Frequency of suicidal ideation and associated clinical features in Lewy body dementia

IntroductionNeuropsychiatric disturbance is common in individuals with Lewy body dementia (LBD). Despite this, there is minimal research regarding suicide risks in this population.MethodsThis study was a retrospective review of a prospectively-collected database at a tertiary movement disorders clinic. Database participants with an LBD diagnosis at their most recent visit and at least one complete Beck Depression Inventory-II (BDI-II) were included. Additional measures included demographics and measures of cognition, psychiatric symptoms, motor function, and the Parkinson Disease Questionnaire-39. The frequency of suicidal ideation was assessed using question 9 of the BDI-II. Features associated with a BDI-II score greater than zero were assessed using logistic regression.ResultsThe database included 95 individuals with LBD and at least one BDI-II (visit years 2010–2020). Most participants were older men who identified as white. Eighteen individuals (18.9%; 95% CI 12.3%–28.0%) reported thoughts of killing themselves without an intent to carry them out (BDI-II = 1). No participants reported a desire or plan to kill themselves. The presence of SI was associated with measures of depression, anxiety, and emotional well-being, but not with demographics, measures of disease severity, or other psychiatric concerns.ConclusionThese findings emphasize the importance of routine screening for psychiatric symptoms in LBD and intervention when such concerns are identified. Interventions could include pharmacologic (e.g. depression treatment) and non-pharmacologic (e.g. firearm screening) approaches. More research is needed to assess suicidal ideation and suicide risks in large and more diverse LBD populations. Prospective studies should include measures of additional potential contributors to suicidality.     

Exploring maximizing,satisficing and minimizing tendency in decision-making among autistic and neurotypical individuals

BackgroundThe tendency to maximize is one of the most frequently studied personal traits in choice-making and decision-making. In spite of the large resemblances between the decision behaviour that is characteristic for maximizers and the decision behaviour displayed by individuals with autism, and the considerable overlap in the list of decision problems and decision experiences commonly reported by maximizers and individuals with autism, the question whether individuals with autism are more maximizing in decision-making as compared to neurotypical controls, has remained unexamined in the literature. The paper measures and compares the tendency to maximize, satisfice, and minimize in choice- and decision-making among autistic individuals and age, gender- and education degree-matched neurotypical individuals.MethodThe Decision Making Tendency Inventory measurement scale (Misuraca et al., 2015) is used to measure six types of decision-making tendency: fearful maximizing, resolute maximizing, more ambitious satisficing, less ambitious satisficing, parsimonious minimizing, and indolent minimizing. A multi-group confirmatory factor analysis and comparison of the differences in latent means is performed.ResultsThe results demonstrate that autistic individuals are similar to neurotypical individuals when it comes to having a tendency to satisfice or minimize in decision-making, however, autistic individuals do score higher in terms of adopting a fearful and resolute maximizing tendency than neurotypical individuals.ConclusionsResults suggest that higher maximizing tendency may explain for some of the difficulties experienced by autistic individuals in decision-making     

Évaluation du risque suicidaire. Entre analyse théorique et applications en pratique clinique

Since the mid-1990s and its recognition as a “public health priority”, suicide has remained at the centre of various mental health policies. With one of the highest suicide deaths at the European level, France is particularly impacted by this issue. The predictability of a self-aggressive act remains the main concern for a patient in suicidal crisis. The Dangerous Emergency Risk Assessment, established at the consensus conference in October 2000, marked a turning point in the analysis of suicidal risk. Through a triple evaluation corresponding to each of its three items, this tool has made it possible to better clarify the proposed therapeutic management and in particular the decision or not of a hospitalization. However, the latter remaining perfectible in its analysis, a mapping of key points at the clinical level has been proposed in this article in order to have the widest possible vision of a patient in suicidal crisis. The assessment of suicidal potential remains subject, despite everything, to a part of improbability. As such, a brief hospitalization in the context of the suicidal crisis has all its interest whether in front of a suicidal person or in front of a suicidal person, this in the absence of a decompensated psychiatric pathology, in order to allow a “distance” from the anxiety-provoking environment and to create a bond of trust facilitating outpatient work.     

阿萨伊油、醇提及水提物对虚热及虚寒小鼠温度趋向性及代谢水平的影响

通过考察阿萨伊油、醇提物和水提物等拆分组分对虚热及虚寒证小鼠的温度趋向性动物行为学表征,环核苷酸及代谢水平等内在生化指标的影响,探讨阿萨伊各拆分组分的寒热药性特点以及寒凉的物质基础。将昆明种雄性小鼠随机分为空白组、虚热模型组、虚热+阿萨伊冻干原粉组、虚热+阿萨伊油组、虚热+阿萨伊醇提物组、虚热+阿萨伊水提物组、虚寒模型组、虚寒+肉桂组、虚寒+阿萨伊冻干原粉组、虚寒+阿萨伊油组、虚寒+阿萨伊醇提物组、虚寒+阿萨伊水提物组共12个组。虚热组小鼠每天下午灌胃给予甲状腺片溶液160 mg·kg-1,虚寒组小鼠给予氢化可的松溶液25 mg·kg-1,连续14 d,各给药组灌胃相关药物,实验结束后测定动物温度趋向性、环核苷酸及代谢水平等相关指标。阿萨伊醇提物同阿萨伊原粉一致,表现出对虚热模型小鼠的调整作用;阿萨伊油及其水提物同肉桂一致,表现出对虚寒模型小鼠的调整作用。该研究基于中药性味可拆分理论,采用同类比较异类反证的方法证明了阿萨伊醇提物性偏凉,油及其水提物性偏温的特征,并明确了醇提物为阿萨伊性凉的物质基础。     

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.     

