December 2016: Science of Suicidality (SOS)

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December 2016: Science of Suicidality (SOS)

Altered brain processing of decision-making in healthy first-degree biological relatives of suicide completers

Y. Ding, F. Pereira, A. Hoehne, M.-M. Beaulieu, M. Lepage, G. Turecki, & F. Jollant.

This study investigated brain processing during decision-making in relatives of suicide completers in order to shed light on heritable mechanisms of suicidal vulnerability.  The authors studied 17 healthy first-degree biological relatives of suicide completers with no personal history of suicidal behavior, 16 relatives of depressed patients without any personal or family history of suicidal behavior, and 19 healthy controls. They acquired functional 3 T magnetic resonance imaging scans while participants underwent the Iowa Gambling Task.  They report individuals with a family history of suicide in comparison to control groups showed altered contrasts in the left medial orbitofrontal cortex, and in the right dorsomedial prefrontal cortex.



Can CCTV identify people in public transit stations who are at risk of attempting suicide? An analysis of CCTV video recordings of attempters and a comparative investigation

B. L. Mishara, C. Bardon, & S. Dupont.

The authors investigated the possibility of training observers of closed-circuit TV (CCTV) feeds from public transit systems to predict which subjects might attempt suicide.  The authors trained 4 psychology students to review video and identify common behaviors from 60 attempted suicides from the Société de Transport de Montréal.  The authors taught an additional sample of psychology students these identified behaviors.  The second sample of students then watched a mixed sample of 119 video clips of both behavior prior to a suicide attempt and videos with no suicide attempter and were asked to identify the suicide attempters.  The authors report that real time observations of CCTV monitors, automated computer monitoring of CCTV signals, and/or training of drivers and transit personnel on behavioral indications of suicide risk, may identify attempters with few false positives, and may potentially save lives.



Comparisons of the Interpersonal–Psychological Theory of Suicide Constructs Among Individuals Without Suicidality, Ideators, Planners, and Attempters

L. N. Forrest & A. R. Smith.

This study tests whether the Interpersonal–Psychological Theory of Suicide (IPTS) constructs (thwarted belongingness, perceived burdensomeness, and fearlessness about death [a component of acquired capability]) differentiate (a) individuals with suicidality (81) from individuals without suicidality (25) and (b) differentiate a combined group of suicide planners (15) and suicide attempters (30) on one side (45) from a group of suicide ideators on the other (36).  The authors reported thwarted belongingness and perceived burdensomeness differentiated individuals with suicidality from individuals without suicidality, and that fearlessness about death did not differentiate the combined group of suicide planners and suicide attempters from suicide ideators.



D-Cycloserine, an NMDA Glutamate Receptor Glycine Site Partial Agonist, Induces Acute Increases in Brain Glutamate Plus Glutamine and GABA Comparable to Ketamine

J. T. Kantrowitz, M. S. Milak, X. Mao, D. C. Shungu, & J. J. Mann.

This letter to the editor reports on the potential use of D-cycloserine as an NMDAR antagonist.  The authors investigated the GABA and glutamate plus glutamine levels in 6 healthy subjects following administration of 1000 mg of oral D-cycloserine.  They report D-cycloserine increased both neurotransmitter levels comparably to ketamine and suggest these increased neurotransmitter levels may be the initial step in the antidepressant cascade of NMDAR antagonism.



Increased plasma levels of circulating cell-free mitochondrial DNA in suicide attempters: associations with HPA-axis hyperactivity

D. Lindqvist, J. Fernström, C. Grudet, L. Ljunggren, L. Träskman-Bendz, L. Ohlsson, & Å. Westrin.

This study investigated whether free circulating mtDNA would be elevated in the suicide attempters and would be associated with hypothalamic–pituitary–adrenal (HPA)-axis hyperactivity.  The authors studied plasma samples from 37 suicide attempters and 37 healthy controls.  The authors found suicide attempters had significantly higher plasma levels of free-circulating mtDNA, which are related to impaired HPA-axis negative feedback, compared with healthy controls.  They recommend future studies to better understand the relevance of increased free-circulating mtDNA in relation to the pathophysiology underlying suicidality.



Reliability, validity and factorial structure of the Arabic version of the international suicide prevention trial (InterSePT) scale for suicidal thinking in schizophrenia patients in Doha, Qatar **

S. Hammoudeh, S. Ghuloum, Z. Mahfoud, M.Opler, A. Khan, A.Yehya, A. Abdulhakam, A. Al-Mujalli, Y. Hani, R. Elsherbiny, & H. Al-Amin.

