Browsing by Subject "Suicidal Ideation"
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Item Open Access Effects of acute estradiol and progesterone on perimenstrual exacerbation of suicidal ideation and related symptoms: a crossover randomized controlled trial.(Translational psychiatry, 2022-12) Eisenlohr-Moul, Tory A; Bowers, Savannah M; Prinstein, Mitchell J; Schmalenberger, Katja M; Walsh, Erin C; Young, Steven L; Rubinow, David R; Girdler, Susan SFemale suicide attempts peak peri-menstrually-around the onset of menses-when the ovarian steroids estradiol (E2) and progesterone (P4) fall rapidly. Given preclinical evidence that withdrawal from either E2 or P4 can provoke behaviors consistent with elevated suicide risk, we hypothesized that withdrawal from one or both of these steroids contributes to perimenstrual exacerbation of suicidal ideation (SI) and related symptoms. In a randomized, controlled, double-blind crossover experiment (NCT03720847), a transdiagnostic sample of naturally cycling, medically healthy psychiatric outpatients reporting past-month SI completed two conditions during two different 14-day experimental intervals (days 7-20 where the luteinizing hormone surge = day 0), separated by a monthlong washout cycle. In the E2 and P4 (EP) condition, participants received transdermal E2 (0.1 mg/day) plus oral micronized P4 (200 mg/day as 100 mg twice daily) to buffer perimenstrual steroid withdrawal. A matched placebo (PBO) condition allowed natural perimenstrual steroid withdrawal. Participants reported daily SI and planning (primary outcomes) and indices of depression (low mood, hopelessness), threat sensitivity (anxiety, perceived stress), executive functioning (difficulty concentrating, impulsivity), and social cognitive bias (rejection sensitivity, perceived burdensomeness). In baseline cycles, no participant met prospective criteria for DSM-5 premenstrual dysphoric disorder, but 59% met all criteria except full follicular symptom remission, and 93% showed the highest SI in the perimenstrual phase. Of 29 randomized, 28 were analyzed (14 EP-PBO, 14 PBO-EP). Experimental administration of E2 and P4 (relative to PBO) reduced perimenstrual exacerbation of SI, suicide planning, depression, hopelessness, perceived stress, rejection sensitivity, and perceived burdensomeness, particularly in the perimenstrual (natural E2 and P4 withdrawal) days. Further, delayed withdrawal from experimental E2 and P4 (but not PBO) recapitulated SI, hopelessness, and rejection sensitivity. Acute perimenstrual withdrawal from ovarian steroids may play a causal role in perimenstrual worsening of depression and SI.Item Open Access Effects of statewide job losses on adolescent suicide-related behaviors.(Am J Public Health, 2014-10) Gassman-Pines, Anna; Ananat, Elizabeth Oltmans; Gibson-Davis, Christina MOBJECTIVES: We investigated the impact of statewide job loss on adolescent suicide-related behaviors. METHODS: We used 1997 to 2009 data from the Youth Risk Behavior Survey and the Bureau of Labor Statistics to estimate the effects of statewide job loss on adolescents' suicidal ideation, suicide attempts, and suicide plans. Probit regression models controlled for demographic characteristics, state of residence, and year; samples were divided according to gender and race/ethnicity. RESULTS: Statewide job losses during the year preceding the survey increased girls' probability of suicidal ideation and suicide plans and non-Hispanic Black adolescents' probability of suicidal ideation, suicide plans, and suicide attempts. Job losses among 1% of a state's working-age population increased the probability of girls and Blacks reporting suicide-related behaviors by 2 to 3 percentage points. Job losses did not affect the suicide-related behaviors of boys, non-Hispanic Whites, or Hispanics. The results were robust to the inclusion of other state economic characteristics. CONCLUSIONS: As are adults, adolescents are affected by economic downturns. Our findings show that statewide job loss increases adolescent girls' and non-Hispanic Blacks' suicide-related behaviors.Item Open Access GWAS Meta-Analysis of Suicide Attempt: Identification of 12 Genome-Wide Significant Loci and Implication of Genetic Risks for Specific Health Factors.