Independent socio-demographic and clinical correlates associated with the perception of quality of life of women with postpartum depressionin North-central,Nigeria

Objective: Quality of life (QoL) is probably the most desired outcome of all health care policies and monitoring. This concept is seldom used on women in the postpartum, especially in the developing world.

Aim: This study aimed at determining the independent socio-clinical variables associated with the perception of QoL of women with postpartum depression.

Methods: A two-stage cross-sectional procedure was used to recruit 550 participants, out of whom 531 participants completed the questionnaires with 116 participants found to have postpartum depression and were the studied population, in Nigeria. The Socio-demographic questionnaire, the Edinburgh Postnatal Depression Scale, the World Health Organization Quality of Life-Bref-26 and the Depression Module of the Structured Clinical Interview for DSM-IV axis I Diagnosis were used.

Results: Participants with postpartum depression had significantly poor perception of QoL in all the four domains of the WHOQoL-BREF-26. The independent socio-demographic and clinical correlate associated with poor perception for both rating of QoL and satisfaction with health was education (β?=?0.321, p?β?=?0.0326, p?=?.002, respectively); for physical domain [(modes of delivery) (β?=?–0.28, p?=?.016)]; psychological domain [(age <35years) (β?=?0.391, p?=?.010)] and for social relationships [(complications during delivery) (β?=?0.257, p?=?.043)].

Conclusions: The determination of the predictors of QoL, which is an indicator of disease outcome will improve service delivery to women of childbearing age.     

Serum levels of second-generation antipsychotics are associated with cognitive function in psychotic disorders

Objectives: Antipsychotics are effective in treating psychosis and mood episodes; however, the effect on cognition is less known. We investigated the association between serum levels of second-generation antipsychotics (SGAs) and cognitive performance in psychosis spectrum disorders in a naturalistic setting.

Methods: A total of 495 patients with a DSM-IV Schizophrenia and Other Psychotic Disorders (SCZ, n?=?373) or Bipolar Disorder (BD, n?=?122) diagnosis treated with olanzapine, quetiapine, aripiprazole or risperidone were tested neuropsychologically with concurrent measurement of the serum concentration of the drug. Linear regression was used for association analyses.

Results: Attention was positively associated with the olanzapine concentration (standardised beta (β) coefficient =?0.19, P?=?.006), and short-term verbal memory and verbal fluency were negatively associated with the quetiapine (β?=?–0.24, P?=?.004) and risperidone (β?=?–0.37, P?=?.007) concentrations respectively.

Conclusions: The present results suggest that SGA serum concentration is associated with better attention (small effect size), and worse verbal memory (small effect size) and verbal fluency (medium effect size). These findings are in line with the notion that SGAs affect aspects of cognitive function, and suggest careful dosing in patients with severe memory and executive problems.     

Early childhood abuse and late-life suicidal ideation

Objectives: In younger populations childhood sexual and physical abuse have been found to be associated with suicidal ideation. Such associations have not been examined among older adults.

Setting: Data from the National Comorbidity Study-Replication (NCS-R).

Participants: Older adults (60+, N?=?1610) from the NCS-R sample.

Measurements: Suicidal ideation occurring after the age of 60 was assessed. Early-life factors were assessed including childhood physical and sexual abuse and parent's internalizing and externalizing symptoms. Participants’ internalizing and externalizing symptoms were also assessed.

Results: Logistic regression analysis showed that male gender, mother's internalizing symptoms and childhood physical and sexual abuse were associated with suicidal ideation. The association between child abuse and suicidal ideation was mediated by participants’ externalizing symptoms.

Conclusions: Health care workers should screen for suicidal ideation among older adults. In particular, older males with externalizing disorders and a history of child abuse may be at a heightened risk for suicidal ideation.     

The characteristics of the comorbidity between social anxiety and separation anxiety disorders in adult patients

Abstract

Objective: In the present study, we compared social anxiety disorder (SAD) patients with (n?=?31) and without childhood and adulthood separation anxiety disorder (SeAD) (n?=?50) with respect to suicidal behavior, avoidant personality disorder (AvPD), other anxiety disorders (ADs), and major depression as well as some sociodemographic variables.

