Suicide Attempts In Patients Research Articles

Alterations in orbitofrontal cortex communication relate to suicidal attempts in patients with major depressive disorder

BackgroundInvestigating how the interaction between the orbitofrontal cortex (OFC) and various brain regions/functional networks in major depressive disorder (MDD) patients with a history of suicide attempt (SA) holds importance for understanding the neurobiology of this population. MethodsWe employed resting-state functional magnetic resonance imaging (rs-fMRI) to analyze the OFC's functional segregation in 586 healthy individuals. A network analysis framework was then applied to rs-fMRI data from 86 MDD-SA patients and 85 MDD-Control patients, utilizing seed mappings of OFC subregions and a multi-connectivity-indicator strategy involving cross-correlation, total interdependencies, Granger causality, and machine learning. ResultsFour functional subregions of left and right OFC, were designated as seed regions of interest. Relative to the MDD-Control group, the MDD-SA group exhibited enhanced functional connectivity (FC) and attenuated interaction between the OFC and the sensorimotor network, imbalanced communication between the OFC and the default mode network, enhanced FC and interaction between the OFC and the ventral attention network, enhanced interaction between the OFC and the salience network, and attenuated FC between the OFC and the frontoparietal network. LimitationsThe medication and treatment condition of patients with MDD was not controlled, so the medication effect on the alteration model cannot be affirmed. ConclusionThe findings suggest an imbalanced interaction pattern between the OFC subregions and a set of cognition- and emotion-related functional networks/regions in the MDD-SA group.

Associations Between Vitamin K and Suicide Attempts in Patients with Depression: A Case-Control Study.

Hypovitaminosis K has been linked to depression and suicide, but epidemiological research is scarce. This study aimed to explore the association among vitamin K with depression and suicidal attempts. This was a retrospective cross-sectional study involving 146 cases with a history of suicidal attempts and 149 subjects without a lifetime history of suicidal attempts. The levels of thyroid hormones, lipid profile, inflammatory cytokines, and vitamins were measured. Subjects who had suicidal attempts presented with a significant decrease in FT4, TC, vitamin D, and vitamin K but increased CRP levels. In these variables, vitamin K has a better diagnostic value for suicidal attempts in depressed patients, with a sensitivity of 0.842 and a specificity of 0.715. Correlation analysis suggested that vitamin K was significantly and positively related to FT4, TC, LDL, and sdLDL. Multivariate analysis showed that serum vitamin K level predicts suicidal attempts in depressive patients (OR = 0.614, P = 0.004, 95% CI 0.153-0.904). Moreover, a negative correlation between vitamin K and suicidal attempts was also noted for partial FT4, CRP, and vitamin D strata analysis. Our study suggests that low vitamin K levels were correlated with suicidal attempts in patients with depression, indicating that vitamin K deficiency might be a biological risk factor for depression.

The relationship between chronotype and suicidal attempt in patients with schizophrenia

IntroductionIndividuals with schizophrenia are known to be at an increased risk of suicidal behavior (Sher & Kahn, 2019). However, the relationship between chronotype, which refers to an individual’s preference for sleep-wake patterns, and suicidal attempts in schizophrenia patients remains an area of interest and investigation.The relationship between chronotype and suicidal attempts in schizophrenia patients has not been extensively studied. However, research in other populations has shown that individuals with evening chronotypes, also known as “night owls,” may be at a higher risk of mental health issues, including depression and suicidal ideation (Verma et al., 2016). It is plausible to hypothesize that individuals with schizophrenia who have evening chronotypes may also be at an increased risk of suicidal attempts. Further research is needed to explore this relationship and its potential implications for clinical practice. In conclusion, the relationship between chronotype and suicidal attempts in schizophrenia patients is an area that requires further investigation.Early identification and intervention are crucial in preventing further suicidal attempts in this vulnerable population. Future research should focus on exploring the relationship between chronotype and suicidal attempts in schizophrenia patients to provide a comprehensive understanding of the factors contributing to suicide risk in this population.ObjectivesThis study investigates the relationship between chronotype and suicidal attempts in patients with schizophrenia.MethodsThe study was conducted cross-sectionally using quantitative research methods and using purposive sampling. The personal information form and scales used for data collection in this study, which was planned with patients hospitalized in the psychiatric ward and patients applying to the outpatient clinic, are based on self-report. The personal information form developed by the researcher by reviewing the literature, the Morningist-Evening Scale (SAM), the Suicide Probability Scale, the Suicidal Behavior Scale, the Positive Symptoms Rating Scale (SAPS) and the Negative Symptoms Rating Scale (SANS) were used as data collection tools. Participants signed an informed consent form before the interview.ResultsData extraction is still ongoing in detailed style by principal authors. A description of the studies and the key findings will be presented.ConclusionsReducing the risk of suicide in patients with schizophrenia is of vital importance. Awareness of the risks related to suicide may help reduce mortality rates in schizophrenia patients as in all patients. It is thought that the study’s results will be an important resource in knowing the risks related to suicide and determining the risk factors so that prevention studies can be initiated.Disclosure of InterestNone Declared

