Depression is a severe mood disorder characterized by complex suicide mechanisms that involve a multitude of psychosocial and biological fac-tors.This paper presents a comprehensive analysis of the psychosocial factor...Depression is a severe mood disorder characterized by complex suicide mechanisms that involve a multitude of psychosocial and biological fac-tors.This paper presents a comprehensive analysis of the psychosocial factors influencing suicidal behavior in depression,including social support,life events,depressive symptoms,and personality traits,as well as biological factors such as brain-derived neurotrophic factor(BDNF),erotonin(5-TH)system dysfunction,and hypothalam-ic-pituitary-adrenal(HPA)axis abnormalities.Collectively,these factors significantly influence an individual’s risk of suicide,with biological factors serving as potential biomarkers for suicidal actions and psychosocial factors underscoring the impact of environmental and individual experiences.Understanding the interaction of these factors is crucial for comprehending and preventing suicidal behavior in depression.Despite considerable progress,current studies have limitations,particularly regarding the unclear interaction mechanisms between psychosocial and biological factors and a predominant focus on adult populations,with insufficient comprehensive studies on adolescents.展开更多
BACKGROUND The subsequent waves of the severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)pandemic have represented a dramatic health emergency characterized by significant consequences on mental health.Diachr...BACKGROUND The subsequent waves of the severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)pandemic have represented a dramatic health emergency characterized by significant consequences on mental health.Diachronic variations in the incidence rates of acute relapse of psychiatric disorders may represent significant"sentinel events"for assessing the mental health response to an unprecedented stressful event.AIM To investigate the variation in psychiatric hospitalization rates and differences in sociodemographic and clinical-psychopathological peculiarities at Bologna"Maggiore"General Hospital Psychiatric Ward(GHPW)between the first two waves SARS-CoV-2 pandemic and the same periods of the previous 3 years.The secondary purpose of the study was to suggest a diachronic response pathway to stress by reporting additional literature data on coping strategies.METHODS This observational and retrospective study collected information on admission to the GHPW at the"Maggiore"Hospital in Bologna in the index periods defined as follows:the first period between February 24,2020 and April 30,2020(first epidemic wave)and the second period between October 8,2020,and January 7,2021(second pandemic wave).Absolute numbers and proportion of admitted patients,their sociodemographic and clinical-psychopathological characteristics were compared with the same parameters recorded in the two same periods of the previous 3 years.No strict inclusion or exclusion criteria were provided in the data collection to collect information on all patients requiring acute psychiatric hospitalization.RESULTS During the first wave,there was a significant reduction in hospitalization rates,although there was a simultaneous increase in compulsory hospitalizations and the acute relapse of schizophrenia spectrum and other psychotic disorders.During the second wave,hospitalization rates reached those recorded during the same period of the previous 3 years,mainly due to the rise of bipolar and related disorders,depressive disorders,anxiety disorders,trauma-and stressor-related disorders and suicidal behaviors.CONCLUSION The coping strategies adopted during the first wave of the SARS-CoV-2 pandemic protected the vulnerable population from the general risk of clinical-psychopathological acute relapse,even if they increased the susceptibility to run into schizophrenia spectrum and other psychotic disorder relapses.In the medium-long term(as in the second pandemic wave),the same strategies do not play protective roles against the stress associated with the pandemic and social restriction measures.Indeed,during the second wave of the SARS-CoV-2 pandemic,an increase in total hospitalization rate,suicidal behaviors and the incidence rate of bipolar and related disorders,depressive disorders,anxiety disorders,trauma-and stressorrelated disorders was observed.展开更多
