Estabilidad diagnóstica del trastorno bipolar

Tesis doctoral inédita leída en la Universidad Autónoma de Madrid, Facultad de Medicina. Departamento de Psiquiatría. Fecha de lectura: 22 de Febrero de 200

Life cycle and suicidal behavior among women

It is nowadays accepted that, independently of methodological issues, women commit fewer suicides than men but make more frequent attempts. Yet, female suicidal risk varies greatly along the lifetime and is linked to the most significant moments in it. A wide analysis of the existing literature was performed to provide a narrative description on the evolution of female suicidal rates from childhood to old age, considering the milestones in their life history. A detailed analysis of gender differences in suicidal behavior is key to establish preventive measures and priorities. More specific studies are needed to adapt future interventions on female suicideJ. Lopez-Castroman was supported by a Fundamental Foundation research grant for this stud

Are we studying the right populations to understand suicide?

International audienc

Psychometrical assessment and item analysis of the General Health Questionnaire in victims of terrorism

The posted article must carry an APA copyright notice and include a link to the APA journal home page or to the final published version using the article’s DOI, or digital object identifier, that may be found on the first page of the published article, in the upper right-hand corner.There is a need to assess the psychiatric morbidity that appears as a consequence of terrorist attacks. The General Health Questionnaire (GHQ) has been used to this end, but its psychometric properties have never been evaluated in a population affected by terrorism. A sample of 891 participants included 162 direct victims of terrorist attacks and 729 relatives of the victims. All participants were evaluated using the 28-item version of the GHQ (GHQ-28). We examined the reliability and external validity of scores on the scale using Cronbach’s alpha and Pearson correlation with the State-Trait Anxiety Inventory (STAI), respectively. The factor structure of the scale was analyzed with varimax rotation. Samejima’s (1969) graded response model was used to explore the item properties. The GHQ-28 scores showed good reliability and item-scale correlations. The factor analysis identified 3 factors: anxious-somatic symptoms, social dysfunction, and depression symptoms. All factors showed good correlation with the STAI. Before rotation, the first, second, and third factor explained 44.0%, 6.4%, and 5.0% of the variance, respectively. Varimax rotation redistributed the percentages of variance accounted for to 28.4%, 13.8%, and 13.2%, respectively. Items with the highest loadings in the first factor measured anxiety symptoms, whereas items with the highest loadings in the third factor measured suicide ideation. Samejima’s model found that high scores in suicide-related items were associated with severe depression. The factor structure of the GHQ-28 found in this study underscores the preeminence of anxiety symptoms among victims of terrorism and their relatives. Item response analysis identified the most difficult and significant items for each factor

Characterization of Suicidal Behaviour with Self-Organizing Maps

The study of the variables involved in suicidal behavior is important from a social, medical, and economical point of view. Given the high number of potential variables of interest, a large population of subjects must be analysed in order to get conclusive results. In this paper, we describe a method based on self-organizing maps (SOMs) for finding the most relevant variables even when their relation to suicidal behavior is strongly nonlinear. We have applied the method to a cohort with more than 8,000 subjects and 600 variables and discovered four groups of variables involved in suicidal behavior. According to the results, there are four main groups of risk factors that characterize the population of suicide attempters: mental disorders, alcoholism, impulsivity, and childhood abuse. The identification of specific subpopulations of suicide attempters is consistent with current medical knowledge and may provide a new avenue of research to improve the management of suicidal cases

Contribution of sleep deprivation to suicidal behaviour: A systematic review

International audienceSleep disturbances and suicidal behaviour are highly prevalent phenomena, representing with a significant burden to society. Sleep has been acknowledged as a potential biomarker for suicidal behaviour. Over the past decade several studies have explored the association between sleep problems and suicidal behaviour. This area has attracted a growing research interest, hence updated information is needed. We therefore present a wide-scope review of the literature summarizing the most relevant studies on epidemiological and theoretical issues underlying this association. Implications of these findings for clinical practice and future research are discussed. We performed a systematic search of PubMed and Embase databases up to October 2018 to identify studies exploring the association between sleep and suicide. Sixty-five articles met the selection criteria, thus they were included in the review. There was a significant and independent association between sleep disturbances and suicide risk. Psychiatric disorders, sleep deprivation-induced neurocognitive deficits, emotional dysregulation, alterations in circadian rhythms, and negative feelings, among other factors, contributed to this relationship. Sleep loss may lead to higher levels of impulsivity, thus increasing unplanned suicidal behaviour. Sleep disturbances may therefore predict suicidal behaviour, hence becoming a potential therapeutic target

Multidimensional variability in ecological assessments predicts two clusters of suicidal patients

