Risk and Protective Factors for Suicide in Patients with Alcoholism

Alcoholism is associated with a high risk for suicidal behavior. Up to 40% of persons with alcoholism attempt suicide at some time and 7% end their lives by committing suicide. Risk factors include being male, older than 50 years of age, living alone, being unemployed, poor social support, interpersonal losses, continued drinking, consumption of a greater amount of alcohol when drinking, a recent alcohol binge, previous alcohol treatment, a family history of alcoholism, a history of comorbid substance abuse (especially cocaine), a major depressive episode, serious medical illness, suicidal communication, and prior suicidal behavior. Suicidal behavior is especially frequent in patients with comorbid alcoholism and major depression. However, all patients with alcoholism should be evaluated for suicide risk. Understanding of risk and vulnerability to suicidal behavior in alcoholism still outweighs our knowledge of protective factors and resilience. Knowledge of protective factors for suicide may help to prevent and/or predict suicidal behavior. Protective factors for suicide in alcoholism are quite varied and include an individual's biological and behavioral characteristics, as well as attributes of the environment and culture. Protective factors include effective clinical care for psychiatric (including alcoholism and drug abuse) and physical disorders, easy access to a variety of clinical interventions and support for seeking help, restricted access to highly lethal means of suicide, strong connections to family and community support, skills in problem solving and conflict resolution, cultural and religious beliefs that discourage suicide and support self-preservation. Future studies are necessary to determine which interventions may reduce suicidal behavior in alcoholism

Dietary impact on canine behaviour

Currently there has been a lot of interest in nutritional effects on behaviour, but the connection between diet and behaviour is still quite unestablished in dogs. This literature review presents connections between nutrition, physiology and canine behaviour, and whether canine behaviour can be regulated by altering the diet, based on current scientific literature in this field. By altering the diet, availability of precursors for hormones and neurotransmitters that controls behaviour may be regulated. Activity level is found to be affected by the fermentability of dietary fibre, energy restriction and indirectly by energy surplus. Aggressive behaviour may be decreased by low protein content and tryptophan supplement. Undesirable behaviour caused by lack of satiety is affected by dietary fibre and their fermentability. Taken together, the studies presented in this review points towards that there is a connection between nutrition, physiology and behaviour in dogs, as well as that canine behaviour can be regulated to some extent by altering the diet. However, further research is required to draw more specific conclusion on how nutrition affect canine behaviour.Hur diet påverkar beteendet är ett aktuellt intresseområde, men sambandet mellan foderintag och beteende är fortfarande till stor del okänt hos hund. Denna litteraturöversikt är baserad på vetenskaplig litteratur och presenterar studier där samband mellan diet, fysiologi och beteende hos hund har undersökts. Hundens beteende kan påverkas genom tillförsel av utgångsämnen för beteendereglerande hormoner och signalsubstanser. Förekomst av aggressiva beteenden kan reduceras med lägre proteininnehåll och tryptofantillsatts. Hundens aktivitetsnivå har visats kunna påverkas av mängden kostfiber och energitillgång. Kostfiber och dess fermentabilitet påverkar också hundens mättnadskänsla, vilket i sin tur inverkar på oönskade beteende som uppstår vid hunger. Studierna i denna litteraturöversikt tyder på att hundens beteende till en viss grad kan regleras med förändringar i dieten. För att kunna dra mer specifika slutsatser krävs ytterligare forskning inom ämnesområdet

Cholesterol in coronary heart disease and psychiatric disorders: same or opposite effects on morbidity risk?

The goal of this article is to review the studies that have linked low cholesterol levels with psychiatric symptoms or behavioral disorders in order to clarify which cholesterol fractions may influence psychological well being and mental health. The distinction between "bad" (i.e., pro-atherogenic) and "good" (i.e., anti-atherogenic) cholesterol is crucial to decide if the clinical benefits of low cholesterol levels for cardiovascular health might turn into a risk factor for psychiatric morbidity. Although the data from studies linking low cholesterol to aggression, suicide and self-harm, impulsivity, negative mood, postnatal depression, and cognitive dysfunction are far from unequivocal, the balance of evidence from new randomized controlled trials is reassuring. However, there are some subgroups of vulnerable individuals who, unlike the majority of persons in the general population, are susceptible to the psychological and behavioral adverse outcomes associated with low cholesterol levels. Because in some cases pro-atherogenic lipid and lipoprotein fractions are involved in this vulnerability, reaching the double goal of promoting both cardiovascular and mental health may be problematic for some individuals. A major task of future research is to identify these vulnerable individuals

Relationship between suicidal behaviour in major depressive disorder and lipid genetic markers