Dispositifs de prévention et de postvention du suicide en prison mis en place par l’Administration Pénitentiaire française

The French Prison Administration has been doing suicide prevention in prison for over 50 years. It is undoubtedly one of the administrations, which best takes these risks into account today. She even made it one of her priorities. On the one hand, by developing an initial and continuous training system on this subject, and on the other hand, by implementing preventive measures based on the assessment of the suicidal potential of anyone arriving in prison. It has thus set up prevention and postvention devices in the face of its own suicide risk. While all of these measures give encouraging signs in terms of results, the fact remains that a certain number of deaths by suicide in prison still occur each year. It is therefore necessary for the prison administration to also take postvention measures in order to minimize the psychological impact on prisoners and on personnel directly concerned by the discovery of a suicide prisoner. The prison staff has an obligation of means with regard to the medical care of detained persons. Several legal texts, European and French, legislate this obligation and lay down the broad outlines. The prevention of suicidal risks in the prison environment is based on the assessment of the suicidal potential of detained persons, upon their arrival in detention. Each inmate is assessed for the risk, urgency and suicidal dangerousness he presents during this incoming interview. Depending on the results, measures specific to the prison administration can be taken to limit, or even prevent, any risk of suicide. All personnel in initial training at the national school of prison administration (ENAP) are made aware of this evaluation method. There after, additional training, throughout their career, is offered to them in continuous training so that they develop their skills in this area. But when a suicide, or an attempt, occurs in detention, postvention measures are put in place for all those affected by this event, in particular prison staff, fellow prisoners and families. The prison administration has been working on suicide prevention in detention for over fifty years, making it one of the French administrations most involved in suicide prevention.     

原生家庭干涉与夫妻离异倾向:婚姻质量的中介及伴侣支持的调节作用

目的:揭示我国文化下原生家庭干涉与夫妻离异倾向的关系,检验婚姻质量的中介及伴侣支持的调节作用。方法:采用原生家庭干涉量表、关系评估量表、婚姻不稳定性量表-简版、亲密关系支持量表对新婚至孩子小学阶段的341对夫妻进行调查。结果:(1)配偶原生家庭干涉对夫妻离异倾向均有显著正向预测作用,自身原生家庭干涉无显著作用;(2)夫妻双方婚姻质量在妻子配偶原生家庭干涉与双方离异倾向间起部分中介作用;(3)妻子伴侣支持在其配偶原生家庭干涉与双方离异倾向间起调节作用,高伴侣支持能完全缓冲妻子配偶原生家庭干涉对夫妻离异倾向的影响。结论:配偶原生家庭干涉对夫妻离异倾向有直接作用,也可通过削弱婚姻质量起作用,伴侣支持在其中起一定的缓冲作用。     

A genome-wide association study of suicide severity scores in bipolar disorder

BackgroundSuicide claims one million lives worldwide annually, making it a serious public health concern. The risk for suicidal behaviour can be partly explained by genetic factors, as suggested by twin and family studies (reviewed in (Zai et al. 2012)). Recently, genome-wide association studies (GWASs) of suicide attempt on large samples of bipolar disorder (BD) patients from multiple sites have identified a number of novel candidate genes. GWASs of suicide behaviour severity, from suicidal ideation to serious suicide attempt, have not been reported for BD.MethodsWe conducted a GWAS of suicide behaviour severity in three independent BD samples:212 small nuclear families with BD probands from Toronto, Canada, 428 BD cases from Toronto, and 483 BD cases from the UK. We carried out imputation with 1000 Genome Project data as reference using IMPUTE2. Quality control and data analysis was conducted using PLINK and R. We conducted the quantitative analyses of suicide behaviour severity in the three samples separately, and derived an overall significance by a meta-analysis using the METAL software.ResultsWe did not find genome-wide significant association of any tested markers in any of the BD samples, but we found a number of suggestive associations, including regions on chromosomes 8 and 10 (p < 1e-5).ConclusionsOur GWAS findings suggest that likely many gene variants of small effects contribute collectively to the risk for suicidal behaviour severity in BD. Larger independent replications are required to strengthen the findings from the GWAS presented here.     

Mortality and morbidity of diabetes in Papua New Guinea

Summary A 95% follow-up of all known diabetic patients in one racial group in Papua New Guinea was performed. Mortality was high with an average life-span of 4–5 years from the time of diagnosis. Microvascular diabetic complications were detected in over half of the surviving diabetic patients whose average duration of known disease was 3.8 years. At present, diabetes mellitus is both a rapidly fatal and morbid disease in Papua New Guinea.