(The American journal of psychiatry, 2023-10) Docherty, Anna R; Mullins, Niamh; Ashley-Koch, Allison E; Qin, Xuejun; Coleman, Jonathan RI; Shabalin, Andrey; Kang, JooEun; Murnyak, Balasz; Wendt, Frank; Adams, Mark; Campos, Adrian I; DiBlasi, Emily; Fullerton, Janice M; Kranzler, Henry R; Bakian, Amanda V; Monson, Eric T; Rentería, Miguel E; Walss-Bass, Consuelo; Andreassen, Ole A; Behera, Chittaranjan; Bulik, Cynthia M; Edenberg, Howard J; Kessler, Ronald C; Mann, J John; Nurnberger, John I; Pistis, Giorgio; Streit, Fabian; Ursano, Robert J; Polimanti, Renato; Dennis, Michelle; Garrett, Melanie; Hair, Lauren; Harvey, Philip; Hauser, Elizabeth R; Hauser, Michael A; Huffman, Jennifer; Jacobson, Daniel; Madduri, Ravi; McMahon, Benjamin; Oslin, David W; Trafton, Jodie; Awasthi, Swapnil; Berrettini, Wade H; Bohus, Martin; Chang, Xiao; Chen, Hsi-Chung; Chen, Wei J; Christensen, Erik D; Crow, Scott; Duriez, Philibert; Edwards, Alexis C; Fernández-Aranda, Fernando; Galfalvy, Hanga; Gandal, Michael; Gorwood, Philip; Guo, Yiran; Hafferty, Jonathan D; Hakonarson, Hakon; Halmi, Katherine A; Hishimoto, Akitoyo; Jain, Sonia; Jamain, Stéphane; Jiménez-Murcia, Susana; Johnson, Craig; Kaplan, Allan S; Kaye, Walter H; Keel, Pamela K; Kennedy, James L; Kim, Minsoo; Klump, Kelly L; Levey, Daniel F; Li, Dong; Liao, Shih-Cheng; Lieb, Klaus; Lilenfeld, Lisa; Marshall, Christian R; Mitchell, James E; Okazaki, Satoshi; Otsuka, Ikuo; Pinto, Dalila; Powers, Abigail; Ramoz, Nicolas; Ripke, Stephan; Roepke, Stefan; Rozanov, Vsevolod; Scherer, Stephen W; Schmahl, Christian; Sokolowski, Marcus; Starnawska, Anna; Strober, Michael; Su, Mei-Hsin; Thornton, Laura M; Treasure, Janet; Ware, Erin B; Watson, Hunna J; Witt, Stephanie H; Woodside, D Blake; Yilmaz, Zeynep; Zillich, Lea; Adolfsson, Rolf; Agartz, Ingrid; Alda, Martin; Alfredsson, Lars; Appadurai, Vivek; Artigas, María Soler; Van der Auwera, Sandra; Azevedo, M Helena; Bass, Nicholas; Bau, Claiton HD; Baune, Bernhard T; Bellivier, Frank; Berger, Klaus; Biernacka, Joanna M; Bigdeli, Tim B; Binder, Elisabeth B; Boehnke, Michael; Boks, Marco P; Braff, David L; Bryant, Richard; Budde, Monika; Byrne, Enda M; Cahn, Wiepke; Castelao, Enrique; Cervilla, Jorge A; Chaumette, Boris; Corvin, Aiden; Craddock, Nicholas; Djurovic, Srdjan; Foo, Jerome C; Forstner, Andreas J; Frye, Mark; Gatt, Justine M; Giegling, Ina; Grabe, Hans J; Green, Melissa J; Grevet, Eugenio H; Grigoroiu-Serbanescu, Maria; Gutierrez, Blanca; Guzman-Parra, Jose; Hamshere, Marian L; Hartmann, Annette M; Hauser, Joanna; Heilmann-Heimbach, Stefanie; Hoffmann, Per; Ising, Marcus; Jones, Ian; Jones, Lisa A; Jonsson, Lina; Kahn, René S; Kelsoe, John R; Kendler, Kenneth S; Kloiber, Stefan; Koenen, Karestan C; Kogevinas, Manolis; Krebs, Marie-Odile; Landén, Mikael; Leboyer, Marion; Lee, Phil H; Levinson, Douglas F; Liao, Calwing; Lissowska, Jolanta; Mayoral, Fermin; McElroy, Susan L; McGrath, Patrick; McGuffin, Peter; McQuillin, Andrew; Mehta, Divya; Melle, Ingrid; Mitchell, Philip B; Molina, Esther; Morken, Gunnar; Nievergelt, Caroline; Nöthen, Markus M; O'Donovan, Michael C; Ophoff, Roel A; Owen, Michael J; Pato, Carlos; Pato, Michele T; Penninx, Brenda WJH; Potash, James B; Power, Robert A; Preisig, Martin; Quested, Digby; Ramos-Quiroga, Josep