June 2017: Science of Suicidality (SOS)

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June 2017: Science of Suicidality (SOS)

A cross-national study on gender differences in suicide intent

A. Freeman, R. Mergl, E. Kohls, A. Székely, R. Gusmao, E. Arensman, N. Koburger, U. Hegerl, & C. Rummel-Kluge.

This cross-national study investigates gender differences in suicidal intent and gender differences in suicide attempts across age and country.  The authors used suicide attempt data from the Optimising Suicide Prevention Programmes and their Implementation in Europe (OSPI-Europe) project that was collected between June 2008 and March 2012.  They studied 5,212 participants from eight regions in Germany, Hungary, Ireland, and Portugal.  Suicide intent data were retrospectively rated on the Feuerlein Scale.  The authors found a significant association between gender and type of suicide intent.  They found a statistically significant gender difference in type of suicide intent on the one side and age groups and between countries on the other side.  They recommend gender targeted suicide prevention and intervention strategies.

This study should be repeated with those rating the level of suicide intent blinded to the patient’s gender.  Since men are assumed to engage in more serious suicide attempts, it is possible the rater’s bias on this account influenced the results of this study.

[https://doi.org/10.1186/s12888-017-1398-8]

 

A standardized crisis management model for self-harming and suicidal individuals with three or more diagnostic criteria of borderline personality disorder: The Brief Admission Skåne randomized controlled trial protocol (BASRCT) **

S. I. Liljedahl, M. Helleman, D. Daukantaité, Å. Westrin, & S. Westling.

This article describes the Brief Admission Skåne randomized controlled trial (BASRCT) protocol designed to investigate whether Brief Admission (BA) can replace general psychiatric hospitalization in those with complex mental illness during times of increased self-harm and suicidal risk.  Brief Admission is a risk and crisis management strategy allowing those with symptoms meeting 3 or more diagnostic criteria of Borderline Personality Disorder (BPD) to self-admit to hospital for up to 3 days when needed due to self-harm and suicidality.  The authors will study 124 participants randomized into 2 groups (treatment as usual, or BA and treatment as usual).  Data collection will continue through June 2018.  The authors discuss their plans to assess the impact of BA on daily functioning, coping, and reduction of psychiatric symptoms.  They intend to investigate whether BA is an effective crisis management model for those with symptoms meeting 3 or more diagnostic criteria of BPD.

This study should be repeated looking at BA across a broader diagnostic range of patients with suicidality, not just those with symptoms meeting 3 or more criteria of PBD.

** The Mini International Neuropsychiatric Interview (MINI) is being 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 royalties from the sale and / or use of the MINI.

[https://doi.org/10.1186/s12888-017-1371-6]

 

Assessment of Suicidal Ideation and Behavior: Report of the International Society for CNS Clinical Trials and Methodology Consensus Meeting ******

P. B. Chappell, M. Stewart, L. Alphs, F. DiCesare, S. DuBrava, J. Harkavy-Friedman, P. Lim, S. Ratcliffe, M. M. Silverman, S. D. Targum, & S. R. Marder.

This article reports on the International Society for CNS Clinical Trials and Methodology’s (ISCTM) Consensus Meeting on the assessment of suicidal ideation and behavior in clinical trials held in Washington, DC November 17-18th, 2015.  Stakeholders from academia, industry, regulatory agencies, NIH, NIMH, and patient advocacy organizations participated in the meeting.  The article describes the pre-meeting and meeting working groups which focused on: 1. Nomenclature and classification; 2. Detection and assessment; 3. Data analysis; 4. Clinical trial design; and 5 Public health approaches.  The article describes areas of consensus and areas to focus future efforts.  The authors report a consensus among all working groups on the barrier posed from a lack of universally accepted and standardized nomenclature and classification system for suicidal ideation and behavior phenomena.

It would be helpful if another survey, similar to the pre-meeting survey, was sent to stakeholders periodically to determine the current status of the field.  In addition, it would have been helpful to include patient advocacy organization stakeholders at an earlier point in the process.  These stakeholders may have been uniquely suited to steer the pre-meeting discussions into focus areas not considered by the other stakeholders.  Other groups tackling a consensus process may wish for initial pre-meeting consensus working groups to decide on the methodology of obtaining final consensus very early in the process, instead of allowing parties to become vested in the process and then imposing the consensus process immediately prior to the meeting.

****** The editor of the Science of Suicidality and the co-founders of Harm Research Press (the publisher of the Science of Suicidality) and Harm Research Institute (the owner of the website on which the Science of Suicidality is published) both attended this consensus conference.  One of them (DS) also participated in the pre-meeting working group.  In addition, the editor of the Science of Suicidality, and the co-cofounders of Harm Research Press (the publisher of the Science of Suicidality) and Harm Research Institute (the owner of the website on which the Science of Suicidality is published) own or receive royalties from the sale and / or use of the Sheehan & Giddens Suicidality Phenomena Definitions.

