Four tumor necrosis factor alpha genes polymorphisms and periodontitis risk in a Chinese population

Background

Tumour necrosis factor-alpha (TNF-alpha) has been implicated in the pathogenesis of generalized aggressive periodontitis (AgP) and chronic periodontitis (CP). The objective of the present study was to evaluate the association of four TNF-alpha gene polymorphisms (−1031T/C, −857C/T, −308G/A and −238G/A) with susceptibility to AgP and CP in a Chinese population.

Methods

A hospital-based case-control study was conducted in in patients with CP (n = 180), AgP (n = 180) and healthy controls (n = 180). Gene promoter polymorphisms were analyzed by polymerase chain reaction–restriction fragment length polymorphism (PCR–RFLP) assay. Genotype and allele frequencies were analyzed using the chi-square test and logistic regression analysis.

Results

TNF-alpha −1031CC genotype was significantly higher [odds ratio (OR) = 2.36, 95% confidence interval (CI) = 1.03, 5.43; P = 0.04] in patients with CP compared with healthy controls. TNF-alpha −308AA genotype was significantly higher (OR = 2.71, 95% CI = 1.09, 6.73; P = 0.03) in patients with AgP compared with healthy controls. No association was found of TNF-alpha −857C/T and −238G/A polymorphisms with susceptibility to AgP or CP.

Conclusions

Our data demonstrated that TNF-alpha −1031CC genotype was a risk factor for CP, and that TNF-alpha −308AA genotype was a risk factor for AgP. But there is a lack of association of TNF-alpha −857C/T and −238G/A polymorphisms with susceptibility to AgP or CP in a Chinese population.     

Association of genetic variation in CACNA1C with bipolar disorder in Han Chinese

Background

A growing body of evidence highlights the existence of shared genetic susceptibility to both major depressive disorder (MDD) and bipolar disorder (BD), suggesting some potential genetic overlap between the disorders. Genome-wide association studies have identified consistent association of single nucleotide polymorphisms of the α-1 C subunit of the L-type voltage-gated calcium channel gene (CACNA1C) with MDD and BD, suggesting CACNA1C as a promising candidate gene for susceptibility to mood disorders. In the present study, we tested the association of CACNA1C with MDD and BD in Han Chinese.

Methods

We genotyped three potentially functional polymorphisms in 635 MDD patients, 286 BD patients and 730 normal, control patients.

Results

The genotype frequencies of SNP rs1051375 showed statistically significant differences between the BD and control groups (P=0.005). At the allele level, the difference of G allele frequency of rs1051375 between BD patients and control subjects was also significant (P=0.011; OR=1.30, 95% CI: 1.06–1.58). We found that GG genotype of rs1051375 carriers had a lower age at onset than those with the AG or AA genotype, and the mean±standard deviation ages at onset of GG, AG and AA carriers were 24.04±4.22, 25.76±4.75 and 25.78±4.33 years, respectively. Neither genotype nor allele frequencies of the three polymorphisms were found to be significantly different between the MDD patients and control subjects.

Limitations

The relative small sample size in BD group should be considered a limitation of this study.

Conclusions

Our initial findings support a potential association of CACNA1C as a genetic risk factor for BD susceptibility.     

C1q but not mannose-binding lectin (Mbl-2) gene polymorphisms are associated with type 2 diabetes in the genetically homogeneous population of the island of Crete in Greece

Aim

To investigate the role of mannose-binding lectin 2 (MBL2) and C1q gene polymorphisms on the susceptibility to type 2 diabetes (T2D), that may contribute to increased risk of infections in the genetically homogeneous Greek population of the island of Crete.

Methods

Ninety five patients with T2D and 333 healthy controls, all local Cretans were genotyped for the MBL-2 rs11003125 (C>G) and C1q rs292001 (G>A) single-nucleotide polymorphisms (SNPs) by the restriction fragment length polymorphism approach.

Results

The A/A genotype and the minor allele A of C1q SNP (P = 0.0001 in both cases) were observed more frequently in T2D than in healthy controls. In contrast, the minor allele G of the rs11003125 MBL2 gene did not show any statistically significant difference between T2D patients and controls. The present study represents the first attempt to implicate the role of MBL2 and C1q gene polymorphisms in the susceptibility to T2D.

