Associations between sleep habits and mental health status and suicidality in a longitudinal survey of monozygotic twin adolescents

Several epidemiological studies have indicated that there is a relationship between sleep habits, such as sleep duration, bedtime and bedtime regularity, and mental health status, including depression and anxiety in adolescents. However, it is still to be clarified whether the relationship is direct cause‐and‐effect or mediated by the influence of genetic and other traits, i.e. quasi‐correlation. To examine this issue, we conducted a twin study using a total of 314 data for monozygotic twins from a longitudinal survey of sleep habits and mental health status conducted in a unified junior and senior high school (grades 7–12), located in Tokyo, Japan. Three‐level hierarchical linear model analysis showed that both bedtime and sleep duration had significant associations with the Japanese version of the 12‐item General Health Questionnaire (GHQ‐12) score, suicidal thoughts and the experience of self‐harm behaviours when genetic factors and shared environmental factors, which were completely shared between co‐twins, were controlled for. These associations were statistically significant even after controlling for bedtime regularity, which was also associated significantly with the GHQ‐12 score. These suggest that the associations between sleep habits and mental health status were still statistically significant after controlling for the influence of genetic and shared environmental factors of twins, and that there may be a direct cause‐and‐effect in the relationship in adolescents. Thus, late bedtime and short sleep duration could predict subsequent development of depression and anxiety, including suicidal or self‐injury risk. This suggests that poor mental health status in adolescents might be improved by health education and intervention concerning sleep and lifestyle habits.     

Structured disposition planning for adolescent suicide attempters in a general hospital: Preliminary findings on short-term outcome

Abstract

Adolescent suicide attempters are often noncompliant with outpatient psychotherapy and drop out of treatment much more quickly than non-suicidal adolescents. In this study, 23 adolescents received medical treatment and a standard psychiatric evaluation in an Emergency Department following a suicide attempt. In addition, all subjects and their parents received a psychotherapy compliance enhancement intervention which included a verbal agreement between the adolescent and parent/guardian to attend at least four psychotherapy sessions. After discharge from the hospital, each subject received three phone interviews over an 8 week period using a problem solving approach around two key areas: suicidal ideation and psychotherapy compliance. Compared to a three month follow-up of 78 subjects (which did not include an experimental intervention), conducted at the same hospital, the experimental intervention resulted in fewer outpatient psychotherapy ‘no shows' (9% vs. 18%) and a trend toward greater number of sessions attended (5.5 vs. 3.9). There were no re-attempts in the experimental group as compared to 9% in the comparison group. Results are promising and a randomized intervention trial appears indicated.     

The impact of child sexual abuse on the course of bipolar disorder: a systematic review

Maniglio R. The impact of child sexual abuse on the course of bipolar disorder: a systematic review.
Bipolar Disord 2013: 15: 341–358. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd. Objectives: The aim of this review was to elucidate the impact of child sexual abuse on all clinical phenomena that occur after the onset of bipolar disorder, including associated clinical features that are not part of the diagnostic criteria for the disorder. Methods: Five databases were searched and supplemented with a hand search of reference lists from retrieved papers. Study quality was assessed using a validated quality assessment tool. Blind assessments of study eligibility and quality were conducted by two independent researchers to reduce bias, minimize errors, and enhance the reliability of findings. Disagreements were resolved by consensus. Results: Eighteen studies that included a total of 2996 adults and youths with bipolar disorder and met the minimum quality criteria necessary to ensure objectivity and not invalidate results were analyzed. Across studies, child sexual abuse was strongly (and perhaps directly) associated with posttraumatic stress disorder; whereas it was less strongly (and perhaps indirectly) related to suicide attempts, alcohol and/or drug abuse or dependence, psychotic symptoms, and an early age of illness onset. In regard to the association between child sexual abuse and other clinical variables concerning the course of bipolar disorder, evidence was scant or conflicting. Conclusions: Child sexual abuse is associated (either directly or indirectly) with some clinical phenomena that represent a more severe form of bipolar disorder. Although such a traumatic experience may directly affect the development of posttraumatic stress disorder, the effects of early sexual abuse on later suicidal behavior, substance abuse, and psychotic symptoms may operate through the mediating influences of certain psychopathological or neurobiological variables.     

Hypericum-induced mood disorder: switch from depression to mixed episodes in two patients

Objective. To point out the danger of worsening mood disorders with the use of hypericum. Methods. Longitudinal clinical observation of two cases treated with hypericum. Results. The two patients underwent mixed episodes following hypericum treatment. One of them needed hospitalization for suicidal risk. Conclusion. Caution is warranted in the use of hypericum in depressed patients with hidden bipolarity. Patients should be informed that hypericum may induce manic symptoms, increase cycling of mood states, or worsen the depressive state.     