Suicidality is a complex phenomenon influenced by genetic,environmental,and epigenetic factors.Current tools to estimate suicide risk are insufficient,and there is an increasing need for reliable biomarkers to complem...Suicidality is a complex phenomenon influenced by genetic,environmental,and epigenetic factors.Current tools to estimate suicide risk are insufficient,and there is an increasing need for reliable biomarkers to complement clinical approaches.Growing evidence suggests that immune system dysregulation contributes to the pathophysiology of psychiatric disorders and suicidal behavior.Epigenetic mechanisms,including DNA methylation,histone modifications,and non-coding RNAs,regulate gene expression and may act as a bridge between environmental stressors and(neuro)inflammatory responses.In this review,we examine the evidence of peripheral and central inflammation in suicide completers and individuals with suicidal behavior.Next,we review current knowledge from various studies on suicide-associated epigenetic alterations.Furthermore,we evaluate the mechanisms by which early life adversity and chronic stress contribute to suicide diathesis,focusing on their association with epigenetic modifications and inflammatory pathways.We also examine future prospects and limitations of immunology-related biomarkers and the possibilities of therapeutic interventions targeting the immune system and epigenetic regulation.While challenging,research on epigenetic and immune alterations in suicidality shows promise for identifying suicide risk subtypes and advancing personalized psychiatry.展开更多
According to magnetic resonance imaging(MRI)studies,brain white matter(WM)abnormalities have been suggested to play a critical role in the pathogenesis of major depressive disorder(MDD)and related suicidal behavior.Ho...According to magnetic resonance imaging(MRI)studies,brain white matter(WM)abnormalities have been suggested to play a critical role in the pathogenesis of major depressive disorder(MDD)and related suicidal behavior.However,MRI findings may be limited by low spatial resolution;therefore,an important contribution to the understanding of the role and significance of WM alterations derived by the development of the most recent magnetic resonance techniques,such as diffusion tensor imaging(DTI).Several DTI studies reported an association between altered WM integrity and MDD/suicidal behavior.Microstructural WM abnormalities may be located in neural circuits critically implicated in emotional processes and mood regulation resulting in enhanced vulnerability to psychiatric morbidity.WM abnormalities detected using DTI may contribute to functional deficits and help to clarify the pathophysiological mechanisms underlying MDD as well as suicidal behavior.By a clinical point of view,research also suggested that affective temperaments may play a relevant role in the psychopathological characteristics of mood disorders,clinical trajectory of episodes and polarity,long‑term outcome and suicidality.Unfortunately,only few studies investigated the association between affective temperaments and WM abnormalities and discussed their possible implications in patients with MDD and suicidal behavior.Using a comprehensive search of Medline database,the aim of the present study was to critically review the current literature on the association between WM alterations as assessed by MRI and DTI techniques,affective temperaments,MDD and suicidal behavior.展开更多
Objective: to explore the effect of psychological crisis intervention on suicidal behavior of depression patients. Methods: 82 patients with depression admitted from October 2018 to June 2019 were selected and randoml...Objective: to explore the effect of psychological crisis intervention on suicidal behavior of depression patients. Methods: 82 patients with depression admitted from October 2018 to June 2019 were selected and randomly divided into control group and intervention group with 41 cases in each group. The control group was given routine nursing while the intervention group was given psychological crisis intervention. The intervention effect of the two groups was compared. Results: the QSA scores of all dimensions in the intervention group were higher than those in the control group, while the suicide behavior scores HAMD the relapse rate of depression in the intervention group were lower than those in the control group (P < 0.05). Conclusion: psychological crisis intervention can strengthen the positive thinking of depression patients, reduce the risk of suicidal ideation and suicidal behavior, and reduce the recurrence rate of depression.展开更多