Methods: In assessment of patients, we used Structured Clinical Interview for Separation Anxiety Symptoms, childhood and adulthood Separation Anxiety Symptom Inventories, Liebowitz Social Anxiety Scale, The SCID-II Avoidant Personality Disorder Module, Beck Depression Inventory, and Beck Scale for Suicidal Ideation.

Results: SAD patients with SeAD had higher comorbidity rates of AvPD, other lifetime ADs and panic disorder, and current major depression than those without SeAD. The current scores of SAD, depression, and suicide ideation and the mean number of AvPD symptoms were significantly higher in comorbid group compared to pure SAD subjects. The SAD and SeAD scores had significant associations with current depression, suicide ideations, and AvPD. The mean number of AvPD criteria and the current severity of depression were significantly associated with the comorbidity between SAD and SeAD.

Conclusion: Our findings might indicate that the comorbidity of SeAD with SAD may increase the risk of the severity of AvPD and current depression.     

Determinants of suicidal ideation and suicide attempt among former and currently homeless individuals

Purposes

This study identified determinants associated with suicidal ideation, suicide attempt and no suicidal behavior in a 12-month period among 455 former or currently homeless individuals in Quebec (Canada).

Methods

Study recruitment took place in 27 organizations located in two major Quebec urban areas, where services for homelessness are offered. Independent variables including clinical, socio-demographic, and service use/outcome variables were measured with eight standardized instruments. Significant associations between these variables and suicidal ideation or attempt in bivariate analyses were produced to build a multinomial logistic regression model using a block approach.

Results

Of 455 participants, 72 (15.8%) reported suicidal ideation and 30 (6.6%) suicide attempt, while 353 (77.6%) had not experienced suicidal behavior. Suicide ideation was particularly high among those with generalized anxiety disorder and substance use disorders, and suicide attempt even higher. Participants with higher functional disability and hospitalizations had a higher incidence of suicide attempt, whereas participants with schizophrenia spectrum and other psychotic disorders, those placed in foster care during childhood and with higher stigma scores experienced more suicidal ideation.

Conclusions

Suicidal ideation and suicide attempt among currently or recently homeless individuals were both strongly associated with clinical variables. Based on the study results, specific interventions may be promoted to improve screening of homeless individuals with suicidal behavior and prevent hospitalization such as training programs and brief care management interventions, addiction liaison nurses, improved access to primary or specialized ambulatory services, and further development of case management and outreach programs for homeless individuals, especially those with functional disabilities.

     

Psychiatric comorbidity and suicidal ideation in psoriasis,melanoma and allergic disorders

Objective: Psychiatric disorders and suicide risk (especially in psoriasis) are frequent and disabling conditions in patients with skin diseases. The aim of this study was to examine the risk of suicide and stressful life events in a sample of patients with skin disease.

Methods: A sample of 242 dermatological patients (142 women and 100 men), 112 of which had psoriasis, 77 had melanoma, and 53 were suffering with chronic allergic diseases. Patients were administered the MINI International Neuropsychiatric Interview (MINI), Hamilton Depression Rating Scale (HDRS), Hamilton Anxiety Rating Scale (HARS), and the Columbia-Suicide Severity Rating Scale (C-SSRS). Patients were also asked about their experiences with stressful life events.

Results: Patients with psoriasis were more likely to have a history of psychiatric disorders (36.6% vs. 13.2% χ²₍₁₎?=?9.55; p?=?0.002) compared to patients with allergies. Specifically, patients with psoriasis more likely had a diagnosis of a mood disorder (16.1% vs. 3.9% χ²₍₁₎?=?6.85; p?=?0.009; 16.1% vs. 0% χ²₍₁₎?=?9.56; p?=?0.002) and reported past suicidal ideation (33.9% vs. 15.6% χ²₍₁₎?=?7.89; p?=?0.005; 33.9% vs. 18.9% χ²₍₁₎?=?3.96; p?=?0.047) as compared to those with melanoma and allergy.

Conclusions: The results from this study suggest that patients affected by psoriasis have an increased risk of psychiatric comorbidities and suicidal ideation compared to those who have other dermatological disorders.     