Conclusions

The study has shown that the rs292001 C1q but not the rs11003125 MBL2 SNP are associated with increased risk for T2D susceptibility in the Cretan population.     

Association between major depressive disorder and the norepinephrine transporter polymorphisms T-182C and G1287A: A meta-analysis

Background

Previous studies have implicated norepinephrine transporter (NET) gene polymorphisms in the etiology of major depressive disorder (MDD). Recently, two single nucleotide NET polymorphisms, T-182C (rs2242446) in the promoter region and G1287A (rs5569) in exon 9, were found to be associated with MDD in different populations. However, inconsistent and inconclusive results have also been obtained.

Methods

In this study, we examined whether rs2242446 and rs5569 genetic variants are related to the etiology of MDD using a meta-analysis. Relevant case-control studies were retrieved by database searching and selected according to established inclusion criteria.

Results

Eight articles were identified that tested the relationship between the NET T-182C and/or G1287A polymorphism and MDD. Statistical analyses revealed no significant association between these polymorphisms and MDD (OR=1.23, 95% CI=0.77−1.97, P=0.38 for T-182C; OR=1.00, 95% CI=0.78−1.29, P=0.99 for G1287A).

Limitations

The results must be treated with caution because of the small sample sizes of several included studies.

Conclusions

Our findings suggest that the NET T-182C and G1287A polymorphisms are not susceptibility factors for MDD.     

Human SA gene polymorphisms are associated with non-high-density lipoprotein cholesterol in postmenopausal women: A pilot study

Objective

The purpose of the study is to evaluate the associations between polymorphisms of the human SA (SAH) gene, an acyl-CoA synthetase gene, with dyslipidemia and phenotypes of the insulin resistance syndrome in postmenopausal women.

Methods

One hundred and forty-two postmenopausal women were recruited for the study. Each subject received anthropometric and blood pressure measurements, fasting sampling for lipids, and a 75-g oral glucose tolerance test for insulin resistance. Genotypes of two polymorphisms in the promoter region (c.-962ins/del, c.-451G > A), one missense variant (c.1077G > C, p.K359N) in exon 8, and one in intron 12 (A > G) of the SAH gene, were determined.

Results

There were significant differences in genetic distribution of the SAH gene promoter I/D polymorphism between the two groups of subjects by non-high-density lipoprotein cholesterol (non-HDL-C) levels (p = 0.004). The subjects with the DD genotype was associated with high levels of non-HDL-C (>160 mg/dL) as compared with the ID or II genotypes (p = 0.002). Furthermore, three haplotypes were constructed based on the promoter I/D and the exon 8 G/C polymorphisms. Homozygosity for SAH haplotype 3 was associated with increased adiposity, insulin resistance, and elevated levels of non-HDL-C in the post menopausal women. The subjects with haplotype 3 had double the risk to have higher non-HDL-C levels than those with haplotype 1.

Conclusion

Our results suggest that the polymorphisms of the SAH gene are associated with non-HDL-C levels in postmenopausal women. Further studies with larger sample sizes or different populations are warranted to confirm our preliminary findings.     

The change of insulin levels after six weeks antidepressant use in drug-naïve major depressive patients

Background

A reciprocal relationship between diabetes risk and depression has been reported. There are few studies investigating glucose–insulin homeostasis before and after short-term antidepressant treatment in drug-naïve major depressive disorder (MDD) patients.

Methods

This study included 104 healthy controls and 50 drug-naïve MDD patients diagnosed according to the DSM-IV criteria. These MDD patients were randomly assigned to receive fluoxetine or venlafaxine for six weeks. Depressive symptoms, body mass index, fasting plasma levels of glucose and insulin were measured.

Results

Compared to the healthy controls, the fasting plasma insulin and the homeostasis model of assessment for pancreatic β-cell secretory function (HOMA-β) was significantly lower in the MDD patients before antidepressant treatment (7.7±4.8 μIU/mL vs. 5.1±4.2 μIU/mL, p=0.006; 114.2±72.3% vs. 74.8±52.0%, p=0.005, respectively). However, these indices were not correlated with depression severity. After 6 weeks of fluoxetine or venlafaxine treatment, the level of HOMA-β borderline significantly increased (108.1±75.5%, p=0.059).