AIM:To investigate the association between juvenile open angle glaucoma(JOAG)and mental health among Koreans.METHODS:This study used nationally representative data from the 8th Korea National Health and Nutrition Exam...AIM:To investigate the association between juvenile open angle glaucoma(JOAG)and mental health among Koreans.METHODS:This study used nationally representative data from the 8th Korea National Health and Nutrition Examination Survey(KNHANES)2021.Glaucoma diagnosis followed the International Society of Geographical and Epidemiological Ophthalmology criteria based on glaucomatous structural defects,visual field defects,corrected vision,and intraocular pressure.As outcomes,suicidal behaviors,psychiatric counseling,and depression were evaluated through mental health questionnaires.Odds ratios(ORs)with 95%confidence intervals(CIs)were estimated using logistic regression models,adjusting for covariates.RESULTS:Among 7090 participants,3446 met the inclusion criteria for analysis,and 88(2.6%)were diagnosed with open angle glaucoma(OAG).After adjusting for age,sex,and best-corrected visual acuity(VA),participants with OAG were revealed to have significantly higher odds of suicidal behaviors(i.e.,ideation,planning,or attempts)compared with those without OAG(OR:2.70;95%CI:1.12-6.54;P=0.028).This association remained significant after further adjustments for socioeconomic status,lifestyle factors,and presence of chronic conditions(P=0.031 and 0.035,respectively).However,there was no significant difference for the other two outcomes,psychiatric counseling and depression.An age-stratified analysis revealed a stronger association between OAG and suicidal behaviors in younger JOAG participants(<40y)than in older OAG participants(≥40y;OR:3.80 vs 2.22;95%CI:0.79-18.22 vs 0.56-8.80,respectively).CONCLUSION:OAG patients show a higher risk of suicidal behaviors than those without glaucoma particularly in JOAG patients.展开更多
BACKGROUND Suicide is a major public health problem.Worldwide,around 800000 people die by suicide every year.Suicide is a multifactorial disorder,with numerous environmental and genetic risk factors involved.Among the...BACKGROUND Suicide is a major public health problem.Worldwide,around 800000 people die by suicide every year.Suicide is a multifactorial disorder,with numerous environmental and genetic risk factors involved.Among the candidate genes,changes in the BDNF locus at the gene,epigenetic,mRNA,and protein expression levels have been implicated in psychiatric disorders,including suicidal behavior and completed suicides.AIM To investigate changes in BDNF methylation and expression of four alternative BDNF transcripts for association with completed suicide.METHODS This case-control study included 42 unrelated male Caucasian subjects,where 20 were control subjects who died following acute cardiac arrest,and 22 were suicide victims who died by hanging.DNA and RNA were extracted from brain tissue(Brodmann area 9 and hippocampus)and from blood.DNA methylation and mRNA expression levels were determined by targeted bisulfite next-generation sequencing and reverse-transcription quantitative PCR.Statistical analysis was done by use of two-tailed Student’s t tests for two independent samples,and the Benjamini-Hochberg procedure was implemented for correction for multiple comparisons.RESULTS In DNA from brain tissue,there were no significant differences in BDNF methylation between the study groups.However,data showed significantly reduced DNA methylation of the BDNF region upstream of exon I in blood samples of suicide victims compared to the controls(5.67±0.57 vs 6.83±0.64,P_(corr)=0.01).In Brodmann area 9 of the brain of the suicide victims but not in their hippocampus,there was higher expression of BDNF transcript I-IX(NM_170731.4)compared to the controls(0.077±0.024 vs 0.05±0.013,P=0.042).In blood,expression analysis for the BDNF transcripts was not feasible due to extensive RNA degradation.CONCLUSION Despite the limitations of the study,the obtained data further support a role for BDNF in suicidality.However,it should be noted that suicidal behavior is a multifactorial disorder with numerous environmental and genetic risk factors involved.展开更多
文摘Depression is a severe mood disorder characterized by complex suicide mechanisms that involve a multitude of psychosocial and biological fac-tors.This paper presents a comprehensive analysis of the psychosocial factors influencing suicidal behavior in depression,including social support,life events,depressive symptoms,and personality traits,as well as biological factors such as brain-derived neurotrophic factor(BDNF),erotonin(5-TH)system dysfunction,and hypothalam-ic-pituitary-adrenal(HPA)axis abnormalities.Collectively,these factors significantly influence an individual’s risk of suicide,with biological factors serving as potential biomarkers for suicidal actions and psychosocial factors underscoring the impact of environmental and individual experiences.Understanding the interaction of these factors is crucial for comprehending and preventing suicidal behavior in depression.Despite considerable progress,current studies have limitations,particularly regarding the unclear interaction mechanisms between psychosocial and biological factors and a predominant focus on adult populations,with insufficient comprehensive studies on adolescents.