Effects of Health-Related Quality of Life on Suicidal Ideation and Depression among Older Korean Adults: A Cross-Sectional Study

Objective The aim of this study was to investigate the prevalence of depression and suicidal ideation among older Korean adults and the predictors of suicidal ideation. Methods We analyzed data from 5,604 Koreans aged 65 or older collected by the Korea National Health and Nutrition Examination Survey in 2012–2016, an annual national, cross-sectional, epidemiologic study of the Korean population. A chi-square test was used to assess differences in socio-demographic characteristics by suicidal ideation. Psychological variables, self-rated physical health, and the five dimensions of the Korean version of the EQ-5D (EuroQoL) were compared between four subgroups categorized according to the presence/absence of suicidal ideation and depression. Multiple logistic regression was used to estimate the predictive power of health-related quality of life variables, as well as physical and psychological factors regarding suicidal ideation. Results Overall, 11.5% of the sample reported suicidal ideation, and 20.0% of the suicidal ideation group were diagnosed with depression. Respondents with suicidal ideation had significantly lower levels of health-related quality of life than those without suicidal ideation. EQ-5D self-control (OR=1.42), anxiety/depression (OR=2.32), depression (OR=2.07), and self-rated physical health (OR=1.36) were found to significantly predict suicidal ideation. Conclusion Suicidal ideation without depression was prevalent among older Koreans. Self-control, anxiety/depression of EQ-5D, selfrated physical health, and depression predicted suicidal ideation. Interventions to screen older Koreans for early detection of suicide risk and prevention strategies should consider evaluating each EQ-5D dimension.     

Hypoesthesia in generalised anxiety disorder and major depression disorder

Abstract

Objective: The determination of soft signs can be a conducive practice to understand the differential etiology between depression and anxiety. This study aims at examining malleolar hypoesthesia role in distinguishing between patients with generalised anxiety disorder (GAD) and major depression disorder (MDD).

Methods: This study examines the presence of malleolar hypoesthesia in patients with GAD (n?=?47) compared to patients with MDD (n?=?48) and healthy individuals (controls; n?=?99). The Wartenberg wheel, a medical device for neurological use, was employed to determine the presence of hypoesthesia on both sides of the ankles.

Results: The data revealed: i) MDD patients showed higher hypoesthesia than GAD patients (p?=?.008), ii) participants with hypoesthesia had higher anxiety and depression scores than participants without hypoesthesia (all p?<?.001) and iii) logistic regression model indicated that hypoesthesia can be a predictor of MDD relative to GAD diagnosis (Odds Ratio: 17.43 (1.40–217.09; p?=?.026)).

Conclusions: Malleolar hypoesthesia was higher in MDD than GAD. The detection of hypoesthesia may help to investigate the differential etiology between MDD and GAD diagnosis.     

High rates of depression anxiety and suicidal ideation among inpatients in general hospital in China

Objective: To investigate the prevalence rates of depression anxiety and suicidal ideation among Chinese general hospital inpatients and to identify the potential associations with sociodemographics.

Method: A cross-sectional survey was applied in a Chinese general hospital. A questionnaire set, including sociodemographic variables, Patient Health Questionnaire-9 (PHQ-9), and the Generalized Anxiety Disorder Scale-7 (GAD-7), was completed by the participants. Clinically significant depression (CSD) and clinically significant anxiety (CSA) were defined as a score above 10 on the two scales. CSD and CSA are proxy measures but not specific diagnoses of mental disorders.

Results: Data from 1329 patients were included in the final analysis. 422 (31.8%) reported clinically significant depressive symptoms, 83 (6.3%) reported frequent suicidal ideation, and 204 (15.3%) reported clinically significant anxiety. Household income was negatively associated with CSD. Inpatients with lower household incomes and educational levels had higher rates of CSA. Middle-aged inpatients were more prone to suicidal ideation, and stable marital status was related to less suicidal ideation.

Conclusion: Depression, anxiety, and suicidal ideation were determined to be common psychological problems in Chinese inpatients. Chinese medical personnel must pay attention to the mental health conditions of inpatients, particularly inpatients with lower income, educational levels, and poor marital status.