[https://doi.org/10.4088/JCP.16cs11417]

 

Association between Catechol-O-Methyltransferase Val158Met (158G/A) Polymorphism and Suicide Susceptibility: A Meta-analysis

T. Sadeghiyeh, F. H. Biouki, M. Mazaheri, M. Zare-Shehneh, H. Neamatzadeh, & Z. Poursharif.

This meta-analysis investigated the association between the Catechol-O-methyltransferase (COMT) gene 158G/A (COMT Val158Met) polymorphism and susceptibility to suicide.  The authors pooled data from 14 eligible case-control studies containing sufficient information for the calculation of odds ratios.  These studies included 2,353 who attempted suicide and 2,593 controls.  The authors report that the pooled data did not find an increased risk for suicide overall.  They found a significant association between COMT Val158Met polymorphism and suicide risk only among females.

[http://journals.umsha.ac.ir/index.php/JRHS/article/view/3302]

 

Association between suicide-related ideations and affective temperaments in the Japanese general adult population

N. Mitsui, Y. Nakai, T. Inoue, N. Udo, K. Kitagawa, Y. Wakatsuki, R. Kameyama, A. Toyomaki, Y. M. Ito, Y. Kitaichi, S. Nakagawa, & I Kusumi.

This article investigated associations between suicidal ideation and affective temperaments in general population Japanese adults.  The authors studied 638 volunteers using the Patient Health Questionnaire (PHQ-9) and Temperament Evaluation of the Memphis, Pisa, Paris, and San Diego Auto-questionnaire (TEMPS-A).  They divided participants into 3 groups based on PHQ-9 item and summary scores: 1. Non-depressive (469); 2. Depressive symptoms, but no suicidal ideation (135); and 3. Depressive symptoms and suicidal ideation (34).  They report the group with depressive symptoms and suicidal ideation (Group 3 above), had significantly higher scores on the irritable, depressive, and anxious temperament subscales of the TEMPS-A than those with depressive symptoms, but no suicidal ideation, on the PHQ-9 (Group 2 above).

[https://doi.org/10.1371/journal.pone.0179952]

 

High Illicit Drug Abuse and Suicide in Organ Donors With Type 1 Diabetes

L. M. Jacobsen, M. J. Haller, A. Parish, M. J. Gurka, S. R. Levine, C. Wasserfall, M. Campbell-Thompson, J. Kaddis, A. Pugliese, M. A. Atkinson, & D. A. Schatz.

This brief, 2-page article, reports on the rates of death by suicide and drug abuse in organ donors with type 1 diabetes.  The authors used data on the first 100 organ donors with type 1 diabetes from the Network for Pancreatic Organ Donors with Diabetes (nPOD) database.  They found 8 deaths by suicide, including 3 under 19 years of age.

[https://doi.org/10.2337/dc17-0996]

 

Impact of the study of marijuana and suicide in Mexico

R. O. Zavala.

This brief, 1-page article provides an overview of the relationship between suicidality and the use of marijuana.  The article explains the need for additional data on this relationship, specifically in Mexico where recently approved amendments authorize the medical and scientific use of marijuana.

[https://doi.org/10.17711/SM.0185-3325.2017.011]

 

Risk of suicide, deliberate self-harm and psychiatric illness after the loss of a close relative: a nationwide cohort study

M. B. Guldin, M. I. S. Kjaersgaard, M. Fenger-Grøn, E. T. Parner, J. Li, A. Prior, M. Vestergaard.

This nationwide Danish cohort study investigated the incidence of serious mental health conditions after the loss of a close relative.  Data from 1995 through 2013 were obtained from the Danish register.  The authors studied 1,445,378 bereaved persons who were matched to 5 non-bereaved persons by age, gender, and family composition.  They report, “the risk of suicide, deliberate self-harm and psychiatric illness was increased in the bereaved cohorts for at least 10 years after the loss, particularly during the first year.”  The authors found 33% of those with a previous psychiatric diagnosis experienced deliberate self-harm, psychiatric illness, or suicide within 1-year post-bereavement.

This article contains many insights on interactions found between age, gender, familial relationship, and serious mental health problems following the loss of a loved one.

[https://doi.org/10.1002/wps.20422]

 

Suicide and Lyme and associated diseases

R. C. Bransfield.

This article provides a thorough investigation into the association between suicide and Lyme and associated diseases (LAD).  The author retrospectively reviewed 253 randomly selected, inactive charts of patients with LAD from the author’s practice with their identity protected.  Patient charts were divided based upon combinations of suicidality, homicidality, and explosive anger.  The author found 110 patients (43%) were suicidal (11% [29] homicidal and suicidal, and 32% [81] suicidal, but not homicidal).  He reports, “LAD contributed to suicidality, and sometimes homicidality, in individuals who were not suicidal before infection.”  The author estimates yearly death by suicide rates in those with LAD.  He emphasizes the need for a greater understanding of and need for a direct method to obtain statistics on death by suicide in patients with LAD.

