Suicide ideation and social desirability among school-aged young people

A mixed male-female sample of 950 school-aged adolescents, corresponding to 10% of the young population aged 15-19 living in a rural district of Northeast Italy, was investigated with self-reported questionnaires about the links between social desirability and suicide ideation. On the whole 30.6% of females and 23.9% of males reported suicidal ideation of some degree, with 5% in both genders reporting suicide ideation of a high degree (i.e. quite a lot/extremely often). Those who scored higher at the Marlowe-Crowne Social Desirability Scale (SDS) reported lower levels of psychiatric symptoms on the Symptom checklist 90R (SCL-90R), with the "denial" subscale of the SDS resulting specifically associated to lower scores on SCL-90R items measuring hopelessness, thoughts about death and suicide ideation. The personality traits measured by the Marlowe-Crowne SDS, such as defensiveness, denial and self-deception, might be conceived as a protection against psychiatric disorders and suicide ideation.     

Differences in cytokines between non-suicidal patients and suicidal patients in major depression

Several studies have shown that there is an imbalance between pro-inflammatory and anti-inflammatory cytokines in major depressive disorder (MDD). However, little is known about the role of cytokines in suicide. In the present study, amounts of IL-6, IL-2, IFN-gamma, IL-4, and TGF-beta1 produced by mitogen-stimulated whole blood were measured in 36 MDD patients who had recently attempted suicide, 33 non-suicidal MDD patients, and 40 normal controls. The severity of depression symptoms and suicidal behaviors was evaluated using Hamilton's depression rating scale (HDRS), the Lethality Suicide Attempt Rating Scale (LSARS), and the Risk-Rescue Rating (RRR). Non-suicidal MDD patients had significantly higher IL-6 production than suicidal MDD patients and normal controls (p<0.001). Suicidal MDD patients had significantly lower IL-2 compared with non-suicidal patients and normal controls (p<0.001). Both MDD groups, with or without attempted suicide, had significantly lower IFN-gamma and IL-4 and higher TGF-beta1 production. HDRS scores had significant positive correlations with IL-6, IFN-gamma, and the Th1/Th2 ratio and significant negative correlations with IL-4 in non-suicidal depression patients (p<0.005); however, these correlations did not hold true for suicidal patients. Suicidal MDD patients had no significant correlations between the LSARS or RRR scores and cytokine release. Our findings suggest that the immune response has distinct differences between non-suicidal patients and suicidal patients. Non-suicidal MDD may be associated with increased IL-6 production and a Th1/Th2 imbalance with a shift to Th1, while suicidal MDD may be associated with decreased IL-2.     

Electroconvulsive therapy for bipolar depressive and mixed episode with high suicide risk after epilepsy surgery

Mood disturbance is a common comorbid condition of temporal lobe epilepsy before and after surgery. Suicide is more frequent in patients with epilepsy than in the general population. As suicide is a major issue in both epileptic and depressive patients, it is critical to treat aggressively any psychiatric illness with suicidal ideation. We describe two patients who, after temporal lobe surgery, developed a serious bipolar disorder that necessitated electroconvulsive therapy (ECT), despite better seizure control. Unfortunately they were not able to commit to a regular treatment plan with their psychiatrists to prevent a suicide. These patients underwent a course of ECT treatments. After the ECT regimen, acute suicidal intent remitted and was replaced by chronic suicidal ideation without active intent or plan. The patients were then able to commit to a treatment plan regarding their medications and control visits. These cases represent the safe utilization of ECT as a rapid and effective treatment option for bipolar disorder with suicide ideation following epilepsy surgery. Patients and parents should be advised about possible psychiatric disturbances and suicide risk after epilepsy surgery, especially in the presence of a temporal lobe epilepsy, even when seizure control is achieved postoperatively.     