• Key Points

• This is one of the first studies focusing on the prevalence of depression and anxiety in Chinese hospitalized inpatients in non-psychiatric departments of a general hospital.

• The PHQ-9 and GAD-7 were determined to be potential screening tools to aid Chinese medical workers in recognizing depression and anxiety in nonpsychiatric departments.

• The prevalence of depression, anxiety and suicidal ideation was observed to be relatively high in inpatients, which requires more attention from Chinese clinicians.

     

Psychotic experiences and suicidal behavior: testing the influence of psycho-socioenvironmental factors

Purpose

Research has produced inconsistent results with respect to whether the association between psychotic experiences and suicidal behavior is independent of co-occurring clinical and socioenvironmental factors, despite substantial evidence linking the two phenomena. This study tests whether a comprehensive set of demographic, socioenvironmental, and clinical variables account for the statistical association between psychotic experiences and suicidal behaviors.

Methods

We utilized blocked multivariable logistic regression models to analyze the association between 12-month psychotic experiences and 12-month suicide behaviors (ideation, plan, and attempt) on a subsample (N = 2307) of the National Comorbidity Survey Replication. The models adjusted for socio-demographic characteristics, environmental factors in the form of childhood adversity, mental health service utilization, and psychiatric and substance abuse disorders.

Results

Psychotic experiences were significantly associated with suicidal ideation, even after adjusting for socio-demographics, childhood adversity. However, the significant association between psychotic experiences and suicidal ideation was not robust to the inclusion of mental health service utilization and psychiatric disorders. There was no significant association between psychotic experiences and suicide plan. Psychotic experiences were associated with a significantly increased risk of reporting suicide attempts (OR 6.52; 95% CI 1.36–31.11), even after adjusting for the full set of variables.

Conclusions

Although psychotic experiences were not associated with suicidal ideation after statistical adjustments, psychotic experiences were associated with a significantly increased risk of suicide attempts after the inclusion of common risk factors and co-morbidities. Thus, psychotic experiences should be included in routine psychiatric assessments to identify the individuals most at risk for attempting suicide.

     

Suicidal ideation in family carers of people with dementia

Objective: Two small studies have suggested that family carers of people with dementia may be a high-risk group for suicide. The objective of this study was to further explore the rate of suicidal ideation in a large sample of carers and identify psychosocial risk and protective factors.

Method: A cross-sectional survey was conducted with 566 family carers. The survey included measures of suicidality, self-efficacy, physical health, depression, anxiety, hopelessness, optimism, burden, coping strategies, and social support.

Results: Sixteen percent of carers had contemplated suicide more than once in the previous year. There were univariate differences between suicidal and non-suicidal carers on self-efficacy, social support, coping, burden, depression, anxiety, hopelessness, optimism, reasons for living, and symptoms of dementia, as well as age and income management. In a multivariate model, age, depression, and reasons for living predicted suicidal ideation. In tests for mediation, satisfaction with social support and dysfunctional coping had indirect effects on suicidal ideation via depression.

Conclusion: Family carers of people with dementia have high rates of suicidal ideation, with depression a risk factor and increasing age and reasons for living as protective factors. Depression and reasons for living should be targeted in interventions to reduce suicide risk in dementia carers.     

Do Addictive Behaviors Matter for College Students’ Depression and Suicidal Ideation?

Previous research has shown that depression is an important predictor for suicidal ideation and that depression, addictive behaviors, and suicidal ideations are highly associated with each other. However, no studies have specifically investigated the role of addictive behaviors (i.e., alcohol use, gambling) as moderators on the association between depression and suicidal ideation among Korean college students. This study examined (1) the association between depression and suicidal ideation using Depression, Anxiety and Stress Scale (DASS-21) and five selected items from the Youth Risk Behavior Surveillance System (YRBSS), and (2) the moderating roles of alcohol use and problem gambling using Alcohol Use Disorder Identification Test (AUDIT) and Problem Gambling Severity Index (PGSI). We collected data from full-time students (n?=?870) enrolled at 14 universities throughout South Korea using a self-reported paper-pencil survey conducted on college campuses. More than half of the total sample (52.3%, n?=?450) reported either alcohol use or gambling, and findings revealed that depression, alcohol use, and gambling are associated with suicidal ideation. We found a significant moderating effect of alcohol use on the relationship between depression and suicidal ideation (ß?=?.151, p?<?.001); whereas, gambling had no significant moderating effect on the relationship (ß?=?.054, p?<?.276). The influence of depression on suicidal ideation was greater for Korean college students who used high levels of alcohol compared to those who used low levels of alcohol. The results suggest that alcohol use is an important modifiable factor for suicidal ideation especially in students with depression, and provide a foundation for future research aimed at understanding complex and nuanced mechanisms linking depression, addictive behaviors, and suicidal ideation.     