[https://dx.doi.org/10.2147/NDT.S136137]

 

The Economy and Suicide: An Interaction of Societal and Intrapersonal Risk Factors

J. J. Mann & A. V. Metts.

This short, but thorough article discusses the relationship between economic variables and suicide rates.  The article also discusses the impact of mental health and life stressors on economic variables related to suicide rates.

[https://dx.doi.org/10.1027/0227-5910/a000487]

 

The Impact of BDNF Polymorphisms on Suicidality in Treatment-Resistant Major Depressive Disorder: A European Multicenter Study **

A. Schosser, L. Carlberg, R. Calati, A. Serretti, I. Massat, C. Spindelegger, S. Linotte, J. Mendlewicz, D. Souery, J. Zohar, S. Montgomery, & S. Kasper.

This study investigated associations between suicidality and the brain-derived neurotrophic factor (BDNF) gene.  The authors studied 250 patients with Major Depressive Disorder as part of the Patterns of Treatment Resistance and Switching Strategies in Unipolar Affective Disorder study using the Mini International Neuropsychiatric Interview (MINI) and Hamilton Rating Scale for Depression (HAM-D).  Patients were treated with antidepressants at adequate doses for at least 4 weeks as part of the multicenter resistant depression study.  The authors conducted genotyping for 8 tagging single nucleotide polymorphisms (SNPs) within the BDNF gene, including the functional Val66Met polymorphism (rs6265).  They report BDNF haplotypes and single markers were not associated with either a lifetime history of suicide attempts or suicide risk.

In treatment remitters (34), they found the rs6265 Val66Met polymorphism and rs10501087 SNP both showed significant haplotypic and genotypic association with suicide risk.  There was no association with suicide risk found in nonresponders, responders, or nonremitters.  This association between suicide risk remission and the rs6265 polymorphism and the rs10501087 SNP warrants further investigation.  This finding is evidence of a pharmacological and a genetic dissection among those with suicidality, suggesting there may be more than one type of suicidality.

** 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 royalties from the sale and / or use of the MINI.

[https://doi.org/10.1093/ijnp/pyx028]

 

The role of DSM-5 borderline personality symptomatology and traits in the link between childhood trauma and suicidal risk in psychiatric patients **

B. Bach & R. Fjeldsted.

This study investigated Borderline Personality Disorder (BPD) symptomatology and traits as a mediator between reported childhood trauma and suicidal risk, even if the patient does not meet full criteria for BPD.  The authors investigated 124 adult psychiatric outpatients from a hospital unit in Denmark specializing in the assessment and treatment of personality disorders.  They used the Structured Clinical Interview for DSM-IV (SCID-II), Personality Inventory for DSM-5 (PID-5), Childhood Trauma Questionnaire (CTQ), and Suicidality Module of the Mini International Neuropsychiatric Interview for DSM-IV-TR (MINI).  They report finding preliminary support that BPD features may partially explain relationship between childhood trauma and elevated suicidal risk.

This study should be repeated: 1. Using both the SCID and the MINI for DSM-5; 2. Including a healthy control group; 3. Increasing the sample size of patients, including patients with psychiatric disorders who do not have a personality disorder (only 7 patients [5.6%] in the current study); and 4. Accounting for the potential of suicidality mediating the relationship between childhood trauma and BPD traits.

** 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 royalties from the sale and / or use of the MINI.

[https://doi.org/10.1186/s40479-017-0063-7]

 

The Prevalence of Psychiatric Distress and Associated Risk Factors among College Students Using GHQ-28 Questionnaire

 

J. Poorolajal, A. Ghaleiha, N. Darvishi, S. Daryaei, & S. Panahi.

This article investigated the associated risk factors and prevalence of psychiatric distress in the college students at Hamadan University of Medical Sciences, Iran.  The authors studied 1,259 students between January and May 2016 using a self-rated questionnaire and a validated Persian version of the General Health Questionnaire – 28 (GHQ-28).  They report 41.1% (518) of students had psychiatric distress, 16.2% (204) admitted suicidal thoughts, and 8.2% (103) had a lifetime-history of at least 1 suicide attempt.

[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5563878/]

 

Utility of a time frame in assessing psychological pain and suicide ideation

E. L. Meerwijk & S. J. Weiss.

This study investigated impact of the addition of a 1-week lookback time frame to the Psychache Scale (PS) instructions on the reflection of current psychological pain and on the ability to identify people with current suicide ideation.  The authors studied 242 online respondents (133 using the original PS and 109 using the PS plus time frame) between September 2015 and June 2016.  They report an increase in positive predictive value of those with current suicidal ideation when the PS is used with a timeframe.

[https://dx.doi.org/10.7717/peerj.3491]


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