Suicide among the elderly and associated factors in South Korea

With the population of the elderly increasing, suicides among elderly people present a serious problem for global societies. However, there are few studies on suicide among elderly subjects, especially in Asia. The study aimed to determine the relationship between physical health, mental health, social environmental condition, and the suicide behavior among elderly subjects in the city of Suwon, located southeast of Seoul. We analyzed 1548 Korean aged over 60 years from baseline data of a larger prospective study called the Suwon Project. The study protocol included sociodemographic variables, mental health factors, and physical health factors. In the interview, the subjects were asked about suicide ideation and history of suicide attempt. Of the total subjects, 7.42% reported suicide ideation and 1.42% reported a history of suicide attempt. A logistic regression analysis showed that physical illness, five stroke warning signs, anxiety and depression associated with suicide ideation, and depression strongly corresponded to the suicide ideation. Anxiety, depression, and stroke warning signs were associated with history of suicide attempt among the elderly. Additionally, stroke warning signs and depression are independently associated with history of suicide attempt. This study revealed that stroke warning signs have a high correlation with history of suicide attempt in the elderly, independent from the depression factors. This study suggests that there is an independent relationship between physical health status and suicide behavior in the case of elders.     

Evolution of the Concept of Altruistic Suicide in Pre-Durkheim Suicidology

Suicide as self-sacrifice was described by early nineteenth century authors before the delineation of altruism by the French Philosopher and Mathematician Auguste Comte. The concept evolved, leading to the categorization of altruistic suicide by Savage in England in 1892 and the elaboration of the term by Durkheim in France in 1897. Pre-Durkheim suicidologists were aware of the subtleties of sacrifice as opposed to revenge in this type of suicide.     

Neither Altruistic Suicide,nor Terrorism but Martyrdom: A Muslim Perspective

The objective of the present article is to elucidate specific Islamic and psychological aspects of martyrdom (Istish'had) in the light of one example, that is the Palestinian martyrs in the Israeli-Palestinian conflict. This conflict has historical roots. The day the British mandate in Palestine ended in 1948, Israel was declared a state. War broke out, and around half of the Palestinian population was expelled in the diaspora. In 1950, Israel passed a law that gave every Jew in any country the right to emigrate to Israel. Israelis are burying POWs alive, using arrested people as human spare parts for wounded Israelis, demolishing more than 17,000 houses, and bulldozing the farm lands. Therefore, the soil has become fertile ground for the growing phenomenon of martyrdom and has given rise to a culture of resistance, based on the Islamic principles of Jihad (holy war) and the right to resist the Israeli colonizer. Several specialists in Islamic law (Shari'a), consider that martyrdom is legitimate and does not count as suicide of any kind.     

Suicidal Ideation among Canadian Youth: A Multivariate Analysis

A majority of case control studies of suicide risks in psychiatric patients reveal an excess of risk factors in cases. None of the case control studies has been conducted blind to case identity. The present study examined the possibility that skilled clinicians could identify suicides blind from case records of last episode of care. Records of 39 suicides of psychiatric patients and their matched controls (N = 78) were abstracted blind and dichotomously rated for suicide by seven raters. Success in identification of cases approximated to chance expectation. Pending replication, these disappointing findings call in question the clinical utility of risk factor findings to date, their validity as a basis for significant change in service provision and the medico-legal significance of records in suicide-related civil law suits.     

An Overview of Suicide Research in China

Chinese suicide research did not start until the end of 1970s, when China opened its door to the West through reforming its economy. Although limited Chinese suicide research conducted overseas is published and known to the West, studies conducted by Chinese researchers and published in Chinese language, which may be of more significance, are rarely known or cited in the West. Further, researchers in China with direct observation of the suicidal environment may understand the suicide differently than scholars overseas with second hand information, and therefore derive different explanations of Chinese suicide. This article provides an overview of suicide research conducted in China and published in Chinese during the past two decades and compares the findings with what has been reported in Western publications. Six research books and 429 journal articles are reviewed. As units of analysis, all journal articles are quantified with 151 variables analysed. Results support findings of previous studies in terms of the suicide rates by gender, age, and rural/urban location. A unique phenomenon in Chinese suicide noticed in the study is that married Chinese are at higher risk of suicide than the non-married. Hypotheses for future research are suggested based on the articles reviewed.

     

Twin Studies of Suicidal Behavior

Research on twin studies of suicidal behavior are reviewed. No Methodologically sound study on twins reared apart has et appeared, and so firm conclusions cannot be drawn from the research. Monozygotic twins reared together do appear to have higher concordance rates for suicide than dizygotic twins reared together. Confounding factors are discussed and suggestions made for future research.