Patterns of antipsychotic prescription in inpatient and outpatient psychiatric settings: a real world study

IntroductionAntipsychotic (AP) are increasingly prescribed off-label and used as, but not limited to, anti-aggressive, anti-impulsive, and anti-suicidal medication. The use of second-generation AP (SGAs) has progressively increased compared to first-generation AP (FGAs). FGAs cause more extrapyramidal motor side effects and tardive dyskinesia than SGAs, whereas SGAs generally cause more weight gain and cardiometabolic adverse effects.ObjectivesAim of this observational study was to describe the socio-demographic and clinical features of the patients receiving new AP treatment and the features of the pharmacological treatment itself in “real world” context. Furthermore, we aimed to compare socio-demographic and clinical characteristics of the subjects who were prescribed either FGAs or SGAs.MethodsData were collected on the latest new AP prescriptions issued across different settings (two psychiatric wards; five outpatients clinics; and one rehabilitation community) belonging to ASST Fatebenefratelli Sacco (located in Milan) in reverse chronological order from May 2023. Socio-demographic and clinical variables of the subjects who received new AP treatment were collected through medical records. We compared age, age at onset, age at first pharmacological treatment, duration of illness, duration of untreated illness, treatment duration, number of hospitalization and admissions to Day Hospital services, involuntary commitments and suicidal attempts in patients who received either FGAs or SGAs. Chi-square was used for qualitative variables and t-test for quantitative variables. Data were collected anonymously and analyzed using SPSS v.27.ResultsThe sample included 155 new AP prescriptions, out of which 29.2% were formulated in the psychiatric wards, 66.9% in the outpatient clinics e 3.9% in the rehabilitative community. Mean age of the subjects was 41.1 ± 16.9 years, 53.2% were male.The most represented diagnoses were psychotic disorders (32.2%), personality disorders (24.8%), bipolar disorder (16.1%) and depressive disorder (12.8%).90.7% of new AP prescriptions were SGAs. The most prescribed were aripiprazole (30.5%), quetiapine (21.2%) and olanzapine (15.2%); while the most prescribed FGAs were haloperidol (5.3%), zuclopenthixol (2%) and chlorpromazine (1.3%). 26.2% of the prescriptions were in monotherapy and 83.8% were for oral administration.The reasons for introduction were partial or absent response to previous treatments (52.3%), disease onset (23.5%), non-compliance (8.3%), adverse effects to previous treatments (6.8%) or other (9.1%). Patients treated with FGA had a longer duration of untreated illness (p<0,001) and a greater number of lifetime hospitalizations (p<0,001) and involuntary commitments (p=0,002).ConclusionsPatients treated with SGAs have a shorter duration of untreated illness and also lower chance of lifetime hospitalization and involuntary commitment.Disclosure of InterestNone Declared