Limitations

The study was limited by the follow-up duration and lack of a placebo group.

Conclusions

Antidepressants might affect insulin secretion independently of the therapeutic effects on MDD. Further studies are needed to investigate the long-term effects of antidepressants on insulin regulation in MDD patients.     

Use of the Suicide Status Form-II to investigate correlates of suicide risk factors in psychiatrically hospitalized children and adolescents

Background

Suicide is the third leading cause of death in the United States for youth 12–17 years or age. Acute psychiatric hospitalization represents a clear worst point clinically and acute suicide risk is the most common reason for psychiatric admission. We sought to determine factors associated with differences in individual suicide risk assessment for children and adolescents during acute psychiatric admission.

Methods

Study participants were 1153 youth consecutively admitted to an inpatient psychiatry unit who completed a self-administered Suicide Status Form (SSF) within 24 h of admission. Additional information on suicide risk factors was obtained through medical chart abstraction.

Results

Females reported significantly greater psychological pain, stress, hopelessness, and self-hate on the SSF and were significantly more likely to have made a suicide attempt just prior to the index hospital admission (OR=1.59, SE=0.29; CI=1.12–2.26), report a family history of suicide (OR=2.02, SE=0.33; CI=1.47–2.78), and had experienced a greater number of inpatient psychiatry admissions related to suicidal ideation (RR=1.33, SE=0.13; CI=1.10–1.61). High school aged youth and those with a primary diagnosis of depression displayed consistently elevated SSF scores and risk factors for suicide compared to comparison groups.

Limitations

Diagnosis was determined through chart abstraction. Responses to access to firearm question had missing data for 46% of the total sample.

Conclusions

Systematic administration of a suicide-specific measure at admission may help clinicians improve identification of suicide risk factors in youth in inpatient psychiatry settings.     

Social support as a protective factor in suicide: Findings from two nationally representative samples

Background

Suicide is a problem of worldwide concern and research on possible protective factors is needed. We explored the role of social support as one such factor. Specifically, we hypothesized that increased social support would be associated with decreased likelihood of a lifetime suicide attempt in two nationally representative samples as well as a high-risk subsample.

Methods

We analyzed the relationship between social support and lifetime history of a suicide attempt, controlling for a variety of related psychopathology and demographic variables, in the National Comorbidity Study Replication (NCS-R), a United States sample and the Adult Psychiatric Morbidity Study (APMS), an English sample.

Results

Results indicate that social support is associated with decreased likelihood of a lifetime suicide attempt controlling for a variety of related predictors in both the full US sample (OR=0.68, p<.001) and the full English sample (OR=0.93, p<.01).

Limitations

The cross-sectional data do not allow true cause and effect analyses.

Conclusions

Our findings suggest social support is associated with decreased likelihood of a lifetime suicide attempt. Social support is a highly modifiable factor that can be used to improve existing suicide prevention programs worldwide.     

Recurrent suicide attempts in patients with depressive and anxiety disorders: The role of borderline personality traits

Background

The presence of a comorbid borderline personality disorder (BPD) may be associated with an increase of suicidal behaviors in patients with depressive and anxiety disorders. The aim of this study is to examine the role of borderline personality traits on recurrent suicide attempts.

Methods

The Netherlands Study on Depression and Anxiety included 1838 respondents with lifetime depressive and/or anxiety disorders, of whom 309 reported at least one previous suicide attempt. A univariable negative binomial regression analysis was performed to examine the association between comorbid borderline personality traits and suicide attempts. Univariable and multivariable negative binomial regression analyses were performed to identify risk factors for the number of recurrent suicide attempts in four clusters (type and severity of axis-I disorders, BPD traits, determinants of suicide attempts and socio-demographics).

Results

In the total sample the suicide attempt rate ratio increased with 33% for every unit increase in BPD traits. A lifetime diagnosis of dysthymia and comorbid BPD traits, especially the symptoms anger and fights, were independently and significantly associated with recurrent suicide attempts in the final model (n=309).