Assessment (EMA). In this study, we aimed to (1) identify clusters of clinical variability, and (2) examine the features associated with high variability. We studied a set of 275 adult patients treated for a suicidal crisis in the outpatient and emergency psychiatric departments of five clinical centers across Spain and France. Data included a total of 48,489 answers to 32 EMA questions, as well as baseline and follow-up validated data from clinical assessments. A Gaussian Mixture Model (GMM) was used to cluster the patients according to EMA variability during follow-up along six clinical domains. We then used a random forest algorithm to identify the clinical features that can be used to predict the level of variability. The GMM confirmed that suicidal patients are best clustered in two groups with EMA data: low- and high-variability. The high-variability group showed more instability in all dimensions, particularly in social withdrawal, sleep measures, wish to live, and social support. Both clusters were separated by ten clinical features (AUC = 0.74), including depressive symptoms, cognitive instability, the intensity and frequency of passive suicidal ideation, and the occurrence of clinical events, such as suicide attempts or emergency visits during follow-up. Initiatives to follow up suicidal patients with ecological measures should take into account the existence of a high variability cluster, which could be identified before the follow-up begins.This work was supported by MCIN/AEI/10.13039/501100011033/ FEDER, UE, under grants PID2021-123182OB-I00 (EPiCENTER) and PID2021-125159NB-I00 (TYCHE); by the Comunidad de Madrid under Grants Y2018/TCS-4705 (PRACTICO-CM), IntCARE-CM and S2017/BMD-3740 (AGES-CM 2-CM); by the Instituto de Salud Carlos III (ISCIII), under grants PI20/01555, PMP22/00032 and PMP22/00084; by the American Foundation for Suicide Prevention under grant LSRG-1-005-16; and by the GCS MERRI Montpellier-Nîmes under grant AOI 2016

Apoyo parental, psicopatología e ideación suicida

In order to estimate the differential effect of anxiety-depressive symptomsand impulsivity on adolescent suicidal ideationdependingon the type of parental support, 440 Chilean students who were attending secondary education were evaluated. The suicidal ideation subscale of the Columbia-Suicide Severity Rating Scale (C-SSRS), the Abbreviated Depression, Anxiety and Stress Scales (DASS-21), the sub-scale of the International Inventory of Personality Disorders (IPDE-SQ) and the Brief Parental Scale (EPB) were administered. A multiple linear regression analysis was performed to estimate the main and interaction effects of the variables studied on the suicidal ideation of adolescents. Women reported greater depressive symptoms, greater anxiety symptoms, greater impulsivity and suicidal ideation than men. Maternal support moderated depressive/anxious symptomsand impulsivityeffects onsuicidal ideation. At high levelsof maternal support, depressive/anxiety symptoms and impulsivity effect onsuicidal ideation was lower. Parental support, meanwhile, was not a significant moderator. This study analyzed parental support effects on adolescent suicidal behaviors by incorporating new antecedents into the discussion. In new lines of research, the relationship between parents and their children should be analyzed in greater detail and included in the development of adolescent suicide prevention and intervention programsCon el objeto de estimar el efecto diferencial de la sintomatología ansiosa-depresiva y la impulsividad sobre los pensamientos suicidas en adolescentes en función del tipo de apoyo parental, se evaluaron a 440 estudiantes chilenos que cursaban estudios secundarios. Se administraron la subescala de ideación suicida de la Columbia-Suicide Severity Rating Scale (C-SSRS), las Escalas Abreviadas de Depresión, Ansiedad y Estrés (DASS-21), la sub-escala del Inventario Internacional de Trastornos de la Personalidad (IPDE-SQ) y la Escala Parental Breve (EPB). Se realizó un análisis de regresión lineal múltiple para estimar los efectos principales y de interacción de las variables estudiadas sobre la ideación suicida de los adolescentes. Las mujeres reportaron mayor sintomatología depresiva, mayor sintomatología ansiosa, mayor impulsividad e ideación suicida que los hombres. El apoyo materno moderó el efecto de la sintomatología depresiva/ansiosa y la impulsividad sobre la ideación suicida. En un nivel alto de apoyo materno, el efecto de la sintomatología depresiva/ansiosa y la impulsividad sobre la ideación suicida fue menor. El apoyo paterno, en tanto, no fue un moderador significativo. Este estudio analizó los efectos del apoyo parental en las conductas suicidas de los adolescentes incorporando nuevos antecedentes a la discusión. En nuevas líneas de investigación, la relación entre los padres y sus hijos deberían ser analizadas con mayor detalle e incluidas en la elaboración de programas de intervención y prevención del suicidio adolescente