“Esketamine” in Borderline Personality Disorder: focud on suicide ideation

IntroductionBorderline personality disorder is often associated with comorbid conditions such as eating disorders, mood disorders, and substance use disorders. The prevalence of BPD and major depressive disorder (MDD) are about 5.9% and 8%, respectively, but up to 80% of patients with BPD experience one or more episodes of MDD in their lifetime. BPD is associated with suicidal behaviors and self-harm, thei are also fifty times more likely than the general population to attempt or die by suicide, Up to 10% of BPD patients will die by suicideObjectivesOur aim is to verify if Esketamine could be effectiveness in treating patterns of behavior that have proven to be socially disruptive like self harm, suicidal attempts in patients with BPD. Suicidal ideation is a major risk factor for suicide in patients with TRD and BPD. The interval between the onset of suicidal ideation and suicide attempt is often very short, highlighting the need for urgent intervention and the development of new rapid-onset antidepressant therapies.MethodsWe recruited 25 adult subjects referred to the outpatient clinics of Pavia suffering from TRD with current Moderate-Severe Depressive Episode (scoring ≥ 22 on the MADRS). Of them 9/25 patients has a BPD. Study duration was 8 weeks.The following evaluation scales were administered before the first drug administration (T0) and repeated after one week (T1), four weeks (T2) and eight weeks (T3) of treatment: Montgomery Asberg Depression Rating Scale (MADRS), Columbia-Suicide Severity Rating Scale (CSSRS), and The Zanarini Rating Scale for BPD subgroup patients. We also collected sociodemographic and clinical information. Dosages and frequency of esketamine administration during the study period, adverse events and reasons for discontinuation were also recorded.ResultsA significant reduction of depressive symptoms was found at T1 and T2 compared to T0. Suicidal ideation disappeared as early as T1 and was maintained at T2, expecially in the BPD group. In the subgroup with borderline disorder we saw more improvement in impulsive (Self-mutilation and/or suicidal efforts; two other forms of impulsivity) and affective categories ( Inappropriate anger / frequent angry acts; chronic feelings of emptiness; mood instability) in Zanarini Rating Scale.ConclusionsOur findings support the safety and tolerability of esketamine in TRD and BPD comorbidity sample. It is noteworthy that esketamine has an action on various pathways that are considered defective in borderline patients. Glutamate plays a key role in personality traits such as impulsivity, aggression, and suicidal behavior. Treatment with esketamine could reduce the number of suicide attempts and help reduce the self-harm of BPD.Disclosure of InterestNone Declared

Epigenetic biomarkers of borderline personality disorder with severe suicidal behaviors

AbstractBorderline personality disorder (BPD) is associated with excess suicide risk, natural-cause mortality, comorbid medical conditions, poor health habits and stress related epigenomic alterations. This presentation will report findings of BDNF and stress system associated epigenetic alterations in a group of severely impaired BPD and suicidal patients. Further, findings of GrimAge – a state-of-the-art epigenetic age (EA) estimator- in patients with BPD and attempted suicide patients will be presented. Genome-wide methylation patterns were measured using the Illumina Infinum Methylation Epic BeadChip in whole blood from well characterized 97 BPD patients, 88 suicide attempters and 32 healthy controls.Disclosure of InterestNone Declared

The characteristics of suicide attempters in Chinese patients: Comparison of adolescents, youths, middle-aged and elderly

BackgroundPotential risk factors for suicide differ by age group. Therefore, this study aims to investigate the characteristics of patients with suicide attempts according to age group and any the relevant risk factors. MethodsThis study retrospectively reviewed the medical records of attempted suicide patients who were admitted to the emergency departments (ED) of the First Affiliated Hospital of Wenzhou Medical University between January 1, 2017, and December 31, 2021. Demographic information and clinical characteristics were collected. The participants were divided into four age groups and the characteristics of each group were compared. ResultsA total of 834 participants were included in this study. Suicide attempts were more prevalent in females, and the gender difference decreased with age. Having religious belief and less educated suicide attempts were concentrated in the elderly groups. Adolescents suicide attempts were more likely to occur in the spring, autumn and during non-office hours. Mental disorders were the major motivation for suicide among adolescents, and interpersonal and social problems were more prevalent among youths. Psychiatric medication was the leading suicidal substances among adolescents, while pesticides and herbicides were more prevalent in adults. The history of psychiatric diagnosis was more common in adolescents, while the history of somatic disorder was more prevalent in the elderly. ConclusionThis study confirmed differences in the demographic and clinical characteristics of patients in different age groups. Therefore, it is necessary to construct individualized intervention strategies for each age group based on the characteristics of the patients in order to reduce suicide.