Limitations

The screening of personality disorders was added to the NESDA assessments at the 4-year follow-up for the first time. Therefore we were not able to examine the influence of comorbid BPD traits on suicide attempts over time.

Conclusions

Persons with a lifetime diagnosis of dysthymia combined with borderline personality traits especially difficulties in coping with anger seemed to be at high risk for recurrent suicide attempts. For clinical practice, it is recommended to screen for comorbid borderline personality traits and to strengthen the patient's coping skills with regard to anger.     

Association between functional Fc receptor-like 3 (FCRL3) −169 C/T polymorphism and susceptibility to seropositive rheumatoid arthritis in Asians: A meta-analysis

Objective

The aim of this study was to determine whether the functional Fc receptor like-3 (FCRL3) −169 C/T polymorphism confers susceptibility to rheumatoid arthritis (RA).

Methods

A meta-analysis was conducted on the associations between the FCRL3 −169 C/T polymorphism and RA.

Results

A total of 17 comparison studies including 11,170 patients and 11,142 controls were considered in the meta-analysis. The meta-analysis showed no association between RA and the FCRL3 −169 C allele in study subjects (OR = 1.046, 95% CI = 0.997–1.098, p = 0.068). Stratification by ethnicity indicated an association between the FCRL3 −169 C allele and RA in Asians (OR = 1.101, 95% CI = 1.035–1.174, p = 0.002), but not in Europeans. Stratification of patients according to the presence of rheumatoid factor (RF) revealed a different significant association between the C allele and RA in RF-positive and RF-negative RA patients. Stratification by ethnicity indicated an association between the FCRL3 −169 C allele and RF-positive RA in Asians (OR = 1.093, 95% CI = 1.004–1.189, p = 0.040), but not in Europeans.

Conclusions

This meta-analysis demonstrates that the FCRL3 −169 C/T polymorphism may confer susceptibility to seropositive RA in Asians.     

Single tube genotyping of TYMS 1494del6 polymorphism in the Chinese Han population by duplex scorpion primers

Background

The development of pharmacogenomics has created an urgent need for robust molecular characterization. And it has become a challenge to develop suitable detecting methods for routine clinical use.

Aim

The aim of the current study is to develop a simple and reliable TYMS 1494del6 polymorphism genotyping assay by duplex scorpion primers in the Chinese Han population.

Method

We evaluated the performance of the duplex scorpion primer assay in the genotyping of TYMS 1494del6 polymorphism and screened 54 DNA samples of the Chinese Han population. The results were further validated by pyrosequencing.

Results

The duplex scorpion primer assay showed high specificity and accuracy for genotyping TYMS 1494del6 polymorphism. Complete concordance was observed between the duplex scorpion primer assay and pyrosequencing. The frequency of the TYMS + 6 bp allele was 34% and the − 6 bp allele was 66% in 54 Chinese Han population DNA samples.

Conclusion

The duplex scorpion primer assay provides a rapid, reliable and high-throughput method to genotype TYMS 1494del6 polymorphism in the Chinese Han population.     

Suicidal behaviors in elderly Koreans: One-month-point prevalence and factors related to suicidality

Background

Suicide prevention in the elderly is a major public health priority worldwide and in Korea in particular. We investigated the one-month-point prevalence and factors related to suicidality for suicidal behaviors in elderly Koreans.

Methods

A simple random sample (N=1588) was drawn from the residential roster of 14,051 Koreans aged 60 years or older who were residents of Osan in February 2010. All subjects were invited to participate in the survey through door-to-door home visits, and the response rate was 59.8%.

Results

The age- and gender-standardized prevalence rates of lifetime suicide attempts, current suicidal ideation without a plan or attempt, and current suicidal ideation with a plan or attempt were estimated at 9.2%, 19.6%, and 2.24%. The prevalence of suicidal ideation without a plan or attempt was higher in women and less-educated individuals and increased with advancing age, whereas the prevalence of suicidal ideation with a plan or attempt was higher in more-educated individuals, was not differentiated by gender, increased until age 70, and then decreased thereafter. The factors related to suicidal ideation differed by the presence of a suicide plan or attempt.

