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.     

停止尿床年龄与青少年自杀行为的关系

目的探讨停止尿床年龄与青少年自杀行为的关系。方法对1920名11岁～16岁的青少年进行调查,由父母完成包括青少年生长发育史、自杀行为、抑郁症状、攻击行为及家庭环境等定式问卷。结果在控制一系列儿童及家庭情况变量后,多变量Logistic回归模型显示3岁后停止尿床与青少年自杀行为的危险性增加显著相关,停止尿床年龄与青少年自杀行为之间存在量效关系（3岁～4岁停止尿床OR值为2.1,5岁及以上停止尿床OR值为3.6）。中介变量分析显示,停止尿床时间晚对自杀行为的效应,至少部分通过抑郁及攻击行为中介。结论停止尿床时间晚可能是青少年自杀行为的早期神经发育预测因素,应进一步探讨青少年自杀行为的早期神经发育危险因素及潜在机制。     

大学生完美主义、自尊、自我和谐和自杀意念的关系研究

目的了解大学生的完美主义、自尊、自我和谐和自杀意念状况,分析影响大学生自杀意念产生的主要因素。方法采用完美主义量表、自尊量表、自我和谐量表和自杀意念自评量表对河南省7所高校800名大学生进行统一问卷调查。结果完美主义和自杀意念在是否独生子上不存在显著差异(P>0.05),而自杀意念在性别上存在显著差异(P<0.01);完美主义及其维度、自尊、自我和谐与自杀意念之间存在显著相关,并且完美主义的4个维度——担心错误、行动的疑虑、条理性,自尊和自我和谐可以预测自杀意念。结论应采取措消除完美主义的消极影响,培养适中的自尊水平和自我和谐的人格,降低自杀意念的产生。     

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。     

综合干预对某部军事人员自杀的影响

目的探讨某部军事人员自杀综合干预措施的效果。方法对某部实施综合性自杀干预措施，使用相同的调查工具和调查流程，对2001年与2004年同一样本人群的自杀率及其相关因素进行比较及评估。结果2004年与2001年某部的总自杀率分别为1．12‰和4．63‰，自杀死亡率分别为0和0．13‰，自杀未遂率分别为0．14％和0．66％，自杀行为发生率分别为0．28‰和1．32‰，自杀意念发生率分别为0．70‰和2．51‰，均有显著性差异；综合干预后负性生活事件导致的自杀率显著下降。结论自杀综合干预措施效果明显。     

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.     

Adverse Childhood Experiences and Suicidal Behaviors Among Youth: The Buffering Influence of Family Communication and School Connectedness

PurposeThe main objectives of this study were to determine (1) whether family communication and school connectedness offer protection against suicidal behaviors in the presence of adverse childhood experiences (ACEs; direct protective effect) and (2) whether family communication or school connectedness buffer the association between ACEs and suicidal behaviors (interacting protective effect) on the multiplicative and additive scales.MethodsData were obtained from a western state's 2019 Youth Risk Behavior Survey that included 5,341 middle school and 4,980 high school participants. Generalized linear models were used to estimate whether family communication and school connectedness offered direct protection against suicidal behaviors or buffered the association between ACEs and suicidal behaviors using adjusted prevalence ratios and corresponding 95% confidence intervals.ResultsFamily communication and school connectedness offered direct protection against suicidal behaviors in the presence of ACEs (a 1-unit higher score was associated with a 32%–42% lower prevalence of suicidal behaviors for middle school youth and a 27%–39% lower prevalence of suicidal behaviors for high school youth). There was evidence that family communication and school connectedness buffered the association between ACEs and suicidal behaviors on the multiplicative scale.ConclusionsThe findings provide support for the development and implementation of interventions that build family communication and school connectedness to reduce suicidal behaviors. Furthermore, screening for trauma and suicidal behaviors is warranted.