Socio-Demographic and Clinical Study of Suicide Attempt Patients Admitted to MGM Medical College and Maharaja Yashwant Rao Hospital, Indore (M.P)

Socio-Demographic and Clinical Study of Suicide Attempt Patients Admitted to MGM Medical College and Maharaja Yashwant Rao Hospital, Indore (M.P)

Electroencephalographic differences in patients with paranoid schizophrenia with or without a history of suicide attempts

To identify differences in electroencephalographic parameters in schizophrenia patients with and without a history of suicide attempts. Eighty-seven inpatients (50 men and 37 women) with paranoid schizophrenia were examined. Suicidal attempts in the anamnesis of patients were verified by a psychiatrist on the basis of clinical interviewing. The severity of psychopathological symptoms was assessed using The Positive and Negative Syndrome Scale (PANSS) based on a five-factor model. Electroencephalogram (EEG) parameters were recorded and evaluated using a 16-channel encephalograph. A clinical and quantitative analysis of the recordings was carried out with the calculation of absolute spectral power indicators for theta, alpha and beta rhythms, as well as the severity of the activation reaction (Berger effect). Significantly higher rates of the PANSS depression factor were revealed in patients with a history of suicide attempts (p=0.016). Clinical analysis of EEG changes did not reveal any significant differences between the groups (p>0.05). The spectral analysis of the EEG showed significant differences only in the spectral power of the beta rhythm in the central (p=0.048) and occipital (p=0.021) leads with closed eyes, which was lower in the group with a history of suicide attempts. The degree of alpha rhythm depression in the occipital leads was also significantly lower in this group (p=0.016). The regression analysis showed that significant correlates of suicidal attempts in patients with paranoid schizophrenia are the PANSS depressive factor (t=2.784; p=0.016) and a deficiency in the activation response to EEG (t=-2.035; p=0.045). The results complement previous studies on the relationship between suicidal attempts, clinical symptoms and neurophysiological features of the functioning of the brain of patients with paranoid schizophrenia.

Interrupting Effect of Social Distancing on Ischemic Heart Disease, Asthma, Stroke, and Suicide Attempt Patients by PM2.5 Exposure.

This study aimed to examine the interrupting effect of social distancing (SD) on emergency department (ED) patients with ischemic heart disease (IHD), stroke, asthma, and suicide attempts by PM2.5 exposure in eight Korean megacities from 2017 to 2020. The study used National Emergency Department Information System and AirKorea data. A total of 469014 patients visited EDs from 2017 to 2020. Interrupted time series analysis was employed to examine changes in the level and slope of the time series, relative risk, and confidence intervals (CIs) by PM2.5 exposure. The SD level was added to the sensitivity analysis. The interrupted time series analysis demonstrated a significant increase in the ratio of relative risk (RRR) of IHD patients in Seoul (RRR=1.004, 95% CI: 1.001, 1.006) and Busan (RRR=1.007, 95% CI: 1.002, 1.012) post-SD. Regarding stroke, only patients in Seoul exhibited a significant decrease post-SD (RRR=0.995, 95% CI: 0.991, 0.999). No significant changes were observed for asthma in any of the cities. In the case of suicide attempts, Ulsan demonstrated substantial pre-SD (RR=0.827, 95% CI: 0.732, 0.935) and post-SD (RRR=1.200, 95% CI: 1.057, 1.362) differences. While the interrupting effect of SD was not as pronounced as anticipated, this study did validate the effectiveness of SD in modifying health behaviors and minimizing avoidable visits to EDs in addition to curtailing the occurrence of infectious diseases.

The altered temporal properties of dynamic functional connectivity associated with suicide attempt in bipolar disorders

ObjectiveThe suicide risk in bipolar disorder (BD) is the highest among psychiatric disorders, and the neurobiological mechanism of suicide in BD remains unclear. The study aimed to investigate the underlying relevance between the implicated abnormalities of dynamic functional connectivity (FC) and suicide attempt (SA) in BD. MethodsWe used the sliding window method to analyze the dynamic FC patterns from resting-state functional MRI data in 81 healthy controls (HC) and 114 BD patients (50 with SA and 64 with none SA). Then, the temporal properties of dynamic FC and the relationship between altered measures and clinical variables were explored. ResultsWe found that one of the five captured brain functional states was more associated with SA. The SA patients showed significantly increased fractional window and dwell time in the suicide-related state, along with increased number of state transitions compared with none SA (NSA). In addition, the connections within subcortical network-subcortical network (SubC-SubC), default mode network-subcortical network (DMN-SubC), and attention network-subcortical network (AN-SubC) were significantly changed in SA patients relative to NSA and HC in the suicide-related state. Crucially, the above-altered measures were significantly correlated with suicide risk. ConclusionsOur findings suggested that the impaired dynamic FC within SubC-SubC, DMN-SubC, and AN-SubC were the important underlying mechanism in understanding SA for BD patients. It highlights the temporal properties of whole-brain dynamic FC could serve as the valuable biomarker for suicide risk assessment in BD.