Conclusions

Depressive elders in their 70s who have recently developed suicidal ideation would be a prime target for suicide intervention programs.

Limitations

The sample was regional, although the suicide rate in Osan was comparable to the average suicide rate in Korea.     

Risk behaviors,suicidal ideation and suicide attempts in a nationally representative French sample

Background

Data from large nationally representative samples are needed to provide the empirical foundation to inform health policies for the prevention of suicide risk and risk behaviors in men and women.

Methods

Data were extracted from the 2010 Health Barometer, a large telephone survey on a representative sample of the general population aged 15–85 years living in France (n=27,653), carried out by the National Institute for Health Promotion and Health Education. Data were collected between October 2009 and July 2010. A computer-assisted telephone interview (CATI) system was used.

Results

Overall, 3.9% of respondents aged 15 to 85 reported past year suicidal ideation, and 0.5% reported a suicide attempt in that time period. Increased rates of risky sexual behavior are associated with ideation and attempt in both men and women, after controlling for sociodemographic variables. Homosexuality or bisexuality are associated with suicidal ideation for both men and women, but not with attempts. Substance misuse, physical and sexual assaults are strongly associated with suicidal symptoms for both men and women. Early first experiences with sex, tobacco, and alcohol are associated with suicidal symptoms though somewhat differentially for men and women.

Limitations

Cross-sectional survey.

Conclusion

The findings underscore associations between suicidal thoughts and behaviors and risk behaviors such as unprotected sex and substance use in men and women throughout the lifespan. These associations highlight the need for preventive strategies such as screening for risk behaviors in order to identify men and women particularly at risk for suicidal behavior.     

Associations between depression severity and purinergic receptor P2RX7 gene polymorphisms

Background

Major depressive disorder (MDD) and bipolar disorder (BPD) have significant genetic predisposition. The P2RX7 gene (coding for P2X7 purinergic receptor) has been suggested as a susceptibility gene for both MDD and BPD. In the current study the genetic effects of rs2230912 (Gln460Arg) and rs1653625 (located in the 3′ untranslated region of the P2RX7 gene) were explored in mood disorders.

Methods

Genotype frequencies were established in 315 patients (195 with MDD and 120 with BPD diagnosis) and in 373 controls. Depression severity was assessed by the clinician-rated Montgomery–Åsberg Depression Rating Scale (MADRS) and by the self-report Hospital Anxiety and Depression Scale (HADS).

Results

In the case-control analysis we did not find any significant differences between genotype frequencies of either BPD or MDD cases and controls. However, BPD patients carrying at least one rs2230912 G-allele scored higher on both MADRS and HADS-depression scale (nominal p-value was 0.028 and 0.003, respectively). The rs1653625 AA genotype was also associated with higher depression scores in the BPD group (nominal p-value of MADRS: 0.019, HADS-depression: 0.017). After correction for multiple testing, the association between rs2230912 and HADS-depression score remained significant in the BPD group (p<0.006); this genetic effect explained 9% of the variance (partial η²=0.09). In the MDD group we did not find any significant genetic effect.

Limitations

The relatively small number of BPD patients warrants for a replication study.

Conclusions

Our genetic association study supports the association between P2RX7 gene and severity of depressive symptoms in BPD patients.     

Association between Interleukin-27 gene polymorphisms and susceptibility to allergic rhinitis

Objectives

Allergic rhinitis (AR) is an inflammatory disorder of the upper airway. Interleukin-27 (IL-27), a novel IL-12 family member, has recently been reported to play a role in some immune-related disorders. This study was performed to evaluate the potential association of IL-27 polymorphisms with AR in a Chinese Han population.

Design and Methods

A case-control study was performed in 445 Chinese AR patients and 691 healthy controls. Three SNPs in the IL-27p28 gene, including rs153109, rs17855750 and rs181206, were detected using a polymerase chain reaction–restriction fragment length polymorphism assay (PCR–RFLP).