Exogenous wt-p53 enhances the antitumor effect of HSV-TK/GCV on C6 glioma cells

Objective To study on the antitumor effect of combining wt-p53 gene with suicide gene therapy (HSV-tk+GCV) for malignant gliomas. Methods AdCMV-p53 was transfected into C6 glioma cells at MOI of (Multiplicity of infection) 0(G100), 10(TPG1), 100(TPG2), then AdCMV-tk was transducted to C6 glioma cells of G100, TPG1 and TPG2, respectively, at MOI of 100. The C6 glioma cells tranfected with both AdCMV-p53 and AdCMV-tk were exposed to various concentration of GCV. The cell survival rate was measured by MTT assay in vitro. Rat glioma model was established by injecting 5 × 10⁵ C6 glioma cells into right caudate nucleus of SD rats. AdCMV-p53 and AdCMV-tk were injected into glioma on day 5 and 6, respectively. On day 7, ganciclovir (GCV) was administrated intraperitoneally at 15 mg/kg/day for 14 days. The survival time of all rats was observed. The growth of intracerebral tumors was monitored dynamically by enhanced MRI. Cell apoptosis was evaluated by TUNEL method. Expression of HSV-tk gene was identified by in situ hybridization and expression of exogenous p53 gene was detected with Western blotting. Results In vitro, wt-p53 significantly enhanced antitumor effect of HSV-tk/GCV. The concentration of GCV for ID50 of TPG2 cells (0.001 μg/ml GCV) was 10 times lower than that for the cells of tk-GCV group (MOI = 100), while the concentration of GCV for ID100 of TPG2 (0.01 μg/ml GCV) and TPG1(0.1 μg/ml GCV) was 100 and 10 times lower than that for the cells of tk-GCV group (MOI = 100), respectively. Apoptosis of C6 glioma cells also could be induced by transfection with wt-p53 gene slightly. For in vivo study, the survival time of tumor-bearing rats treated with HSV-TK/GCV or wt-p53 combined with HSV-TK/GCV was significantly prolonged and the intracerebral tumors were regressed and disappeared earlier in the combined gene therapy group than those in the HSV-TK/GCV therapy group as shown in enhanced MRI. However, only half dose of GCV for the rats treated with both wt-p53 and HSV-TK/GCV was needed to obtain the same efficacy as those rats treated with HSV-TK/GCV alone. These results indicate that the transfection of wt-p53 potentiates the effect of HSV-TK/GCV therapy. Conclusions The combination of HSV-tk/GCV system with wt-p53 gene transduction is optimal for clinical therapeutic trials of suicide gene therapy for malignant gliomas.     

学术压力、自我效能和乐观对博士生自杀意念的影响

目的:考察学术压力对博士生自杀意念的影响机制。方法:通过随机抽样法对武汉市4所高校博士生进行问卷调查,获得375份有效数据。结果:学术压力对高年级博士生自杀意念有显著的直接影响。低自我效能博士生最消沉、最抑郁时的自杀意念表现出随学术压力增加而上升的趋势,低乐观博士生近一周自杀意念也呈同样趋势。学术压力通过自我效能与乐观的链式中介间接影响低年级博士生自杀意念,其中,乐观是影响博士生自杀意念的近端前因。结论:学术压力对博士生自杀意念的影响存在直接和间接效应。     

The Association between Unstable Employment and Suicidal Behavior in Young-Adult Precarious Workers

ObjectivePrecarious workers have increased over the past two decades in South Korea. Employment instability, especially among young adults, is considered a serious social problem. The unstable employment status of precarious workers has negative impacts on their mental health, such as suicidal behavior. This study aims to identify the effect of the unstable employment conditions on the suicidal behavior of precarious workers. MethodsAn online survey was conducted with a panel sample of South Korean adults (n=797) who were precarious workers aged between 25–34 years. We applied Model 6 of SPSS PROCESS MACRO 3.5 to examine the multiple mediation effects of depression and anger in the relationship between employment instability and suicide. ResultsUnstable employment had no direct effect on suicidal behavior. The path of unstable employment to suicidal behavior via depression and anger had a significant indirect effect. However, employment and anger were negatively related. The indirect effect of depression and anger on the relation between unstable employment and suicidal behavior was statistically significant. ConclusionThis study suggests an association between unstable employment and suicidal behavior, mediated by depression and anger. Specifically, a high level of unstable employment status increased depression. In contrast, a low level of unstable employment status increased anger, which ultimately led to an increase in suicidal behavior. These contrasting findings are likely to reflect the heterogeneity of precarious workers. Further longitudinal studies are necessary to identify the causality between precarious employment and suicidal behavior over time.     