Anxiety disorders and CRP in a population cohort study with 54,326 participants: The LifeLines study

Objectives: Growing evidence indicates that inflammatory processes may play a role in the pathogenesis of anxiety disorders. Nevertheless, much remains to be learned about the involvement of inflammation, including C-reactive protein (CRP), in specific anxiety disorders. This study examines the relation between anxiety disorders and CRP.

Methods: Associations of serum CRP with anxiety disorders were determined in a large population study (n?=?54,326 participants, mean age?=?47 years; 59% female), the LifeLines cohort. Depressive and anxiety disorders (generalized anxiety disorder, social anxiety phobia, panic disorder with or without agoraphobia and agoraphobia without panic disorder) were assessed using the Mini-International Neuropsychiatric Interview.

Results: Anxiety disorders, with the exception of social anxiety disorder, were significantly associated with increased CRP. After adjusting for demographics, life style factors, health factors, medication use, depression, and psychological stressors, CRP remained significantly associated with panic disorder with agoraphobia (β?=?0.01, P?=?.013). Moreover, CRP levels were significantly higher in people with panic disorder with agoraphobia compared to other anxiety disorders, independent of all covariates (F?=?3.00, df?=?4, P?=?.021).

Conclusions: Panic disorder with agoraphobia is associated with increased CRP, although the effect size of this association is small. This indicates that neuroinflammatory mechanisms may play a potential role in its pathophysiology.     

Hypothalamic–pituitary–adrenal axis hyperactivity is associated with decreased brain-derived neurotrophic factor in female suicide attempters

Introduction: Both decreased levels of brain-derived neurotrophic factor (BDNF) and hypothalamic–pituitary–adrenal (HPA) axis dysregulation may be involved in the pathophysiology of suicidal behaviour, as well as cognitive symptoms of depression. Pre-clinical and clinical studies have shown interactions between HPA-axis activity and BDNF, but this has not been studied in a clinical cohort of suicidal subjects. The purpose of this study was, therefore, to investigate associations between HPA-axis activity and BDNF in suicide attempters. Furthermore, this study examined the relationship between the HPA-axis, BDNF, and cognitive symptoms in suicidal patients. Since previous data indicate gender-related differences in BDNF and the HPA axis, males and females were examined separately.

Method: Seventy-five recent suicide attempters (n?=?41 females; n?=?34 males) were enrolled in the study. The Dexamethasone Suppression Test (DST) was performed and BDNF in plasma were analysed. Patients were evaluated with the Comprehensive Psychopathological Rating Scale (CPRS) from which items ‘Concentration difficulties’ and ‘Failing memory’ were extracted.

Results: Only among females, DST non-suppressors had significantly lower BDNF compared to DST suppressors (p?=?0.022), and there was a significant correlation between post-DST serum cortisol at 8 a.m. and BDNF (r_s?=??0.437, p?=?0.003). Concentration difficulties correlated significantly with post-DST cortisol in all patients (r_s?=?0.256, p?=?0.035), in females (r_s?=?0.396, p?=?0.015), and with BDNF in females (r_s?=??0.372, p?=?0.020).

Conclusion: The findings suggest an inverse relationship between the HPA-axis and BDNF in female suicide attempters. Moreover, concentration difficulties may be associated with low BDNF and DST non-suppression in female suicide attempters.     