Results

A significantly increased prevalence of the rs153109 TT genotype and the T allele was found in AR patients, while a decreased prevalence of the CT and CC genotypes and the C allele was found. For rs153109, the TT genotype and the T allele were significantly associated with the risk of AR, but the CT and CC genotypes and the C allele decreased the risk of AR; for rs17855750, the TT genotype and T allele were risk factors for AR, and the GT genotype and G allele provided protection. TTT and TTC haplotypes in the IL-27p28 gene were positively correlated with AR, while CGT, CTC and CTT haplotypes were associated with a significantly decreased risk of AR.

Conclusion

This study indicates that IL-27p28 polymorphisms rs153109 and rs17855750 are likely involved in AR susceptibility, making them potentially useful genetic biomarkers for AR susceptibility in the Chinese Han population.     

Comparison of the clinical features of suicide attempters by jumping from a height and those by self-stabbing in Japan

Background

A history of psychiatric disorders is a high risk for suicide. The present study compared the clinical features of psychiatric patients in Japan who attempted suicide by jumping from a height and those who attempted suicide by self-stabbing.

Methods

We compared two groups of suicide attempters who were hospitalized for both physical and psychiatric treatment (n=202). We compared the psychiatric diagnoses and clinical features between those who attempted suicide by jumping from a height (N=147) and those who did so by self-stabbing (N=55).

Results

The self-stabbing group (mean age 52.3 years) was significantly older compared to the jumping group (mean age 37.9 years). A significantly higher proportion of females were found in the jumping group. Jumping from a height was significantly associated with schizophrenia spectrum disorders, whereas self-stabbing was significantly associated with mood disorders.

Limitations

The results were drawn from data from a single hospital in a large urban city, and the study population did not include subjects who completed their suicide attempts.

Conclusions

Our findings show that differences in suicide methods (here, between jumping from a height and self-stabbing) may be related to suicide attempters' psychiatric diagnosis, gender and age. It is thus important to obtain a more detailed background information about a patient's suicide attempt and to create suicide prevention plans in accord with individuals' psychiatric diagnosis, age and gender, especially among those who have attempted suicide by jumping from a height or self-stabbing.     

Correlates of proximal premeditation among recently hospitalized suicide attempters

Background

Different conceptualizations of an impulsive suicide attempt (ISA) have not been studied systematically and there is no standard assessment of an ISA. This lack of clarity hinders the advancement of suicidological research and knowledge. The aim of the current study was to examine clinical correlates of different facets of an ISA (reduced proximal contemplation, planning, and decision to act) across divergent methodologies.

Methods

Participants included 212 recent suicide attempters presenting to a Level 1 trauma hospital. The Suicide Intent Scale and the Timeline Follow-Back Interview for suicide attempts were used to assess different facets of an ISA and their associations with other attempt characteristics, and proximal and distal clinical correlates.

Results

A large percentage of patients had an ISA using facets of varying severity (ranging from 42% [contemplation] to 85% [decision]). Multivariate analyses revealed unique associations between a particular ISA facet and the following: hopelessness and depressive symptoms (contemplation), subjective expectation of fatality (planning), and acute negative life events (decision).

Limitations

Validated self-report screening measures were used to assess current psychopathology and future studies should include structured interviews to assess diagnostic features.

Conclusions

Our results suggest that a fine-grained approach is needed for furthering our understanding of the ISA construct. In light of the current findings, ISA should be seriously considered given clinicians’ task of determining whether a particular patient is at imminent risk for suicide.     

Predicting relapse in major depressive disorder using patient-reported outcomes of depressive symptom severity,functioning, and quality of life in the individual burden of illness index for depression (IBI-D)

Background

Patients with Major Depressive Disorder (MDD) often experience unexpected relapses, despite achieving remission. This study examines the utility of a single multidimensional measure that captures variance in patient-reported Depressive Symptom Severity, Functioning, and Quality of Life (QOL), in predicting MDD relapse.

Methods

Complete data from remitted patients at the completion of 12 weeks of citalopram in the STAR*D study were used to calculate the Individual Burden of Illness index for Depression (IBI-D), and predict subsequent relapse at six (n=956), nine (n=778), and twelve months (n=479) using generalized linear models.

