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.     

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.     

La psychopathologie nous aide-t-elle à penser les théories du complot ? Trois modèles cliniques d’un imaginaire collectif

ObjectivesConspiracy theories appear today as a specific collective imaginary. Belief in conspiracy theories seems to have clearly increased during the last decades, partly due to their elaboration and diffusion via social media. A lot of empirical research about conspiracy theories are designed in social and cognitive psychology, but only a few studies adopt a clinical point of view. One reason is that such a clinical approach carries the risk of abusively applying some psychopathological notions to a wide range of the general population, and to a social – and not only individual – construct. This paper aims to promote a psychodynamic approach to conspiracy theories. We argue that this approach allows to studying them as subjective and collective constructs, leaving aside any attempt to make a diagnosis on people believing in conspiracy theories, and any dichotomy between the normal and the pathological.Materials and methodsWe discuss three clinical ways to represent the psychological functions of conspiracy theories: paranoid ideation, perverse uses, and reaction to traumatic events. As a matter of fact, these clinical notions are often explicitly referred to, or implicitly implied, when psychological motives or functions of belief in conspiracy theories are discussed. We seek to point out the implications of these three clinical notions and their ability to shed light on conspiracy theories. This leads to discuss their relevance for a differential clinic of the belief in conspiracy theories, allowing to identify the various dimensions of conspiracy theories, and of their subjective uses and functions.ResultsThrough a psychodynamic understanding of clinical entities, conspiracy theories can be studied as both subjective and collective constructs. In this way, we argue that a psychodynamic approach can avoid the risk of a diagnostical and pathological use of clinical concepts stemming from a binary distribution between the normal and the pathological. It rather leads to question along a continuum the various dimensions of conspiracy theories and of the belief in their content.ConclusionsThe phenomenon of conspiracy theories seems to emerge from a wide range of heterogeneous and distinctive constructs, uses and attitudes. Belief in conspiracy theories can provide several kinds of psychological benefits, implying various subjective functions and psychic mechanisms. Moreover, in terms of psychological attitudes, we have to clearly distinguish different phenomena: some spontaneous and collective elaborations of conspiracy theories, belief in conspiracy theories, the process of their diffusion, and their political, social and psychological intentional uses. These heterogeneous dimensions raise the risk of undermining any study of this phenomenon considering it as a unidimensional and a unified construct. In this way, we argue that a differential clinic of this conspiracy phenomenon is a methodological need, prior to the design of empirical clinical studies and to the reflection about preventive actions.