文摘BACKGROUND The subsequent waves of the severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)pandemic have represented a dramatic health emergency characterized by significant consequences on mental health.Diachronic variations in the incidence rates of acute relapse of psychiatric disorders may represent significant"sentinel events"for assessing the mental health response to an unprecedented stressful event.AIM To investigate the variation in psychiatric hospitalization rates and differences in sociodemographic and clinical-psychopathological peculiarities at Bologna"Maggiore"General Hospital Psychiatric Ward(GHPW)between the first two waves SARS-CoV-2 pandemic and the same periods of the previous 3 years.The secondary purpose of the study was to suggest a diachronic response pathway to stress by reporting additional literature data on coping strategies.METHODS This observational and retrospective study collected information on admission to the GHPW at the"Maggiore"Hospital in Bologna in the index periods defined as follows:the first period between February 24,2020 and April 30,2020(first epidemic wave)and the second period between October 8,2020,and January 7,2021(second pandemic wave).Absolute numbers and proportion of admitted patients,their sociodemographic and clinical-psychopathological characteristics were compared with the same parameters recorded in the two same periods of the previous 3 years.No strict inclusion or exclusion criteria were provided in the data collection to collect information on all patients requiring acute psychiatric hospitalization.RESULTS During the first wave,there was a significant reduction in hospitalization rates,although there was a simultaneous increase in compulsory hospitalizations and the acute relapse of schizophrenia spectrum and other psychotic disorders.During the second wave,hospitalization rates reached those recorded during the same period of the previous 3 years,mainly due to the rise of bipolar and related disorders,depressive disorders,anxiety disorders,trauma-and stressor-related disorders and suicidal behaviors.CONCLUSION The coping strategies adopted during the first wave of the SARS-CoV-2 pandemic protected the vulnerable population from the general risk of clinical-psychopathological acute relapse,even if they increased the susceptibility to run into schizophrenia spectrum and other psychotic disorder relapses.In the medium-long term(as in the second pandemic wave),the same strategies do not play protective roles against the stress associated with the pandemic and social restriction measures.Indeed,during the second wave of the SARS-CoV-2 pandemic,an increase in total hospitalization rate,suicidal behaviors and the incidence rate of bipolar and related disorders,depressive disorders,anxiety disorders,trauma-and stressorrelated disorders was observed.
基金Supported by Slovenian Research and Innovation Agency Program,No.P1-0390 and No.N3-0349Slovenian Research and Innovation Agency Program,Young Researcher Grant(toŠmon J).
文摘Suicidality is a complex phenomenon influenced by genetic,environmental,and epigenetic factors.Current tools to estimate suicide risk are insufficient,and there is an increasing need for reliable biomarkers to complement clinical approaches.Growing evidence suggests that immune system dysregulation contributes to the pathophysiology of psychiatric disorders and suicidal behavior.Epigenetic mechanisms,including DNA methylation,histone modifications,and non-coding RNAs,regulate gene expression and may act as a bridge between environmental stressors and(neuro)inflammatory responses.In this review,we examine the evidence of peripheral and central inflammation in suicide completers and individuals with suicidal behavior.Next,we review current knowledge from various studies on suicide-associated epigenetic alterations.Furthermore,we evaluate the mechanisms by which early life adversity and chronic stress contribute to suicide diathesis,focusing on their association with epigenetic modifications and inflammatory pathways.We also examine future prospects and limitations of immunology-related biomarkers and the possibilities of therapeutic interventions targeting the immune system and epigenetic regulation.While challenging,research on epigenetic and immune alterations in suicidality shows promise for identifying suicide risk subtypes and advancing personalized psychiatry.
文摘According to magnetic resonance imaging(MRI)studies,brain white matter(WM)abnormalities have been suggested to play a critical role in the pathogenesis of major depressive disorder(MDD)and related suicidal behavior.However,MRI findings may be limited by low spatial resolution;therefore,an important contribution to the understanding of the role and significance of WM alterations derived by the development of the most recent magnetic resonance techniques,such as diffusion tensor imaging(DTI).Several DTI studies reported an association between altered WM integrity and MDD/suicidal behavior.Microstructural WM abnormalities may be located in neural circuits critically implicated in emotional processes and mood regulation resulting in enhanced vulnerability to psychiatric morbidity.WM abnormalities detected using DTI may contribute to functional deficits and help to clarify the pathophysiological mechanisms underlying MDD as well as suicidal behavior.By a clinical point of view,research also suggested that affective temperaments may play a relevant role in the psychopathological characteristics of mood disorders,clinical trajectory of episodes and polarity,long‑term outcome and suicidality.Unfortunately,only few studies investigated the association between affective temperaments and WM abnormalities and discussed their possible implications in patients with MDD and suicidal behavior.Using a comprehensive search of Medline database,the aim of the present study was to critically review the current literature on the association between WM alterations as assessed by MRI and DTI techniques,affective temperaments,MDD and suicidal behavior.
