Neurocognitive markers of suicidal ideation in patients with anxiety and mood disorders

Abstract

Objective: This study aims at identifying associations between cognitive function and suicidal ideation in the sample of patients with anxiety and mood disorders (AMD).

Methods: In sum, 186 (age = 39?±?12.3 years; 142 [76.3%] females) patients with AMD were enrolled in the study. Assessment included evaluation of socio-demographic information, medication use, anxiety and depression symptoms. Cognitive tests included measures of psychomotor performance and incidental learning using the Digit Symbol Test. Trail Making Tests respectively measured perceptual speed, task-switching and executive control. Additionally, 21 patients completed tests from the Cambridge Automated Neuropsychological Test Battery measuring set shifting (Interdimensional/extradimensional set-shift), executive planning (Stockings of Cambridge), and decision making (Cambridge Gamble Task [CGT]).

Results: Almost half (45.0%, n?=?86) of the study sample patients had experienced suicidal ideations. In multivariable regression analysis, suicidal ideation was associated with a greater overall proportion of bet and risk taking on the CGT task (β?=?0.726, p?=?.010 and β?=?0.634, p?=?.019), when controlling for socio-demographic characteristics, medication use, anxiety and depression symptoms.

Conclusions: Outpatients with AMD and suicidal ideation could be distinguished by the presence of cognitive deficits in the executive function domain, particularly in impulse-control and risk taking.     

Evolutionary puzzle of Toxoplasma gondii with suicidal ideation and suicide attempts: An updated systematic review and meta‐analysis

The World Health Organization has reported an annual global suicide rate of 14.5 per 100,000 people. On the other hand, it is estimated that approximately one‐third of the global population are infected with Toxoplasma gondii (T. gondii) parasite. It is widely assumed that microbial pathogens, such as T. gondii, are probably associated with affective and behavioural modulation. The present article aimed to assess the proposed role of toxoplasmosis in raising the risk of suicidal ideation (SI) and suicide attempts (SA) using the available epidemiological data. Seven major electronic databases and the Internet search engine Google were searched for all the studies published between the 1st of January 1950 and 31st of October 2019. The heterogeneity and the risk of bias within and across studies were assessed. Following data extraction, pooled odds ratios (ORs) with 95% confidence interval (CI) across studies were calculated using the random‐effects models. A total number of 9,696 articles were screened and 27 studies were regarded as eligible in our systematic review (SI with five papers and 22 papers on SA). A significant association was detected between antibodies against T. gondii with TA (ORs = 1.57; 95% confidence interval [CI] 1.23–2.00, p = .000). Exploration of the association between T. gondii and SA yielded a positive effect of seropositivity for IgG antibodies but not IgM. Despite the limited number of studies, a statistical association was detected between suicidal behaviours and infection with latent T. gondii.     

Early separation and suicidal behaviour in the parental homes of 40 consecutive suicide attempters

Forty suicide-attempt patients who were consecutively admitted to an intensive-care unit, their significant others and treatment personnel were investigated by semistructured interviews. The patients were divided into neurosis (n = 14), abuse (n = 19) and psychosis (n = 7) groups. Twenty-one of the patients (52%) had lost contact with one or both parents before the age of 18, in 25% of cases owing to death and in 27% because of the parents' divorce or separation. Parents and/or siblings of 19 patients (47%) had shown suicidal behaviour in the form of attempted suicide and/or suicide. Differences between the groups were not significant. Alcohol abuse in the parental home was overrepresented in the abuse group compared with the other groups. The role of identification with the dead and suicidal parent in prompting suicidal actions in adulthood is discussed, as well as that of the impeded evolution of stable external object relations owing to parental losses.     

住院精神分裂症患者自杀危险因素调查

对全国９省市９所医院１０年间住院精神分裂症自杀死亡资料分析，自杀率占住院病人总数的０．６３％，占精神分裂症总数的０．７８％，占慢性精神分裂症的０，５０％。偏执型占６５．６·％。自杀原因受幻觉妄想支配２３．８％，悲观厌世２８．６％；精神症状好转（５９．５％）和自知力恢复期（４７．６％）易自杀。自杀方式自缢（５７．１％）和服药（２３．８％）居首。男性自杀多于女性。     

湖南某镇农村居民自杀意念影响因素

目的:探讨农村居民自杀意念的影响因素,为自杀干预提供依据。方法:对湖南浏阳市永安镇常住农村居民,采用分层随机整群抽样法确定样本人群,使用自行设计的调查表,采取入户、单独面谈的方式进行调查。结果:共851名调查对象接受了面谈并完成调查问卷。终生自杀意念发生率为23．6％,经多因素logistic嘲归分析,自评心理健康状况、自评经济水平、性别、自评躯体健康状况为自杀意念的影响因素(OR值分别为2．107、1．910、1．630、1．596)。结论:农村常住居民自杀意念发生率处于较高水平。自评心理健康状况差、自评经济水平低、女性、自评躯体健康状况差是产生自杀意念的危险因素。应针对危险因素予以积极的干预。     