A multimodal prediction model for suicidal attempter in major depressive disorder.

Suicidal attempts in patients with major depressive disorder (MDD) have become an important challenge in global mental health affairs. To correctly distinguish MDD patients with and without suicidal attempts, a multimodal prediction model was developed in this study using multimodality data, including demographic, depressive symptoms, and brain structural imaging data. This model will be very helpful in the early intervention of MDD patients with suicidal attempts. Two feature selection methods, support vector machine-recursive feature elimination (SVM-RFE) and random forest (RF) algorithms, were merged for feature selection in 208 MDD patients. SVM was then used as a classification model to distinguish MDD patients with suicidal attempts or not. The multimodal predictive model was found to correctly distinguish MDD patients with and without suicidal attempts using integrated features derived from SVM-RFE and RF, with a balanced accuracy of 77.78%, sensitivity of 83.33%, specificity of 70.37%, positive predictive value of 78.95%, and negative predictive value of 76.00%. The strategy of merging the features from two selection methods outperformed traditional methods in the prediction of suicidal attempts in MDD patients, with hippocampal volume, cerebellar vermis volume, and supracalcarine volume being the top three features in the prediction model. This study not only developed a new multimodal prediction model but also found three important brain structural phenotypes for the prediction of suicidal attempters in MDD patients. This prediction model is a powerful tool for early intervention in MDD patients, which offers neuroimaging biomarker targets for treatment in MDD patients with suicidal attempts.

Socio-demographic Status and Psychiatric Morbidity of Suicide Attempters in a Tertiary Care Hospital of Bangladesh

Background: Suicide is a worldwide growing but neglected problem crossing culture, geographies, religious, social and economic boundaries. Suicide is a perplexing phenomenon of taking one’s own life. As versatile human beings are, reasons behind suicide attempts are also unique. There is paucity of study on the clinical characteristics of these patients from a psychosocial and psychiatric point in Bangladesh. Objective: The study was aimed to assess the socio-demographic profile and psychiatric morbidity in attempted suicide patients. Methods: This cross-sectional observational study was carried out for 4 months (May’2017-September’2017) at the Rangpur Medical College Hospital, Rangpur, Bangladesh. ). A total of 101 patients were purposively selected from the patients with suicidal attempt from different departments of the hospital (Medicine, Surgery, Head-Neck & Otorhinolaryngology). Informed written consent was obtained from all patients. The interview was conducted once the patient was considered fit for a psychosocial assessment using a semi-structured questionnaire and clinical interviews. Diagnosis was made according to DSM-IV. Data was entered and analyzed using SPSS version 24 and results were expressed as proportions and percentages. Results: The majority of suicide attempts seen are in socio-economically-deprived young persons. Majority were <20 years age (41.59%), Female (53.47%), Unmarried (51.49%), Rural dwellers(72.28%), students (38.62%) and 58% attempts were impulsive. 63% without any prior suicidal thoughts, 56% resorted to poisoning, 49% attempted due to domestic quarrel, 65% suffered from a psychiatric disorder and major depressive disorder (18%) was found to be one of the commonest diagnosed disorders. Conclusion: Psychiatric disorders and their co morbidities are common in suicide attempt patients which calls for implementation of hospital guidelines for routine psychiatric and psychosocial assessments. J Rang Med Col. September 2023; Vol. 8, No. 2: 7-13

Gender and Age Bias in the Evaluation of Suicide Attempt Behavior in an Emergency Department.

We aimed to investigate whether demographic characteristics such as age and gender of attempted suicide patients are associated with bias in the post-Emergency Department (ED) discharge program manager's evaluation of genuineness of the patients' suicide attempts. In the ED-Based Post-Suicide Attempt Case Management (ED-PSACM) program, the manager interviews patients with suicide attempts and makes subjective judgement on the patient's genuineness of the suicide attempt. After patients' discharge, the manager provides follow-up post-discharge care management services. Compared to ≥ 65 years old male patients as a reference group, 18-39 years old female patients showed significantly lower judgment for a genuine suicide attempt (OR = 0.34; 95% CI 0.12-0.81). Other groups did not show significant differences from the reference group. Our study result suggests the possibility of the effects of bias on young females on the judgment of the suicide attempt genuineness. Medical staff and interventions managers in the ED should be concerned to avoid knowledge-mediated bias, especially by gender and age.