Antoni; Reif, Andreas; Ribasés, Marta; Richarte, Vanesa; Rietschel, Marcella; Rivera, Margarita; Roberts, Andrea; Roberts, Gloria; Rouleau, Guy A; Rovaris, Diego L; Sanders, Alan R; Schofield, Peter R; Schulze, Thomas G; Scott, Laura J; Serretti, Alessandro; Shi, Jianxin; Sirignano, Lea; Sklar, Pamela; Smeland, Olav B; Smoller, Jordan W; Sonuga-Barke, Edmund JS; Trzaskowski, Maciej; Tsuang, Ming T; Turecki, Gustavo; Vilar-Ribó, Laura; Vincent, John B; Völzke, Henry; Walters, James TR; Weickert, Cynthia Shannon; Weickert, Thomas W; Weissman, Myrna M; Williams, Leanne M; Wray, Naomi R; Zai, Clement C; Agerbo, Esben; Børglum, Anders D; Breen, Gerome; Demontis, Ditte; Erlangsen, Annette; Gelernter, Joel; Glatt, Stephen J; Hougaard, David M; Hwu, Hai-Gwo; Kuo, Po-Hsiu; Lewis, Cathryn M; Li, Qingqin S; Liu, Chih-Min; Martin, Nicholas G; McIntosh, Andrew M; Medland, Sarah E; Mors, Ole; Nordentoft, Merete; Olsen, Catherine M; Porteous, David; Smith, Daniel J; Stahl, Eli A; Stein, Murray B; Wasserman, Danuta; Werge, Thomas; Whiteman, David C; Willour, Virginia; VA Million Veteran Program (MVP); MVP Suicide Exemplar Workgroup; Suicide Working Group of the Psychiatric Genomics Consortium; Major Depressive Disorder Working Group of the Psychiatric Genomics Consortium; Bipolar Disorder Working Group of the Psychiatric Genomics Consortium; Schizophrenia Working Group of the Psychiatric Genomics Consortium; Eating Disorder Working Group of the Psychiatric Genomics Consortium; German Borderline Genomics Consortium; Coon, Hilary; Beckham, Jean C; Kimbrel, Nathan A; Ruderfer, Douglas MObjective
Suicidal behavior is heritable and is a major cause of death worldwide. Two large-scale genome-wide association studies (GWASs) recently discovered and cross-validated genome-wide significant (GWS) loci for suicide attempt (SA). The present study leveraged the genetic cohorts from both studies to conduct the largest GWAS meta-analysis of SA to date. Multi-ancestry and admixture-specific meta-analyses were conducted within groups of significant African, East Asian, and European ancestry admixtures.Methods
This study comprised 22 cohorts, including 43,871 SA cases and 915,025 ancestry-matched controls. Analytical methods across multi-ancestry and individual ancestry admixtures included inverse variance-weighted fixed-effects meta-analyses, followed by gene, gene-set, tissue-set, and drug-target enrichment, as well as summary-data-based Mendelian randomization with brain expression quantitative trait loci data, phenome-wide genetic correlation, and genetic causal proportion analyses.Results
Multi-ancestry and European ancestry admixture GWAS meta-analyses identified 12 risk loci at p values <5×10-8. These loci were mostly intergenic and implicated DRD2, SLC6A9, FURIN, NLGN1, SOX5, PDE4B, and CACNG2. The multi-ancestry SNP-based heritability estimate of SA was 5.7% on the liability scale (SE=0.003, p=5.7×10-80). Significant brain tissue gene expression and drug set enrichment were observed. There was shared genetic variation of SA with attention deficit hyperactivity disorder, smoking, and risk tolerance after conditioning SA on both major depressive disorder and posttraumatic stress disorder. Genetic causal proportion analyses implicated shared genetic risk for specific health factors.Conclusions
This multi-ancestry analysis of suicide attempt identified several loci contributing to risk and establishes significant shared genetic covariation with clinical phenotypes. These findings provide insight into genetic factors associated with suicide attempt across ancestry admixture populations, in veteran and civilian populations, and in attempt versus death.Item Open Access Predicting future suicidal events in adolescents using the Concise Health Risk Tracking Self-Report (CHRT-SR).(Journal of psychiatric research, 2020-07) Mayes, Taryn L; Killian, Michael; Rush, A John; Emslie, Graham J; Carmody, Thomas; Kennard, Betsy D; Jha, Manish K; King, Jessica; Hughes, Jennifer L; Trivedi, Madhukar HBackground
