2.2 Suicidality Flashcards
Waar gaat artikel DeJong over?
DeJong et al. (2010)
Comparison between suicide attempters and suicide completers on symptoms of depression
Results
Lethality
DeJong et al. (2010)
- Individuals who completed suicide used more lethal methods, like shooting, compared to attempters
- Attempters can be devided in two groups: high lethality or low lethality, based on severity of their attempts.
Results
Demographics
DeJong et al. (2010)
Those who commited suicide were older and mainly male
No sign differences were found in relation to marital status.
Results
Actions
DeJong et al. (2010)
- Attempters usually has a history of more suicide attempts and had been through inpatient psychiatric treatment.
- Completers were more likely to leave a suicide note and majority consumed drugs or alcohol prior to the act.
Results
Stressful life events
DeJong et al. (2010)
Completers experienced more work related stress and financial problems preceding suicide.
Waar gaat artikel Turecki over?
Turecki et al. (2016)
Onderzoek naar suicidal behaviour.
Variations in suicidal behaviour across age groups, gender, geographical and sociopolitical context, there is currently no reliable algorithm to predict suicide in clinical practice.
Suicide and countries/culture
Turecki et al. (2016)
Suicide rates show differences between and within countries
- Due to economic status and cultural differences
- Cultural differences affect people more than their geographical location
Which type of suicidal behaviour is more prevalent
Turecki et al. (2016)
More non-fatal suicidal behaviours than completed suicides.
Among which group is suicide more prevalent?
Turecki et al. (2016)
Middel aged and elderly men in high income countries
Among which group is suicidal ideation most prevalent?
Turecki et al. (2016)
Most occurs in adolescents and young adults
Which rates are higher in men and which rates are higher in women?
Turecki et al. (2016)
Men = suicide death rates
Women = ideation and suicide attempts
Population-level risk factors
Turecki et al. (2016)
- Suicide infrequent in societies with strong cohesion, shared values, and moral opposition to suicide.
- Bad economics (unemployement/lower income) associated with higher suicide rates, especially among men.
- The way the media covers suicides also influences suicide rates.
Individual risk factors for suicide
Turecki et al. (2016)
- Suicidal behaviours run in families.
- Herited impulsive aggression found to be a mediator for suicidal behaviour.
- Sexual orientation –> increased suicide risk (same sex, especially in men)
- Exposure to early nega life events (relationship between victim and abuser, frequency of abuse and type of abuse were moderators for lifetime suicide risk)
- Early nega life events could cause changes in genetic pathways, such as increased stress response (HPA-axis)
- Brain parasite Toxoplasma Gondii can alter neurotransmitter activity and increase vulnerability to suicide
Individual risk factors in 3 categories
Turecki et al. (2016)
- Distal or predisposing factors
- Developmental or mediating factors
- Proximal or precipitating factors
Developmental or mediating risk factors
Turecki et al. (2016)
More prevalent in adolescents:
1. Impulsive aggression
2. Conduct disorder
3. Interpersonal conflict
4. Antisocial behaviour
5. Alcohol and substance abuse
More prevalent with increasing age:
1. Mood disorders
2. Harm avoidance
Which type of disorders lead to highest risk suicidal behaviour?
Turecki et al. (2016)
Mood disorder with another disorder that:
1. Decrease restraint (beheersing), like antisocial disorders and substance misuse, or:
2. Increase distress, like PTSD or panic disorder
Early negative life events can lead to:
Turecki et al. (2016)
Cognitive deficits (memory specificity and problem solving) –> contributes to suicidal ideation.
PFC in adolescents
Turecki et al. (2016)
Could lead to more risktaking behaviour –> could lead to suicidality
Proximal or precipitating risk factors
Turecki et al. (2016)
Risk of suicide is highest within the first year of disorders and is linked with feelings of hopelessness.
Schizophernia = also elevated risk suicide
Main clinical predictors of suicide
Turecki et al. (2016)
- Past suicide attempt and psychopathology
- Young age
- Presence of depressive symtoms
- Male sex
- Lack of positive symptoms
- Education
- Insight indivual has on their disorder
- Cluster B personality disorders and eating disorders –> common die by suicide
Link age and suicide
Turecki et al. (2016)
- Young age: substance misuse disorders and cluster B personality disorder
- Middle age: depression disorder, anxiety, alcohol and substance misuse
- Old age: psychopathology, especially MDD
Somatic treatments
Turecki et al. (2016)
Like antidepressants, which reduces suicidal ideation in people ages above 25 years
Other somatic treatments:
- Lithium
- Ketamine
- Antipsychotics (olanzapine) for schizophrenics
Psychotherapeutic interventions
Turecki et al. (2016)
- Dialectic behaviour therapy (encourage belief in individual ability to succeed)
- Mentalization-based therapy (thinking of actions as product of emotion and thoughts, to help understand the perception of others)
- CBT
Conclusion
Turecki et al. (2016)
Various biological, psychological and social elements should be considered to understand suicide risk.
Recognizing warning signs like behaviour, mood and communication changes are essential for treatment.
Waar gaat artikel Lönnqvist over?
Lönnqvist (2021)
Mood and anxiety disorders in suicide and suicide attepters
Depressive disorder - suicide
Lönnqvist (2021)
More than 50% of depressed patients have suicidal ideation (depending on severity)
Which factors could predict earlier suicidal events?
Lönnqvist (2021)
- Onset of mood disorders and impulsive aggression in offspring
- History of sexual abuse
- Parental depression
Which depressive symptom is most prevalent in predicting suicidal ideation?
Lönnqvist (2021)
Hopelessness
Along with feelings of:
- Guilt
- Low self-esteem
- Loss of interest
Risk of suicide highst in:
Lönnqvist (2021)
niet in mannen deze keer
Former psychiatric inpatients and outpatients.
Lowest in depressed individuals in primary care.
Depression in suicide victims have more of following symptoms:
Lönnqvist (2021)
- Weight or appetite loss
- Insomnia
- Feelings of guilt/worthlessness
- Thoughts of death and suicidal ideation (duh)
Bipolar disorder en suicidal behaviour
Lönnqvist (2021)
Strong link between the two.
Bipolar disorder = highly heritable, majority of episodes coonsist of depression.
Suicide mortality rate of bipolar disorder is 15 times higher than in general population
Bipolar disorder
Hopelessness
Lönnqvist (2021)
Predictor of suicidal behaviour during depressive phase.
Bipolar disorder
Risk factors for suicidal behaviour but not suicide:
Lönnqvist (2021)
- History of abuse
- Extent of depressive symptoms and hopelessness
- Early age at onset of bipolar disorder
- Family history of suicide
- Mixed affective states
- Comorbid mental disorders like anxiety disorder
Lithium
Lönnqvist (2021)
Should be prioritized in therapy for bipolar patients, including the ones ar tisk of suicidal behaviour.
It is important in relapse prevention.