Impact of COVID-19 on suicidal attempts identified by face-to-face interviews

Epidemics of infectious diseases, such as the coronavirus disease 2019 (COVID-19) pandemic, have various psychiatric effects. These psychiatric problems are affected not only by the fear of infectious diseases, but also by economic and social changes following the epidemic. The aim of this study was to investigate the effect of COVID-19 pandemic on their suicide attempts through face-to-face interview records of suicide attempt patients who came to the emergency department (ED). This single-center, retrospective observational study was conducted with suicide attempt patients who visited ED from February 2020 to January 2021, who underwent a face-to-face interview with a psychiatrist. The patients were classified as a COVID-19 related group if they clearly mentioned a causal relationship between the COVID-19 pandemic and suicide attempts in the interview record, and a non-related group if they did not. A total of 502 patients were included, of which 90 were classified as a COVID-19 related group. As a result of comparing the demographic characteristics between the two groups, there were more patients who were employers by occupation and patients without a psychiatric history in the COVID-19 related group compared to the non-related group. There were various differences in motives for suicide attempt between the two groups, and unemployment, financial difficulty, and loneliness were statistically significantly higher in the COVID-19 related group than in the non-related group. The number of COVID-19 related groups increased toward the late period, but there was no statistically significant difference in suicide attempt motives. In conclusion, the COVID-19 pandemic has had a variety of effects on suicide attempt patients and also affects suicide attempts in patients with no psychiatric history. As motives for suicide attempts by the COVID-19 related group, unemployment, financial difficulty, and loneliness showed statistically significant results.

NR3C1 and NR3C2 Genes Increase the Risk of Suicide Attempt in Psychiatric Disorder Patients with History of Childhood Trauma.

Hypothalamic-pituitary-adrenal axis gene variants and childhood trauma (CT) are considered risk factors for suicide attempt (SA). The aim of the present study was analyzed gene x environment (GxE) interaction of NR3C1, NR3C2, and CT, and NR3C1 and NR3C2 gene expression in the development of SA with CT. A total of 516 psychiatric Mexican patients from Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz. Among them, 274 had SA at least once and 242 had not SA. Genetic variants of NR3C1 and NR3C2 were genotyped in all the patients, of which were obtained the CT information from medical records. Additionally, the gene expression of NR3C1 and NR3C2 was also analyzed for a subsample of 96 patients, obtaining the TC information from Childhood Trauma Questionnaire (CTQ). The analysis showed a GxE interaction of NR3C1, NR3C2, and CT (OR=2.8, 95% CI [1.9-3.9], p<0.0001). Interactions were also observed with neglect (OR=2.1, 95% CI [1.4-3.1], p<0.0001), emotional abuse (OR=2.1, 95% CI [1.5-3], p<0.0001), and sexual abuse (OR=2.4, 95% CI [1.4-2.9], p<0.0001) in the prediction of SA. The analysis of gene expression identified an overexpression of NR3C1 in SA patients with high scores for physical and sexual abuse (p<0.0001; p<0.0006, respectively) and emotional neglect (p=0.014). An underexpression was observed of NR3C2, associated with high scores of trauma subtypes (p<0.0001) except physical neglect. Additionally, we observed an overexpression of NR3C1 gene in patients with SA carriers of A allele of rs6191 (p=0.0015). Also, overexpression of NR3C1 gene in carriers of G allele of rs6198 and underexpression of NR3C2 gene in carriers of G allele of rs5522 (p<0.0001). Our findings suggest that genetic variants of NR3C1 and NR3C2 differentially affect expression levels, increasing the susceptibility to SA in psychiatric patients with a history of CT.

Correlation Between Sleep Electroencephalogram, Brain-Derived Neurotrophic Factor, AVPR1B Gene Polymorphism, and Suicidal Behavior in Patients with Depression.