Several self-report rating scales have been developed to assess suicidal ideation, yet most have limited utility in predicting future suicide attempts. This is particularly critical in adolescence, where suicide is the second leading cause of death. This study evaluated the Concise Health Risk Tracking Self-Report (CHRT-SR) as a prospective predictor of suicide attempts and events in high-risk adolescents enrolled in a suicide-prevention intensive outpatient program (IOP).Methods
Data were collected by retrospective chart review of adolescents treated in IOP for youth with severe suicidality. At baseline, youth completed the 14-item CHRT-SR (CHRT-SR14), which assesses suicide risk based on 3 subscales: Propensity, Impulsivity, and Suicidal Thoughts. Two outcomes were assessed: actual suicide attempts and suicidal events (suicide attempt, inpatient hospitalization, or emergency department visit) during the IOP.Results
Of the 251 adolescents who completed the baseline CHRT-SR14, 26 had a suicidal event during IOP (mean time in IOP: 5.4 ± 2.3 weeks), of whom 14 had an actual suicide attempt. Youth with any suicidal event had higher scores than those without an event on the CHRT-SR14 Total (p = .005), Propensity (p = .008), and Suicidal Thoughts (p = .001) scales at baseline. Youth who made a suicide attempt had significantly higher scores than those without an event for the Total Score, Propensity, and Suicidal Thoughts subscales. CHRT-SR14 Total Score of 28 had a sensitivity of 85.7% and specificity of 56.5% in predicting suicide attempts. A score of 22 predicted suicidal events, with a sensitivity of 80.8% and specificity of 40.9%. CHRT-SR7 Total Score of 12 predicted suicide attempts, with a sensitivity of 85.7% and specificity of 53.4%.Conclusions
The CHRT-SR14 self-report predicts suicide attempts and events with at least 80% sensitivity and acceptable specificity in adolescents at high-risk for suicide.Item Open Access Prevalence and Correlates of Suicide and Nonsuicidal Self-injury in Children: A Systematic Review and Meta-analysis.(JAMA psychiatry, 2022-07) Liu, Richard T; Walsh, Rachel FL; Sheehan, Ana E; Cheek, Shayna M; Sanzari, Christina MImportance
Considerably less is known about self-injurious thoughts and behaviors (SITBs) in preadolescence than older age groups, owing partly to the common view that young children are incapable of suicidal thoughts. Yet, preadolescent suicide has increased in recent years and is now the fifth leading cause of death in this age group, leading the National Institute of Mental Health to identify it as a priority for research and intervention.Objective
To assess prevalence estimates of preadolescent SITBs, identify correlates of these outcomes, and conduct head-to-head comparisons of preadolescent and adolescent SITBs in terms of associated characteristics.Data sources
MEDLINE, PsycINFO, and Embase were systematically searched from inception through December 23, 2021, for studies on the prevalence and correlates of preadolescent SITBs. The search was restricted to English language publications and peer-reviewed journals.Study selection
Two reviewers independently identified studies providing data on prevalence and correlates of preadolescent SITBs.Data extraction and synthesis
Two reviewers independently extracted data from each study, and the Joanna Briggs Institute Checklist for Prevalence Studies was used to assess study quality. Pooled prevalence and Cohen d were derived from random-effects meta-analyses. Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) reporting guideline was followed.Main outcomes and measures
