Influence of Sex on Suicidal Phenotypes in Affective Disorder Patients with Traumatic Childhood Experiences.

Alexandra Bernegger,Birgit Ludwig,Laura Carlberg,Nestor D Kapusta,Michaela Schmöger,Alexandra Schosser,Siegfried Kasper,Patrick Swoboda,Romina Koller,Klemens Kienesberger,Helmuth Haslacher,Martin Aigner,Marianna Mazza

doi:10.1371/journal.pone.0137763

Alexandra Bernegger, Birgit Ludwig + Show 11 more

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https://doi.org/10.1371/journal.pone.0137763

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Abstract

ObjectivesIn the current study, we aimed to investigate the impact of childhood trauma on suicidal behaviour phenotypes in a group of patients with diagnosed affective disorder (unipolar or bipolar affective disorder).Patients and MethodsPatients with and without a history of childhood abuse, measured by Childhood Trauma Questionnaire (CTQ), were assessed to explore risks for suicidal behaviour (including suicide attempt, self-harm and non-suicidal self-injury). The tested sample consisted of 258 patients (111 males and 147 females, in-patients and out-patients at the Department of Psychiatry and Psychotherapy, Medical University of Vienna and University Hospital Tulln, Lower Austria). Psychiatric diagnoses were derived from the SCAN (Schedules for Clinical Assessment in Neuropsychiatry) interview. In addition, patients were administered the Lifetime Parasuicidal Count (LPC), Suicidal Behaviour Questionnaire (SBQ-R), and Viennese Suicide Risk Assessment Scale (VISURIAS) questionnaires.ResultsIn contrast to male suicide attempters, female suicide attempters showed both significantly higher total CTQ scores (p<0.001), and higher CTQ subscores (emotional, physical and sexual abuse, as well as emotional and physical neglect) in comparison to the non-suicidal control group. Besides, females with a history of self-harming behaviour (including suicidal intention) and Non-Suicidal-Self Injury (NSSI) had significantly higher CTQ total scores (p<0.001) than the control group.ConclusionThese findings suggest gender differences in suicidal behaviour after being exposed to childhood trauma.

Highlights

Suicide is a still increasing major public health issue
This does not alter the authors' adherence to PLOS ONE policies on sharing data and materials. These findings suggest gender differences in suicidal behaviour after being exposed to childhood trauma
It is well known that 70–90% of completed suicides are preceded by mental disorders, mostly affective disorders [2, 3], and patients suffering from major depressive disorder (MDD) have an estimated 6–15% lifetime risk of suicide, [4] indicating the importance of adequate biological treatment of major depressive disorder

Summary

Introduction

More than 800,000 people all over the world commit suicide.[1] It is well known that 70–90% of completed suicides are preceded by mental disorders, mostly affective disorders [2, 3], and patients suffering from major depressive disorder (MDD) have an estimated 6–15% lifetime risk of suicide, [4] indicating the importance of adequate biological treatment of major depressive disorder. Risks for suicidal behaviour have been described by distal and proximal factors. Distal factors define the predisposing diathesis and determine the response of an individual to a proximal stressor. This group of distal factors includes variables as development, personality traits as well as biological and genetic variables. Proximal factors, which include life events, stress, psychiatric illness, alcohol or substance abuse, increase the individual risk on the basis of the distally determined threshold. Proximal factors, which include life events, stress, psychiatric illness, alcohol or substance abuse, increase the individual risk on the basis of the distally determined threshold. [7, 8]

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