Tesis doctoral inédita leída en la Universidad Autónoma de Madrid, Facultad de Medicina, Departamento de Psiquiatría. Fecha de lectura: 29-06-2018INTRODUCCIÓN. El suicidio es uno de los problemas de salud pública más importantes a nivel mundial ya que supone entorno al millón de fallecimientos anuales, con una tasa estimada de 11,6 por 100.000 habitantes. Sus causas son multifactoriales y hay diversos modelos que han intentado explicarlo de forma holística. Lo que está ampliamente demostrado es que tras la gran mayoría de los suicidios se encuentra una enfermedad mental. Dentro de éstas, la depresión es ampliamente prevalente. Por otra parte, los estudios familiares conducidos en pacientes apuntan a que existe cierta agregación genética en el suicidio; y se ha llegado a identificar que existen ciertos polimorfismos geneticos implicados en un mayor riesgo suicida. Por ultimo, otra de las rutas del estudio sobre la conducta suicida ha sido el metabolismo lipídico desde que se publicara en los años 70 una posible relación entre niveles bajos de colesterol y suicidio. No obstante, los datos obtenidos hasta la fecha son dispares. Por todo ello, el presente estudio quiere plantear si existe una alteración genética común en el metabolismo lipídico que pueda suponer un riesgo para llevar a cabo actos suicidas en pacientes aquejados de trastornos depresivos. MATERIAL Y MÉTODOS. Se ha realizado un estudio de casos y controles analizando variantes polimórficas y haplotipos relacionados con el metabolismo lipídico en pacientes depresivos con un intento de suicidio. La muestra estuvo compuesta por un total de 791 sujetos de nacionalidad española. 414 controles sanos y 377 pacientes depresivos, de los cuales 245 habían realizado un intento de suicidio y 132 no, que sirvieron asimismo como grupo depresivo control. RESULTADOS. Se realizó un análisis logístico multinomial ajustado para edad, sexo, diagnóstico de ansiedad y de consumo de sustancias y se encontraron un total de 10 polimorfismos (SNPs) estadísticamente significativos (p<0,05) relacionados con la conducta suicida de los pacientes depresivos: rs10493377, rs1076063, rs1137101, rs12041859, rs1805134, rs2167270, rs2269657, rs3806318, rs7799039 y el rs9324026. Se trata de polimorfismos de los siguientes genes: LEP, LEPR, ASTN1, DNAJC6, PPARGC1B, SREBF2 y de los miRNA-370 y 488. CONCLUSIONES. Los SNPs rs10493377, rs1805134, rs3806318, rs2167270 y rs1137101 se asociaron con un incremento del riesgo de conducta suicida en pacientes con trastorno depresivo mayor. Los SNPs rs10493377, rs12041859, rs7799039, rs9324026 y rs1076063, con protección frente a la conducta suicida. Se necesitan estudios, a poder ser prospectivos, que repliquen estos datos, por un lado, y ahonden en la posible implicación de los genes situados en el locus 1p31.3 y de la leptina sobre la conducta suicida, por otro.BACKGROUND. Suicide is one of the most important public health problems worldwide, causing around one million of deaths per year, with an estimated rate of 11.6 per 100,000 inhabitants. It is a multifactorial issue and there are several models that have tried to explain it. What is thoroughly demonstrated is the presence of a mental disorder behind the great majority of suicides. Within these, depression is widely prevalent. On the other hand, family studies indicate that there is some genetic aggregation in suicide; and it has been found that there are certain genetic polymorphisms involved in an increased risk of suicide. Finally, another branch of the study on suicidal behavior has been the lipidic metabolism, since a possible relationship between low cholesterol levels and suicide was published in the 1970s. However, the data obtained to date are not consistent. The aim of the present study is to consider whether there is a common genetic alteration in the lipidic metabolism that could be a risk to carry out suicidal acts in patients suffering from depressive disorders. METHODS. A retrospective case-control study was conducted in order to analyze polymorphic variants and haplotypes related to lipidic metabolism in depressive patients with an attempted suicide. The sample consisted of a total of 791 subjects of Spanish nationality. 414 healthy controls and 377 depressive patients, of whom 245 had made a suicide attempt and 132 had not, who also served as a depressive control group. RESULTS. A multinomial logistic analysis adjusted for age, sex, diagnosis of anxiety and substance use was performed and a total of 10 statistically significant polymorphisms (SNPs) were found (p <0.05) related to the suicidal behavior of depressive patients: rs10493377, rs1076063, rs1137101, rs12041859, rs1805134, rs2167270, rs2269657, rs3806318, rs7799039 and rs9324026. These are polymorphisms (SNPs) of the following genes: LEP, LEPR, ASTN1, DNAJC6, PPARGC1B, SREBF2 and miRNAs-370 and 488. CONCLUSIONS. The SNPs rs10493377, rs1805134, rs3806318, rs2167270 and rs1137101 were associated with an increased risk of suicidal behavior in patients with major depressive disorder. The SNPs rs10493377, rs12041859, rs7799039, rs9324026 and rs1076063, with protection against suicidal behavior. More studies are needed, preferable prospective, in order to replicate these data, and to consider the possible implication of some genes placed in the locus 1p31.3 and leptin on suicidal behavior