Prevalence of comorbid depressive symptoms and suicidal ideation in children with autism spectrum disorder and elevated anxiety symptoms

Objective: Children with autism spectrum disorder (ASD) often have comorbid depressive symptoms and suicidal ideation. The aim of this study was to examine levels of depressive symptoms and suicidal ideation in a sample of children with ASD, normal cognitive functioning and elevated anxiety.

Methods: In total, 93 children aged 8–16 years with ASD and with normal cognitive functioning and (sub)clinical anxiety symptoms participated in the present study. Both parents and children filled in questionnaires to measure the level of depressive symptoms. Moreover, children reported their level of suicidal ideation.

Results: More than 35% of the children with ASD reported clinical levels of depressive symptoms while, according to parents, even more than 75% of these children showed clinical levels of depressive symptoms. Girls reported significantly higher levels of depressive symptoms than boys. Moreover, 32.2% of the children with ASD and anxiety had suicidal thoughts and 2.2% of the children showed active suicidal ideation. No gender differences were found in suicidal ideation.

Conclusions: The findings indicated that children with ASD, normal cognitive functioning and anxiety symptoms have an increased prevalence of clinical depressive symptoms and suicidal ideation. Therefore, depressive symptoms and suicidal ideation should be assessed when working with anxious children with ASD.     

Association between body weight status and suicidal ideation among Chinese adolescents: the moderating role of the child’s sex

Purpose

Suicidality (ranging from suicidal ideation to suicidal attempts and completed suicide) is a major and preventable public health concern, and body weight is considered a modifiable factor which might be helpful to the early risk assessment of suicidal ideation. This study aimed to comprehensively evaluate the association of body weight status with suicidal ideation across sex among Chinese adolescents.

Methods

Data were drawn from the 2015 National School-based Chinese Adolescents Health Survey, and 54,640 students’ questionnaires were completed and qualified for the survey. Body mass index z scores were calculated and categorized into four levels: underweight (less than the 5th percentile for sex and age), normal weight (between the 5th and 85th percentile), overweight (between the 85th and 95th percentile), and obese (above the 95th percentile).

Results

Of the total sample, 47.3% (25,852) were boys. The weighted prevalence of suicidal ideation among Chinese adolescents is 15.7% (14.6% in boys and 17.3% in girls). After adjusting for demographics, smoking, drinking, and depressive symptoms, our final multivariate logistic regression models demonstrated that only boys identified as underweight (Adjusted odds ratio [AOR] = 1.23, 95% CI = 1.06–1.44) or obese (AOR = 1.19, 95% CI = 1.02–1.38) were at a higher risk of suicidal ideation. Additionally, the association between weight status and suicidal ideation among boys might be moderated by academic pressure, smoking, and depressive symptoms.

Conclusions

There was a significant J-shaped association between relative body weight and suicidal ideation in boys. The child’s sex should be taken into consideration when developing interventions against unhealthy weight and suicidal ideation.

     

Mental disorders and risk of suicide attempt in prisoners

Background

Mental disorders are overrepresented in prisoners, placing them at an increased risk of suicide. Advancing our understanding of how different mental disorders relate to distinct stages of the suicidal process—the transition from ideation to action—would provide valuable information for clinical risk assessment in this high-risk population.

Methods

Data were drawn from a representative sample of 1212 adults (1093 men) incarcerated across 13 New Zealand prisons, accounting for 14% of the national prison population. Guided by an ideation-to-action framework, three mutually exclusive groups of participants were compared on the presence of mental disorders assessed by validated DSM-IV diagnostic criteria: prisoners without any suicidal history (controls; n = 778), prisoners who thought about suicide but never made a suicide attempt (ideators; n = 187), and prisoners who experienced suicidal ideation and acted on such thoughts (attempters; n = 247).

Results

One-third (34.6%) of participants reported a lifetime history of suicidal ideation, of whom 55.6% attempted suicide at some point (19.2% of all prisoners). Suicidal outcomes in the absence of mental disorders were rare. Whilst each disorder increased the odds of suicidal ideation (OR range 1.73–4.13) and suicide attempt (OR range 1.82–4.05) in the total sample (n = 1212), only a select subset of disorders was associated with suicide attempt among those with suicidal ideation (n = 434). Drug dependence (OR 1.65, 95% CI 1.10–2.48), alcohol dependence (OR 1.89, 95% CI 1.26–2.85), and posttraumatic stress disorder (OR 2.09, 95% CI 1.37–3.17) distinguished attempters from ideators.