Results

Depressive Symptom Severity, Functioning, and QOL were all predictors of subsequent relapse. Using Akaike information criteria (AIC), the IBI-D provided a good model for relapse even when Depressive Symptom Severity, Functioning, and QOL were combined in a single model. Specifically, an increase of one in the IBI-D increased the odds ratio of relapse by 2.5 at 6 months (β=0.921±0.194, z=4.76, p<2×10⁻⁶), by 2.84 at 9 months (β=1.045±0.22, z=4.74, p<2.2×10⁻⁶), and by 4.1 at 12 months (β=1.41±0.29, z=4.79, p<1.7×10⁻⁶).

Limitations

Self-report poses a risk to measurement precision. Using highly valid and reliable measures could mitigate this risk. The IBI-D requires time and effort for filling out the scales and index calculation. Technological solutions could help ease these burdens. The sample suffered from attrition. Separate analysis of dropouts would be helpful.

Conclusions

Incorporating patient-reported outcomes of Functioning and QOL in addition to Depressive Symptom Severity in the IBI-D is useful in assessing the full burden of illness and in adequately predicting relapse, in MDD.     

Differentiating army suicide attempters from psychologically treated and untreated soldiers: A demographic,psychological and stress-reaction characterization

Background

Suicide is the leading cause of death in most armies during peace-time. The recent dramatic rise in suicides in the US Army further focuses attention on the causes of suicidal behavior in the military.

Methods

This study investigated demographic characteristics, psychological profile and stress-related risk factors associated with suicide attempts in Israelis aged 18–21 years, who served in the Army in 2009. Soldiers who attempted suicide (N=60) were compared to soldiers treated by a mental health professional, but reported no suicidal behavior (N=58), and to controls (N=50).

Results

Suicide attempters had lower socioeconomic status and less cognitive ability compared with treated soldiers and untreated control soldiers. Only 25% of the suicide attempters had received mental healthcare prior to the attempt. The majority of the attempts were non-lethal (86.2%), and only 5.2% used firearms. Attempters had more previous suicide attempts (37.9%) and deliberate selfharm incidents (19.3%), compared to almost no such behaviors in the other two groups. Following the suicide attempt, 77% were diagnosed with moderate to severe mental disorders, 44.8% personality disorders and 8.6% mood disorders. Attempters reported higher levels of general stress compared to their peers in the other two groups. Being away from home and obeying authority were especially more stressful in attempters.

Conclusions

Young soldiers are less prone to seek mental health assistance, despite suffering from higher levels of stress. Screening is required to detect soldiers at risk for suicidal behavior and preventive intervention will require active outreach.     

National study of suicide method in violent criminal offenders

Background

Gaining a greater knowledge of the mechanisms and means by which violent offenders die by suicide can inform tailored preventive strategies.

Methods

Using interlinked national Danish registry data we constructed a nested case-control study dataset of all adult suicides during 1994–2006: N=9708 cases and N=188,134 age and gender matched living controls. Completely ascertained International Classification of Diseases 10th revision cause-specific mortality codes were examined, with all criminal charges since 1980, and covariate information on psychiatric treatment and socio-demographics. Self-poisonings were classified as ‘nonviolent’ suicide and all other methods as being ‘violent’ ones.

Results

Compared with the general population, risk among male and female violent offenders was strongly and significantly elevated for suicide by either a violent or a nonviolent method, although the relative risk was greater for nonviolent suicide. These patterns were also observed among nonviolent offenders, albeit with smaller effect sizes. Risk was especially raised for self-poisoning with narcotics & hallucinogens. We could only examine the full range of suicide methods in male violent offenders. In these men, hanging was the most frequently used method, although risk was markedly and significantly elevated virtually across the entire range of regularly used suicide methods.

Limitations

We lacked sufficient statistical power for undertaking a detailed profiling of specific suicide methods among female violent offenders.

Conclusions

Our findings indicate that comprehensive and broadly-based preventive approaches are needed for tackling the markedly raised risk of suicide by both violent and nonviolent means in this population. Their high relative risk for self-poisoning by illicit or illegal drugs underlines the importance of access to means and of prevailing subculture.