文摘Objective: to explore the effect of psychological crisis intervention on suicidal behavior of depression patients. Methods: 82 patients with depression admitted from October 2018 to June 2019 were selected and randomly divided into control group and intervention group with 41 cases in each group. The control group was given routine nursing while the intervention group was given psychological crisis intervention. The intervention effect of the two groups was compared. Results: the QSA scores of all dimensions in the intervention group were higher than those in the control group, while the suicide behavior scores HAMD the relapse rate of depression in the intervention group were lower than those in the control group (P < 0.05). Conclusion: psychological crisis intervention can strengthen the positive thinking of depression patients, reduce the risk of suicidal ideation and suicidal behavior, and reduce the recurrence rate of depression.
文摘AIM:To investigate the association between juvenile open angle glaucoma(JOAG)and mental health among Koreans.METHODS:This study used nationally representative data from the 8th Korea National Health and Nutrition Examination Survey(KNHANES)2021.Glaucoma diagnosis followed the International Society of Geographical and Epidemiological Ophthalmology criteria based on glaucomatous structural defects,visual field defects,corrected vision,and intraocular pressure.As outcomes,suicidal behaviors,psychiatric counseling,and depression were evaluated through mental health questionnaires.Odds ratios(ORs)with 95%confidence intervals(CIs)were estimated using logistic regression models,adjusting for covariates.RESULTS:Among 7090 participants,3446 met the inclusion criteria for analysis,and 88(2.6%)were diagnosed with open angle glaucoma(OAG).After adjusting for age,sex,and best-corrected visual acuity(VA),participants with OAG were revealed to have significantly higher odds of suicidal behaviors(i.e.,ideation,planning,or attempts)compared with those without OAG(OR:2.70;95%CI:1.12-6.54;P=0.028).This association remained significant after further adjustments for socioeconomic status,lifestyle factors,and presence of chronic conditions(P=0.031 and 0.035,respectively).However,there was no significant difference for the other two outcomes,psychiatric counseling and depression.An age-stratified analysis revealed a stronger association between OAG and suicidal behaviors in younger JOAG participants(<40y)than in older OAG participants(≥40y;OR:3.80 vs 2.22;95%CI:0.79-18.22 vs 0.56-8.80,respectively).CONCLUSION:OAG patients show a higher risk of suicidal behaviors than those without glaucoma particularly in JOAG patients.
基金Slovenian Research Agency,No.P1-0390,and No.J3-7132.
文摘BACKGROUND Suicide is a major public health problem.Worldwide,around 800000 people die by suicide every year.Suicide is a multifactorial disorder,with numerous environmental and genetic risk factors involved.Among the candidate genes,changes in the BDNF locus at the gene,epigenetic,mRNA,and protein expression levels have been implicated in psychiatric disorders,including suicidal behavior and completed suicides.AIM To investigate changes in BDNF methylation and expression of four alternative BDNF transcripts for association with completed suicide.METHODS This case-control study included 42 unrelated male Caucasian subjects,where 20 were control subjects who died following acute cardiac arrest,and 22 were suicide victims who died by hanging.DNA and RNA were extracted from brain tissue(Brodmann area 9 and hippocampus)and from blood.DNA methylation and mRNA expression levels were determined by targeted bisulfite next-generation sequencing and reverse-transcription quantitative PCR.Statistical analysis was done by use of two-tailed Student’s t tests for two independent samples,and the Benjamini-Hochberg procedure was implemented for correction for multiple comparisons.RESULTS In DNA from brain tissue,there were no significant differences in BDNF methylation between the study groups.However,data showed significantly reduced DNA methylation of the BDNF region upstream of exon I in blood samples of suicide victims compared to the controls(5.67±0.57 vs 6.83±0.64,P_(corr)=0.01).In Brodmann area 9 of the brain of the suicide victims but not in their hippocampus,there was higher expression of BDNF transcript I-IX(NM_170731.4)compared to the controls(0.077±0.024 vs 0.05±0.013,P=0.042).In blood,expression analysis for the BDNF transcripts was not feasible due to extensive RNA degradation.CONCLUSION Despite the limitations of the study,the obtained data further support a role for BDNF in suicidality.However,it should be noted that suicidal behavior is a multifactorial disorder with numerous environmental and genetic risk factors involved.
