Effect of a legal prime on clinician’s assessment of suicide risk

The present study evaluates how liability influences mental health clinicians’ assessment of suicide risk. In this online vignette-based experiment, clinicians (N = 268) were either primed with a legal standard prior to a case vignette or presented the case vignette alone. Clinicians then rated the patient’s likelihood of suicide and need for hospitalization. Results indicated that trainees provided significantly lower ratings of suicide risk following presentation of the legal standard, but this was not associated with hospitalization endorsement. Results have training and legal implications for improving the accuracy of suicide risk assessment in both trainees and licensed professionals.     

Association between parity and autoimmune thyroiditis in a general female population

Background: Autoimmune thyroid disease (AIT) is more common in females than in males. Furthermore, it is well documented that the risk of thyroid autoimmunity increases during pregnancy and in the postpartum period. The objective of the present study was to analyse the association between parity and AIT by using ultrasound and serological data.

Methods: The study population included 2156 women, aged 20–79 years. Serum thyroperoxidase antibodies (anti-TPO) and thyrotropin levels were measured and thyroid ultrasonography was performed. AIT was defined according to the combined presence of a hypoechogenic thyroid pattern and positive anti-TPO levels (>200 IU/ml). Odds ratios (OR) and 95% confidence intervals (CI) were calculated.

Results: The analyses revealed an association between parity and AIT. Women with at least one pregnancy had increased odds for AIT (OR 4.6 [95%-CI 1.4–15.1], p < 0.05) compared to women who have never been pregnant. Similar results were observed using hypoechogenic thyroid pattern (OR 1.7 [95%-CI 1.0–2.9], p < 0.05) and positive anti-TPO levels (OR 1.8 [95%-CI 1.0–3.3], p = 0.05) as separate dependent variables or using number of births as alternate independent variable.

Conclusion: In this female population we found an association between parity and AIT and conclude that parity appears to be a potential risk factor for AIT.     

Right heart function in impaired left ventricular diastolic function: 2D speckle tracking echocardiography–based and Doppler tissue imaging–based analysis of right atrial and ventricular function

Aim

The aim of our study was to describe right atrial (RA) and right ventricular (RV) function, assessed by Doppler tissue imaging and 2D speckle tracking echocardiography (2DSTE), in women with signs of early impaired left ventricular diastolic function (DD).

Methods and Results

In a cross‐sectional trial, standard parameters of diastolic and right heart function were investigated in 438 women of the Berlin Female Risk Evaluation (BEFRI) study. In a subset of women, average peak systolic RA strain (RAS), as well as the average peak systolic RV strain of the free wall (RVS free wall) and of all RV segments (average RV strain; RVS Avg), was analyzed using 2DSTE. Compared to women with normal diastolic function (DD0), RAS, RVS free wall and RVS Avg were significantly reduced in DD (43.1% ± 11.9%, ?26.7% ± 5.6%, and ?23.3% ± 3.5% in DD0; vs 35.1% ± 10.4%, ?23.9% ± 5.5%, and ?20.6% ± 3.8% in DD; P < .01). Peak RV myocardial velocity (RV‐IVV) and acceleration during isovolumetric contraction (RV‐IVA) were markedly higher in DD (15.0 ± 3.9 cm/s and 3.1 ± 1.0 m/s² in DD vs 11.9 ± 3.2 cm/s and 2.8 ± 0.8 m/s² in DD0; P < .05). RAS and RV‐IVV were significantly associated with DD after adjustment to age, BMI, and left atrial strain in multivariate regression analysis.

Conclusion

Systolic right heart function is significantly altered in DD. DTI as well as 2DSTE constitute sensitive echocardiographic tools that enable the diagnosis of impaired right heart mechanics in early‐staged DD.