以学校为基础的自杀高危青少年针对性预防研究

目的 对有自杀风险的高危青少年进行针对性干预,评估干预方案的效果.方法 选取上海市浦东新区2所初中的初一和初二年级、2所高中的高一和高二年级,以班级为单位随机分为干预班级和对照班级.通过问卷筛查出有自杀风险的高危青少年210人,研究组101人,对照组109人.研究设计为add-on.研究组高危青少年除接受学校常规心理课程以外,另外接受20节团体认知行为课程,其父母接受青少年自杀预防宣教;对照组只接受学校常规心理课程,其父母不干预.在干预前和干预结束后6个月进行问卷调查,评估自杀行为和相关因素的变化.结果 干预前除研究组的敢于自表因子分高于对照组外(P=0.012),两组其他评估指标无统计学差异(P>0.05).干预后,研究组的自杀行为(P值分别为0.000、0.000、0.006)、最近1周和最严重时的BSI-CV(Beck自杀意念量表中文版)得分(P值分别为0.000、0.003)、BDI(Beck抑郁量表)得分(P=0.000)、BHS(Beck绝望量表)总分及对未来感觉和动力丧失因子分(P值分别为0.015、0.040、0.020)均显著低于干预前,SSRS(社会支持评定量表)总分及主观和客观支持因子分(P值均为0.000)、ESAP(情绪智力技能问卷)的敢于自表(P=0.017)和压力管理因子分(P=0.042)均显著高于干预前;干预后对照组的自杀行为(P值分别为0.000、0.002、0.008)、BDI得分(P=0.000)均显著低于干预前,SSRS总分(P=0.042)及主观支持因子分(P=0.001)、SCSQ(简易应对方式问卷)的积极应对因子分(P=0.009)均显著高于干预前;除研究组的客观支持因子分(P=0.013)和敢于自表得分显著高于对照组(P=0.004),最近1周的自杀意念显著低于对照组(P=0.048)外,上述其他指标在两组间无统计学差异.结论 干预方案能够改善自杀高危青少年的部分自杀行为和相关因素.目前干预结果提示我们应延长随访时间以便能够观察到最大化的干预效果.     

Broadening our horizons: gene expression profiling to help better understand the neurobiology of suicide and depression

The complexity of the neurobiological alterations underlying major depression and suicide is significant. Gene expression studies using high-throughput genomic technologies have provided important insight into novel genes and pathways displaying alterations associated with major depression and suicide, thereby providing a global view of the pathological changes taking place, as well as indicating potential new targets for therapeutic interventions. This review discusses the methodologies which have been used to profile gene expression patterns in depression and suicide, as well as examines several of the metabolic pathways which have been frequently implicated by studies using this approach. Future directions to be taken towards increasing our understanding of the origin and downstream effects of altered gene expression are also discussed.     

大学生述情障碍与自杀倾向的相关性

目的 了解在校大学生述情障碍与自杀倾向的相关性.方法 采用多伦多述情障碍量表(TAS-20)、贝克绝望量表(BHS)以及自编的一般资料问卷对在校大学生进行现场调查.结果 男生在因子3分上显著性高于女生(P＜0.05),不同年级、学习成绩、家庭来源的大学生在TAS总分及3个因子分上均存在显著性差异(P＜0.05),独生子女的TAS总分、因子1、因子3得分高于非独生子女,差异有显著性(P＜0.01);有自杀倾向大学生TAS总分、因子1、因子3得分均高于无自杀倾向者,差异有显著性(P＜0.05);BHS总分与TAS总分及因子1、因子2、因子3都显著正相关(P＜0.01,r=0.08～0.33);通过Logistic多元回归分析,BHS总分、年级、动机丧失、成绩、独生子女5个变量依次进入回归方程.结论 在校大学生述情障碍和自杀倾向密切相关.     

Temperament and character in euthymic major depressive disorder patients: the effect of previous suicide attempts and psychotic mood episodes

Objective

The purpose of this study was to examine personality traits of patients with major depressive disorder and explore the possible connections between personality and clinical and sociodemographic variables.

Methods

The sociodemographic and clinical properties of 80 patients with major depression, who were euthymic according to Hamilton Depression Scale scores, were recorded. Their personality was evaluated by using Temperament and Character Inventory and results were compared with 80 age- and sex-matched healthy controls. We used general linear model analysis to evaluate the manner in which the variables contributed to TCI scores.

Results

Remitted depressive patients scored significantly lower on on self-directedness and higher on harm avoidance than HC. Previous suicide attempts had a main effect only on harm avoidance while previous psychotic mood episodes were significantly associated with novelty seeking, self-directedness and cooperativeness. With respect to numeric clinical variables, only duration of illness was significantly and negatively correlated with NS and RD scores.

Conclusion

Patients with euthymic major depressive disorder may have significantly different personality traits than the normal population, and patients with different clinical and sociodemographic characteristics may show different personality patterns. In addition, assessment of major depressed patients by means of the Temperament and Character Inventory may be helpful to get a deeper insight into those personality traits underlying suicidality and the emergence of psychotic mood episode.