Prevalence and correlates of suicidal ideation, suicide attempts, suicide deaths, and nonsuicidal self-injury among preadolescents.Results
Fifty-eight studies with 626 486 590 individuals were included. Lifetime prevalence of suicide in the general population was 0.79 per 1 million children. Prevalence for lifetime suicidal thoughts, suicide attempts, and nonsuicidal self-injury among preadolescents were 15.1%, 2.6%, and 6.2%, respectively, in community samples. These data suggest that approximately 17.0% of preadolescents with suicidal ideation transition to attempting suicide. Across several analyses, male individuals appear more likely to have SITBs in preadolescence than adolescence. Correlate data were modest for SITBs other than suicidal ideation, but among specific disorders, attention-deficit/hyperactivity disorder (suicidal ideation: d = 0.54 [95% CI, 0.34-0.75]) and depression (suicidal ideation: d = 0.90 [95% CI, 0.71-1.09]; suicide attempts: d = 0.47 [95% CI, 0.26-0.68]) emerged as the strongest correlates. Among interpersonal factors, child maltreatment (suicidal ideation: d = 2.62 [95% CI, 1.56-3.67]) and parental support (suicidal ideation: d = -0.34 [95% CI, -0.46 to -0.22]) yielded the largest effect sizes.Conclusions and relevance
In this systematic review anda meta-analysis, although preadolescent suicide deaths were rare, other SITB types occur with concerning frequency. Male individuals were at greater risk for SITBs in preadolescence relative to adolescence. Attention-deficit/hyperactivity disorder, child maltreatment, and parental support were especially relevant to suicidal ideation, as well as depression for suicidal thoughts and behaviors, in this age group. Further study, especially of SITBs other than suicidal ideation, is needed.Item Open Access Suicidal ideation and substance use among adolescents and young adults: a bidirectional relation?(Drug and alcohol dependence, 2014-09) Zhang, Xiaoyun; Wu, Li-TzyTo examine reciprocal associations between substance use (cigarette smoking, use of alcohol, marijuana, and other illegal drugs) and suicidal ideation among adolescents and young adults (aged 11-21 at wave 1; aged 24-32 at wave 4).Four waves public-use Add Health data were used in the analysis (N=3342). Respondents were surveyed in 1995, 1996, 2001-2002, and 2008-2009. Current regular smoking, past-year alcohol use, past-year marijuana use, and ever use of other illegal drugs as well as past-year suicidal ideation were measured at the four waves (1995, 1996, 2001-2002, and 2008-2009). Fixed effects models with lagged dependent variables were modeled to test unidirectional associations between substance use and suicidal ideation, and nonrecursive models with feedback loops combining correlated fixed factors were conducted to examine reciprocal relations between each substance use and suicidal ideation, respectively.After adjusting for the latent time-invariant effects and lagged effects of dependent variables, the unidirectional associations from substance use to suicidal ideation were consistently significant, and vice versa. Nonrecursive model results showed that use of cigarette or alcohol increased risk of suicidal ideation, while suicidal ideation was not associated with cigarette or alcohol use. Reversely, drug use (marijuana and other drugs) did not increase risk of suicidal ideation, but suicidal ideation increased risk of illicit drug use.The results suggest that relations between substance use and suicidal ideation are unidirectional, with cigarette or alcohol use increasing risk of suicidal ideation and suicidal ideation increasing risk of illicit drug use.