamic progression of suicidality phenomena over time. There was no linear progression in the rate of change in the relationship between suicidal ideation and behavior, over time.

Conclusion: The trajectory of suicidal phenomena over time is non-linear and dynamic.  This data is displayed graphically as attractor plots that reflect the underlying structure of suicidality and its dynamic, turbulent change over time.  To improve predictive models of suicidality, progressive, linear models need to be abandoned in favor of non-linear, mathematical modeling of dynamic systems that more accurately reflect the turbulence, unpredictability, and dynamic nature of the complex systems of suicidality phenomena as they move through time

Learning Objectives:

Following this presentation, participants will be better able to:

1.  Understand that suicidality may not follow a linear progression, but follows a model of chaos dynamics.

2.  Appreciate the need to consider non-linear dynamic systems mathematical modeling when building predictive models of suicidality.

3.  Understand that most (if not all) research on risk and protective factors for suicidality are based on linear models and may not accurately model the true non-linear dynamic nature of suicidality.

Literature References:

1.  Robert Shaw, The Dripping Faucet As a Model Chaotic System, Science Frontier Express Series, Aerial Press, December 1984, ISBN 0-942344-05-7.

2.  Giddens JM, Sheehan DV. Study of Magnesium in the Treatment of Impulse Attack Suicidality Disorder. In: Sheehan, DV and Giddens, JM. Suicidality: A Roadmap for Assessment and Treatment. (1st ed.). Tampa, FL: Harm Research Press. November 2015, p. 249-247.

3.  Sheehan, DV and Giddens, JM. (2016). Suicidality Assessment and Documentation for Healthcare Providers: A brief, practical guide. (1st ed.). Tampa, FL: Harm Research Press. May 2016. p. 93-99.

How to Cite:

Giddens JM, Sheehan DV. Suicidality: A Linear or a Non-linear Progression Over Time? Poster. Annual Conference, Western States Conference on Suicide (WSCOS), Boise, ID, June, 23, 2017.