Conclusion

Consistent with many epidemiological studies in the general population, our data suggest that most mental disorders are best conceptualized as risk factors for suicidal ideation rather than for suicide attempt. Once prisoners consider suicide, other biopsychosocial factors beyond the mere presence of mental disorders may account for the progression from thoughts to acts of suicide.

     

Alcohol use predicts emergency psychiatric unit admission for non-fatal suicidal behaviour in the Western Cape (South Africa): a case–control study

Abstract

Objective: We aimed to describe patterns of substance use among patients admitted to an emergency psychiatric unit for non-fatal suicidal behaviour (NFSB) or another psychiatric reason and establish whether there were significant differences in patterns of substance use between the two groups.

Methods: We employed a case–control design (N?=?50) and collected data about participants' substance use in Cape Town, South Africa. Data were analysed using Chi-square and Mann–Whitney tests, factor analysis, and logistic regressions.

Results: Prevalence of lifetime Alcohol Use Disorder (AUD) was 60% in the NFSB group and 28% in the control group. 12% of the NFSB group and 20% of the control group had a lifetime Tobacco Use Disorder. Prevalence of lifetime illicit Substance Use Disorder was 44% in the NFSB group and 60% in the control group. Hospital admission for NFSB was associated with: any past 24-hour alcohol use; quantity of past 24-hour alcohol use; quantity of past-month alcohol use; lifetime AUD; past 12-month AUD; and current AUD; and was not associated with the use of any other substances (p<.05). Past 12-month AUD was the best predictor of hospital admission for NFSB, controlling for, respectively, any past 24-hour alcohol use (aOR = 13.33, p?=?.023) and quantity of past 24-hour alcohol use (aOR = 9.01, p?=?.022)

Conclusions: Patients admitted to emergency psychiatric units for NFSB have increased needs for the treatment of AUDs compared to patients admitted for another psychiatric emergency. Findings support calls for interventions to prevent NFSB among psychiatric patients with a history of AUD.

• Key points

• Rates of substance use among patients admitted to emergency psychiatric units in South Africa were high compared to the general population.

• Hazardous alcohol use was uniquely associated with hospital admission for non-fatal suicidal behaviour compared to another psychiatric emergency.

• Tobacco use and illicit substance use were not associated with hospital admission for non-fatal suicidal behaviour compared to another psychiatric emergency.

• The association between hazardous alcohol use and hospital admission for non-fatal suicidal behaviour did not appear to be affected by demographic variables.

• Patients admitted to hospital for non-fatal suicidal behaviour have increased needs for the treatment of alcohol use disorders compared to other psychiatric patients.

     

Antiphospholipid antibodies are associated with positive screening for common mental disorders in women with previous pregnancy loss. The NOHA-PSY observational study

Objectives: Case reports describe neuropsychiatric manifestations associated with antiphospholipid antibodies (aPlAbs). In patients sharing the same symptoms fulfilling the antiphospholipid syndrome (APS) clinical criteria, the prevalence of common mental disorders has, however, never been studied.

Methods: We observed women with three consecutive abortions before the 10th week of gestation or one foetal loss at or beyond the 10th week. We compared the prevalence of common psychiatric disorders detected through screening using the Mini International Neuropsychiatric Interview, 10 years after inclusion, in women with APS (n?=?506), women negative for aPlAbs but carrying the F5rs6025 or F2rs1799963 thrombogenic polymorphism (n?=?269), and women with negative thrombophilia screening results as controls (n?=?764).

Results: Similar prevalence values were obtained for controls and women bearing one of the two thrombogenic polymorphisms. Women with APS more frequently had mood disorders (relative risk (RR) 1.57 (1.262–1.953), P?=?.0001) and anxiety (RR 1.645 (1.366–1.979), P?Conclusions: Women with obstetric APS have a higher risk of positive screening for common mental disorders than women without APS.