The Differential Effects of Social Media on Depressive Symptoms and Suicidal Ideation Among the Younger and Older Adult Population in Hong Kong During the COVID-19 Pandemic: Population-Based Cross-sectional Survey Study

BackgroundSocial media has become a ubiquitous part of daily life during the COVID-19 pandemic isolation. However, the role of social media use in depression and suicidal ideation of the general public remains unclear. Related empirical studies were limited and reported inconsistent findings. Little is known about the potential underlying mechanisms that may illustrate the relationship between social media use and depression and suicidal ideation during the COVID-19 pandemic.ObjectiveThis study tested the mediation effects of social loneliness and posttraumatic stress disorder (PTSD) symptoms on the relationship between social media use and depressive symptoms and suicidal ideation, as well as the moderation effect of age on the mediation models.MethodsWe administered a population-based random telephone survey in May and June 2020, when infection control measures were being vigorously implemented in Hong Kong. A total of 1070 adults (658 social media users and 412 nonusers) completed the survey. Structural equation modeling (SEM) and multigroup SEM were conducted to test the mediation and moderation effects.ResultsThe weighted prevalence of probable depression was 11.6%; 1.6% had suicidal ideation in the past 2 weeks. Both moderated mediation models of depressive symptoms (χ²₆₂=335.3; P<.05; comparative fit index [CFI]=0.94; nonnormed fit index [NNFI]=0.92; root mean square error of approximation [RMSEA]=0.06) and suicidal ideation (χ²₃₄=50.8; P<.05; CFI=0.99; NNFI=0.99; RMSEA=0.02) showed acceptable model fit. There was a significantly negative direct effect of social media use on depressive symptoms among older people (β=–.07; P=.04) but not among younger people (β=.04; P=.55). The indirect effect via PTSD symptoms was significantly positive among both younger people (β=.09; P=.02) and older people (β=.10; P=.01). The indirect effect via social loneliness was significant among older people (β=–.01; P=.04) but not among younger people (β=.01; P=.31). The direct effect of social media use on suicidal ideation was not statistically significant in either age group (P>.05). The indirect effects via PTSD symptoms were statistically significant among younger people (β=.02; P=.04) and older people (β=.03; P=.01). Social loneliness was not a significant mediator between social media use and suicidal ideation among either age group (P>.05).ConclusionsSocial media may be a “double-edged sword” for psychosocial well-being during the COVID-19 pandemic, and its roles vary across age groups. The mediators identified in this study can be addressed by psychological interventions to prevent severe mental health problems during and after the COVID-19 pandemic.     

上海地区青少年精神障碍患者非自杀性自伤行为现状及影响因素研究

目的 调查上海市青少年精神障碍患者非自杀性自伤行为（NSSI）现状,并探讨其相关影响因素。方法 以上海市精神卫生中心于2019年6月至2021年12月收治的青少年精神障碍患者为研究对象,参照《精神障碍诊断与统计手册》评定研究对象过去2年内非自杀性自伤行为发生情况,并采用自制调查问卷收集调查对象基本情况,采用Barratt冲动量表（BIS-11）对冲动状况进行评估,采用青少年生活事件量表（ASLEC）评估应激性生活事件发生的频率和强度。采用描述性分析方法对青少年精神障碍患者非自杀性自伤行为发生情况进行分析,并采用单、多因素分析方法对非自杀性自伤行为发生的影响因素进行分析。结果 1 683例青少年精神障碍患者中657例出现NSSI,发生率为39.03%。其中男262例,女395例,年龄13~20岁,平均年龄（14.63±; 3.09）岁,病程1~4年,平均病程（2.87±; 1.21）年; 268例为偶发NSSI,389例反复出现NSSI。下臂及腕部、手是发生NSSI患者的主要自伤部位（分别为40.03%、33.03%）。多因素Logistic回归分析结果显示抑郁程度越严重（OR=2.255）、遭受校园暴力（OR=2.289）、母亲教育程度为大专及以上（OR=2.428）、抑郁障碍（OR=1.855）、双向障碍（OR=2.212）、冲动总分偏高（OR=1.401）、人际关系得分高（OR=1.398）和学习压力得分高（OR=2.098）等均是导致青少年精神障碍患者发生NSSI的危险因素。结论 NSSI在青少年精神障碍患者中的发生率较高,重度抑郁、遭受校园暴力、母亲教育程度高、抑郁障碍、双向障碍、冲动总分偏高、人际关系差和学习压力大等的患者更易出现NSSI,应提高具有以上特征患者的关注度,并及时制定相应的干预策略,尽可能避免NSSI的发生。