This study aimed to culturally adapt the Arabic translation of InterSePT Scale for Suicidal Thinking (ISST) and to examine its psychometric characteristics among patients with schizophrenia in Qatar.  The authors studied the scale in a sample of 100 patients diagnosed with schizophrenia and 99 controls.  They report the Arabic version of the ISST had satisfactory psychometric properties with good reliability and validity measures.  This study provides a culturally adapted and scientifically validated Arabic ISST that can be used in the assessment of suicidality among Arab speaking patients with schizophrenia.

** The Mini International Neuropsychiatric Interview (MINI) was used in this study.  Harm Research Press (the publisher of the Science of Suicidality), Harm Research Institute (the owner of the website on which the Science of Suicidality is published), the editor of the Science of Suicidality, and the owners of Harm Research own or receive proceeds from the sale and / or use of the MINI.



Psychiatrists’ experiences of suicide assessment

M. Waern, N. Kaiser, & E. S. Renberg.

This study looks at the behaviors, attitudes, and emotions related to suicide assessment consultations from the perspective of the psychiatrist.  The authors used a semi-structured in depth interview with 15 psychiatrists who were selected based on age, gender, geographic location (amongst the 3 different sites in Sweden), and within-psychiatric specialization.  They report 3 main themes (understanding the patient, understanding and coping with one’s own reactions, and understanding the influence of the patient doctor relationship) and 15 subthemes.  This study highlights a number of common issues facing psychiatrists when they conduct suicidality assessments.  Each of these themes and subthemes are areas on which the field can focus further research.  Such research may assist all clinicians conducting suicidality assessments.



Rafi’s Red Racing Car: Explaining Suicide and Grief to Young Children

L. Moir.

This illustrated children’s book was written to help young children come to terms with the death of a family member by suicide.  Rafi the rabbit enjoys playing with his father, but one day his father gets sad, leaves home, and never comes back.  The story honestly describes Rafi’s father’s death by suicide and Rafi’s grief (confusion, anxiety, anger, sadness).  The book ends with a thoughtful, clear guide for parents and professionals on how to help a child heal from the grief of losing a loved one to suicide.




Rare CNVs in Suicide Attempt include Schizophrenia-Associated Loci and Neurodevelopmental Genes: A Pilot Genome-Wide and Family-Based Study

M. Sokolowski, J. Wasserman, & D. Wasserman.

The authors investigate the role of copy number variations (CNVs) as a possible genetic component in suicidal behavior.  They studied genome-wide association of CNVs with a history of severe suicide attempt (SA), in a sample of nuclear family trios from an existing database.  Although CNVs did not show genome-wide association using the FBAT-CNV methodology, their preliminary observations suggest rare pathogenic CNVs affecting neurodevelopmental functions in a subset of SA, who were distinct from SA having increased SNP risk-allele burden.  These observations provide another avenue of exploration in the genetic etiology of suicidal behavior.



Targeted Sequencing of FKBP5 in Suicide Attempters with Bipolar Disorder

M. E. Breen, S. C. Gaynor, E. T. Monson, Klerk, M. G. Parsons, T. A. Braun, A. P. DeLuca, P. P. Zandi, J. B. Potash, & V. L. Willour.

This study investigated a systematic, targeted sequencing approach, developed by study authors, to study the association between coding and regulatory regions in or near FKBP5 and suicide attempts in Bipolar Disorder.  The authors studied a sample of 476 bipolar disorder suicide attempters and 473 bipolar disorder non-attempters.  They found one variant, rs141713011, showed an excess of minor alleles in suicide attempters that was statistically significant following correction for multiple testing but, were unable to replicate this result in an independent cohort.  They report that further investigation is required in larger sample sets to understand the association of this variant with suicidal behavior.

However, it is possible the sample size is not the only problem in this study.  The study investigated a mixed suicidality disorder phenotype sample of patients that happened both to have bipolar disorder and to have made a suicide attempt.  Data gathered for this study does not in any way tie the patient’s suicidality to their bipolar disorder.  Within this study’s sample might be patients that made a suicide attempt because a loved one died, because they heard a command hallucination telling them to kill themself, and / or because they felt significantly suicidal while withdrawing from an opiate.  These unique (phenotype) groups of patients are likely to have different genotypes, but were all considered as one homogenous phenotype in this study.


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