The purpose of this article was to investigate the level of serum brain-derived neurotrophic factor and its relationship with suicidal symptoms and severity in mentally ill suicide attempt patients, and to explore the possible role of serum brain-derived neurotrophic factor (BDNF) in the occurrence of psychotic suicidal behavior. A retrospective analysis was performed on patients with depression in the neurology department of a hospital. General physical examination, neurological specialist examination, and cranial magnetic resonance imaging (MRI) examination were performed on any selected group. We applied the 24-item Hamilton Depression Scale, Hamilton Anxiety Scale, and Mini-Intelligence Mental State Scale, and performed polysomnography and electroencephalography (EEG) monitoring to conduct statistical analysis on sleep indicators. The amplitude of low-frequency fluctuation (ALFF) values of the right frontal gyrus, left posterior cerebellar lobe, right anterior cerebellar lobe, and right occipital lingual gyrus of the patient group were significantly lower than those of the control group. The ReHo values of the right superior parietal lobule, the left precuneus, and the right occipital lingual gyrus were significantly higher than those of the control group. The genotype and allele frequency distribution of FKBP5, AVPR1B, and CRHR2 gene SNPs had no significant difference between the case group and the control group (P > 0.05). The ReHo value of the precuneus is significantly correlated with the proportion of N3 sleep, and the dysfunction of the precuneus or default network may be related to the altered sleep structure in patients with depression. The GT and TT genotypes at rs9324924 of the NR3C1 gene are associated with suicide attempts.

A prospective study on clinical profile and trend in suicide attempters

There is a high risk of suicidal attempts in patients with psychiatric problems. This risk varies according to the sociodemographic status and clinical presentation. Periodic systematic profiling of suicidal risk factors in developing countries is an established need. Objectives. The objective was to study the sociodemographic data, psychiatric disorder, precipitating events, mode of attempt, and intent of attempt in suicide attempted patients. Material and methods. During the 1.5 years, 150 referrals were screened for the presence of suicide attempters in consultation-liaison services. Those who fulfilled the criteria for suicide attempters were evaluated by using semistructured pro forma containing sociodemographic data, precipitating events, mode of attempt, psychiatric diagnosis by using ICD-10 and intent of the attempt. Results. Adult age, rural background, housewives and students, unemployed, below matriculation educated were more represented in this study. Gender wise more females are represented. More than 80 % of all attempters had a psychiatric disorder. The majority had a precipitating event before the suicide attempt. The most common method of attempt was by use of insecticide poison. Many have moderate intent in the attempt. Conclusions. The majority of suicide attempt patients had a mental illness. Early identification and treatment of these disorders would have prevented morbidity and mortality associated with this.

Increased levels of neurofilament light chain in suicide attempters' serum.

BackgroundA specific biological vulnerability underlies suicidal behavior. Recent findings have suggested a possible role of inflammation and neuroaxonal injury. However, the relationship between inflammation and clinical symptoms in this disorder is still unclear. The objective of this study is applying novel blood markers of neuroaxonal integrity such as neurofilament light chain (NfL) and comparing the results with the healthy control subjects.MethodsIn this cross-sectional study patients with suicide attempts were evaluated. The serum concentration of NfL on admission was measured by enzyme-linked immunosorbent assays.ResultsA total of 50 patients with a suicide attempts and 35 healthy controls were included in the study. The levels of NfL in attempted suicide patients were significantly higher in comparison with healthy controls (40.52 ± 33.54 vs 13.73 ± 5.11, P < 0.001). A significant association between serum levels of NfL and risk factors for suicide was not found.ConclusionThese findings indicate that axonal damage may be an underlying neuropathological component of suicide attempt patients, although no correlation was observed with clinical features. This line of work could lead to new horizons in understanding the neurobiology of suicidal attempts and the development of better management strategies for these patients.

COVID–19流行下における自殺企図患者の推移(Changes in suicide attempt patients during the COVID–19 pandemic)

ABSTRACT Aim : We aimed to investigate the influence of the COVID–19 pandemic on suicide and suicide attempts in Japan. Methods: We retrospectively reviewed the clinical records of patients with suicide and suicide attempts who were transferred to our hospital during the COVID–19 pandemic period (January to December 2020) and a similar non–COVID–19 pandemic period (January 2018 to December 2019). We also investigated the age and monthly number of patients with suicide and suicide attempts during the COVID–19 pandemic period and compared them with the number of patients with COVID–19. Results : In 2020, 39% of patients attempting suicide were in their 20s or younger, an increase in the proportion of younger patients compared to 27% in the non–COVID–19 pandemic period. During the COVID–19 pandemic period, the monthly number of suicide attempts showed an inverse variation with the increase or decrease in the number of COVID–19 patients. The same trend was also observed for patients committing suicide. Conclusion : The number of suicide attempts among young people increased during the COVID–19 pandemic and the number of suicide attempts seemed to be affected with the number of COVID–19 patients. Further analysis of the impact of the pandemic on suicide attempts is needed.